An Indian superhero in the fight against TB


Cough-detecting Indian superhero Bulgam Bhai in action

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Tuberculosis is the biggest single infectious cause of death in the world. In 2012, Indian superhero Bulgam Bhai joined the fight against it. 

The superhero was unveiled to India's media in February 2012. Bulgam Bhai appeared out of nowhere when the master of ceremonies started coughing. He advised her that if she had been coughing for two weeks then she should go and get her sputum tested.

But who is Bulgam Bhai?

He's not muscular, can't see through walls and doesn't have a cape. Instead Bulgam Bhai is a little overweight, wears a stripy suit with a bow tie and has grown a curly moustache.

But Bulgam Bhai also has a cough-detecting gadget. When someone coughs, wherever they are, he appears out of nowhere. The superhero, whose Hindi name translates into 'Mr Sputum' in English, pesters people to get their sputum – saliva mixed with mucus – tested for the disease.

He asks people if they have been coughing for two weeks. If they have, he informs them that the cough could be TB and urges them to get a test.

Hardest hit

Tuberculosis, or TB, is an infectious disease caused by mycobacteria. It is spread through the air when people cough or sneeze and usually affects the lungs.

In India there are about 1.8 million new cases of TB reported annually. The disease accounts for over 1,000 deaths a day in India alone. This is the highest rate in the world and one in five new cases across the world occurs in India. New strains of the infection are drug resistant.

Research carried out by Population Services International (PSI) looked at reasons people didn't go to the doctors when they had symptoms. Instead of getting their sputum tested, carriers were ignoring the cough, using home remedies or were just unaware that a testing service was available.

This insight shaped BBC Media Action's work to drive home the message that if you have been coughing for two weeks, you should get tested for TB.

Popping up everywhere

The aim of the project was to increase the number of people going for sputum testing.

The target audience was broad. It included men and women from the ages of 15 to 54 from rural and urban areas. This was reflected in the TV advert. Bulgam Bhai pops up in a scooter driver's sidecar, in a sculptor's workshop, in a housewife's wardrobe and underneath the vegetables on a market trader's stall.

And Bulgam Bhai also appeared everywhere, with the project using a multiplatform approach to drive home the message. A radio drama gave Bulgam Bhai his very own 'agony aunt' slot, for people to call in with their problems. As the plot unravels, it becomes clear that each problem is caused by a two-week-old cough.

Interpersonal communication toolkits, games and street theatre scripts were also part of Bulgam Bhai's superpowers.

The adverts formed part of Project Axshya, funded by The Global Fund, whose partners included the Government of India's Central TB Division, the International Union Against Tuberculosis and Lung Disease, Population Services International and the charity World Vision.

Despite India’s significant economic progress, around 90% of the country’s workers still work, unregulated, in the informal sector
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