Cheeta Camp exists on the outskirts of Mumbai, the financial capital of India, where sunlight struggles to reach the ground due to densely packed housing and narrow lanes, and the skyline is made of tin and tarpaulin.
I entered Cheeta Camp as part of my fieldwork with a community-based organisation focused primarily on tuberculosis prevention and control. I quickly came to realise that tuberculosis in urban informal settlements like Cheeta Camp isn’t just a biomedical condition but a symptom of systemic neglect and social exclusion.
To understand why Cheeta Camp remains vulnerable to the disease, it is essential to know its origins. In 1976, 72000 people were forcefully displaced from Janata Colony and resettled to the marshy lands of Cheeta Camp to facilitate the construction of houses for the personnel of the Bhabha Atomic Research Centre (BARC) located close to the Janata Colony. According to a local leader, people were transported to Cheetah Camp in a lorry, with each family assigned a 10×10-foot patch to live on. For five years, residents faced challenges securing basic amenities such as water, electricity, roads and pavements, drainage systems, sanitation, a medical dispensary, a market, and transportation.
Each existing amenity in the area carries a story of struggle, protests, years of petitioning the state, and a significant amount of self-help. Unfortunately, the education of an entire generation of young children suffered due to this displacement.
India shoulders nearly a quarter of the world’s TB cases, about 2.8 million a year. Under the National Tuberculosis Elimination Programme (NTEP), the government’s flagship programme, the goal is to eliminate TB by 2025, a target five years ahead of the global deadline set by the World Health Organization. But on the ground, this vision feels more like an aspiration than a reality in urban informal settlements like Cheeta Camp. TB continues to thrive in Cheeta Camp because of overcrowded housing, poor ventilation, undernutrition, and unequal access to healthcare. These are not just health barriers, but structural ones.
During one of our home visits in Cheeta Camp, I met a 55-year-old woman who lived in a small, 10×10-foot room with her daughter and her paralysed husband. The space felt suffocating—there were no windows or natural light, and the air was thick with smoke from the chulha where she was cooking. They washed their utensils outside in a narrow gully that served as a drain..
Both the woman and her daughter were being treated for tuberculosis for the third time. Unable to work, her husband lay on a cot smoking a beedi. The daughter juggled college, multiple domestic jobs, and caring for her parents. Their lives revolved around survival, not recovery.
When I asked what they had eaten that morning, the woman replied, “Chai aur paav.” I told her that proper nutrition was essential for recovery from tuberculosis. She smiled tiredly and said, “Saare paise to inke ilaaj mein chale jaate hain” (All the money goes into his treatment).
This single sentence encapsulates what I frequently observed during my fieldwork: tuberculosis (TB) does not thrive in isolation but rather in the gaps created by poverty, gendered labour, and a lack of state support. In places like Cheeta Camp, illness is not merely a biological issue but fundamentally structural.
This experience highlighted a theoretical framework I had studied: the social determinants of health. These determinants refer to the conditions in which people are born, grow, live, work, and age, and they significantly influence the health outcomes of entire communities.
The high incidence of tuberculosis in Cheeta Camp can be attributed to several interconnected factors, including overcrowded living conditions, malnutrition, inadequate sanitation, and restricted access to healthcare services. These issues have developed over many years due to ongoing urban neglect and spatial segregation, often intersecting with complexities related to caste, class, and religious dynamics.
Complex social and political circumstances result in structural conditions that affect health inequalities.
The majority of the population of Cheeta Camp is Muslim. Since the post-Bombay violence, Muslims have been segregated and pushed to the edges of the city. The Sachar Committee Report, a ground-breaking government document that took stock of the extent of socio-economic marginalization of Muslims, has explicitly mentioned it in the document that, ‘fearing for their security, Muslims are increasingly resorting to living in ghettos across the country.’ Segregation of Muslims in urban India is thus increasingly perceived to be problematic, and commonly attributed to the state’s negligence towards this religious minority, prolonged histories of so-called ‘communal’ violence between religious groups, and resulting prejudices and security concerns. In contemporary times, the anti-Muslim rhetoric can be observed in the current governance.
The spatial segregation of Muslims in urban India, such as in Cheeta Camp, results in state neglect and unequal access to quality healthcare. In Cheeta Camp, the public healthcare infrastructure is minimal, private healthcare is unaffordable, and preventive care is nearly nonexistent, which contributes to the spread and persistence of tuberculosis.
During my fieldwork, I encountered several incidents that led me to conclude that tuberculosis disproportionately affects women residing in Cheeta Camp. One doctor from an organisation in the community working for TB prevention and treatment explained that women are more vulnerable to the disease. Since tuberculosis is an airborne illness and many women in the community spend their time in poorly ventilated homes, they have a higher susceptibility to the bacteria. Additionally, I encountered several instances where the patient had to conceal their condition due to the stigma around TB, which could impact marriage proposals.
In summary, tuberculosis should not be viewed as an isolated health issue; it is essential to consider the broader social determinants that influence its prevalence, including caste, class, gender, and religion. The current tendency to over-medicalise TB treatment highlights the need for a more comprehensive approach to care that goes beyond merely prescribing medication. Addressing structural factors such as socio-economic conditions, sanitation, housing, and public infrastructure is vital, especially in marginalised areas like Cheeta Camp that have faced systemic neglect.
If tuberculosis is a disease of poverty, then ending TB must begin with ending the conditions that keep people poor, unseen, and unheard.
Talha Tanweer is a Bachelor of Social Work (BSW) student at the Tata Institute of Social Sciences (TISS). He recently completed his fieldwork with PATH, a community-based organisation dedicated to tuberculosis prevention and care.
