Undercurrents

3Communities Are the CustomersHow Activists Must Heed the Voices and Demands of Communities

There is no power for change greater than a community discovering what it cares about.

—Margaret J. Wheatley, American author on leadership

IN THE TEEMING Dharavi slum of Mumbai, a 17‐year‐old girl named Rabiya had a nagging pain in her shoulder. Her family thought it might be a pulled muscle. But Rabiya also developed breathlessness, and the pain got worse. Not far away, in the same overcrowded urban ward, a laborer ignored his persistent cough. Another worker, the only breadwinner in his family, grimaced through unaccountable back pain, unable to sleep until, finally, he skipped a day's work to visit a folk healer. The diagnosis—tuberculosis—didn't require much guesswork. More than two million people in India were suffering from the fatal disease in 2011, most of them living shoulder to shoulder in Mumbai's impoverished slums. That's a public health nightmare. But there was worse to come.

“Incurable TB an Epidemic?” screamed multiple newspaper headlines across the country that year. The fear was entirely reasonable. India had become one of the largest middle‐income countries in the world, and Mumbai was its financial center, a city of millionaires and slum‐dwellers, the latter susceptible to diseases that could spread like wildfire, affecting all.

Among all the world's infectious diseases, tuberculosis is by far the biggest killer. And in Mumbai, the fifth most populous city on the ...