Delayed aid, broken treatment: TB patient's ordeal in Andhra Pradesh's tribal belt
In a remote tribal hamlet near Paderu in Alluri Sitharama Raju district, Sandhya, a woman in her 40s, sits crouched outside her mud house. Her frail frame makes her appear decades older. She says she completed every dose of medication prescribed for her tuberculosis (TB), but neighbours dispute this, saying she stopped in the second month after severe stomach pain.
Sandhya's struggle extends beyond the disease. Like many TB patients in the state, she has been waiting for financial assistance meant to support her through treatment. This delay in disbursing aid has compounded the hardships faced by one of the most vulnerable patients.
Diagnosed with pulmonary TB in December 2025, Sandhya depends on her elder daughter, the sole breadwinner for a family of four. The daughter earns between ₹100 and ₹150 per day when she finds work in agricultural fields. On other days, the family has no income.
The hamlet, home to about 200 people, sits on a hillock accessible only by a muddy, unpaved road. There is no school or anganwadi within five kilometres, and the nearest shop is two kilometres away. Eggs or milk are a once-a-month indulgence.
Sandhya belongs to a Particularly Vulnerable Tribal Group (PVTG). Her neighbour Satya, who also acts as a caretaker in the absence of an Accredited Social Health Activist (ASHA) worker, says, “All she can afford is ragi ambali for breakfast and rice with chaaru for lunch and dinner.” The ASHA worker from a nearby village visits only in times of need, villagers say.
Healthcare workers point out that stomach irritation is a common side effect of anti-TB drugs. They recommend increased fluid intake and a proper diet to minimise gastrointestinal issues, along with a doctor's consultation for further complications. Nutrition plays a direct role in treatment outcomes, said Dr. Swathi Krishna, a public health physician and TB researcher based in Maharashtra. “Undernutrition, as is the case with Sandhya, creates the most favourable condition for the disease to progress, increasing the risk of death by four to five times,” she added.
Seven months after discontinuing her medication, Sandhya now has fever and body aches. Discontinuation of anti-TB drugs can lead to relapse, and the condition may progress to multidrug-resistant TB, though this cannot be confirmed without a hospital visit. A medical expert who assessed her condition says she may not live long if she does not immediately resume medication and eat properly.
Dr. Swathi Krishna says a Body Mass Index below 18.5 should be a definite criterion for admitting patients to hospital, which applies in Sandhya's case. “But this crucial risk factor is often missed at the time of diagnosis,” she added.
According to the WHO's Global TB Report 2025, India has the highest number of TB cases globally, accounting for 28% of deaths due to TB. As of July 3, 2026, Andhra Pradesh had reported 37,130 TB cases. The financial assistance Sandhya and others await is part of the government's TB support scheme, which provides monthly nutritional aid to patients. Delays in delivering this aid undermine the effectiveness of treatment programmes, particularly for patients in remote areas facing multiple deprivations.
Sandhya's story highlights the intersection of poverty, distance, and inadequate support systems. While she insists she cannot make the 10-kilometre journey to the Primary Health Centre, her condition deteriorates. Immediate medical intervention and timely financial aid could alter her trajectory, but both remain uncertain.
