MARGAO: The TB Hospital in Margao has continually been in the news for the wrong reasons. For its filth and unsafe conditions, lack of security, bad food to inmates or negligence by doctors or even the fact that a majority of its 26 patients are abandoned migrants leading to the hospital having no beds and place for local TB patients.
This time around, the controversy has got murkier. Not only is the TB Hospital at Margao Monte constructed during the Portuguese regime in a rundown condition, sisters and nurses working at the hospital now live in fear.
The problem arose when Dr Navjot from the Tuberculosis Unit of the Directorate of Health Services accompanied two MDR tuberculosis cases and admitted them at the Margao Hospital shifting them out of St Inez Government TB Hospital due to lack of space.
One of the nurses at the TB Hospital explained that individuals suffering from TB go through a DOTS treatment of CATS (category) 1, CATS 2 CATS 3, CATS 4. And the CATS 1 and 2 category when tested negative means that the patients in not infective in nature and allowed to return home.
The nurses point out that the patients brought in from St Inez, who are migrants from Gujarat and not admitted anywhere in their state, are CATS 4 patients who are multi-drug resistant and cannot be treated to bring into the negative category. The nurses pointed out that these patients are to be isolated and cannot be put with other patients who are on their way to recovery.
The nurses and families of the TB patients have requested DHS and the Medical Superintendent to move the MDR cases to the recently created Swine Flu/Ebola Isolation ward created at GMC instead of keeping the high risk contagious patients at the hospital.
“These patients are highly infective in nature and even the sputum is contagious. These patients being in the Margao unit mix with our other 26 patients and are interacting with them and playing cards with them. Even we don’t have the right equipment and safety precautions to treat them. Worse, DHS has sent them here without their medicines which cost around Rs two lakh,” explain the nurses seeking anonymity, afraid of being suspended.
The nurses also point out that one TB patient from CATS 1 has been moved to the hospital verandah in cold dew to make place for a bed for the MDR TB cases.
Dr Govind Desai, Senior Chest Physician, DHS (Hospicio) asserted that the decision to shift these patients was lack of space and done in consultation with the WHO doctor who looks into the TB scenario in Goa and hence, the fear psychosis should be downplayed.
Dr Desai, who works out of Hospicio and visits the TB patients once a week, told Herald that the apprehension of the nurses and TB patients’ relatives will die down over a period of time.
Medical Superintendent of the TB Hospital, Dr Marcia Pacheco pointed out that the worry is of the nurses and her focus is to counsel the nurses not to fear rather than creating the isolation ward or moving the MDR TB patients to another facility wherein they don’t come in contact with others.
“Isolating them could lead to stigma and is not right. I know they are MDR cases but they are separated and I can’t do much with they’re interacting with the other patients, this issue will settle over time,” asserted Dr Pacheco.
Similarly, Deputy Chief Minister and Health Minister Dr Francis D’Souza went on to say that if HIV patients can move freely in society why can’t TB patients? He stated that he would rather face the music of the other TB patients than that of the Human Rights Commission, hence he is fine with the highly infected MDR TB patients mixing with the others who are on the road to recovery from TB.
But nurses at the TB Hospital, who do not have in stock proper medicines or gloves or masks to come in contact with the MDR TB patients, are afraid of illness and feel betrayed by the health department.
