Mr. Sputum, Public Health Superhero, Fights TB in India

PATNA, India – Perched high on a rooftop amid the pollution and noise of a vibrant Indian city, a new kind of superhero listens for signs of the enemy.

His ears tuned to an array of elaborately curved trumpets, Bulgam Bhai strains to hear the ever-present danger and then pounces. When an Indian coughs, this jocular public health avenger — all candy stripes and waxed mustache –- appears in a flash with a potentially life-saving question:

“Has it been two weeks?”

A persistent cough of more than two weeks can indicate tuberculosis. An estimated 330,000 Indians die each year from TB, according to the World Health Organization, and more than 2 million become infected.

Bulgam Bhai –- his appetizing name means Mr. Sputum in Hindi –- is part of a delightful public service campaign to convince more Indians to visit a clinic or lab if their coughs turn pernicious.

Most cases of tuberculosis are easily curable. Bulgam Bhai’s goal is to spread word f the ready availability of testing and treatment, says Dr. Sarabjit Chadha, project director at Project Axshya which created the engaging superhero. (Project Axshya is part of the International Union Against Tuberculosis and Lung Disease.)

The Bulgam Bhai campaign ran on television and radio in 300 districts of 21 Indian states between February and March, with a potential audience of 234 million people, and was restarted again in July. A nationwide toll-free helpline received more than 1,600 calls during the ad’s first 30 days on the air.

“The campaign was primarily focused on creating awareness about symptoms of TB (i.e. 2 weeks of cough) and the call for action (sputum examination) in the community,” Dr. Chadha said via email. “Preliminary findings suggest that the campaign has been able to achieve the viewership. The response on the advert from the community including physicians has been extremely positive and encouraging.”

India needs more such campaigns, which harness to the public good the infectious humor and imagination of an advertising industry that’s usually devoted to selling products like cars and — much less delightfully — skin-whitening cream.

Bulgam Bhai couldn’t come at a better time.

Even as tuberculosis rates are falling in India and across most of the world, Indian doctors this year announced the first cases of a TB strain that is totally resistant to all antibiotic treatment. Government officials first denied these reports, the Wall Street Journal reported last month, and later – quietly – confirmed them.



Meet the Author
Dan Morrison is a contributor to National Geographic Voices. From 2007 to 2012 he reported for National Geographic News from South Asia, Africa, and the Middle East, filing dispatches on climate change, conflict, the environment, and antiquities. Dan is author of The Black Nile , a nonfiction account of his 3,600-mile journey down the length of the White Nile through Uganda, Sudan, and Egypt. The Daily Beast called The Black Nile "a masterful narrative of investigative reportage, travel writing, and contemporary history," and The Village Voice named it one of the Ten Best of 2010. Dan was a 2013 United Nations Foundation Global Health Fellow. Currently at work on a book about the Ganges River, Dan also contributes to the New York Times, POLITICO Magazine, Slate, The Arabist Network and the Dhaka Tribune. To contact Dan please see his website.