India's Ticking Time Bomb! | Dr. Zarir Udwadia | TEDxGateway

this is not a glamorous disease it kills you slowly and agonizingly ravaging your lungs it stops you breathing makes you cough up blood look your friends and family will shun you because it's infectious it doesn't require the mosquito vector of malaria or dengue doesn't need the sexual intimacy of hiv/aids this is the perfect assassin all it takes is a cough ah millions of infectious droplets released and all you folk in the front row could be infected I see you collectively hold your breath now relax safe to breathe you probably figured out by now that it's tuberculosis or TB I'm speaking about haven't you but did you know were you aware that this one disease over the last 200 years alone has been responsible for the death of a thousand million human beings that's a lot of zeros and that the deaths from TB alone far outnumber those from smallpox and plague and cholera and malaria and AIDS and influenza all put together Ebola gets all the recent attention doesn't it and in the last outbreak which lasted precisely 15 months 11,000 people died terrible publicized agonizing deaths but in that same time window TB killed 2.1 million people you didn't hear of those deaths perhaps they didn't matter yet TB is Ebola with wings it flies through bombay's crowded local trains ticketless invisibly infecting thousands every day with millions of coughs and we're a nation of coffers you hear the cacophony around you every day in India TB exists on an epic scale it's our biggest public health problem it refuses to go away India houses the most TV patients in the world TB kills the most Indians globally one Indian dies of tuberculosis every minute think of it that's a grim statistic a shameful one unchanged over the decades TB cost this country twenty four billion dollars every year something a poor country can't afford you take this world map behind me and watch as I mathematically stretch it in proportion to deaths from TB finally we emerge as the superpower we've dreamed of being but but perhaps in not in the way that we would have wanted I now need to introduce to you someone very important my patients Alma but bear in mind that her story could have been any of yours in this room today if you had been infected furtively does not distinguish between the chauffeur in the front of the Mercedes from the CEO at the back or the maid in her kitchen from the Mensa playing bridge on her veranda Salma was a resident of Dharavi the world's most densely populated slum and she had spent the last sixty six zero months before she met me desperately fighting off her TB in her quest she had criss crossed two states you pee and Morosco 1500 kilometers apart on multiple occasions she had accessed for government clinics 12 private practitioners she had received countless drugs what could be more soul-destroying than taking five years of treatment yet find yourself getting steadily worse with each doctor visit not better what made Salma special why do I want to devote no dedicate my TED talk to her not the fact that she had TB sadly millions do in this country you've heard that it was the type of tuberculosis she had her pattern of resistance let me explain it's a simple concept it turns out that normal TB is really easy for me to treat I give you four drugs for six months and at a cost of eight dollars of course I can cure you 95% of times but if you are given the wrong doses the wrong drugs you take your treatment irregularly your TB bacillus will mutate to a drug-resistant form the drugs won't work this kind of TB takes two years to treat this kind cost thousands of dollars of course 250 painful injections 15,000 tablets you thought seven days of antibiotics was too long you stack those tablets up and that is a 30-story tar your patient has to climb these are drugs that make you go blind and deaf and pack your kidneys up and look if you're resistant to two of the drugs we call you mdro multi drug-resistant TB and if it's four we call you X dr which sounds pornographic but means extensively drug-resistant TB how many drugs do you think my patient Salma was resistant to take a guess 12 and how many drugs did we have to treat TB at the time we had 12 we called her totally drug-resistant TB you know I think Salma understood this concept of resistance faster than all of us in this room myself included because at each visit she sat across me hopelessness in her eyes and said the drugs don't work I take them but they don't work they wouldn't have she was resistant to them all well we wrote her up in a prominent medical journal and suddenly suddenly after decades of neglect TB could not be kept off the news and perhaps off the nation's conscience which was a good thing because finally these marginalized deprived patients had a voice we were determined to cure her we gave her a cocktail of every available drug left we operated to remove her destroyed left lung a pneumonectomy but we were unsuccessful Salma died two days after surgery therapeutically destitute of an untreatable form of TB who kills Salma that's easy to answer we did collectively drug-resistant TB represents a collective indictment of us all as a society of the tests that are too slow of the drugs that are too toxic of the government program that's underfunded and inefficient of the private practitioners who will dole out the drugs but no compassion no science of public policy failure and of poverty all these kills Salma so time for a reality check friends it's the 4th of December today and on our count our shift already from the start of this year 10 million globally are sick from TB suffering from it and 2 million are dead and a hundred and fifty thousand Indians with drug-resistant TB that's the number we produce shamefully each year back a train station the size of this room desperate for a train that will relieve them instead all they see is the sign which speaks of delays disruptions disillusion please Prime Minister Modi forget your bullet trains help our patients get on this one and and and give us the tools we need to fight this scourge give me the drugs the labs the funds and give us social change because TB is the perfect expression of an imperfect civilization isn't it there's there's one final thing I almost forgot to say and that is that Salma was a mother and she often came with her four-year-old child this is a haunting picture I still can't sleep when I see it at night of mother and daughter on one of their multiple visits that's in my clinic I turns out Salma had infected her daughter living with her for 60 months and longer it turns out that probably the strain was the same totally drug-resistant strain I have yet to see a more TB ravaged x-ray in a four-year-old child in all my 30 years of chess medicine I know for a fact from her father that I sha her daughter is still alive today I know that I Shah is still coughing therefore today and I guess that I shall still infecting many around her in Dharavi scrout communities you don't need to be a doctor to read that x-ray just look into their eyes but there are thousands of Selma's and thousands of Aisha's and I want each of you as you leave this room for your lunch to promise not to abandon them let's promise to treat all forms of tuberculosis irrespective of their resistance pattern for each death from TB diminishes me diminishes us because it's preventable all we need is collective will to turn the tide for as the great urban sinner reminds us from a thousand years ago he said there are no incurable diseases there is only lack of will so I'll end where I began this is not a glamorous disease I'm sorry to put your mood off before lunch I am no glamorous doctor you've probably suss that out already but if working together we can save some lives what could be more glamorous than that [Applause] you

Channel: TEDx Talks

Views: 177,240

Keywords: TEDxTalks, English, India, Health, Big problems, Biology, Cancer, Cause, Death, Developing World, Disease, Empathy, Global issues, HIV, Illness, Life, Life Development, Medicine, Pandemic, Population, Poverty, Public health, Research, Science, Slum, Social Justice, Surgery, Tragedy, Vaccines

Id: ziB_OwLda-g

Length: 10min 32sec (632 seconds)

Published: Wed Mar 22 2017