There are two explanations for how Reshma (name changed) died. In one, she is a disease statistic. A 30-year-old new mother, living on the pavement in Jaipur, died from contracting tuberculosis. The bacteria settled in her lungs, immunity weakened, medicines failed.
The other story is not as linear or logical. Reshma’s family cast her out when the diagnosis came belatedly. She fought disease and destitution on the streets, between the stifling summer sun and crisp cold at night. The absence of proper treatment, and minimal food, however, allowed the TB pathogen to evade her immune defence.
Reshma’s story – as a woman and as a person without shelter – isn’t singular. A new study, supported by the Dr. Amit Sengupta Fellowship on Health Rights (ASFHR), captures the gendered lens of a clinical disease and challenges rigid mortality numbers. In addition to economic precarity, patriarchal norms decided if Reshma’s cough was accurately diagnosed, when she reached a health facility, how often she followed the six-month drug regimen, and if she would go on to develop drug-resistant TB infections. Experts suggest that stigma and isolation further wrinkle women’s access to care in a system becomes hostile to people lacking institutional agency or autonomy.
