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A patient named Zarina, 23 years, suffering from extensively drug resistant tuberculosis (XDR-TB), had been making the rounds of Thane’s Rajiv Gandhi Medical College for almost a month. Although, it has been given the go-ahead to receive bed aquiline, one of the new TB drugs to be discovered in 40 years, she had not been started on the medicine for lack of hospital beds. However, the hospital sources told TOI late on Friday that a bed was being arranged for Zarina.
Preliminary protocols designed under Revised National TB Control Programme (RNTCP) required patients to be hospitalized for observation for two weeks so that adverse effects of the new drug can be managed in the hospital. But this guideline had become a problem for patients like Zarina. She told TOI that every time she comes prepared to take admission in the hospital, doctors tell her that there are no beds available. She further said that she lives with her one-and-a-half-year-old son, husband and grandmother in Kalwa. Due to severe chest pain, she cannot sleep, work or rest and is afraid that shemight die before getting the medicine. Almost 50 other patients are waiting to be given bed aquiline at the college, the nodal centre for seven corporations, including Vasai-Virar, Mira-Bhayander, Thane, and Thane and Palghar districts.
A doctor said that the hospital has only 15 beds, seven each for male and female patients, which are always occupied. They try to accommodate as many, but the burdenis above the capacity. Many centres in Mumbai have started administering bed aquiline on an outpatient basis under the close observation of a specialist. Dr Lalit Anande, medical superintendent of the Group of TB Hospitals in Sewri, said people were unwilling to get hospitalized merely for observation and most of them opted to be closely monitored by a chest expert. However, the Thane hospital, like many others in Maharashtra, has been unable to implement the OPD model due to unavailability of experts and technicians to carry out ECGs. Also, lack of manpower is a big hurdle than hospital beds.
A 17-year-old told TOI about her difficult journey from Kalamboli to MGM Vashi to collect medicines, including delamanid, which is another new TB drug, every two days. She said that it is nearly 1.5-2-hour travel. Most days she is not in a condition to travel, but she will miss out on doses if she don’t visit the Vashi hospital. HIV/TB activist Ganesh Acharya said that the patients in the state who are getting controlled access to bed aquiline and delamanid, are facing problems like long commute, unavailability of hospital beds and lack of doctors.
State TB officer, Dr Padmaja Jogewar, said that they have given permission to most centres to start bed aquiline on an OPD basis and even hire chest physicians adding that nearly 3,000 patients were on the drug.