World TB Day

On my third day in Mumbai I met Rehmat Shekh, a 28 year old woman who is HIV postive and battling TB for the first time in her life. When I walked into her home, a small 8×10 foot room that she shares with 3 family members, she was on the floor, her gaunt frame covered by a thin blanket. She is weak, unable to sit up for more than 10 minutes at a time, and usually needs an hour to get all of her pills down.

Rehmat lives in Rafik Nagar, a slum in eastern Mumbai. She shares the small room with her mother, husband and son; the family cooks and bathes in the room, and sleeps lined up in a row on the floor. There are no windows in the room, but a ceiling fan helps to combat the stifling heat.  I had come to Mumbai to continue a photo project I am working on about TB across the globe. I began the story in South Africa, where I documented the effects of the disease within the country’s gold mining community. The mining industry relies on migrant labor, with workers coming from across South Africa as well as neighboring countries. The miners have always battled TB, traditionally living in cramped dormitories, suffering from high rates of silicosis (an occupational lung disease that increases the likelihood of developing active TB), and having had very little access to health care. With the explosion of HIV within the work force, TB incidence has risen dramatically, reaching levels three times what is commonly defined as an epidemic. Many of the miners develop active TB after leaving the mines and returning to their home communities, which are often in rural areas and have little or no health infrastructure. While there are organizations that are working on the issue, there is still very little awareness of the disease and a significant stigma attached to it. The miners are forced to live, and often die, with a disease that is entirely treatable. I want the stories I am working on to profile entire communities that are affected by TB, moving beyond depictions of the sick to give an idea of what it means, and what it feels like, to live surrounded by the disease. The mining community in South Africa is largely a rural community, so for the next chapter I wanted to focus on an urban setting.

During the next few weeks I will be documenting TB in the slums of Mumbai, focusing on the relationship between the disease and urban poverty. I will look at the risks associated with living in the slums, the obstacles that arise and also some success stories. I am interested in learning what is unique to the fight against TB in urban slums and if there are common threads that can connect communities divided by geography and demographics. I will be in India until the end of February and will make regular blog posts. Please check back for updates.

Photojournalist David Rochkind, winner of the 2009 Stop TB Partnership Images to Stop Tuberculosis Award is travelling in India and producing a photo reportage about TB.