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People not aware of cheast diseases fallouts

Rafiqul Islam Azad:
Hafizul Islam, 25, a van driver, living at the village of Mohajampur under Sadar Upazila of Mymensingh district was found in a queue in front of a health centre at Shambhuganj recently with two cough pots in his hand.
 "I came here to let my coughs examine as to whether I have been infected by Tuberculosis (TB) germs as I have been suffering from fever and coughing for more than 21 days," he said.
Asked whether he came to Shambhuganj BRAC Susashtha Kendra taking suggestion from anybody, Hafiz replied in the negative. "I have come here from my own decision. I know the health centre examines coughs. I had heard from a Television advertisement that if anyone suffers from coughing with fever for more than three weeks should examine his/her sputum at a nearby lab or hospital for treatment," he added.
Fatema Begum, 45 of the village of Ishwardi and Rokeya Begum, 37 of Raghurampur and some others from different villages of the same upazila were also found in the queue for the same purpose. They also echoed Hafiz that they know cough should be examined if anyone suffers from fever and coughing for over three weeks.
Bilkis Akhter, a lab technician at Shambhuganj BRAC Susashtha, said usually 8 to 10 persons come to the health centre everyday (except government holidays) to test their coughs at a free of cost. An average, she said, one positive case is found among 10 persons who come here for their sputum test.
 "We only test pulmonary TB cases. If we cannot detect TB germs in lungs we refer suspect persons to upazila health complex to visit doctors and examine whether they are infected with extra pulmonary TB," she said.
 "The tests for infection of TB include smearing, scanning and microscopy of coughs. The report is given on the following day," she said.
Irrespective of age and gender, many people like Hafiz, Fatema and Rokeya living in urban or rural areas across the country now know as to what they have to do if they suffer from coughing and fever for more than three weeks as government-NGO has been carrying out joint initiative with door step programme to detect TB patients across the country.
Tuberculosis (TB) is a major public health problem in Bangladesh. The WHO ranks Bangladesh 6th on the list of 22 highest burden TB countries in the world.
The government instituted the National TB Control Programme (NTP) in 1965 to combat TB havocs and the NTP adopted the Directly Observed Treatment Short Course (DOTS) strategy in 1993. The DOTS strategy was further expanded in cooperation with NGOs, including BRAC covering the all upazilas (sub-districts) in the country.
Currently BRAC works in 42 districts, 24 acdemc institutions, Chittagong Export Processing Zone (EPZ), Chittagong and Khulna port authority hospitals, 36 prisons and various parts of the 5 city corporations covering 89.5 million population.
Sarwar Zahan, senior social communicator of BRAC Advocacy, said of the 12 upazilas of Mymensingh district, BRAC works in four upazilas-Sadar, Trisal, Muktagacha and Fulpur. The Damien Foundation, one of the government's partners in dealing with Leprosy and Tuberculosis Control Programme, covers the rest eight upazilas of the district.
Sarwar said, the BRAC has 3,200 Shastha Sebika for 2231,013 population of the four upazils. Besides, 333 health volunteers and 12 laboratory technicians are involved with the Tuberculosis Control Programme.
Dulal Chandra Barman, District Manger of BRAC said they started Tuberculosis Control Programme in Mymensingh from 2004.
They have 166 union based smearing test centres which work two days in a week.
Kausar Zahan, social mobilisation officer of BRAC said the TB patients are feed medicine by health workers, who visit about 250 to 300 households each a month. Normally it takes six to eight months treatment for a TB patient, she said.
According to her, a total of 120,000 patients are detected a year and the success rate is about 93 per cent.
Biswajit Sarker, Regional Manager of BRAC (Mymensingh) said if smearing test found a positive case, he/she is sent to upazila helath complex.
The on duty medical officer determines and provides his/her category and treatment. New cases are determined as category 1 and old patients as category 2.
The medical officer provides patients three-day medicine and sends them to BRAC office for further treatment under the direct supervision of a Shastha Sebika nearby.
Sarker said, as of May this year, coughs of a total of 8,400 suspect persons were examined; of them the rate of new smear positive was 8.14 per cent.
A total of 257 extra pulmonary cases were detected during the period, he said.
Md Sakhawat Hossain, senior district manager of BRAC Health Programme, said new patients normally have to take a six-month course. For first two months, they remain under intensive supervision of Shastha Sebika and their have to test their cough again. If the test found negative, the patients are given a four months treatment.
Asim Kumar Baddya, programme organizer (PO) of the BRAC health programme said after detection of a positive case, a PO will take the patient to hospital through Shastha Sebika. "We do follow up and monitor the treatment of TB patients," he said.
Polack, (not real name) a college student, takes TB medicine from Bedana Akhter, 35, a Shastha Sebika who resides at Shambhuganj Bazarpara everyday from January 27 this year.
 "I do believe that I'll be recovered from the disease if I can take medicine twice a day regularly," he said.
Bedana Akhter said everyday she provides medicines to 7 to 8 patients twice and visits 10 to 12 households to check whether anyone was suffering from fever with coughing for over three weeks.