Annawadi, India
Producing Hope in the Face of Conflict
HEALTH:
All humans deserve the right to live their lives unencumbered by diseases such as tuberculosis.
The inhabitants of Annawadi struggle daily with problems concerning their social caste, family, income, and assurance to their home's safety, as the Annawadi government wishes to raze the slums to build hotels. Why should they also have to deal with bloody coughs?
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Affecting one new person every second according to the World Health Organization, the disease known as Tuberculosis, or TB, devastates Annawadi families. Not only do the symptoms of TB include a persistent bloody cough, fever, and night sweats, often leading to tissue damage in the lungs, but the disease is also terribly infectious. Distributed by even simple acts of coughing and sneezing, the bacteria causing TB is transmitted through air. When one considers the lifestyle of a typical Annawadi person, it is not hard to imagine the dust and dirt found in the garbage that constitutes many of their incomes.
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PBS, analyzing the spread of TB, has derived alarming statistics. They report that "A healthy adult spending eight hours a day for six months with an infected person has a 50 percent chance of becoming infected. Alarmingly, each person who has active TB may infect on average 10 to 20 others, often family members and caretakers" ("Deadly Diseases: Tuberculosis"). In the case of the Husains, TB has disabled Karam, who would otherwise be the chief worker for the family. In Karam's stead, the eldest son Abdul works tirelessly for his family, bringing in the money from garbage work so that they may all survive. Threatening to debilitate any other member of the family, TB forces Zehrunisa to train her "work force" of children from an early age so that doom does not fall if the eldest, and most experienced, child Abdul contracts it. The struggle with TB affects the Husains' daily life, as well as hopes for their long-term prospects.
Tuberculosis in Annawadi:
Causes of Tuberculosis:
Working with garbage in hopes of collecting a sufficient income, the other Husains are at even greater risk of contracting TB from Karam Husain.
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In a study analyzing TB resistance to antibiotics, social tendencies are shown to impact the bacteria's resistance to doctors' methods of helping victims.
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Chao reports, "In this study, the strongest risk factors for drug resistance were previous treatment with second-line drugs -- indicating that prior treatments were ineffectual and exacerbated the resistance of the tuberculosis. Other factors associated with resistance to second-line injectable drugs were unemployment, a history of imprisonment, alcohol abuse and smoking" (Chao).
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This analysis does not bode well for any of the inhabitants of Annawadi. Unemployment is rampant, with 'wealthy' families like the Husains exchanging trash for money, as well as buying the trash of other trash collectors to sort and resell. Furthermore, even young Abdul has spent several weeks in the town prison, as well as a juvenile detention center. The corruption of the government does not improve the health condition of Annawadi inhabitants.
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Alcohol abuse is even more widespread. In her book Behind the Beautiful Forevers, Boo reports that a worker helping the Husains with their renovations had TB and was drinking as a way of lessening the pain. He says, "Lately, if I don't drink, I don't have the strength to lift anything" (89). As a man who survives by working with his muscles, this worker must fight through the symptoms of his advanced TB to raise money for base necessities.
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Increased by alcoholism and the unfair conditions of life in Annawadi, TB's resistance to antibiotics is steadily growing. Development of new antibiotics seems futile, as the TB bacterium has resisted both fluoroquinolone (shown in the graph as FQ) and combined drugs, including isoniazid and rifampicin (D, Agrawal). The increasing resistance to drugs such as FQ may be "due to widespread use of this vital group of dugs in the treatment of community-acquired infections" (D, Agrawal).
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Thus, the doctors prescribing antibiotics to TB victims do not always judge wisely; often the drug is delivered in insufficient quantities by doctors who wish to save money, or only partially ingested by patients who believe that the drug is not necessary once symptoms of the TB have vanished.
Is There a Solution?
Although pernicious and infectious, TB is being widely analyzed by scientists. Doctors and humanists alike hope for an end to the raging bacteria. But is hope really practical?
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From both a scientific and social perspective, hope lies in the prevention of TB.
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Dr. Peter Hotez, dean of the National School of Tropical Medicine at Bayor College of Medicine and president of the Sabin Vaccine Institute, believes that the TB bacterium is flexible enough to circumvent any antibiotic that scientists can apply, but he still holds hope for the future. He says, "This study pointsto the urgency for accelerating the development of a [tuberculosis] vaccine" (Chao).
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However, how could ordinary people help, without the knowledge to develop such a thing?
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Looking at the causes of TB from a social standpoint, it is possible to see that the physical and social environment of Annawadi invites diseases such as TB. Leading parents to consume alcohol and children to start working at a young age, the lack of jobs and an uncertain future for those born into an unfavorable caste precipitate contraction of TB. This can then be spread easily in small neighborhoods, where even small houses of different families often share a wall.
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Prevention of TB might result from improving the living conditions of people such as the Husains. However, attempts such as those of WorldVision to improve sanitation in Annawadi thwarted by corrupt officials, good intentions can fuel the exploitation of peoples' problems. On the other hand, with more effective monitoring of the government and health officials, proper care might replace corruption.
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Organizations such as the Bill Gates Foundation are attempting to improve the everyday lives of real people like the Husains. If you wish to contribute to such endeavors, you can learn about more organizations:
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or click this link to read more about Bill Gate's plan and his interview with Katherine Boo, author of Behind the Beautiful Forevers:
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