With an estimated 2.7 million infection cases in 2019, India has the highest burden of tuberculosis in the world. The numbers are worse for people residing in tribal areas of India -- five times higher than the non-tribal population.
In the Pakur District of Jharkhand, ninety-seven percent of residents belong to indigenous groups. The district is among the poorest in a state, with suboptimal health infrastructure and limited access to care.
Simon Kisku has lived in Pakur all his life. A tuberculosis (TB) survivor himself, Kisku is passionate about making his community TB free. When he learned of the USAID-supported ALLIES project, which empowers TB survivors to become community leaders who work to support TB patients and change behavior in relation to TB, he signed up to be a “TB Champion.” Thanks to training from the project and his own experience, Kisku became well versed in raising awareness about TB symptoms, testing, treatment, and nutrition needs of TB patients, and helping to mitigate the stigma often associated with TB. The ALLIES project also helps connect TB Champions like Kisku with local stakeholders such as district TB officers, frontline workers, and village leaders.
As a way to supplement his income, Kisku sold shoes on his motorcycle. As he traveled through villages with his mobile shoe-selling business, he recognized TB symptoms in some of the people he met. Knowing that TB is a deadly but curable disease, he thought of a way to help people who were delaying testing or treatment due to the pandemic related lockdown or fear of stigma.
Kisku turned his motorcycle into a mobile TB knowledge center and testing facility.
With the help of the ALLIES project, Kisku picked up sample collection cups at a local health facility and began carrying them on his motorcycle. Wherever Kisku went to sell shoes, he talked with local residents about alarming TB symptoms to watch out for and how to get tested. He understood that many people, especially women, were reluctant to go to health facilities to get tested for the fear that they would be rejected or resented by neighbors or even family members. Kisku would offer to collect and transport sputum samples for anyone who appeared symptomatic, a safer and more discreet way under the circumstances.
Throughout the seven months of lockdown in 2020, Kisku has helped over 150 people get tested for TB. At least 30 of them tested positive and have begun treatment. Since 2019, Kisku has mobilized a network of 30 TB Champions in Pakur working with local stakeholders to make the district TB free. When asked how he felt about the project, Kisku said, “As a TB Champion I serve a tribal community and provide support to members of my community affected with TB. The USAID-funded and REACH-executed ALLIES Project is a ray of hope for me.”
To the tribal communities in Pakur, Kisku is the ray of hope.
Indigenous people are among the most marginalized and disadvantaged socio-economic groups in India. While supporting the Government of India to achieve the ambitious goal of ending TB by 2025, USAID works to support the full inclusion of all people, including Indigenous Peoples in quality healthcare. By working with “TB Champions” like Simon Kisku, the USAID-supported ALLIES project has provided screening, counselling, and raised awareness for more than 30,000 people in 2020.