Theme | Quote |
Impact of TB-related financial hardship on participants and households | |
Reduced standard of living | ‘Since the time I was diagnosed with TB until now, I am staying in a bad looking house, with bad sleeping environment along with bad food’ (female participant, 39 yrs ‘As [name of participant] hasn’t been able to find work since he completed his treatment, the family had to move up the hill, where housing is cheaper. They also had to sell most of their furniture. There was only a mat on the floor, a little stool and a couple of mugs for a family of four…Another interesting observation we made relates to his relocation. Moving to cheaper accommodation on top of the hill means that he leaves the house less, as physical exercise remains a big challenge for him. This in turn limits his occupational activities and affects his health seeking behavior’ (Research Assistant, relating to male participant, 32 yrs) |
Anxiety around debt and financial insecurity | ‘I never used to have financial difficulties. Now, my business is just so small with borrowed capital and the creditors keep coming to my house, saying they want their money. If I fail to pay, there will be bigger interest. I have been in debts ever since I completed the treatment’(female participant, 29 yrs) ‘Now, I am not having anything to eat and sometimes I don’t have money to pay for rent. For example, I haven’t paid rent yet. In the past, before I became sick, I could pay rent in advance’ (male participant, 34 yrs) |
‘I have been facing financial challenges, lack of food and so on. In 2016, my girl failed to write her form two exams, due to lack of schooling that I couldn’t pay for. So, I have faced so many difficulties from the time that I was diagnosed with TB until now’ (female participant, 39 yrs) ‘I used to sell our house equipment to sustain my family. So, we sold our TV and some small items. Others who could help us were living far from us and they can’t just be helping you every day. Our children stopped going to school, so we had to sell whatever household equipment we had to sustain our living’ (male participant, 32 yrs) | |
Dependence on others | ‘As of now, I have difficulties to get food, but I do try my level best to hunt for money to buy the food. My family supports me since I’ve completed treatment. Whenever I say that I don’t have money to pay rental expenses and to buy food, they do send me the money’ (female participant, 27 yrs) |
Loss of social standing | ‘While I was sick and during the time when I completed my treatment people were not respecting me, but people were respecting me before I became unwell with TB. I think this is because I lost my income, and my family helps me. When you have money, people tend to respect you’ (male participant, 34 yrs) ‘He feels, once you have money, you have so much power and you can tell your employees what to do. In his case, his employees overtook power while he got sick, which still affects him’ (Research Assistant, relating to a male participant, 34 yrs) When asked about how the income loss affects life: ‘It has affected me a lot. I just feel depressed and sometimes I wonder if I am the same person’. (male participant, 18 yrs) |
Barriers to income recovery | |
Ongoing physical morbidity | ‘There are so many problems, I am facing these days because everything needs money… I still need to work, so I do some piece work, whether it means that I am still feeling pain, but I do work in order to get money to help myself…. The most important thing is to get money, so if you don’t work then you have to do business in order to maintain your health and to fulfil your needs’ (male participant, 37 yrs) |
Stigma | ‘My boss said that I should wait at home during treatment…My boss accepted my TB diagnosis, but she didn’t want me back after I completed’ (female participant, 42 yrs) ‘I went back to my work, but my boss discriminated against me and he told me that he wouldn’t be helping me anymore financially, so I am just staying here at home’ (male participant, 32 yrs) ‘They [colleagues] would be surprised to see my work performance, which was dropping as I could sometimes work well one day and sometimes, I could not work well …they were saying that it was AIDS’ (male participant, 18 yrs) ‘The wife of the participant told us that she sells food items in front of the house and noted that some people don’t want to buy from her, because they know that her husband is sick’ (Research Assistant, relating to male participant, 32 yrs) |
Loss of social and work relationships | ‘Our customers really had forgotten us, so I think it will take time for me to grow the business again’ (male participant, 33 yrs) |
Lack of capital for reinvestment | ‘My life has changed now …I have little capital … I don’t do hard work now, so my employees help me do business. My business isn’t the way it was before, because some of my business centers are closed now, I stopped selling Irish potatoes, I closed my take-away shops and I only have one bench of chips’ (male participant, 48 yrs) ‘The TB symptoms affected my business so much, to the extent that it went down up to date and it’s not at all growing, though I was cured…My husband cannot even afford to give me MK 20,000.00 to start up a new business. I went to borrow money from someone on interest, but I haven’t paid the person back. The capital you have determines what kind of business one engages in. So, instead of starting up a business with the little money borrowed, you start buying maize to feed children at home’ (female participant, 39 yrs) |
TB, tuberculosis.