Thursday, April 17, 2008

Eye wash pattern of the DOTS

Asian Human Rights Commission (AHRC) with People’s Vigilance Committee on Human Rights (PVCHR) appoints Mr. Ajay Kumar Gautam as volunteer-doctor to diagnose the tuberculosis patient from Lohta, Harpalpur and Dhamariya of Kashi Vidyapith block in Varanasi district of Uttar Pradesh in India.
In the month of March 20 patient were diagnosed in Sarojini Naidu hospital in Lohta by Dr. Ajay Km. Gautam. Eight patients were found positive in which three women Ms. Akila and Ms. Aliya Bibi and Zubeeda are suffering from tuberculosis.
Now these eight started taking DOTs (directly observed treatment, short-course) implemented under the Revised National Tuberculosis Control Programme (RNTCP) in India, by WHO recommendation in 1997 is a comprehensive package for TB control. On alternate days i.e. Monday, Wednesday and Friday. With the DOTs medicine supportive medicine and complete nutritious diet is necessary. Due to economic poverty and collapse of livelihood due to declining the market for weavers in imperialistic globalization, they are unable to buy supportive medicine which cost 300 - 400 Rupees in a week.
Ms. Zubeeda, Mr. Ramzan Ali and Ms. Aliya Bibi are facing the ominous menace of multidrug-resistant tuberculosis (MDR-TB). MDRTB refers to strains of the bacterium which are proven in a laboratory to be resistant to the two most active anti-TB drugs, isoniazid and rifampicin. Treatment of MDRTB is extremely expensive, toxic, arduous, and often unsuccessful. They already took tuberculosis medicine earlier and they default medicine in between. MDRTB is a tragedy for individual patients and a symptom of poor TB management. The best way to confront this challenge is to improve TB treatment and implement DOTS.
http://www.tbcindia.org/RNTCP.asp#About%20RNTCP
As we all know tuberculosis is communicable disease and with the close contact of tuberculosis patient it will spread in Lohta region. From last 25 years no new medicine of tuberculosis is invented.
Case detail of a weaver who died due to Tuberculosis
Ramzan Ali 35 years old permanent resident of Mahmoodpur, Lohta in Kashi Vidyapith block in Varanasi district. Ramzan Ali was patient of tuberculosis from last one year. Due to plight of weaving industries Ramzan Ali elder daughter does embroidery on sari and earn thirty to forty in three or four month and two sons of Ramzan Ali is working as bonded labour to manage the need of his family. Even when Ramzan Ali weave sari in his neighbor loom when he feels better. But with this income the family cannot survive or even have a single day’s decent meal. Ramzan did not have Antodaya Anna Yojana (AAY) card where he can buy ration at cheap price from nearest PDS shopkeeper.
Ramzan went to several hospitals for his treatment like Shiv Prasad Gupt hospital, Primary health centre Kashi Vidyapith block but due to economic poverty Ramzan Ali does not continue tuberculosis medicine because with DOTs medicine nutritious diet and supportive medicine is necessary. As he default DOTs medicine in between and again start medicine he gets affected with MDRTB (Multi drugs resistance tuberculosis).
Ramzan Ali was diagnosed in Sarojini Naidu hospital on 10th March, 2008 as pulmonary tuberculosis patient. He feels difficulty in breathing, continuous bleeding while coughing. Slowly and gradually Ramzan Ali health starts deteriorating he became very weak. On 31st March he died at his house at time there was not a single penny to do his funeral. Ramzan’s Ali neighbor and relative gave money for his funeral.
Dr. Ajay Kumar Gautam from the starting month of March is continuously diagnosing patient in the Lohta region with the help of grass root activist Mr. Aftab Alam of People’s Vigilance Committee on Human Rights he has direct. He is the local person and has close contact with the people he mobilize local people for diagnoses in of tuberculosis.
The 40 percentage of tuberculosis patient diagnosed in random sampling in Lohta, Harpalpur, Dhamariya of Kashi Vidyapith block shows that TB stop strategy of WHO is entirely failed here.
http://www.who.int/tb/dots/en/
http://www.who.int/tb/strategy/stop_tb_strategy/en/index.html
The success of this initiative was in the month of March no tuberculosis patient default the medicine and they are continuously taking medicine on alternate days because of social mobilization. The main motive behind this appointment of grass root activist was to give complete information to the people because most people belong to this area are illiterate and second to have friendly relation with those people who are suffering from tuberculosis and to re-habilitate them in the society.
Every tuberculosis patient should have Antodaya Anna Yojana (AAY) card and re-habilitation strategy to prevent no other cases like Ramzan Ali should not revise in future with any other tuberculosis patient.

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