Stigma often accompanies TB and can be the cause of significant suffering. It is often regarded as a strong barrier to health seeking behaviour. The fear of losing employment, social networks, social status and marital problems and insensitive behaviour by the community are some challenges that a TB affected person might face. Stigma also has an impact on treatment adherence, determines the behaviour of family and community towards the patient. This in turn influences the mental health and well being of the patient.
Stigma occurs because of community and institutional ignorance. The most common cause of TB stigma is the perceived risk of transmission. The other common, though incorrect belief, is that TB is somehow the result of poor hygiene and hence the individuals fault. However, TB is also stigmatized because of its associations with HIV, poverty, malnutrition, or disreputable behaviour. In general, however, TB stigma leads to shame, metal trauma, discrimination, diagnostic delays and treatment non-completion.
TB is normally cured in 6 months to 2 years but social stigma sticks on with patients being identified as ‘that person who had TB’ even long after cure. Hence the silence around TB is accentuated and mostly unbroken.
Addressing stigma is critical in the global fight against TB. Massive public information campaigns to sensitize and educate communities on TB, stigma and its repercussions on a TB patient are urgently needed. TB affected individuals need counselling and strategies on how to address and cope with both self-stigma and social stigma. We need sensitization programs for all stakeholders within the health system to ensure care is free of stigma. Special workshops and seminars within schools and colleges would also help in spreading awareness on TB and its impact on the society.
A TB patient should not have to live with stigma- all they need is a bit of empathy, acceptance and a supportive environment for complete recovery. Without addressing the issue of stigma, our battle against TB shall remain incomplete and our desire to eliminate TB from India unfulfilled.