Jan 24, 2012

India - TDR panic spreads: Worried docs want out of TB hospital



Hospital to hold counselling sessions for its staff as 10 members, including doctors, nurses and lab technicians, threaten to quit

Barely two weeks after it was revealed that the most dangerous strain of the tuberculosis (TB) bacteria has found its way into Mumbai, Asia's largest TB hospital in Sewri is battling another problem: worried about contracting the virus, several staff members are threatening to quit if not transferred from the hospital at the earliest.

The doctors say constant exposure to TB patients – many of whom are drug-resistant – has created a massive scare. Two of the doctors, diagnosed with TB, are being treated by private hospitals, while 17 other paramedics at the facility have also tested positive.

A hospital source said, "The two resident doctors' TB positive report set the cat among the pigeons. It is obvious that there is no way out; we come in contact with TB patients up to 10 hours a day. Just how much precaution can one take? There is a feeling of inevitability among us, that sooner or later, we are bound to be affected by the disease." There are 850 patients undergoing treatment at the 1,000-bed hospital, of which 42 have been identified as multi-drug resistant cases; while one is an extra extensively drug resistant (XXDR) case. The strength of staff attending to them is abysmal; one doctor for 150 patients when an acceptable number would be 20.

Despite this, at least eight staffers – including resident doctors – have approached the civic authorities seeking transfers, and at least two doctors have gone on leave while their applications are pending. Both are pregnant. One, who is already on maternity leave, has said she will not return for the time being, while the second has now applied for leave.

Doctors say they are confused, helpless. A resident doctor said, "All these years, we had been taking precautions against TB, or multi-drug resistant strains at the most. But this totally drug resistant strain, which the State calls XXDR… how do we protect ourselves against that? It's time the authorities think about us too."

The embattled civic body, already struggling to recruit staff for the TB hospital, is now doing all it takes to raise the morale. It has initiated training, education and counselling sessions to begin with. On Monday, staff from across TB departments in civic hospitals, including the Sewri hospital, have been lined up for a counselling session.

Indeed, the helplessness that arises out of lack of treatment options has steadily depleted the hospital, which was forced to stop major surgeries. The last major operation at the hospital was performed in 2006. The old hands have retired, and cardiovascular thoracic surgeons are opting for private hospitals.

Recently, the authorities selected 12 out of 20 doctors interviewed; not one has joined the hospital. There are 54 posts for nurses lying vacant (out of 225), and of 658 posts for Class IV workers (ward boys, etc), 127 are yet to be filled up. At the root of the problem, however, is the hazard of working there, a source said. A resident doctor said, "Most patients – and we cater to almost 1,000 patients – come here at a very advanced stage of the disease. We have families too, and for their sake, I will quit if I don't get a transfer."

While the hospital authorities refused to comment saying there was a gag order from the civic authorities, BMC officials put up a brave front. Dr Anil Bandiwadekar, BMC's executive health officer, said, "We have started counselling doctors and medical staff who are exposed to TB patients. We have told them that there is nothing to worry about. As far as the Sewri hospital is concerned, nobody has given anything in writing, saying he/she wants a transfer."

Lata Mishra
Mumbai Mirror



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