Mita was seven years old. She had been out sick from our kindergarten program for over a week. When we went and checked on her, we decided it was time to take her to a hospital. A fever and lingering cough had left her weak. My husband literally carried her up the stairs to the pediatric department of the hospital.
The next day we got her diagnosis: active tuberculosis. We helped her get registered to receive the free cocktail of four antibiotics from the nearby government health clinic. Her mother faithfully helped Mita take her drugs for the next six months. She gained weight and recovered, and Mita is still alive and healthy today — now twelve years later!
Until encountering Mita, I naively thought tuberculosis (TB) was a disease of the past — or at least a disease of “somewhere else” or “someone else.” Now the deceptive veil had been lifted, and I learned over the course of the following months and years that TB is all-too common in the world today. It is especially common in Indonesia, the country with the second highest number of active TB cases in the world (India has the highest number). It seems like every family had an uncle, a grandma, a child, or a neighbor who had died from TB.
Tuberculosis showed up recently in my family’s bedtime reading. In Laura Ingalls Wilder’s By the Shores of Silver Lake, Pa helps a settler who is sick with “consumption.” The settler had moved out West for the “prairie cure” but was still skin-and-bones and needed to return East to his family for the winter. As I read to my two boys, I reflected on another book I had finished reading recently: Everything Is Tuberculosis by John Green. When Laura Ingalls Wilder penned her book in 1939, she still lived in a world where “consumption” was untreatable. Unfortunately, now a century after Laura’s book, we still live in a world where over a million people die of TB each year. How can this be?
In Everything is Tuberculosis, John Green shares the fascinating history of global TB. He also eloquently highlights the complexities and injustices that have allowed TB to still be the infectious disease that kills the most people every year.
Tuberculosis used to be believed to be a hereditary disease. In fact, for many centuries in Western societies, TB was partly glorified — it was thought to be a sign of intelligence and sophistication. Kings, artists, authors, and many famous people died of tuberculosis. It was not until 1882 that Dr. Robert Koch in Germany discovered that TB was a bacteria.
It took another sixty years until the first antibiotic was discovered that could help fight TB. And since the 1950s, most developed countries have been very successful at fighting TB. The combination of mobile x-ray clinics and treatment with four antibiotics effectively lowered the rates of TB in the USA by 90%. Now, most people in developed countries have the luxury of living with the illusion that TB is a thing of the past. Tragically, this is not true for the majority of people in the world.
Living in this slum community, where my family has made our home for the past thirteen years, I know this is true. I not only read facts about TB from a book about TB; I see the faces of students and their families. I remember friends whom we have successfully helped to receive TB treatment. I also remember the long lines, the heated conversations with doctors, and the devastating disappointments that were all wrapped up in trying to help people access TB treatment. Some people survived. Others stopped treatment and literally coughed themselves to death.
I found my voice joining in with the cry of John Green, “How can I accept a world where over a million people will die this year for want of a cure that has existed for nearly a century?” (page 191). Because now, tuberculosis is no longer considered a disease of intelligent artists — it is stereotyped as a disease of poverty. Green writes:
It is an illness of poverty that worsens poverty. It’s an illness that worsens other illnesses- from HIV to diabetes. It’s an illness of weak healthcare systems that weakens healthcare systems. It’s an illness of malnutrition that worsens malnutrition. And it’s an illness of the stigmatized that worsens stigmatization. In the face of all this, it’s easy to despair. TB doesn’t just flow through the meandering river of injustice; TB broadens and deepens that river. (page 195)
As I reflect on reading this book, it seems all too close to home. My own son has been coughing for months and months. We are on a medical quest to try to reach a diagnosis and effective treatment. I am very aware that many of my friends and neighbors have no such access to good medical treatment. And part of me cringes with the underlying fear that my own son might have TB.
As we await more tests and clarity, I cling to the truth that God is a healing God, who desires no one to suffer from tuberculosis or other illnesses. We live in a fallen world, a broken world. We all know this. We see brokenness all around us — in our friends, our co-workers, and in ourselves. And we see our physical bodies wearing down, getting older, fighting against viruses and bacteria that one day will be done away with.
Perhaps many of you reading this live in a country where you have encountered people who are sick with tuberculosis (see the top 10 countries here). Or perhaps you have never met someone fighting TB. My invitation to all of us is to educate ourselves about TB. Learn what the local government is doing (and not yet doing). Perhaps you could help train small groups in your community to look out for basic TB symptoms, (The CDC provides basic 101 TB education here.) Perhaps you could encourage a neighbor to get tested– or even accompany them along to the doctor to help advocate for them.
Additionally, as cross-cultural workers, do not forget to get checked for TB yourself. An IGRA blood test (also known as “TB-Spot”) can detect if you carry the bacteria. A chest x-ray can help catch active pulmonary cases. Even if you do not have any symptoms, it is good practice to get checked every couple of years if you think you have been exposed. TB can be “latent” in your body for years, causing no symptoms, but then become active at a later time.
There are many “Mitas” around us. Many people who are lacking the emotional (and financial) support to get the help they need to receive a TB diagnosis and start on life-saving drugs. Let’s work together to help make TB into a disease of history.
As John Green ends his book, he challenges his readers: “A preventable, curable infectious disease remains our deadliest. That’s the world we are currently choosing. But we can choose a different world. In fact, we will choose a different world. The world will be different a generation from now. The question is whether we will look back in gratitude at the virtuous cycles, or in horror at the vicious ones” (page 222).
Work Cited
Green, John. Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection. Large print edition. Crash Course Books, 2025.
For more information and resources, check out TB Fighters: https://tbfighters.org/
