In Matunga’s labour camp, a 19-year-old bachelor of management studies (BMS) student undergoing treatment for multi-drug resistant tuberculosis (MDR-TB) since May last year has seen changes in his overall health ever since a monthly nutritional support, he received alongside the treatment, was stopped.
Under the Revised National Tuberculosis Control Programme (RNTCP), monthly ration supplies — in form of wheat, gram flour, jaggery and protein supplements — for tuberculosis patients was halted. The patients instead were given a monthly monetary incentive towards ration — a regular TB patient gets Rs 500 and a MDR-TB patient Rs 1,000 per month — till their treatment is complete.
The fund is directly transferred to a patient’s bank account under the Direct Bank Transfer (DBT) scheme.
In tribal areas, an additional Rs 750 is provided to patients towards travelling expenditure. Each private doctor is paid Rs 1,000 for notifying a TB patient.
However, since January several patients have neither received ration nor the sum assured.
“I was able to eat sprouts. The jaggery they would provide also helped me when I had vomiting sensation after taking medicines,” the student said. He said that MDR-TB requires at least two years’ treatment and causes several side-effects due to an intensive drug regime.
“After I started the treatment, I would receive a monthly ration comprising moong dal, jaggery, rice, wheat and peanut — in all 11.5 kg as nutrition supplement — under the government scheme. The ration would at times also help to sustain my family of six,” he said.
In January, the youth submitted all documents required for the DBT scheme to the DOTs centre, however, he claimed, the money transfer was yet to begin.
Across Maharashtra, 2.26 lakh TB patients are enrolled to receive benefits under the DBT scheme. So far, 1.26 lakh patients across the state are receiving money in their accounts as a part of the scheme. In Mumbai, of the total 52,008 registered TB patients, only 18,000 have been covered.
According to officials with the RNTCP, the process to cover the entire population would take some time.
“The DBT scheme had some online issues, for two months data was not fed. We are trying to cover the entire population,” Dr Daksha Shah, RNTCP in-charge in Mumbai, said. Dr Shah said that while Aadhaar was not mandatory for processing the DBT request, “banks require it”.
In the private sector, lack of patient’s bank account details has also punctured the implementation of the DBT scheme. According to Dr Anup Kumar Yadav, director of state National Health Mission, private doctors are unable to procure bank account details of TB patients and share it with the government to expand the scheme.
In Mumbai, the Brihanmumbai Municipal Corporation has expanded diagnostic services resulting in a rise in TB detection — from 271 in 2013 to 397 per lakh population in 2018. There are at least 4,969 multi-drug resistant and 526 extensively-drug resistant patients, who require special nutrition support, strong counselling and close monitoring, to adhere to the treatment.