From the frontlines: Homeless person won over alcoholism, survived floods and defeated TB

Shobha Shukla, Bobby Ramakant (Citizen News Service)
After suffering debilitating TB symptoms for over a year, a homeless person got life saving help from a community health worker. Thanks to her, he was eventually diagnosed with TB of the lungs and put on treatment, quit alcohol, and survived one of the worst Delhi floods during his treatment, and got cured.
A month before the 25th International AIDS Conference (AIDS 2024) opens in Munich, Germany, here is a real-life story from the frontline that makes a clarion call to #PutPeopleFirst.
Surendra migrated to Delhi from Bihar State of India in search of livelihood. For some years he tried his hands as a cycle rickshaw puller, worked in a school, and eventually settled as a ragpicker. He now lives in a temporary dismal slum on the banks of river Yamuna in East Delhi with his partially paraplegic wife and earns whatever he can through ragpicking.
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“I was an alcoholic, and a bidi smoker (bidi is a leaf filled with tobacco). Continuous drinking took a toll on my health, which started deteriorating. I lost my appetite and became very weak, so much so that I could not lift even a glass of water. I lost weight and there was no strength left in my body. I would cough day and night and had fever. My whole body would ache, and it became difficult for me to walk even a few steps without support. I had become a bundle of bones. My neighbours said that I had TB and told me to go to Pushta (an elevated road near the river Yamuna) and get treated for TB. They even threatened to throw me out of the slum. But there was no one to support me get treated. My wife is physically incapacitated and is herself unable to walk properly. I had no strength left in me to go to a clinic on my own. I suffered like this helplessly for over one year,” Surendra said to CNS (Citizen News Service) in early April 2024.
The difference which community health workers make
It was just like any other day with Surendra lying limp on a side. Priyanka, a frontline community health worker who works as a Field Officer of Humana People to People India (HPPI), chanced to pass by him. She was on her round of mapping the area for active TB case finding. She saw Surendra’s pitiable condition. He was unable to even stand up because of his cough, fever, and extreme weakness. From her experience in the field, she thought it could be TB.
After counselling, Surendra agreed to take a TB test. She gave him a container (to collect his morning sputum). Next morning, she took him on a cycle rickshaw (as he was unable to walk even that short distance) to the nearby TB clinic which is part of the Government-run Shastri Park hospital.
Although WHO recommendation is to offer a molecular test upfront to every person with presumptive TB (as microscopy underperforms in diagnosing TB), Surendra could only get sputum microscopy done, which gave a negative result. But his X-ray indicated presumptive TB. Based upon X-ray and clinical evaluation, the doctor’s advice was to put him on TB treatment immediately.
Surendra’s TB drug susceptibility test via Line Probe Assay (LPA) was also done to ensure that the TB bacteria that infect a person are not resistant to the medicines he or she is treated with. His HIV test was negative.
As Surendra was too weak to stand, Priyanka queued up in the clinic to collect his medications so that his treatment could start without any further delay.
She then counselled him on how to take his 3 pills every day, importance of treatment adherence, nutritional support, and other health and treatment literacy related issues.
Priyanka also briefed him about the nutritional support offered by the Government of India: Nikshay Poshan Yojna under which he was able to get INR 500 every month during his TB treatment. She helped him complete all the formalities so that he can receive this benefit.
As there is a likelihood of TB of the lungs to spread to others, Priyanka also counselled his wife to consider taking a TB test, which she did and tested negative.
Surendra’s arduous journey through the treatment pathway
At the onset, he faced severe side effects related to TB medication. He would feel very dizzy after taking his medicines. Upon consulting the doctor, his medication was changed, and side effects subsided eventually.
The next obstacle was his alcohol addiction. Priyanka told him that he would have to quit alcohol if he wanted to get cured of TB. He said that was an impossible task for him to do. She retorted that in that case the TB medicines would be ineffective, and he would die sooner or later. That perhaps set alarm bells ringing and Surendra promised to try to quit alcohol. And he eventually did.
“Madam (Priyanka) had taken a lot of pains to get me started on treatment. Now I had to quit alcohol to get cured. This was not easy for me. I thought, let me have a quarter of a bottle of liquor at least. I went to the shop with money in my hands. But suddenly I do not know what came over me. I came back to my hutment without buying any liquor, drank a glass of water and lay down. That moment I left drinking once for all,” shared Surendra.
Slowly his condition improved. He regained his strength and started walking and even lifting 10-12 kg of weight as part of his ragpicking work. Soon after, he could go to the clinic to collect his medicines with his 10-year-old grandson. His neighbours’ attitude had also changed. They no longer discriminated or stigmatised him.
There was more trouble brewing
But the path to his recovery was fraught with more challenges. In mid-2023, Delhi battled one of its worst flood-like situations in several pockets because of heavy rains. Many media reports described it as the worst floods in the last 40 years (in terms of volume of rain that poured in a single day).
(To be contd)