Suruli

A beneficiary of our existing tuberculosis control programme

Suruli is a very special man; you know this as soon as you meet him. You can see his kindness in his eyes and smile. He looks quite frail; he is 6 feet tall but weighs only 50 kg. He has had a very sad life but despite this, his enthusiasm and energy for life and care for other people are remarkable.

He is 43 years old and lives in a small village called Melapatty. Over the years, many of his close family have died from TB. First it was his father, then his wife died from it 12 years ago and finally his only child, his daughter aged 13 died from a form of TB meningitis. She returned home from school one evening complaining of a headache and was dead the next morning.

Suruli was himself diagnosed with TB 3 years ago at a Seva Nilayam TB camp. He had had a cough for 6 weeks but was still surprised to discover he had the disease. His weight had reduced to 45 kg. He underwent treatment for 6 months but was still left with a dry cough and his sputum was still positive with the TB bacilli. He then underwent 3 months of streptomycin
injections, which worked, and he has now been sputum negative for 2 years. Suruli had also infected his brother with TB, but fortunately his brother also responded positively to treatment and has been sputum negative for the past year.

Before his illness, Suruli worked as a manual labourer but TB has left him too weak to continue in this area. He now earns his income from some land he owns, plus the 500 rupees per month (7 pounds) which he receives from Seva Nilayam for work as a 'peer educator'. He has been working for Seva Nilayam for the past two years. When asked why he became a peer
educator, he smiles and says he has seen a lot of suffering and he doesn't want others to experience what he has been through.

Suruli's work as a peer educator involves visiting 30 homes a day asking whether any family members have any symptoms of TB - a cough, fever at night, chest pain. If they do, he takes down their name and then accompanies them to the village (Seva Nilayam) sub-centre every Thursday for treatment. The first line of treatment is a course of antibiotics to rule out any infections. If this fails Suruli takes a sputum sample from the patients for laboratory testing. Should the test prove positive for TB, Suruli gives advice about subsequent treatment. People ask him what will happen to them at Seva Nilayam's hospital - they even ask what the food will be like!

The villagers trust Suruli. He has an excellent rapport with them. He is seen as a role model, because he has been cured of TB. He is able to cover the whole village of 1,250 people once a fortnight. Apart from checking for TB symptoms, he also checks that TB patients are taking their medication, and provides advice about getting symptoms of sexually transmitted disease treated early.

His work in this village is vital as it has a variety of health and social problems. For some reason it is a TB hotspot. There is also a lot of alcoholism, promiscuity and drug taking. Typically, within the general population in India, 1% of sputum samples will test positive for the TB bacilli. However, figures for a TB camp conducted in Melapatty in October 2000, show 25% (5/20) of the patients tested at the camp had sputum positive samples. Further studies will be carried out in the village to try and understand why it has such a high incidence rate.

Suruli will no doubt take an active role in such investigations, for as he says TB has killed his father, wife and only child and he doesn't want others to suffer from the scourge of TB as much as he has.