Frontline Issues and the Role of Community Health Workers (unsung heroes) in Thar Desert of India

This article describes community involvement as an effective way to combat Tuberculosis (TB), which is taking the lead in disease mortality rates in the Thar Desert of India. The article describes the patients, their families, and villagers as the experts when it comes to understand TB and how it affects
their lives. According to author Evelyn Harvey, education, motivation and empowerment are
key to community health workers.

The article describes that the villages at the frontline of TB care are located where the rural health
infrastructure has never been brought to full capacity, where the vacancies and absentee rates among doctors and technical staff runs high, and where there's the "sheer physical difficulty" of working conditions. The majority of individuals with TB in this region do not attend the clinic as required. Traveling is described as "prohibitively expensive" and in some cases travel can be up to 30km over the rough terrain. For a sick patient, the walk is too long. In a region described as having one of the highest illiteracy rates in India, some patients are described as not being able to take the drugs correctly because they can not read.

The article describes a number of local non-government organisations attempting to help. A group known as GRAVIS (Gramin Vikas Vigyan Samiti) operating in Jodhpur and Jaisalmer Districts seeks to offer assistance through a TB programme. It helps to train village health workers (VHWs) recruited from within the community. Their training includes
recognition of the signs and symptoms of TB, what to do, and the importance of continuing to take the medication. VHWs speak to patients "peer-to-peer" and share information and reassurance regarding treatment. VHWs are described as "bridging the gap" between the medical establishment and the community. They are further characterised as wishing to improve their community's wellbeing.