Mumbai: When infrastructure projects are planned in Mumbai, officials are often unsure about what to do with the hundreds of families who live in informal accommodations – chiefly slums – on land that belongs to various government agencies. The government is obligated to provide alternative accommodation (through its rehabilitation and resettlement policies), so the government has often done so in buildings in remote parts of the city.
The people in the slums are moved to multi-storey apartment complexes with houses that have toilets on the inside. Each resident receives ownership of the house after occupying it for a few years. And once that happens, the government and other authorities consider the ‘problem’ solved.
A new study has found that poor access to natural ventilation and sunlight and dearth of space has resulted in an abnormally high incidence of tuberculosis (TB) among the residents of these complexes. Overall, it establishes a strong correlation between mortality due to TB and housing conditions.
As per the survey report, Mumbai has had over 1.3 lakh cases of the disease recorded in the region. In the M- Eastward, nearly 78 per cent of the residents live in dilapidated tenements; the ward is host to some 10 per cent of the total TB cases in the city and to as much as 20% percent of drug-resistant infections.
According to the TB India 2017 report, Chembur area of Mumbai had 3,452 TB cases and Govandi, 4,642 cases, in 2016. The respective normalised figures – 758 cases per lakh persons in Chembur and 1,055 cases per lakh persons in Govandi – are 3-5x higher than the national average.
To make sense of these startling numbers, researchers from the IIT and Doctors For You analysed data collected by a door-to-door survey in three colonies and they found that the Slum Rehabilitation Authority (SRA) structures in Natwar Parekh had the poorest layout of the three colonies, and 8-10 per cent of the households here had people with TB. The PMG project had a relatively better layout, allowing for more ventilation and sunlight, and was host to only 1 per cent of diagnosed cases of TB.
On the other hand, residents of buildings outside the surveyed cluster – who had better access to sunlight, ventilation and more windows – had a lower incidence of TB.
Dr Santosh Datar, Medical Director, Ziqitza Healthcare Ltd (ZHL) said TB is curable, however, we need to create awareness about this disease. It is imperative that everybody should have easy and affordable access to TB diagnosis and treatment facilities, especially in rural India. Tuberculosis control is not possible without the active participation of people.
Precautions while at home: TB is an infectious disease. Patients who show the presence of tuberculosis bacteria in their sputum examination should wear a surgical mask at home as per their doctor’s advice. TB patients should avoid close contact with family members, especially children and elderly, and avoid going to crowded places or use public transport.
Adhere to the treatment: One of the major problems of TB treatment is that it is prolonged (at least for 6 months) and patients stop the treatment when they feel better or due to some other social reasons. Not completing the treatment period is dangerous because there is a strong chance of relapse of the disease and the TB germs become resistant to the medicines.
Side effects: All Anti-TB medicines have some side effects which the patient should be aware of. The patient or her/his relative should keep a tab on any such developments and inform the doctor at the earliest.
Diet: Adequate nutrition plays an important role in recovery as it boosts the immune system which fights against the infection. A person suffering from TB should consume well balanced and nutritious diet consisting of adequate carbohydrates, proteins, vitamins and minerals. Our Indian diet of rice, dal, roti, vegetables including green leafy vegetables, salads and fruits is adequate.
Psychological support: TB can lead to a lot of psychological distress for the patient as well as the family members. This can lead to depression and a sense of loneliness. Hence, it is necessary to look for symptoms of mental illness and help her/him cope with the disease.