Outpatient assistant Ganga KC assumed her regular post at the Alka hospital’s tuberculosis (TB) treatment center, south of Kathmandu, less than 24 hours after an earthquake shook Nepal on April 25. She opened the doors to the Lalitpur-based facility ready to receive patients at 8 a.m. sharp local time, on April 26.
It was a new day for Ganga and despite Saturday’s disaster, she knew a lapse in TB care for her patients could result in their medicines becoming less effective.
Ganga said the number of patients coming to the facility has not fallen since the earthquake hit, reflecting the Nepalese health and population ministry’s long-term emphasis on the provision of continuous, supervised care.
“When the patients come, we tell them that if even one day is dropped, it won’t work, so you need to come every day – we counsel them that way,” she said in a statement on Sunday.
“The patients think, ‘Oh yes, we have to come here, otherwise the medication we have taken until now will not work.’ So they come.”
The treatment center ensures direct observation of therapy for those requiring TB medication, in line with the World Health Organization’s (WHO) globally disseminated Stop TB Strategy. This approach allows patients to receive free daily medicine and ensures that they are given adequate care and support to complete their treatment course.
Alka’s treatment center sustained only minor damage as a result of the earthquake, but many others were damaged beyond repair, with patients being forced to travel farther to receive care. The biggest challenge for the control of TB post-disaster is not generally a lack of drugs, but that of reaching patients who have not come to the health center or don’t know where to go for treatment when their usual center is no longer functioning.
TB patients whose treatment has been disrupted risk developing drug resistant strains of the disease, a growing public health threat, which is a further burden on Nepal’s health care system.
Nepal’s National Tuberculosis Centre director, Bikash Lamichhane, said a contact tracing mechanism developed in collaboration with WHO would be critical to reaching TB patients who had not arrived for treatment.
“If these centers become non-functional, then district TB officers trace the patients and enable their care at another treatment center,” he said.
Source: Jakarta Post