How Air Pollution And Congestion Promote Diseases Requiring Long Duration Cures

At the Siddhi Vinayak Textile Mill in Lalbaugh, Bahadur, a young migrant from Nepal, had found a temporary job. Thapa, a neighbour in his village who had come to Bombay some years earlier and who was working here, had fixed up the job for him. Thapa had impressed the factory’s Welfare Officer as a sincere worker and when a vacancy arose the Welfare Officer agreed to give Thapa’s man a chance. Thapa was happy to have someone from home around and found Bahadur a place in Pinto’s ( another worker in the same mill ) hut in the Sanjay Gandhi Nagar Zhopadpatti Sangh on Senapati Bapat Marg.

Homesick for the village and feeling strange being in a city for the first time in his life, Bahadur was devoted to Thapa, Pinto and the Welfare Officer Joseph George - the only three persons he felt were his well wishers. His childlike ways endeared him to Joseph George who also found in him a willing and intelligent worker.

A few months after he began working in the mill, Bahadur developed a persistent cough. He worried about it. In one of his chats with Joseph George , he confided his worries in him.

"It is only after I cam to Bombay that I developed this nagging cough, " he said. " Now, I don’t seem to be able to stop coughing. IN my village they say all ailments are due towater. Perhaps it is the Bombay water which doesn’t agree with me. I have tried boiling pudina leaves in water and dry ginger in water but nothing seems to relieve the cough. "

" Cough have nothing to do with water, " replied Joseph George with an amused smile. " Why don’t you go and see a doctor ?"

"Going to a doctor for a cough doesn’t come easily to me, " laughed Bahadur. " In my village people rarely ever visit a doctor for such ailments, unless they are willing to walk two days to the nearest town. "

It was evening and the Welfare Officer rose to leave. Bahadur went back to the shop floor. A small shaft of the evening sunlight was coming in through the single ventilator high up and in it he could see the hundreds of tiny specks that kept the hot heavy air inside the huge shed permanently hazy.

He talked to Thapa about his cough. " It is not water, perhaps, that is the culprit. But so many of the men are coughing. Pinto, my partner, is greatly bothered by a cough, too. But I seem to worry about my cough more than the others do. Perhaps I ‘ll get used to it, like them. "

Pinto, Bahadur’s partner, was suffering from TB. He was on a long course of medicines for it. But he went and brought his medicines as and when he felt like it and swallowed them even more irregularly. Recently, when he had gone to his native place in Goa, he had just forgotten all about his medicines.

Bahadur was beginning to understand that there was something serious about his cough with so many people in the factory had. Pinto seemed to be swallowing an awful lot of medicines even if he did it irregularly. He often went into long bouts of coughing which left him breathless and exhausted. And every night he insisted on drinking his favorite Fein which made him cough even more. Bahadur forced him to rest whenever he was home and willingly did the chores around the house. But he lay awake at nights worrying.

Pinto seemed to be getting thinner day by day.

Then one day another worker, Ramesh, doubling up in a coughing bout, suddenly brought out blood. Terrified that he might be dying, Bahadur rushed to call the Welfare Officer.

"Ramesh’s problem is a very serious one,"said the officer gravely. "Probably an advanced case of untreated TB."

"Can’t we take Ramesh to the doctor ?’ asked Bahadur. " Please, sir, let us take him to the mill doctor, " he pleaded.

"He is not a permanent worker although he has been working in the factory, off and on, for some years. And the mill cannot take responsibility for his medical problems. He can go to a private doctor if he wishes to. " There was a sharp note in the officer’s voice which Bahadur had not heard before.

By now there was a crowd around them. The officer abruptly went back to his cabin. Ramesh, wanting to escape the attention, was feebly hobbing away saying, " I am better now. Bahadur, don’t put yourself out for me. You are young and hot blooded and still new to the city. But once you have seen life like I have, a few drops of blood coughed out will become routine. "

" Enough of all this commotion. Get back to work, all of you," the Supervisor called out.

For the next few days Bahadur remained quiet and thoughtful. His happy laugh and friendly jokes were missing. Some of the workers knew what was bothering him. But Ramesh coughing out blood on the shop floor had set everyone thinking.

" Let us go to the Union, " said Bahadur to some others one afternoon as they sat eating their lunch. "Even if some of us temporary workers are not members, let us ask the Union to take up this issue of workers health. But we should also learn something about the diseases which can affect us and not just leave it to the Union. "

Thapa told Bahadur about the Bombay Social Education Society which was running night classes for workers in the BDD Chawls. Thapa had attended them for a while. They hadn’t taught anything about health. But he told Bahadur that he might be able to find out from the Society Secretary whose office was in the chawls.

Bahadur went to see the Secretary. It felt new and exciting, going to find out things. So far all he had been doing was feeling homesick and finding comfort in a small social circle. In any case some friendships did not last long, like the one with the Welfare Officer, Joseph George.

" I have heard that a persistent cough could be an indication of TB. But I do not know what causes it, " he told the Secretary of the Education Society. " I am a 9th standard pass and was keen to finish school. But my family couldn’t afford it. Could you give me some books in Hindi that I could study from ?"

Bahadur spoke earnestly to the other workers about what he had learnt. "WE all live in chawls and hutments ; we cannot do much to get better housing. At least in the factory we have a Union. Shall we put up certain demands through the Union in the interests of our health ?"

With Bahadur’s guidance, though he was only a temporary worker, the union laid down the following demands. During the period, the Welfare Officer Joseph George had left to take up another higher paid up job. The new Welfare Officer, fresh from the University , was enthusiastic to find a trade union which was beginning to take workers’ health seriously. He had studied about occupational diseases in his text books and arranged for Dr. Patel the ESIS doctor to whom many of the workers went, to come to the factory one evening to talk about TB. Bahadur asked if the Secretary of the Bombay Social Education Society might be invited too. It took a lot of work by Thapa, Bahadur, Pinto and Ramesh to persuade the workers to attend the meeting. This was not something they were used to doing but Ramesh reminded them of the gloom that they had all felt just a few days earlier when he had collapsed on the factory floor. Even Pinto seemed to have become serious.

"Ramesh is a case of advanced untreated TB," explained DR. Patel.

"And Pinto is a case of person who is taking treatment, but carelessly and irregularly, There are many,many like you in Bombay, who suffer from TB. Many are not diagnosed early. Many who are told to begin the treatment never show up again and go to private doctors now and again for temporary cures. By neglecting the problem we are spreading the disease to our wives and children and others around us. All those who breathe in TB germs do not get TB, but whenever they become weak due to not being able to regularly eat sufficient food, the TB germs can begin to multiply in their bodies. "

"Can children also get TB?" asked one of the workers. "Yes, children can get it easily. That is why it is very important to give them the BCG vaccination as soon as they are born. This protects them against TB in the early years. But as children get older, continuously live in overcrowded houses and in the midst of the TB patients the germs can quietly lie in their bodies. Whenever their bodies become very weak due to inadequate food or other illnesses, there is a chance that TB germs might begin to multiply as the body’s soldiers are too few and too weak to resist, " explained DR. Patel.

"Then , does every cough mean TB ? Does it mean that everyone in Bombay has TB because everyone coughs and spits?" spoke up another worker.

There was general laugh.

"No, No ! Only if you cough out blood does it mean you have TB," answered someone else who felt by now that he had understood everything.

" Both of you have got it wrong, " smiled Dr. Patel. "Because of general air pollution, coughs are common in Bombay and acute cough, called bronchitis, is also common. But TB is caused by a very specific germ which multiplies rapidly and kills. Testing of the spit can definitely prove whether one has TB and once you have it, the only way to cure yourself and prevent it spreading from you to others is to take medicines which kill the germs in your body and prevent them from multiplying. "

Pinto suddenly came alive. " But doctor, this treatment is a terrible thing. Who ever can go to a hospital twice a week for one full year just for medicines ? It takes so much time, I get late for work , in the hospital, I have to stand in a long queue and on top of it all they insist that I swallow the medicines there and then. " He looked around at his friends smiling broadly and winking at Bahadur, added " there is a compounded there who allows me to take the medicines home although it is not allowed ! Special for Pinto, you see ! But I never seem to remember when to take what . And once when I was waiting in the hospital they made me pass urine. They said they were gong to test it. And the next time I was shouted at for not having taken the medicines regularly. Are they CIDs or doctors !" "Urine-CIDs," bellowed out another worker. Everybody laughed. "What Pinto is doing is dangerous both to himself and to others, " said DR. Patel gravely. The laughter and jokes were still going on and Bahadur asked everyone to be quiet. "What Pinto is doing by his irregular treatment is to make the TB germs in his body resistant to the medicines. Then, through his breathe he is spreading these drug resistant germs to others so that they in turn will find it difficult to cure themselves unless they take even stronger medicines. The medicines for TB are already very strong and can produce strong reactions in most persons. If more and more people had to take even stronger medicines because of careless people like Pinto, they would be fighting two battles - one against the germs and the other against the reactions to the medicines. "

" And there is anyway a continuing battle at home, " reminded the Secretary of the Social Education Society. "TB patients need to eat specially nourishing food. They could often be sick with the disease.

or with reactions and could lose wages. So the household’s budget must be managed better than otherwise and the patient can show how much he cares for his family by going through the treatment properly and also not wasting money on other habits like smoking and drinking which are harmful anyway. "

By the end of the meeting, Pinto’s joking had stopped. He told Bahadur earnestly, " But I didn’t know it was such a serious matter. No one had explained to me before in this way. At the hospital or any where else. "

"Yes," replied Bahadur. " It is true that we don’t get to learn of these things. When we are sick and go to a doctor or hospital we are just given medicines and sent away. Nothing is explained to us so that we can understand what is happening to us. Perhaps we should take the responsibility in our own hands - to find out more, to understand, by asking questions of people who know better wheneve