TB Case Study - Chandni.
Her real name is Nasreen, nicknamed Chandni, meaning Moonlight. 12 years old. Her father is a rikshaw puller. The family lived in Munger district of Bihar.

When Chandni was five years old her father left home for another woman and started living with his new wife in Kolkata (Calcutta). Chandni with her mother and two other siblings were left in Munger to live with her grandparents. Her grandfather, also a rikshaw puller, earned very little and was unable to meet the needs of the family, he married off the daughter-in-law to another man. The new husband refused to take the children along. Meanwhile Chandni was sent to Kolkata (Calcutta) to take care of her step sisters. At the age of six she was made to do all the house work. Physical and mental abuse was a day to day feature. When Chandni was 10 years old her grandmother came to Kolkata complaining of feeling unwell and demanded some money for treatment from her son. He refused to give any money. Instead offering to send Chandni back to Munger to take care of his Mother (Chandni's grandmother).

They both returned to Munger, Chandni’s grandmother was tested sputum positive and put on medication for TB. Chandni took charge of the household work. She took care of her grandmother and also looked after the other three members in the family, grandfather, nine year old sister and her seven year old brother. Her grandfather earned 20 to 25 Rupees per day which was not enough to support a family of five. So during the holy month of Ramadan, Chandni worked as a domestic helper to a rich family in the neighbourhood, who in return gave her some money and clothes.

There was an Urdu government school in the neighbourhood. Under the mid day meal scheme of the government, the students there were given mid day meals. Chandni with her brother and sister were enrolled in the school. Every month they received about 4 kilograms of cereals from the school. As the year passed by the grandmother’s health started to improve but Chandni’s health started to deteriorate. Due to lack of blood in her body her menstrual cycle also stopped. It came once in few months. She also had persistent fever and cough. Her grandmother took her to a private practitioner where she was given some medicine, her condition improved slightly for a short while, the symptoms then returned.

Almost a year had passed and Chandni’s condition deteriorated day by day. One day Chandni’s grandmother’s sister, Najma visited them. Najma was the lady who swept and cleaned the Munger Referral Unit of LEPRA. Seeing Chandni’s condition she took her to the Referral Unit. There her sputum was taken for examination and she was tested positive to TB. She was put on DOTS treatment on 23/09/09. Her weight at that time was 21 kilograms. Pediatric drugs PC 13 and PC 14 were started. Initially when she was put on the medication, she used to vomit. She was given several doses of antacids. After one month of medication her condition had improved significantly. In one month, her weight has increased from 21 kilograms to 24 kilograms. The smile on her face returned. Dr P V Ranganadha Rao asked Chandni what she would like to be in the future,
she said - ”I want to be a teacher"
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