“It started with my heart”: Tota Mia’s journey to community-supported health
In a small village nestled in the Bogura district of northern Bangladesh, 53-year-old Tota Mia carries the quiet dignity of a man shaped by hard work. But the past two years have tested him in ways he never imagined. It all began with his body sending signals he couldn’t ignore.
“It started with my heart,” he recalled. “I would feel palpitations whenever I walked or worked. My chest would feel tight. There was pain, uneasiness — I just knew something wasn’t right.”
Worried, he visited a nearby private clinic. After a series of tests, the doctor confirmed his worst fears: high blood pressure, putting him at risk of heart attack and stroke. Medicines were prescribed, and for a while, he managed. But with a monthly income of just 4,500 taka, spending 2,000 taka on medicines was never sustainable.
“I had to stop my medicines. There simply wasn’t enough money,” he said. “That’s when things took a turn for the worse. I started having health complications, and when I went to the doctor, there was more bad news: I also had diabetes.”
To cover his rising treatment costs, Tota made a heartbreaking decision — he sold his only goat. Even then, it wasn’t enough.
One day, as he confided his worries to a neighbor, he learned about the NCD corner at the nearby Gabtoli Upazila Health Complex — the local public health center where patients could receive free medication. He registered immediately.
Today, Tota receives his hypertension and diabetes medication from the NCD corner each month. But the daily reality of managing his conditions continues to be a struggle. Fatigue and weakness have become his unwelcome companions, and his relationship with food has fundamentally changed. “I used to eat a full meal, with a lot of rice,” he said, “but now I eat maybe one-fourth of that. Two pieces of roti and some vegetables, that’s all. I know I can’t eat rice because of my diabetes, but I miss it. I feel hungry. I don’t feel strong.”
Physical work — once the foundation of his livelihood — is also no longer possible. He can’t move quickly, nor can he work in his field. “Even walking exhausts me. I sweat too much. I have to walk slowly.” With his two children living and working far away, his wife has become his sole caregiver. “I’m grateful for her, she takes care of everything — my food, my water, and even walks with me to make sure I don’t trip,” he shares.
On a recent visit to the Upazila Health Complex to collect his medication, Tota stumbled upon a Care Companion Program session — a nurse-led group offering guidance on managing diabetes and hypertension through healthy behaviors. For him, it was a turning point.
“I learnt so many things today,” he said, the hope clear in his voice.
As the only man in the room, he sat attentively, eyes fixed on the colorful posters, absorbing every word. “The nurse explained what we should eat, and how much. Turns out I can eat some rice and meat — just in the right proportions,” he explained, his excitement palpable.
When the nurse asked if anyone wanted to continue receiving guidance on diet, medication, and healthy behaviors via Noora Health’s mobile service, Tota was the first to sign up.
Motivated and hopeful, he now wants to take what he’s learned beyond his own home. “I will try my best to follow everything the nurse said. And I will encourage others in my community too. Many people don’t know the right way. They follow harmful habits like eating too much rice and not walking every day. I want to change that,” he concluded, determined to not just survive his conditions.
A special thanks to Abhijit Sarker Arka and Wahida Zaman Shithi for bringing this story to life, and to Kawshick Biswas for the illustration!
