TB: Return of the Plague. BBC 4 9pm written and directed by Jezza Neuman

Tuberculosis is something we don’t really need to worry about here in the West. We used to get inoculated against it at secondary school and it was a rite of passage about how big the needle was how little it hurt (ouch, ouch). There was a little BCG stamp on your shoulder that showed you were a real man, and women could be real men too, with the same little stamp on their shoulder. Tuberculosis was a thing of the past associated with tenement buildings, and writers and poets sloping off to pen their last notes in sanatoriums.  Like the great flu epidemic of 1919 that killed more than those involved in the First World War it is remembered and forgotten at the same time. But TB remains the second most common cause of death from infectious disease.

          Last year there was an article in The Observer Magazine about the return of TB, a new and aggressive strain that was killing homeless people in New York. The modus operandi is a simple one and it applies equally in Swaziland were this film was made. The TB victim becomes infected. They spread the disease by coughing, sneezing, droplets in the air we breathe. In planes, of course, it’s all recycled air. The victim feels better and stops taking their medication. TB returns in a new and attenuated form. Conventional treatments, that worked fifty or seventy years ago, are no longer effective. TB has mutated into a new and more pathological form.

          In Swaziland it’s a national emergency. A quarter of adults have HIV, which has a stigma no one wants to admit to and TB has associated connotations. Bhekki, for example, is a football fanatic who works a builder and has TB. We watch him over a year degenerate and complain and threaten suicide. He needs to take ten tablets every day. The cure can be worse than the sickness. His sister also has TB. She loses so much weight from vomiting they have to stop giving her medication. She dies and we watch Bhekki helping to dig her grave and bury her.

          Nokubegha is a twelve-year-old orphan and has TB. It is likely she got it from her mother, who died of the disease. Her seventeen-year-old brother who cares for her does not have the disease initially helps care for her. But the risk of her infecting him is too great and she’s moved to the National TB hospital where she can receive her treatment and injections every day. The hospital sign says its open twenty-four hours a day. But there are only so many beds. Treatment can take two to three years for adults. We watch as it proves ineffective and patients die. Some commit suicide rather that carry on with the cure. Two care staff, even with the protocols in place, also become infected. Nokubegha is a success. After six months she is no longer infectious and is allowed to continue her treatment outside the hospital. The Return of the Plague is a wake-up call to us in the West.

http://www.bbc.co.uk/programmes/b03qljf1