Champa and Rekha: Fighting Tuberculosis Through Fear and Floods in Bangladesh

By The Global Fund

March 17^th, 2025

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It started raining mid-morning – a light drizzle.

Community health worker Champa Tidakar was prepared. She'd heard there would be a huge storm.

Together with her husband, father-in-law, teenage son and young daughter, she gathered some non-perishable food. They built a barrier around their home and Champa moved a few precious items – including her stock of tuberculosis (TB) medicine – to a high shelf.

“Have you ever seen a storm so fierce that it felt like it was coming from all sides?” Champa asks. “You hear the roar of water and feel the strong winds...people grab their children and run as fast as they can – my body is still shaking to describe it.”

The water kept rising. The walls of her home – made of soil and packed earth – started to collapse. Health facilities in the community also flooded rapidly. Government health workers scrambled to save medications, equipment and medical records.

By 2 pm, Champa's home – and her gardens, farmland and neighborhood – was destroyed.

Cyclone Remal tore through Bangladesh in spring 2024, with winds rising to 111 kilometers per hour and heavy rainfall causing up to eight feet of flooding in places including Champa's home: Fulbari village in Khulna district.

More than 800,000 people were displaced across the country.

In Fulbari, Champa's home was one of the first to fall.

Rekha Goldar, her friend and neighbor, lives on higher ground. She and her husband rushed over with supplies and helped Champa to a nearby primary school where they took shelter together. “Everyone was scared,” says Rekha.

One of Champa's first thoughts when the cyclone hit was: Save the medicine. She knew the floods would bring incredible hardship – she would not let her community suffer even more.

Champa and Rekha: Fighting Tuberculosis Through Fear and Floods in Bangladesh

Champa is a community health worker with Global Fund partner BRAC. She and her colleagues, who work closely with the government's National TB Control program as well as other nongovernmental organizations, are vital to Bangladesh's community-based TB prevention, response and treatment program.

With help from her neighbors, Champa rescued the TB medicine for her patients from the floodwaters. Rekha looked on as Champa cared for patients, sheltered alongside them and waded through waist-high water to deliver TB medicine to a neighbor.

For 15 days, the community huddled together – sharing food, caring for the sick and wondering about the future. “We all worked together,” Rekha says. “That's all we had to survive.”

Just a few months after Cyclone Remal, another catastrophe: Heavy seasonal rains led to further flooding, compounding damage caused by the cyclone.

Again, Champa, Rekha, local leaders and the community came together to rebuild. Soon after, Rekha's head started to ache, and she had an unrelenting cough.

Champa collected a sputum sample from Rekha and brought it to a government health facility, where the sample was tested, and TB was confirmed. Doctors initiated Rekha's TB treatment and assigned Champa to be her health worker to support her treatment adherence. They also ensured Champa had medications for Rekha − all of these lifesaving services were provided free of charge.

State-of-the art GeneXpert technology is used at the government's Batiaghata Upazila Health Complex in Khulna District to diagnose for TB cases.

At first, Rekha was scared – but immediately after the initial diagnosis, she received counseling at the local health facility. Rekha also visits Champa every day to collect and take her TB medicine.

“She comforts me, she says everything will be alright,” Rekha says.

Bangladesh has the seventh-highest TB burden in the world, but the country’s response has been consistent and robust. This is thanks in large part to the government’s free-of-cost TB diagnosis and treatment services as well as the tireless efforts of community health workers supported by the government and BRAC.

These community health workers – people like Champa – teach their communities to recognize TB symptoms, collect sputum samples for testing and support patients throughout their treatment. They are the bridge connecting people from the most remote communities, whose access to health services is limited at the best of times, to lifesaving health care.

The Global Fund has supported this work for more than two decades – and it is paying off.

Since 2002, the TB case detection rate in Bangladesh has nearly tripled. Every year for the last five years, about 300,000 people were treated for TB, and for the last decade 95% of people who have been put on TB treatment have recovered from the disease – a standout in the region.

But overlapping and intensifying crises put all of this incredible progress at risk.

People living in remote and rural areas like Fulbari feel the immediate, punishing impacts of extreme weather events most acutely – and have fewer resources to cope. Often, disease outbreaks occur following storms like Cyclone Remal, and the results can be catastrophic for people in the community and beyond.

In October 2024, the Global Fund approved US$1.06 million to fortify and sustain health services in two districts in Bangladesh still recovering from multiple disasters. This was followed by an additional US$7.5 million to support projects designed to build stronger health systems that are more resilient to the devastating health consequences of extreme weather events.

The Global Fund’s rapid, flexible emergency funding helps ensure quality health care is accessible to all – and that gains made fighting deadly diseases aren’t lost, even when disaster strikes.

Reduced investments in the fight against TB could lead to widespread disruptions in activities fighting the disease in high-burden countries, including Bangladesh. Gaps in service delivery, diagnosis and treatment adherence could lead to TB spreading.