acknowledgements

This story book has been written by Dr Alka Aggarwal Singhwith Astha Singh , illustrated by Anupama Singh andproduced by Media Workshop India Pvt Ltd

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This is the story ofKuchi and her friends.Kuchi studies in classfive and is good instudies, but that isbecause she paysattention in class. Whatshe really loves is tohave fun and hangaround with her friends.

And boy, what a bunchthey are. Quite a mix.

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Then there is Ali, thecricketer who is famousfor being naughty.

First there is Badri, thebookworm, who is famousfor making formulae.

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Then, Sunil, the ‘mummy’ whois famous for being a singer’sbrother. (He is called mummybecause he stays mum mostof the time! And perhapsalso because he is full ofwisdom — like a mummy. Buthe doesn’t hesitate to speakif required.)

Then, there is Chehek thepilot, who loves cycling. She

is an expert at flyingpaper aeroplanes in theclass. If the teachercatches her, shegets turned out ofthe class. Then

she startssearching foraeroplanes in the sky!

The five are great friends. They study in the same classand play together in the evening. Kuchi also has a sixthfriend– a special one, who usually comes to meet her inthe night. This special friend is a secret. No one knowsabout her, but you will get to know in a while. 3

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It was like any other day inschool. Kuchi came in to seethat Ali had come early toplay cricket in the schoolplayground. He was battingand was talking loudly as usual.

And then his ballhit one window.Quite expectedfrom Ali. Yet again,he was taken tothe principal’soffice and then…ooof …the usualstuff.

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Badri was in class trying tofinish off his comic.Sunil was again tellingstories of his sister’sstage performance.

Only Chehek, the pilothadn’t come. The classroomwas so clean without her.

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But the otherfour missedher.

They did notsee her in theevening attheir usualplace.

“Somethingmust be wrong,”they thought.

All fourdecided to goto her house tofind out.

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Chehek was at the door. “Whathappened? Why did you not come toschool today?” asked Kuchi. Cheheklooked sad. “Mom is not well. Icouldn’t get ready in time for school.She could not even make breakfasttoday…”

Just as Chehek said this, they hearda sound of someone coughing inside.

“But, what happened to yourmother?” asked Sunil. Chehekcontinued to be quiet and sad.

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He persisted, “Why are youquiet? Tell us what happened toyour mother?” Then Chehekreplied, “Papa has asked me notto tell anyone.” Ali wouldn’t buythat. “Anyone means everyoneexcept friends. You got to tellyour friends. We promise not totell anyone else”.

Chehek gave in. “I overheardPapa tell Grandma that Mom hasprobably got TB. That’s when Igot to know that her brotherhad also died of TB. He used tocough blood.”

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Badri asked, “Does your motheralso cough?” “Yes, mom has beencoughing for a long time andtoday morning she even coughedblood”. Chehek started crying.“Papa was saying he will send meto my aunt’s house”. No oneknew how to console her. Justthen the door opened andChehek’s father called for her.“Chehek!” Again they heard thecough. “Khon-khon”. Chehekwent inside.

The friendsreturned,very sad.

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That night, in her bed, Kuchi satthinking. “All of us will missChehek. She too will be sad togo. More than that, what willshe do without her mother? Willher mother really die?”

Just then Kuchi’s special friendappeared: Mishti fairy. Mishtiknows magic. She keeps playingmagic tricks and Kuchi has somuch fun.

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As soon as she came that night shereached out for Kuchi’s toys.She tookout Bo-Bo the bear’s ears and put it onMolly the doll and gave Molly’s ears toBo-Bo. Molly looked funnywith her big andhairy ears andBo-Bo lookedequallyhilarious.

Kuchi would havelaughed on anyother day but notthat day.

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Mishti tried again. She took out Kutta the dog’stail and put it in Biggie the elephant’s ear. Shehid the dog and said to Kuchi, “See Kuchi, Biggiewas not listening to Kutta so Kutta jumped intohis ears. Only his tail is left hanging outside”.Kuchi did not laugh.

Kuchi broke her silence.“Chehek’s mother is notwell. She probably has TB.Chehek’s father is going tosend her to her aunt’shouse. And her mother isgoing to live for only a few

days”. Mishti appearedquite unperturbed

on hearing this.“Don’t worry,Kuchi. TB iscurable”. Kuchididn’t seem tobelieve. “Kuchi,haven’t youheard ofDOTS?”

Now Mishti was concerned.“Is something on your mindKuchi? What’s up?”

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“Well, whatis DOTS?”asked Kuchi.

