World Tuberculosis Day: Tea workers exposed to TB

Thirteen-year-old orphan Supra Bawri's lives with her grandparents  on the Jagchara tea estate in Sreemangal upazila of Moulvibazar.   

Last year, suffering from a mild cough for three weeks, Supra then  developed a dry, itchy cough and began to lose weight rapidly. 

"At first, we didn't believe that Supra was seriously ill," said  Supra's grandfather Nitai Bawri, adding that they didn't start buying  the necessary medicine because of fear of the social stigma and  discrimination TB patients and their families face. 

"Later, I took her for treatment when she became very weak."

The family lives in a one-room house with no ventilation or  drainage, which they share with their domesticated animals. Many tea  workers still live in basic mud houses.

"We have eight families in six houses in a small space, and these  eight families have 34 members in total. We live together with our cows  and goats," said 45-year-old Santosh Rally, a female tea worker at  Shamshernagar tea garden in Kamalganj upazila of Moulvibazar.

In such cramped living quarters, it is easy for contagious diseases such as TB to spread.

Densely populated living quarters, malnutrition, lack of awareness,  unhygienic living conditions, and weak immunity all compound in a  relatively high incidence of TB among these workers.

Countrywide, 221 out of every 100,000 people suffer from TB; among  tea garden workers in Sylhet division, this figure is over 433. 

TB is caused by bacteria called Mycobacterium tuberculosis, which  usually attacks the lungs, but can also damage other parts of the body.  Many cases do not show symptoms and those with a weak immune system are  more likely to get TB. If left untreated, TB can be fatal.

Dr Tauhid Ahmed, civil surgeon of Moulvibazar, said the district has  a greater prevalence of tuberculosis. "Therefore, cough examination and  treatment are given special importance in hospitals."

A total 3,251 tea garden workers were found infected with  tuberculosis among 23,185 presumptive examined in 16 upazilas of Sylhet,  Habiganj, and Moulvibazar last year, said Munuru Jacob, project  director of Challenge TB under HEED Bangladesh, which works with the  cooperation of the Global Fund for Aids, TB, and Malaria.

In 2018, 2,933 tea gardens workers with TB were found among 20,428  presumptive examined; the figures in 2017 and 2016 were 2,233 and 1,382  respectively.

Forty-year-old pregnant tea worker Sanjha Tanti at Hossainabad tea garden in Sreemangal said she works from morning to 5:00pm. 

"When I need to use the toilet, I have to do it in the open as there  is no latrine in the tea garden section." Afterwards, she has to use  water from the dirty canals running through the tea garden.   

This is common for all workers in tea gardens, said Sitaram Bin, a  union parishad member of the Shamshernagar tea garden. A combination of  poor nutrition, lack of awareness of hygiene, and an unclean living and  working environment means these workers' immune systems are  comparatively weaker and makes TB more likely to spread among workers,  he added.

"TB is more prevalent in the tea gardens area. We are taking  initiatives to raise awareness among the workers," said Dr Premananda  Mandal, civil surgeon of Sylhet.

The Challenge TB project covers 184 tea gardens in 16 upazilas in three districts under Sylhet division.

"The number of TB affected tea garden workers is high because these  workers cannot meet their basic needs as their daily wages amount to  only Tk 102," he added.

Shah Alam, chairman of Bangladesh Cha Sangshad, the tea garden  owners' association, told this correspondent Heed Bangladesh is  responsible for undertaking various measures for TB-affected tea  workers. "It is Heed Bangladesh's negligence," he said.

Heed Bangladesh is implementing Tb control programme for 16 upazilas  in three districts under Sylhet division in collaboration with the  government.  

Munuru Jacob of the organisation said the organisation follows up on  each TB patient at every stage for 28 days. "Further follow-up in  improving living and working conditions is important and depends on the  tea gardens' management."