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.
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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.