“Oh, I hear of TB and DOTS in so many countriesacross the world. Even in your country, DOTS isavailable. You can go and ask in any governmenthealth center about DOTS.” Kuchi tried toabsorb all this. Mishti continued, “….but I willtell you this - TB has a definite cure. Chehek’smother will be fine”.

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Kuchi started thinking:‘There is a governmentdispensary on the wayto school. Surely theywill have informationon DOTS’. She wasrelieved. She smiledand started playing.She tried to pullKutta’s tail fromBiggie’s ear, but it wasstuck fast. Instead,Kutta jumped out fromthe other ear. He thentook Biggie’s tail andwent away. Poor Biggiewas left standingwithout a tail. He ofcourse had Kutta’s tailhanging from his ear.Kuchi laughed and sodid Mishti.

Finally it was time for Mishti togo. “Time for me to go Kuchi,but don’t be sad. Tell Chehekalso not to worry. TB hasa definite cure. Go andfind out about DOTS.”

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“We can findout about

DOTS fromthe

governmentdispensary”.

Ali, thecricketer said

withcharacteristic

loudness, “Wow!You’ve hit a sixer Kuchi.

Let’s go today afterschool”

All four found it difficult toconcentrate on studies.

Next day, in school, Kuchi couldn’t wait to tellthe others. During the break, finally when theyhad an opportunity to be together without

the fear of being overheard byanyone, Kuchi told Ali,

Sunil and Badri thatTB has a definite

cure and thatis DOTS.

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When school was finallyover, they ran withtheir bags. On theway, Badri startedthinking aloud,“Who will we talkto in thedispensary?”

At first everyone was quiet. They lookedat each other. Ali broke the silence, “Letus see who we meet there.” It was good tohave someone with that much confidence.

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The first person theymet in the dispensarywas a nurse. Shelooked a little stern.“What do you kidswant?” she asked. Notwanting to annoy her,Ali and Badri spokequickly.

Ali gushed, “TB!” andso did Badri, “DOTS!”

She was a littlesurprised, but askedsoftly, “Does someoneyou know have TB?”“Our friend’s mother,”said Kuchi. “You cansend her here.” Andwith that the nursestarted to go away.But Ali still had onequestion. “Will she getwell again?”

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The Nurse replied,“We use DOTShere – a definite cure for TB”.

The children were delighted to hearthis. They had reached the rightplace! And that brought morequestions.

Kuchi asked, “What is DOTS?”

The nurse was quite surprised withthe questions. “Why are you kidsasking so many questions?”

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The nurse began to understand.“Hmmm….So, that is what is botheringyou. Let’s go into this room and talk.”She led them into a small corner roomin the dispensary. Ali looked around andsolemnly pointed to the various bottlesand jars on the shelves. The dispensaryhad taken away some of his loudness.They all pulled chairs and sat down.Now the nurse started askingquestions. “What exactly has happenedto your friend’s mother? How do youknow she has TB?”

Sunil who had been mumtill now spoke at last.“Our friend is afraidthat her mother willget seriously ill and shewill have to go to heraunt’s house.”

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The nurse was concerned. “Oh! Sheshould surely be examined for TB.You people were right in coming here.Anyone with cough for 3 weeksshould get examined for TB”.

Badri, the bookworm asked, “Howdoes one get examined for TB?”

“That is simple. The sputum thatcomes out with cough is examined.And it is examined 3 times,”answered the nurse.

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Sunil said,“She has cough forquite some time and now shehas started coughing blood”.

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Badri repeated again. “3 weekscough = 3 sputum examinations over 2 days.”

Ali had to tease Badri now. “Badri, does this looklike a maths formula to you?” Kuchi did not havepatience with them. “Please tell us about thetreatment also.” The nurse was quite amused. “Havesome patience. I will tell you everything. You arestudents. Don’t you want to know the complete

formula?” So saying she smiledat everyone and they alllaughed.

Slowly Badri repeated after her, “Coughfor 3 weeks means 3 sputumexaminations.”

The Nurse was quite impressed with hisintelligent questions and with the way hewas trying to learn up all the answers.“Yes, that is right. And 3 sputumexaminations are done over 2 days.”

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Ali had more questions, “I was going to ask you how do youfind out that a person has TB by examining his sputum.”

The nurse explained, “TB is caused by a bacteria. If aperson with TB has cough, then the TB-bacteria can comeout in his sputum. So when we examine the sputum underthe microscope and if we see TB bacteria, it means thecough is because of TB. Now isn’t that smart and simple.”

Ali couldn’t resist another question, “The same microscopethat we have in school?” “Yes, of course, that samemicroscope that helps us in seeing very small things,” thenurse said, amused.

Sunil, the wise mummy, had been following each word verycarefully. He asked a very pertinent question. “You saidthat if a person with TB has cough… Does that mean TB canbe without cough also?”

