Indian Express: Mumbai: Monday,
March 31, 2014.
The 1,200-bed
Sewri TB Hospital in Mumbai, one of the largest tuberculosis hospitals in Asia,
has struggled to contain the spread of the disease amongst its doctors, nurses
and Class 4 workers. The number of hospital staff currently diagnosed with
various forms of TB now stands at a record 46, with the last TB screening at
the hospital conducted in December 2013.
From 2005
till January this year, 38 hospital employees have succumbed to the disease.
As per data
obtained under the Right to Information (RTI) in 2013, the hospital has a total
strength of 1,015 employees 44 medical staffers, 46 paramedical staffers, 265
nurses, eight administrative employees and 652 Class 4 workers. Of these, 40
Class 4 employees, five nurses and a doctor are undergoing treatment for TB.
Another cause
for concern is that 23 of the infected employees have contracted multi-drug
resistant (MDR) TB, a jump from 12 MDR cases recorded in July 2013. One doctor
has advanced to extensively drug resistant (XDR) TB.
Dr Lalitkumar
Anande, the hospital’s deputy medical officer, said, “There is a sudden spike
in MDR cases since 2012. Since the bacillus has power to quickly mutate, it is
spreading faster. Several Class 4 employees have low immunity, and it has hit
them the worst.”
Pradeep
Narkar, secretary Municipal Mazdoor Union Mumbai, said, “The unofficial figures
of employees contracting TB are higher than what the hospital suggests. Several
employees opt for treatment from private centres. They are not accounted for.”
A ward boy at
the hospital said, “I took on my father’s position after his death. Since I
have nowhere else to go, I have to work here even if there are chances of
contracting TB.”
Mohammad
Sabir, father of 20-year-old MDR TB patient Tabassum Seth, said, “The bed
sheets and clothes of patients are changed once a week. The infection
multiplies in the ward because of this and as nurses and ward boys come in
direct contact, they are prone to infection.”
From May 1,
2012, after several staff members contracted TB, the hospital started providing
every employee with ‘sakas ahaar’ a supplement containing 12-15 gm protein and
350-400 gm calories. However, Narkar alleged that the quantity of food provided
is small. “The breakfast provided costs Rs 10 per person. How can you get
wholesome diet in that amount? Employees are given either a boiled egg or a
handful of chana. It cannot help build their immunity,” he said.
Additional
municipal commissioner Sanjay Deshmukh from the BMC, under which the hospital
functions, said, “We have started screening the hospital’s employees once in
every three months. There is also going to be an orientation programme once
every two months. In the orientation, a medical officer will brief them on ways
to avoid infection.”
Despite TB
screening facility being available at the hospital, the count of employees
appearing for it has dwindled. A senior medical officer said, “In 2011, around
700 employees turned up for screening. But the figure came down to 328 in December
last year. Employees don’t want to get screened because they do not wish to
undergo DOTS. The treatment regime is exhaustive.”
DOTS
(Directly Observed Treatment – Short Course) is a regime followed under Revised
National Tuberculosis Control Programme. However, employees have claimed that
they are called to centres thrice a day for medication, and that public
hospitals follow Category 1 and Category 2 treatment while private hospitals
follow the far more effective Category 4 treatment.
Senior
doctors from the hospital added that the count of MDR TB cases detected among
the hospital staff has also increased after GeneXpert machine was installed in
November last year. GeneXpert is useful in diagnosing MDR TB. Currently, the
city has five such machines.
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