Entrance gate of Hoolungooree Tea Estate, Image credit: Mahesh Deka

35-year-old Minati Poran, a Tuberculosis (TB) survivor from Mariani in upper Assam’s Jorhat district, is determined to eliminate the disease from the tea gardens in and around Mariani.

Minati, who belongs to the Adivasi community, does not want others to suffer the same health ordeal as she had undergone.

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Unfortunately, in her TB eradication mission in the tea gardens, the garden management has emerged as a stumbling block.

TB is a major health issue in Assam’s tea gardens, often leading to the death of workers.

According to government data presented in the Assam Assembly in 2015, around 17% tea garden workers in the state were suffering from tuberculosis and there is no sign of significant improvement in the situation despite sincere efforts of a section of health workers and TB fighters like Minati.

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Doctors working in tea estate hospitals say lack of awareness, poor living conditions and non-nutritious dietary practices are the root causes behind rampant cases of TB among tea garden workers in Assam.

“The light of education has not yet touched the greater section of the tea workers and they are not aware of the peril that if not treated properly, TB can be fatal. Due to ignorance, most of the TB patients in tea gardens don’t complete their courses of medication,” says Abhisek Bora, a physician who worked in a tea hospital in Dibrugarh district.

The housing condition of the tea workers is generally unhygienic. Many workers, along with their children, live in mud houses with tinned roof.

Again, though sizable section of tea workers live in brick wall houses with tinned roof provided by the management, the houses are small in size, particularly for large families.

Further, the problem of ventilation is generally a matter of concern from the point of health.

“Overcrowding is a major factor for the spread of infection. The workers live in one-bedroom houses with big families…since TB is contagious, family members of a patient immediately become vulnerable,” Rajib Sharma, a tea estate doctor, says.

Minati recovered from TB in 2016 and since then she has been actively involved in an anti-TB mission.

Beginning with the task of organizing awareness camps to educate the tea workers on the much needful treatment for TB patients and also preventative measures against TB, Minati never looked back while leaving no stone unturned in her fight against TB.

But recently when she approached the management of Hoolungooree Tea Estate seeking permission and logistic support to organise an awareness programme on TB inside the tea estate, the instant response of the tea estate manger was ‘no’.

Minati was, however, not ready to call off the plan. She continued to pursue with the management and finally managed to get the permission for the programme.

“After repeated requests, the management agreed to grant permission to hold the community awareness meeting,” she says.

A tea garden workers house at Hoolungooree Tea Estate

However, except granting permission, the management refused to extend any other help in conducting the programme.

“Despite asking them time and again, they refused to offer any logistic support for the programme. The management even did not allow the doctor of the tea estate hospital to attend the programme,” rues Minati.

Located near Mariani in Jorhat district, Hoolungooree Tea Estate, administered by Kolkata based Andrew Yule & Co. Ltd, reported at least 15 cases in recent times.

This is just an example of the tea estate management’s indifference towards the health condition of the workers. The list of cases of management’s negligence is far from being exhaustive.

Arjun Mirdha, 40, a worker of the garden, was admitted to Hoolungooree Tea Estate hospital when one fine morning he was down with fever and felt dizzy.

The doctors at the hospital administered an injection and saline, prescribed fever tablets but never recommend sputum test nor advised for an X ray.

He was in the hospital for more than 40 days but his condition hardly improved. Even after that the TE hospital doctor did not refer him to a better hospital for advanced treatment.

It was only after Minati got to know about his condition, Arjun was rushed to Jorhat Medical College Hospital (JMCH), where he was diagnosed with pulmonary TB.

Labour line in Hoolungooree Tea Estate

Arjun is now recovering and was discharged from the hospital recently. Almost for sure, had Minati not known about his condition, Arjun might not have returned home from the TE hospital; it might have been a return of his body.

Still worse, all efforts to meet the tea estate manager and the doctor proved futile. When this correspondent visited the TE hospital, the doctor was not available. When contacted over phone, he refused to meet this correspondent citing ‘his busy schedule’.

Again, while there is a treatment provider in the hospital to follow up the recovery of a TB patient, the said health worker allegedly never visits the houses of the workers.

Allegations are rife that many a TB patients died solely due to the negligence of the management in the matter of providing the needful treatment and the follow-up medical assistance.

Another case that has come to light is that of 28-year-old Purushuttam Turi, a worker of Borholla Tea Estate in Jorhat district.

He was allegedly not admitted to tea estate hospital despite being bedridden for more than two months.

He was admitted to JMCH only after his poor health condition came to be known to the staffers of Jorhat District TB Centre (under Revised National Tuberculosis Control Programme RNTCP).

He was admitted to the hospital at the initiative of Jorhat District Tuberculosis Officer (DTO) Bhaktimay Bhattacharyya and district PPM coordinator Biju Kaman.

Unfortunately, the doctors could not save the precious life of Purushuttam as the case was already too late.

Another bitter reality that needs to be taken note of is that many tea estate hospitals lack the required staff strength. Some such hospitals lack even full time doctors.

At the hospital of Sesha division of Dikom Tea Estate in Dibrugarh, which is home to over 2000 workers, the doctor attends only on Wednesday.

Most unfortunately, the Plantation Labour Act, 1951 which makes it compulsory for tea estate management to provide health care facilities to workers is turning into a paper tiger.

(This story has been written as part of REACH Media Fellowship, 2019.)