Breathless: Tuberculosis, Inequality and Care in Rural India

India accounts for 30% of the world’s TB cases

2023 saw 28.2 lakh cases, 3.4 lakh deaths

50% of the affected suffer from malnutrition

State apathy towards a poor-person disease

Welcome to Ambawati. A village in Rajasthan, midway between Delhi and Mumbai, where the western wind kicks up a dust. It irritates the lungs. The residents are mostly Adivasis and Dalits. Tuberculosis is rampant. It is entangled with inequality. This is the price the marginalized pay for health and policy decisions made in faraway Delhi and Geneva.

Andrew McDowell gets entangled in the lives of the people of Ambawati, spending time at tea stalls, clinics, bedsides, fields, forests, and with nurses, doctors, quacks, mediums and mystics. He shows us how TB is an atmospheric illness dictated by social and biological realities.

With chapters on dust, clouds, breath, mud, and ghosts, McDowell develops a philosophy and phenomenology of breathing that attends to medical systems, patient care, and health justice. Breath—intimate and personal, shared and distributed—throws new light on public health and inequality. Breathless is both an act of meditation and a call to action.