The paper outlines the trajectories of Tibetan refugees afflicted by tuberculosis (TB) within the exile community of Dharamsala (H-P). These stories reveal the political nature of TB status disclosure, highlighting the often conflicting ways in which the disease is perceived among different Tibetan exile regional and generational groups. On the basis of these case studies, I aim to show that differentiated experiences of treatment and stigma within "intermediary" host communities such as Dharamsala partially determine the ways in which Tibetans deal with the risk of TB in their "onward" journeys further afield, in Europe, Canada and the United States. With the now well-established connection between migration-related stresses and the onset or reappearance of TB symptoms, we may need to consider that, in some cases, it is the compounding of attitudes to disease in "intermediary" diasporic communities with the stigmatising label of "migrant menace" in the second stages of migration that impedes the care of migrants and even precipitates illness. With this premise the paper proposes that investigations of disease in diasporic communities should explore the totality of migration "stages" and their impact on health. © 2008 The Author Journal compilation © 2008 International Organization for Migration.

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population migration tuberculosis Eurasia refugee diaspora India disease treatment Himachal Pradesh Dharamsala South Asia health impact Asia