Tuberculosis is one of the oldest diseases known to man and certainly one of the deadliest. Evidence of tuberculosis has been found in the skeletons of Egyptian mummies and in an Iron Age settlement in Dorset. Scientists estimate that in the past 400 years TB has killed some 2bn people worldwide, and disfigured, crippled and blinded countless more. It is not for nothing that the 17th-century English writer and preacher John Bunyan called TB ‘the captain of all these men of death’.
Spread like the common cold or flu by coughing and sneezing, the tubercle bacillus most commonly infects the lungs, slowly eating away at the spongy tissue essential for respiration and forming abscesses that discharge foul-smelling pus. However, the microbe spares no part of the human body and can also spill into the digestive tract, causing ulcerations of the throat and bloody diarrhoea, or into the bloodstream where it causes a condition known as milliary tuberculosis that can prove fatal to the kidneys, heart and other organs. If it crosses the blood-brain barrier, TB can also cause meningitis, coma and death.
More usually, however, Mycobacterium tuberculosis is a seductively slow assassin. Hippocrates labelled the disease phthisis – from the Greek term for ‘wasting’ – because of the way that patients under its influence seemed to gradually wither away, and even after Robert Koch’s groundbreaking isolation of the bacillus in 1882 doctors continued to refer to TB as ‘consumption’ well into the Twenties. At the height of the disease’s prevalence in the 18th and 19th centuries it claimed the lives of as many as 100,000 Britons every year. Prominent victims included John Keats, Emily Brontë and Robert Louis Stevenson – associations that gave it an aura of romance and poetry. However, for anyone who has witnessed the disease at close hand, there is nothing romantic about TB, and today it is back with a vengeance.
The World Health Organisation (WHO) estimates that every year TB kills 1.6m people – or one person every 18 seconds (by contrast, malaria is responsible for some 1m deaths worldwide, or roughly one person every 30 seconds). Although that is still short of the annual death toll from HIV/Aids (between 1.8m and 2.3m), separating the two diseases increasingly makes little sense. ‘If there’s a high population with HIV, then people are much more susceptible to the disease,’ explains Nachtwey.
To bring it back to a feminist perspective, TB itself was, in the late ’90s, “the leading infectious cause of death in women worldwide”, according to the World Health Organization.
You might also be interested in iZivisio.com, which recently laid out some of the gendered impacts of TB on women.