Nurse was impressed again. “You kids ask clever questions.It is true that a person can suffer from TB without havingcough – for example, if TB is of joints, glands etc. But mostTB causes cough, as it mostly affects the lungs.”

Kuchi was the most practical of them all. She wanted toknow what was to be done for Chehek’s mother. She asked,“So shall we tell our friend’s mother to get 3 sputumexaminations done?”

“Yes, definitely,” said the nurse

Kuchi asked,“And if you see TB-bacteria in her sputum…?”22

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“If we see the TB-bacteria in hersputum, we will put her ontreatment.” She paused andadded, “If we don’t see the TB-bacteria, we will give her someother medicines. If she stilldoesn’t get well, then we will getan X-Ray of her chest.”

Now Badri asked,“Can’t we do theX-Ray first?”

Nurse smiled, “No, my dearmathematician! Follow the formula- cough for 3 weeks should beexamined with 3 sputumexaminations. Sputum examinationshows you the TB bacteria. Doingsputum examination is smart andsimple”.

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Ali now had something more totease Badri about, “Badri, don’tforget your own formula.”

Kuchi had toadmonish him.“Stop teasinghim.”

“Yes, stopteasing him.Kuchi wants tohear about thetreatment,”said the nurse.

She hadguessed right,for Kuchi said,“Yes, please.”

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Nurse continued. “Treatment is easy. Few things should beremembered. Treatment is for at least 6 months and thattoo without interruption.

Ali exclaimed,“6 months!”

Badri too was surprised, “Half a year!”

Nurse just shrugged her shoulders, “What of 6 months- itis a definite cure.”

Kuchi was thinking of Chehek’s mother.She said, “If it is a definite cure and saves life, then 6months of treatment is worth it.”

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Nurse resumed, “Treatment for TB has to be for a minimumof 6 months – without interruption.” Turning to Badri, sheasked, “So now, our mathematician, has the formula gonefurther?” Badri was only too eager. “3 weeks cough = 3sputum examinations over 2 days. If TB is confirmed, thentreatment is for at least 6 months without interruption.”

Nurse had taken over the role of teacher and was verypleased that her students were doing so well in her class inthe dispensary. “Great! There are some other thingsregarding treatment. The medicine has to be taken in frontof a health worker or a volunteer.”

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Sunil asked, “Why is the medicine to betaken in front of someone?”

Nurse explained, “Remember, the medicinehas to be taken for at least 6 months. Thereis a chance the patient will forget to takemedicines. Moreover, after a few days oftreatment, the patient starts feeling welland then the chances of forgetting to takethe medicines increases. Patients often stoptheir medicines altogether. And stoppingtreatment mid-way makes TB worse. So theworker helps the patient take medicines forthe required time”.

But what Kuchi wanted to know was “Who willhelp Chehek’s mother?”

The Nurse said, “I see. Your friend’s name isChehek.”

Kuchi really regretted it. She told the nurse,“Oh, please don’t tell anyone. She hadforbidden us to tell others. Her father willget very angry with her.”

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Nurse reassured them, “Alright. Iwill keep your secret,” she saidwith a wink. “Where does she live?How far is her house from here?”

Ali said, “It’s not far. It’s near.”

The Nurse continued, “ThenChehek’s mother can come to thisdispensary to have her medicines.”

Sunil couldn’t believe it. “You mean she can haveher medicines in front of you? You will help her incompleting her treatment?”

Nurse asked smilingly, “Isn’t that a good idea?”

Ali spoke, “No its not good…..”

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Everyone looked at him incredulously. But Alihad more coming. “No it’s not a good idea. Itis an excellent idea.” Everyone had to laugh atAli. He could be really naughty. Just then aman peeped into the room and greeted thenurse.

Nurse asked him “How are you Ravi? Did youcollect your sputum examination report?” Ravilooked very cheerful. He said with a chuckle,“There are no more TB bacteria in mysputum.”

The Nurse turned to the children and said,“Ravi has completed 6 months of treatment.To make sure that he is cured, we tested hissputum again for bacteria”. Ravi added ratherproudly, “And the bacteria have disappeared.”

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Sunil said to the nurse admiringly, “You do make surethat the treatment is successful.”

Ali answered him. “Didn’t she say in the beginning that itis a definite cure”.

Ravi joined in. He too pulled a chair. “It is indeed adefinite cure. Look at me. Can anyone guess I had TB?”

All children had been rather surprised to know that hehad TB. He seemed quite healthy. “No. No way.”

Badri said, “Meaning zero money.”

Ravi smiled, “DOTS is adefinite cure for TB andthat too free.”

