India: Tackling TB: It leaves a person with depression, no energy, recalls survivor

Of all the ills that kill the poor, none is as lethal as the bad govt: Experts

“I was diagnosed with TB when my kids were just three and six years old. It was unexpected and startling. The first doctor I consulted was reassuring and I began my treatment. However, complications arose and the treatment prolonged. Coping with the family routine and other responsibilities became difficult,” recalls Marzia.

Marzia would not have been able to fight a long battle against the disease without the help of Dr Zarir Udwadia, a chest physician at P D Hinduja Hospital, whose group was the first to report XDR-TB from India.

Of all the ills that kills the poor, none is as lethal as the bad government, said Dr Udwadia, pointing to the government’s TB control programme that failed to appreciate the severity of the unfolding MDR-TB crisis.

For Marzia, who has now been cured of TB, the main worry was the safety of her family. “Doctors explained how taking the medication regularly and without fail several times a day was important not just for my recovery, but also to protect those around me from TB as the medication reduced the contagious effects,” she said.

Marzia recalls how difficult it was to take all those tablets and follow the strict regime of cleanliness and separate cutlery and crockery at home. However, surgery was required to remove the infected tissue and enable complete recovery, she added.

“TB leaves a person with depression, no energy, no appetite, and many side effects to deal with from the medication. But help from family and friends played a huge role in encouraging me to push towards recovery,” said Marzia. Since TB is frighteningly widespread in India, the role of the government becomes even more important, she added.

“We need more hospitals, doctors and clinics to deal with the illness… After all there is an increase in the daily crowd of patients who wait for hours,” she points out.

She said formerly it was believed that TB largely affected only the poorer sections of society, but this is no longer true. “People from all sections of society need to be aware of the illness and understand that prevention is much easier and cheaper than cure. Again, the role of civic authorities in providing garbage disposal, efficient drainage and reliable drinking water sources is critical,” said Marzia.

Experts speak

MDR-TB patients first seek treatment in the private sector and until 2012, these cases were not even notified with most of them slipping under the radar, said Dr Udwadia. XDR-TB has in all probability existed for years in India because of the cavalier manner in which second-line drugs, especially fluoroquinolones, are abused, he added.

In a stark commentary on ‘Eradicating TB in India’ in this year’s issue of ‘International Journal on Public Policy’, Dr Udwadia writes that the MDR situation in the country has been aggravated by a ‘public policy paralysis’. The TB control programme failed to take note of the unfolding MDR-TB crisis and so seduced was the government by the success of the DOTS (Directly Observed Treatment) in treating sensitive TB that they presumed this would prevent drug resistant TB as well, says Dr Udwadia.

Prof Madhukar Pai, Associate Director of McGill International TB Centre, Canada, told Newsline that reducing TB incidences has been disappointing. The TB epidemic is declining at the rate of 1.5 per cent per year, much slower than what mathematical models had predicted. At the current rate of decline, TB elimination by 2050 is considered impossible. “TB control requires new tools, policies and delivery models,” said Pai. Since the private sector is largely unregulated, it is vital to educate private practitioners about the standards for TB care in India and monitor whether they are following it or not.

Source: The Indian Express