Towards the end of a tiring day, a 19-year-old in Madhya Pradesh’s Panna can be found checking on TB and silicosis patients at their homes to ensure they are taking their medication on time and eating nutritious meals. Apart from such visits to patients, the youngster also helps collect sputum samples from suspected and diagnosed patients, and coordinates with the local public health center (PHC) for their treatment.
Raj Bhan Singh, lovingly called Chotu, is currently pursuing a Bachelor of Science degree and has been working as a barefoot health volunteer in the forest regions of Panna for the past few months. The region reports a high incidence of lung diseases among mine worker families – Chotu’s being one of them – as many are forced to work long hours in stone quarries without safety gear as a result of displacement due to the tiger reserve and dispossession of their land. The youngster aims to help TB and Silicosis patients like his father, who worked in stone quarries for close to a decade, receive care and support.
However, juggling between his work on health, studies, household responsibilities and his personal bodybuilding aspirations, is not easy and takes a lot of dedication and optimal use of time from Chotu. His daily routine is a busy one. Every morning he starts off by taking care of household chores and looking after the needs of his cattle. This takes a lot of time, and he only gets free late in the afternoon. It is then that he goes to visit the patients. In between, he also has to find time for his studies and working out. “I am unable to go to college every day, as it is 15 kilometres away. Buses are few and far in between, so I try and study at home as much as possible,” he says.
In the evenings, he begins visiting patients in his own village of Umravan, followed by Madaiyan nearby. Once every few days, he visits Hirapur, which is far away.
“I first visit those patients who have already been diagnosed with TB or silicosis. If there’s time left, I proceed to other homes to enquire about any symptoms. This might not sound like a lot of work, but it takes a lot of time. Homes here are not clustered together and walking from one house to the other takes time.”
“If the patient is not yet back from work, I first talk to the caregiver (most often, women family members) at home, enquiring about the patient’s general health and nutrition. Then I wait for the patient as I prefer directly speaking with them about their medication and treatment.”
If it is found that patients have been irregular in taking medicines, Chotu tries convincing them about the seriousness of the disease and explains the repercussions of discontinuing their medication. While most listen to Chotu as he is educated, some naysayers spread misinformation about the disease, he says.
“Most of the patients are illiterate, and hence a majority of them listen to me. But there are some people who disregard my work, play down the seriousness of the disease, and accuse me of having selfish motives. But I try to remain calm, and carry on with my work.”
The key here, Chotu says, is to understand the patient’s “swabhaav (nature)” and based on it, tweak his style of interaction with them. “If they’re rude and short-tempered, one needs to talk to them with a calm head and have patience. Many times I have to leave and return to the patient the next day when their anger has hopefully subsided. With some people, you can’t be direct, you have to sweet-talk them.”
The latest wave of misinformation in the region following the death of a long-time TB patient was perhaps the toughest situation for young Chotu to navigate. Misinformation was at its peak, with some even blaming medicines or the treatment itself for the death.
While he had a tough time convincing patients and bringing them back on their treatment track, Chotu says things are now looking up, with most of the patients reporting some improvement in their health.
“It is good to see that patients are optimistic that they’ll recover. At least now they’re confident that they can extend their lifespan.”
The job involves risks to Chotu’s health, as he remains in constant danger of contracting the disease through his interactions with the patients. But he is not one to back down, instead using the opportunity to allay the fears of the villagers.
“Yes, TB is dangerous, but should not lead to discrimination. I convince people about the same. I wear masks and maintain a little distance from the patients. That should be fine. It should not lead to patients being treated as untouchables.”