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Kuchi asked, “But what exactly is DOTS?

Nurse replied, “All that we talked is DOTS. DOTS is the strategy for diagnosis and treatment of TB.”

3 sputumexaminationsover 2 days.

So thenDOTS means…3weeks of cough

should beexaminedfor TB.

Treatment is tobe taken for atleast 6 months –

withoutinterruption.

Medicineshave to be

taken in frontof someone.

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Nurse was happy. “Great. You kids have got itabsolutely right.”

Kuchi asked, “One last question please. Does TBspread from one patient to another? FirstChehek’s uncle had it. Now her mother has TB.”

Nurse had an answer to that too. “Well kids, thebacteria that the TB patient coughs out can bebreathed in by another person. These bacteriacan then cause TB in this second person.Therefore, it is important that a person withcough of 3 weeks gets sputum examination doneearly and is started on treatment early so thatthe bacteria disappear fast. Second, whilecoughing, the mouth should be covered withcloth. That is good manners also, isn’t it?”

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Finally all questions were answered & Kuchi said,“Thank you somuch. It seems certain that Chehek’s mother will also get well.”

Nurse smiled, “You can tell Chehek’s mother to come and meetme. My name is Leela.”

All the children thanked her. “Now, our friend will not have to goto her aunt’s house. We will all be together,” saying this they

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As soon as they come out, Sunil said, “Let’s go straight toChehek’s house and give her the good news.” Said Ali,“Yes, let’s tell her we will continue to have fun.”

Sunil reminded him, “Don’t forget heraeroplanes will continue to land on yourcricket pitch and spoil it.” But Ali didn’tseem to mind today, “That’s OK as long asshe stays with us.” Badri couldn’t let go ofhis turn to tease Ali. “You mean you won’t fight withher if her aeroplanes land on your cricket pitch?”

Everyone laughed. It seemed such a nice day.

came out of the dispensary. They had already taken too much of her timeand her patients were waiting.

Ali said,“No, I swear, I won’t fight with heranymore for that.” But they all should haveknown better, for he added, “I shall fight oversomething else”.

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They reached Chehek’s house. Her father opened the door.Even Sunil, the mummy, couldn’t contain his excitement. “Uncle, wefound a definite cure.” He was most surprised to hear this. He waswondering what Sunil was talking about. Chehek had also come out onhearing their voices. She quickly realized that they were talking abouther mother’s TB. She guessed something was up. Her father askedSunil to repeat what he was saying.

Kuchi came to rescue the situation. “Uncle, we found adefinite cure for TB”. Soon Ali & Badri gushed.

“Uncle, DOTS!”

“Uncle, it is a 6 months formula.”

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Sunil tried to save the situation. “Uncle, please don’t getangry. Nurse Leela in the dispensary told us about TB. Shesaid she will help Chehek’s mother also.”

Badri added, “And with zero money.” Sometimes Badri gotso carried away with his formulae that he quite forgot thatadults don’t go to school any more and are not so good withformulae. Ali had to help, “He means for free.”

Surprise had still not left Chehek’s father: “Who told youChehek’s mother has TB?” Chehek’s face paled. She fearedher father would get angry with her for telling herfriends. Kuchi was smart though. “Uncle anyone with coughfor 3 weeks or more should get investigated for TB. Weheard her cough the other day we were here.”

Chehek’s father smiled. He knew the children were tryingto cover up. And, of course, he guessed who told themwhat. He ran his hand over Chehek’s head and said: “Yourfriends are naughty, but good. They are concerned aboutyou.” Turning to the children, he said, “Thank you kids. Weshall go to the dispensary tomorrow.”

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The next time Mishti fairy came, Kuchi hugged herwith delight. “Mishti, Chehek is staying here. You dida wonderful thing by telling me about DOTS. Hermother is improving.”

Mishti only smiled. She said very knowingly, “DOTS isa definite cure for TB.”

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Kuchi said, “I think I will start calling you DOTSfairy”. Both laughed. They had lots of fun that nightwith Bo-bo the bear, Biggie the elephant, Kutta thedog and Molly the doll.

At school too, all five friends are together again…..

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They continuewith their pranksand have fun. And ifthey see anyone coughing,they ask if the cough is for3 weeks or more and then youcan see them advising aboutsputum examination, treatmentunder observationand DOTS.

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They have become TB experts ofthe school. What about you?

World Health OrganizationRegional Office for South-East Asia

TB UnitDepartment of Communicable DiseasesWorld Health House, Indraprastha EstateNew Delhi-110 002, IndiaTel: 2337 0804-2337 0809, Fax: 91-11-2337 0197, 2337 9395http:/www.searo.who.int/tb