NEW DELHI - When Indian street-food seller Kumar Pal first began treatment for multi-drug resistant tuberculosis two years ago, he quickly spiralled into depression and gave up hope of living.
Weighing just 35 kg (77 lbs), shunned by his relatives and friends and in extreme pain due to the side effects of a cocktail of medicines, 40-year-old Pal spent weeks in bed.
"I stopped taking the medicines. I was certain that I was going to die anyway. I worried about how my wife would manage with four children," said Pal, sitting in his two-roomed home in the maze of lanes in Sunder Nagari slum in northeast Delhi.
"The health visitors gave me support ... they used to tell me to take my medicines, do exercise, eat properly. It gave me hope for the future," said Pal, who now weighs 55 kg and has recently been cleared of the disease.
Pal is one of hundreds of multi-drug resistant tuberculosis (MDR-TB) patients at St. Stephen's Hospital in Delhi who have been cured, aided by a unique programme providing psychosocial support to sufferers of one of the world's most deadly diseases.
Despite a lot of progress over the past two decades, the bacterial lung disease TB, that is spread through coughs and sneezes, infected nine million people and killed 1.5 million in 2013, according to the World Health Organisation (WHO).
"One of the things overlooked when it comes to curbing tuberculosis is the mental health problems of patients," said Joyce Vaghela, deputy director at St. Stephen's Hospital's Community Health Department.
"The long duration of the treatment which can be more than two years, the adverse side effects of all the drugs and the social shame attached to the disease can cause patients to suffer problems like depression, anxiety, anger or even feeling suicidal ... and they soon stop taking their medication."
Vaghela said the hospital's home care mental health programme has treated over 400 patients with impressive preliminary success rates, proving that psychological support is crucial.
Studies by the hospital in 2011 found 5.7 per cent of MDR-TB patients under the home care programme quit treatment compared to the national average of 23 per cent. The death rate under the programme was 6.9 per cent compared to the average of 23 per cent.