The passing number of national highways outlined to the Meghalaya plateau is easy to skip the village of Pahamsyi in the Ri Bhoi district. With a population of approximately 2,000 people, the village is almost hidden among the fresh green of this subtropical mild climatic state.
Pahamsyi is one of the 7,000 villages scattered after 22,429 km Meghalaya with an estimated population of 39.39 Lakhs, of which 85.9% are tribal, according to the government.
The smooth, hoarse highway Nongpoh is slowly turning into Pahamsyi Village. Here, at his traditional healing clinic Elington Syiemsad, 41, he is too hurried to greet someone. There is a constant stream of patients tonight on Wednesday morning. The clinic washed white with wooden furniture and green curtains has several bottles of traditional herbs at the entrance.
“This is my daily load of patients,” he says, he can hardly look up from her prescription pad, even as an older lady who reported with a fever, complains about her 40 minutes of waiting. Syiemsad writes his symptoms and probes.
“How often do you have a fever? What is your appetite? Is there a persistent cough or weight loss? The healer is gentle and gives her time to answer. It records every answer to the pad and then puts the same questions again to confirm the answers.
His patience with a woman is not well received by those who are waiting for a traditional medicinal clinic. Most of them had to give up daily wages to come here. Their illness contributes to their inconvenience.
“The fact that another five minutes with any patient asking them are an important connection in the state campaign” Stop TB “. Most patients do not even realize that TB could be positive. Testing on TB is the most aggressive approach to solving and eliminating disease,” he explains.
Syiemsad, who has been practicing traditional medicine for 19 years, is one of the 1,227 state traditional healers, Meghalay of Infantry soldiers in the Battle of TB. The state is one of the first in the country to employs tribal heales in its TB control program. The aim is to create on roads into a dense tribal population in a state where the first contact point for diseases is most often a traditional healer.
India represents an estimated 26% of global cases of TB and death. At the national level, within the national program elimination of tuberculosis (NTEP), the incidence of TB of cases decreased by almost 17.7% – out of 237 cases per 1 people in 2015 to 195 in 2023.
Elington Syiemsad, one of the traditional healers in Meghalaya, which has started into the TB state program at its clinic with the patient. | Photo Credit: Special Arrangement
The northeastern states of India, with the exception of Assam, show a heavy TB burden, with a reported prevalence of 497 cases per 100,000 inhabitants. As part of the TB Meghalaya control program, 4,573 TB cases were announced in 2024.
The Indian goal to remove TB by 2025 is one of the most ambitious health missions in the world. Within NTEP India, she strengthened her reaction TB with diagnostics, politics, private sector partnerships and patient approach, officials say. As part of this mission, the central government of the 100 -day TB Mukt Bharat Abhiyaan, in December 2024, launched.
Minister of the Union Health JP Nardda, while announcing the completion of 100 days at the beginning of this week, said in the 100 -day program 12.97 crore people were projected on TB and more than 7.19 TB patients in India. Approximately 2.85 Lakh patients were asymptomatic. Accordingly, up to 867 patients tested positive in Meghalaya.
Be a bridge
So far, there have been 625 villages in Meghalaya, one of the seven Indian nurses in the northeast, declared free of charge. With Assam in the north and east and Bangladesh to the south and west is known for its hilly terrain. The state fought with the mortality rate of TB, which has not seen any significant decline since 2015, remaining 5-6%. Looking at the local solution, as they say, officials say, led to a decrease in mortality to 4%, because the project of integration of traditional healers was carried out in 2024.
Meghalaya has other health challenges, including malnutrition, especially in children of younger five. It is presented in the National Family Health survey (NFHS-5), as shown in the National Family Health survey, a high degree of stamping, wasting and underweight.
Poor nutrition may disrupt the ability of the immune system to fight infections, including TB. Other risk factors include people living with HIV and diabetes; Those for certain medicines, such as those used to transplant organs or cancer treatment where the immune system is suppressed. Other conditions that cause people’s vulnerabilities are poverty, cramped unhygienic living conditions and abuse of addictive substances.
