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Journalism of Courage
NURSE DIVYA Sojan has contracted drug-resistant TB on the job — thrice. Today, after multiple injections and 22 tablets a day, she is back with her patients in AIIMS-Delhi, her hours after work dedicated to building a support group of TB survivors. As the world marked World TB Day Friday, Divya’s story serves as a tale of caution and inspiration for healthcare professionals, and a symbol of hope for their patients. And she does not miss any opportunity to create awareness about the disease in which the bacteria is disseminated easily into the immediate environs when the infected person coughs, sneezes or even speaks.
Divya says her third bout with TB was particularly debilitating. “I was so sick that I was not able to care for my patients. I was taking as many as 22 tablets every day apart from a series of injections. This led to blurred vision, loss of hearing and constant nausea during the nine-month treatment for drug-resistant TB,” she says. The “biggest problem” in such cases is the toxicity of drugs, says Dr Lancelot Pinto, consultant pulmonologist at P D Hinduja Hospital, Mumbai. “I prepare all my patients to be mentally strong and be ready for two years of hell. According to the India TB report, 2022, the number of drug-resistant TB cases has increased by 32 per cent from 2021,” he says. Hailing from Kerala’s Pathanamthitta, Divya completed a diploma course in general nursing at P D Hinduja College of Nursing and started working in the ICU in 2009.
By 2011, when she turned 23, she had become an expert in dealing with ICU patients. But it was during one of the night shifts that she faced difficulty in breathing. An X-ray showed water accumulation in the lungs. She consulted Dr F N Kapadia, an intensivist at Hinduja Hospital, who put her on a treatment cycle. Divya suffered side effects like joint pain over six months of treatment that involved her taking four drugs daily.
In 2012, she felt fit enough to apply for a certificate course in post-basic nursing(BScNursing) at AIIMS, Delhi. She proceeded to undertake a master’s course in neuroscience. In 2014, she again complained of breathing difficulties. Radiological investigations showed a patch on the left lung. She had moderate water accumulation, and a month-long hospitalisation meant removing the fluid at least five to six times. She had a relapse and this necessitates. A second round of treatment, which included Streptomycin injections daily for three months.“I was under the care of former AIIMS director, Dr Randeep Guleria, and since I was staying in the hostel, found emotional support among my friends. I became extremely weak and did not have
the energy for anything. It was extremely frustrating when I was in the isolation room,” says Divya.
She learnt to manage her life beyond therapy, choosing morning hours to work at the clinic and attending classes in the afternoon. Her treatment lasted eight to nine months. In 2016, after her training, she got a job as a nursing officer at AIIMS. “My happy days were back,” Divya recalls. Till the TB returned. She got married in 2017 and was seeking better opportunities abroad in 2019 when a routine Xray showed consolidation on the upper and left part of her lungs. A Cartridge-Based Nucleic Acid Amplification Test (CBNAAT) showed she had TB that was resistant to Rifampicin, a key drug.
“The diagnosis was devastating…I had to take an injection for three months apart from the daily dose of 22 tablets,” says Divya, who gave up her job and returned to her hometown in Kerala. Her weight had dropped to 48kg.She slipped into depression as distance meant that her marriage had hit a rough patch. Eventually, what saw her through, she says, were the inspirational words of former President Dr APJAbdul Kalam: “Difficulties in your life do not come to destroy you but to help you realise your hidden potential and power, let difficulties know that you too are difficult.”
She returned to work after three months of treatment and sought a transfer to the ophthalmology section at AIIMS. She completed the remaining six months of therapy while working. During the pandemic, she got infected with Covid but with mild symptoms. Looking back, Divya, who now campaigns for Survivors Against TB, has regained weight. And the one lesson she has learnt is not to skip meals.
