«I walked into the hospital as a vagabond, and I was treated like a millionaire,» says a grateful Ila Zaion, a 52-year-old native of Guinea Bissau, West Africa. His words reflect the deep gratitude he feels towards the public health system of Catalonia, Spain, for treating and curing him of a tuberculosis infection that would have been fatal in his home country.

Tuberculosis is one of the oldest infectious diseases known to mankind. The number of cases globally has increased in the wake of the Covid-19 pandemic, as it monopolized epidemiological surveillance systems worldwide for nearly two years. In Spain, Catalonia is the autonomous community with the most cases of tuberculosis.

Ila’s journey to Catalonia started in 2004 when he arrived in the Canary Islands after a three-day boat trip from Mauritania. The journey cost him about 1,000 euros at the time, and he was among 58 others onboard. He was fleeing the civil war in his country, where he had previously worked as the Spanish consul’s driver, who was also the director of Coca-Cola. This job equipped him with Spanish language skills before setting foot in Spain.

Over the last two decades, Ila lived between Portugal and Spain, mostly working precarious jobs in construction. Also a reggae singer-songwriter, he performed his music on the streets. Mid-2020 found him in Barcelona, where he has family. Interestingly, Ila is a cousin of FC Barcelona player Ansu Fati. «They gave me money, branded clothes, and a phone. They recognized me as family,» he says.

However, his arrival in Barcelona marked a rough period in his life. In 2022, he spent two weeks sleeping rough on the beach in Badalona, struggling with the cold and poor nutrition, while battling excessive drinking and smoking. «One day, I started to feel feverish,» Ila recalls.

According to Jesús Ospina, coordinator of the community health agent programs of the Agència de Salut Pública de Barcelona (ASPB), it is unclear whether Ila contracted tuberculosis in Barcelona or if it was a latent infection from his childhood that manifested once his immune system was compromised.

When Ila could no longer bear the discomfort, he sought help at the Municipal Hospital of Badalona, where he was admitted for a month and a half. Despite the numerous tests conducted, the doctors were unable to determine the cause of his illness. With sunken eyes and a concave belly, he cried at his reflection in the mirror.

He was later transferred to the Sociosanitary Center El Carme, also in Badalona, where he was diagnosed with tuberculosis on December 20, 2022. «People die from this in my country. Here, the public health system treated me very well. This was the greatest gain from my boat journey,» Ila asserts.

Ospina explains that the incidence of tuberculosis is higher among immigrants and increasingly among homeless individuals. Despite this, it is a respiratory disease that can affect anyone. In Ila’s case, the delayed diagnosis complicated his recovery.

Upon his admission to the hospital, Ila was isolated due to his contagious condition. He had never been in a hospital before and was startled by the need for visitors to wear masks to see him. He had never seen a thermometer in his life until he was hospitalized. He emphasizes the compassion with which he was treated, not having to pay a single cent for his treatment, despite not having a Spanish residence permit. «In my country, my family would not have been able to afford it,» he says.

Post-hospitalization, Ila was moved to Serveis Clínics. Located in the Sarrià-Sant Gervasi district of Barcelona, it is the only center for tuberculosis patients in Spain. The professionals at Serveis Clínics provide not only medical care but also social support, as their patients are typically vulnerable individuals.

«I arrived at Serveis Clínics weighing 45 kilos (normally weighs 58). I was like a one-year-old child: I couldn’t walk, I couldn’t handle my life,» recounts this tuberculosis survivor. He lived there for about six months until he was discharged. «I am very grateful to the Catalan health system and especially to the healthcare staff. Thanks to them, I have saved my life,» he concludes. His future plan is to continue making music.