Healers across this state have so far referred to 302 cases, six of which were positively tested on TB. The state provides a cash incentive of 500 GBP for each positive case that helps healers help monitor.
“Training of these traditional heales to identify symptoms and early TB symptoms was a game drive to the state. We have achieved areas that were impenetrable,” says ABHILASH BARANWAL, Deputy Commissioner in RI Bhoi, adding that they have treatment with treatment. The patient’s approach also helps in de-stigmatization, he says.
Stop TB
Dr. Amica Joan Rynjah, program assistant, NTEP, Meghalaya, says: “The TB state program is forced to navigate the hilly terrain meghalaya, poor connectivity, health infrastructure and diagnostic gaps.” He adds that within a 100 -day TB campaign the Central Government of the State Government, the State Government has conducted a program in five districts with a high burden of illness: East Khasi Hills, Ri Bhoi, East Garo Hills, West Garo Hills and South Garo Hills.
HASE Shadap, 58, traditional healer from Umpohwin Village, Bhoi Rymsong Block, says most tribal people believe that TB is not easy to treat. “There is still fear. Testing is now the first defense line. Our mandate is clear: we project and provide maximum testing, especially for people coming from vulnerable populations, including pregnant women, addictive substance and those who have the history of TB,” Shadap says.
Traditional medicinal clinic in Meghalaya. Traditional healers were trained to diagnose and refer patients with tuberculosis. | Photo Credit: Special Arrangement
This resulted in a 126% increase in the expected TB testing in the state, the officials say. Most people are worried about the financial losses that TB brings and the stigma associated with diseases. “Consistent counseling and hand holding also play an important role. People’s education also plays,” Shadap adds.
He notes that the TB state control program realized that the involvement of the community is crucial. “The medical machine in Meghalaya needs people who have an impact on the population. As tribal communities we have our own set of traditions and customs. Most decide on the public health system and we are their first port when they get sick,” he explains.
Nursing
TB is one of the most infectious diseases in India. The National Survey of the prevalence of TB, which was issued this year by the Central Government, suggests that 64% of people who showed symptoms did not look for care. The reasons for the doctor do not involve the ignorance of symptoms, not recognizing symptoms, self -healing, and having no funds to find care.
While drugs on TB are free of charge throughout India, loss of reward, when they behave for treatment, is difficult for everyday wage workers.
The cost of the disease is also. Saima Wazed, regional director of the World Health Organization, Southeast Asia, says: “In our region of Southeast Asia, 30% -80% of households affected TB are experiencing.”
The article in Lancet in October 2023 estimated that for each TB episode in low -income patients and central income countries (LMICs), direct costs of treatment up to $ 1,253 were incurred, including direct medical, direct non -mine and indirect costs.
India now uses the BPALM regimen consisting of a combination of a drug- Bedaquilin, prestress, linezolide, moxifloxacin- which has proved to be safe, more effective and faster than previous resistant to multiple drugs (MDR) TB. While traditional MDR-TB treatment can take up to 20 months with severe side effects, the BPALM regime will cure TB resistant to medicines in just six months.
India also cooperates with the private sector, which takes care of more than 49% of patients. “State governments are concluding NGOs to facilitate free care in the private sector,” says a higher official of the Ministry of Health.
Aakaar Kapoor, founder and partner, urban imaging and clinical laboratories, Delhi, says: “Forcing compulsory accreditation for all diagnostic laboratories and implementation of triple -layer verification system for TB detection will strengthen diagnostic accuracy and control.” The triple layer checks the levels at which the inspections are carried out on equipment and results.
Meanwhile, Syiemsad, who recently referred to a patient who has positively tested on TB and gained 500 GBP, says: “TB has the potential to bankrupt the family and destroy lives. Early detection is the key to fighting TB.
bindu.p@thehind.co.in
Edit Sunalini Mathew
Published – March 30, 2025 17:46
