Shibani Rani is almost invisible in her bed. Three weeks back, she was admitted at Jalachhatra Hospital of Madhupur Upazilla in Tangail. She gets easily suffocated while talking. She has got TB. But it has traveled a long way before diagnosed.

Shivani came with her brother to this Jalachhatra Leprosy & TB Hospital from Melandaha Upazilla of Jamalpur district where her parents live.

Apparently, TB identification among women is less in Bangladesh compared to men. It is said that as women’s’ traveling area is smaller than men so their infection rate and risk is also lower. Many think that women’s sickness get less priority. Negligence is present in the family to diagnose a disease in women. And even the woman herself, if she understands symptoms of TB within her, hides that from others as she becomes frightened to social reactions and disgrace.

TB identification among women is less: The latest report of National TB Control Program states that in 2005, a new group of people were identified with first time TB; among them there were 57,420 men and only 27,282 women.

TB Control Programs are implemented by 28 NGOs including BRAC. BRAC has the vast program among them. According to their information, in 2006 they have identified 56,583 new male TB patients while there were only 30,495 new female patients in that year.

Assistant Professor of National Chest Disease Institute Dr. Quazi Saifuddin Ben-noor has said, “There is no reason that female will be less affected by TB virus. Some arranges daughter’s marriage first then bring her for treatment.” He observed that some hide their disease even after the marriage for the sake of their marriage.

World Health Organization along with quite a few international organizations have conducted a research on TB Tendency regardless of gender in Bangladesh, India, Africa, Malawi, South America and Columbia. The report was published last year. It says women of Bangladesh leave the matter of getting infected by TB on fate. Women first hide their disease. Then go for herbal medicine, to quacks and finally come to the professional doctors. But this research shows that when come under treatment TB affected women get cured faster than men.

BRAC participated in this research from Bangladesh. Surveillance shows, 69% men go to private doctors or to government health centers. On the contrary, only 52% women go to doctors. Among the total TB affected population, percentage of divorced women is higher than divorced men.

TB treatment for women: BRAC has a publication regarding TB Control Problems among men and women which was published in 2003. It says, comparatively fewer women than men in Bangladesh go to health centers to inform about the symptoms of TB, to test or to be diagnosed with the disease due to social and cultural difficulties.

BRAC’s Health Program Manager Dr. Akramul Islam has said that as women have less money in hand and they have restrictions to wander alone, going to the health center is itself a problem for them. She has to go with the man, with his expense. Sometimes the family is not interested in woman’s treatment.

On the other hand, a mother with TB has to carry on her duty toward her children. In Jalachhatra hospital directed by an NGO called Demien Foundation, TB patient Shibani is accompanied by her eight year old daughter. Little skinny girl was also coughing with her mother. Duty doctor said that it is assumed that the girl has also got TB just because of staying close to her mother.

We talked to 17 year old Beauty Akhtar’s mother in TB and Leprosy Hospital of Anantapur village in Sadar Upazilla of Netrokona district. She is staying with her daughter in hospital to take care. Beauty needs to stay nine long months. She will take time to become MDR to TB or resistant to medicine. Doctors said, if the caregiver does not stay alert, she might catch the disease.

Risk of working women: Beauty used to work in a garment industry at Shyamoli of Dhaka. Few months back while she was diagnosed with TB; her employer sanctioned her holiday and asked her to come back after recovery. But Beauty said to Prothom Alo that she can not rely on that she would get back the job after recovery.

Working women in different industries including garment industries in cities with polluted environment have the risk of catching TB very easily. When they are found affected by TB they get holidays which is virtually layoff.

National TB Controll Council is directing treatment for TB in DOTS (Directly Observed Treatment Short course) system since 1993. In this system, a patient has to go to the hospital everyday and take medicine under direct supervision of a doctor or a health worker. But many workers cannot manage to go to the center for treatment. Many do not want to go for flashing it to news.

BRAC has started to work on Chittagong Export Processing Zone under this program. Demien Foundation is working on Dhaka Export Processing Zone including some other industries. Health & Education Coordinator of this NGO Sayed Tariqul Islam has said, “As the service has reached to the hand of the industry workers, benefit has been observed. Number of identified persons (TB virus carriers) and treatment takers are increasing.” But he also added that the effectiveness of this service is not recognized by all owners.
World Health Organization (WHO) is giving technical support to our National TB Control Program. A high official of this organization who does not want to publicize his name has said that it is necessary to take special steps even in National Program aiming women.

Newspaper: Prothom Alo (National)
Date of publication: 5th June, 2007
Reporter: Mansura Hossain
Translated by: Mir Laila Ferdous