INTRODUCTION

National Tuberculosis Institute (NTI) is conducting National Sample Survey in different parts of India, to estimate the prevalence of tuberculosis infection and Annual Risk of Infection among 1-9 year children by administering tuberculin test. For the purpose of survey, the country has been divided into four geographical zones, north, south, east and west. I was given a posting to Rae Bareilly, Hardoi and Jaunpur for a period of 14 months to supervise the field work. I faced a few problems while implementing the survey, which enabled me to learn a lot. Some of my experiences are as under:

RAE BAREILLY

a. The village Kathaura in Jagdishpur block of Tiloi taluk, was about 120 kms from Rae Bareilly camp. First we did planning there. Later while going for testing to the village it was raining heavily. The panchayat election was also scheduled that day. One of our team members remarked it is some thing like entering into a cave as it is dangerous to work in that village at that particular juncture. However, I convinced all the team members and we proceeded towards the village.

After travelling about 50 kms. on Tiloi road we came across a big Shesham tree which had fallen across the road and many other trees were seen falling here and there. Then Mr Mirza S.Hussain, Field Worker sarcastically remarked that the place may be inhabited by “Godzila”. We could not proceed further and got struck. It was around 7.15 a.m. Then, At this juncture some villagers who assembled there informed that a bus of ITI company with its employees passes daily around 9.00 a.m. on this road who possess the necessary equipments to cut and clear off the tree

· Field Investigator, Epidemiology Section, National Tuberculosis Institute, No.8, Bellary Road, Bangalore 560 003

from the road. Then I decided to wait for the bus, which was heavily opposed by the local health workers. The local health workers suggested that we can go back around 35 kms and take a different route to reach the place. When I enquired the villagers about the route they informed that the roads are bad, we have to travel another 175 kms. by crossing too many small villages, to reach the destination, which was wastage of time and money. I was firm in my decision and wanted to wait for the ITI bus. To our luck, one more vehicle came there. The driver of the vehicle was very much co-operative. He took Mr G Venkatesh, Driver with him to the nearby village in search of an axe. After half an hour they came back with the axe. Then we all started cutting the tree one by one. It was a Herculean task and took about one hour to cut the tree into two. Then the ITI bus arrived. I requested them to help us in lifting the tree from the road. They agreed and we all put our hands together to remove the tree from the road and were successful in the venture. Then we proceeded towards the village.

After reaching the village we observed that majority of them were engaged busily in the panchayat election and nobody was listening to us. However, I was able to convince a lady who was a participant for the Block Development Community (BDC) membership. She co-operated to get the children tested. With her support and our efforts we could finish the testing successfully. Then the local workers started appreciating my decision.

b. I like to recollect an instance during the planning of the village Kotiya Aht in Sareni block of Lalgang taluk of Rae Bareilly district, which was about 85 kms. from the camp. After dropping the testing team at a village we enquired the route to the above village and some villagers informed that our destination is about 25 kms. from the testing site. I, Mr Prem Chand, Field Worker and Mr G Venkatesh, Driver proceeded towards the village in Eicher Mini Bus. The road was narrow, with big ditches and gutters filled with rainy water and the vehicle often used to get struck. The villagers on the way misguided us saying that the village is located near the bank of river “Ganga”. After covering some distance though we could see the river “Ganga” the village was not found nearby and actually the village was on the opposite bank of the river. I thought after parking the vehicle on the bank we can cross the river by boat and reach the destination. However, when we started proceeding further we noticed that we had to cross a small canal over the bridge and travel 3 kms. to engage a boat to cross the river. The bridge over the canal was narrow and not strongly built. I was doubtful whether our vehicle could cross the bridge or not. On enquiry a passerby told us that even trucks and tractors often cross the bridge. Then we proceeded further. But we were shocked to notice that the moment our vehicle crossed the bridge, part of the bridge broke down. On proceeding about 100 mts. from there we found a big ditch across the road and the vehicle could not move further. Added to this there was no other route to reach the village and also we were getting late since we had to pick up the testing team on our way back. Since there was no other go I decided to come back. Since the part of the bridge was broken, Mr Venkatesh had to take real risk. Since there was no other route to return we had no choice. God is great. We were saved. The same was discussed with Sr Epidemiologist and as per his advice the village was eliminated from the survey due to its untraceability.

Jaunpur

Both at Rae Bareilly and Hardoi districts of Uttar Pradesh several times I came across a few villagers who were of the opinion that children get sterilized by tuberculin testing. However, in a village at Jaunpur district I went through a really funny experience. Cadbury chocolate are usually given to children after testing. In the village while testing, a lady panchayat leader broke the Cadbury chocolate into two parts and by seeing the blackish ingredients she thought it is a medicine which may sterilize the child and she conveyed the same to the entire village and misguided them. By hearing to her words villagers refused to get their children tested and everyone left the testing centre and rushed towards their houses. It was quite a strange situation for me. Then I decided to convince the lady politely. I knew that if she does not co-operate testing cannot be done, which was also the opinion of the entire team. Then I rushed to her house and tried to convince her but she did not care to listen to me. Then I told her I am hungry and thirsty and requested her to get me something to eat and drink. Then she offered me seat and served biscuits, jaggery and water. While having the refreshment I calmly explained to her all about our programme and finally I was able to convince her. Then she realized her mistake, apologized and also helped our team to get the children tested. This is one of the most unforgettable experience.

I am happy that in spite of the hurdles and hardships I was able to successfully complete the supervision of the survey at the above mentioned places where I was posted. I wish to convey my heartfelt gratitude to Dr (Mrs) P Jagota, Director, Dr V.K. Chadha, Sr Epidemiologist, Dr Preetish S Vaidyanathan, SMO and Dr V.H. Balasangameshwara, CMO of NTI for their guidance and encouragement. I also like to thank District TB Officers, local health workers and contractual field health workers who were involved in the survey work of the above mentioned districts.