Mala – Bangladesh

The name of the child in this story has been changed to protect confidentiality.

Mala grew up in a slum in Bangladesh where MDR-TB is endemic. In March 2006, Mala first began to show signs of illness, but she was not diagnosed with TB until June 2007, more than a year later. Another year and seven months after being diagnosed, Mala commonly used first-line drugs—ethambutol, rifampicin, and isoniazid, as well as streptomycin, another drug often used to treat TB. Bangladesh’s national MDR-TB treatment guidelines require hospitalization until four cultures come back negative for TB. However, when Mala was diagnosed with MDR-TB, the hospital was overcrowded and she had to wait three weeks to be admitted and begin treatment. Despite this delay in treatment, Mala was eventually cured of TB. Even though Mala is cured of TB, she still must deal with other hardships that come with poverty. Mala’s doctor wishes that rehabilitation programs existed in Bangladesh so patients like Mala could receive financial and nutritional support during treatment. Mala’s doctor also would like to see patients receive vocational training so that when they do get better, they can lift themselves out of poverty.

Story Collected by: Asif Mujtaba Mahmud, Respiratory Medicine; Nazmul Hossain, MD, Medical Officer; Ali Hossain, MD, Respiratory Medicine; and Rashidul Hassan, Respiratory Medicine – National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh