How TB patients left to die by kin 100 years ago set up Himachal town

DHARAMPUR (KASAULI): Gurbachan Singh Sethi, 68, owns a hotel and homestay in Dharampur, a small town near Kasauli in Himachal Pradesh. He is a prominent citizen, well-known in these parts. But, what connects him with most of the local residents is also what makes the town remarkable: most of its people are descendants of patients who had come to the 107-year-old tuberculosis sanatorium generations ago. medium67320848After they were cured at the sanatorium, the British government gave patients parcels of land in the neighbourhood so that they could do fend for themselves. This was because families would often not take back those afflicted with the disease even after recovery was completed. Taboo around it in those days was severe. Over the decades, though, these patients prospered, forging a life at a time when the very mention of TB led to social ostracism.“An ancestor of mine was from Mangwal village in Jhelum district of what became Pakistan. Sometime after partition, he came to the sanatorium for treatment. They settled here permanently and we have been here ever since,” Sethi said. medium67324732“Dharampur has a population of close to 10,000 today. Almost 90% of them are descendants from patients back then,” said Om Prakash Pawar, president of Dharampur gram panchayat.The sanatorium was inaugurated by the then Viceroy Lord Charles Hardinge on October 3, 1911. It began with 100 beds. It is now a proper TB hospital and has seen remarkable change over the years. The roof of the main complex was 20 feet high for proper ventilation and sunlight. The heating system was designed in such a way that warm air could kill the TB bacteria inside the wards. One can see the divide between the rich and poor as well — there were cottages for the rich, while the poor were admitted to wards. medium67322185“The first patient was one a lala (trader) from Lahore who was admitted in 1911. He was very depressed, but he recovered after natural treatment and went on to graduate in law,” said Dr Satish Pundir, an epidemiologist at the hospital.“Till 1909, patients were kept in open tents. There were seven sanatoriums in Dharampur at one point a century ago, but now there is only one complex. The others have been converted into CRPF camps and Central Research Institute (CRI), Kasauli,” said Kuldeep Kanwar, a senior laboratory technician at the hospital. CRI is today a well-known centre for research into vaccines."Earlier, patients who recovered were not accepted back by their families, so they built their lives again in Dharampur and set up timber and other businesses," added Pundir. medium67324579“During the Raj, the Maharaja of Patiala used to support this hospital. No TB patient could freely roam in the town. If they did, there was a small town committee that included doctors who used to identify and take them back to the sanatorium,” Sethi said. The presence of so many patients eventually led to it being called ‘TB town’, with all the stigma attached.“In those days, people were so scared of TB that after a patient’s death the family used to remove the plaster on the walls of their houses and get it completely whitewashed again,” said Pawar.“I remember when I was a child decades ago, whenever any bus or train used to pass by this town, the conductor used to ask passengers to pull down the shutters as it was thought the very air of the place had TB bacteria,” said Sushil Sharma, vice-president of the gram panchayat in Dharampur.Patients used to come to Dharampur from across the country and even abroad. “They would be screened by a committee and only those at the initial stage of the disease were selected for stay,” said Dr Anita Mahajan, medical superintendent at the hospital.In 1997, the Revised National TB Control Program was implemented, and it almost brought treatment to the doorsteps of patients. At any given time, patients in the sanatorium are now not over 25. However, the disease remains a challenge for health workers as the stigma continues. “Some of the patients have been brought into the hospital in the boot space of cars,” said Kanwar. medium67322209Some of the patients at the hospital today are multidrug resistant TB (MDR-TB) and most of them seem to have been dumped by their families. “I have been here for a year now with a hope that my son will come to take me back. The doctors say I am improving. I have not seen my grandchildren ever since the time I contracted this disease,” said a patient. medium67319884The hospital is now a state TB training and demonstration centre. It is the only TB hospital in Himachal which has an intermediate reference laboratory that has state-of-the-art machines to detect MDR- TB. “This facility has increased our cure rate from 40% to 70%. It is also attributed to clean air and good sunlight in this area,” said Mahajan. medium67319587