#WorldTuberculosisDay: Death-call at Asia's biggest TB hospital

When 33-year-old Poonam Gaikwad, a staff nurse at Asia's biggest Tuberculosis (TB) Hospital in Sewri, Mumbai, breathed her last on March 4, she weighed a mere 26 kg. She died of extensively-resistant (XDR) TB, which means that a majority of drugs failed to work on her.

DNA accessed medical records of the 1,000-bed TB hospital, which revealed that since 1999 to date, as many as 218 staffers have been infected with TB, of which at least 86 have died of the disease. On an average, twelve workers contract TB in Sewri, every year, of which five (up to 40 per cent) die.

Contrast this with deaths in patients and a grim picture emerges. The rate of death amongst caregivers like ward boys, nurses, sweepers, doctors in the hospital is higher than that of patients. The hospital saw 29,020 patients in Out Patient Department in 2015-16, of which 6,858 were admitted. Of those admitted, 1,575 died.

A sprightly young lady, Poonam had completed her Bachelor's in Nursing from the adjoining KEM Hospital. "She suffered for a year before succumbing," said her sister Kavita.

Dr Kuntal Pal, a Mumbai-based pulmonologist, who tended to her, recollected her as a thin frail woman. "She was absolutely spent when I first saw her. She came to me in a wheelchair and was breathless all the time. And every time she coughed there was blood," said Dr Pal. TB spreads through droplet infection of 'Mycobacterium Tuberculae,' that is suspended in the air. Dr Pal explained that it will infect majorly those who are low on immunity, do not eat well, have an underlying diabetes, or HIV.

Going empty stomach while having prolonged contact with TB patients is like inviting death at your door. In Poonam's case, Kavita said, "She did not eat well. Her work hours were long. And she was constantly in contact with drug-resistant patients at the hospital."

Prescriptions a month before her death show that she was put on salvage drug Linezolid, one of the last resorts for treating TB. "She had to be weaned off Linezolid, as it had adversely affected her hearing. She had become hard of hearing. To reverse the side effects, we had to take her off Linezolid," said Dr Pal.

In 2016, two staffers, Santosh Tukaram Kamble and Rajendra Tanaji Jadhav, succumbed to the scourge, on February 25 and September 18, respectively. DNA accessed their death certificates from civic medical records.

Rajendra, 42, who was working as a sweeper in the hospital for the past 22 years, died a lonely death. Earlier, in May 2016, his wife who was suffering from depression, had committed suicide. Rajendra's death has left their seven-year-old son Rutvij orphaned.

Rajendra had acquired the job after his father Tanaji retired from a clerical post. In August last year, his sister Komal Mohite got a distress call from him. "He called me and asked me to reach his Sion home, we realised he could not get up. He was coughing incessantly. He had lost his appetite. We lifted him and admitted him to Sewri TB hospital," said Komal. Twenty days later, when Rajendra breathed his last, no family member was by his bed-side.

A month and a half ago, Mangesh Sawant, 45, ward boy at Sewri TB Hospital, who has served in Brihanmumbai Municipal Corporation (BMC) for over two decades, was detected with abdominal TB.

Despite it being of utmost importance to join duty on a full stomach, so as to be protected against the deadly bacteria, hospital employees get paltry diet. "The employees have a quota. A small bowl of snack, an egg and fruit, and close to 70 ml of milk. I can eat three platefuls of breakfast in the morning, but we receive only limited quantities," said Sawant.

Distressed employees of the hospital are fighting on all fronts. Auditors have raised queries on salary payments of at least five employees, who were on a 24-month break to recover from TB, while a written circular grants them only nine months of leave. "When staffers have been suffering from TB for years, how are they expected to recover within nine months, as mentioned in the circular?," said Pradeep Narkar, secretary, Municipal Mazdoor Union, Mumbai. Since 2011, MMU is also fighting for staffers in Sewri to be given risk allowance. "When fire brigade officials can get a risk allowance, why can't the staffers in the hospital? A fire breaks out once in a while, here the staffers are working under risk conditions 24x7. We are demanding a risk allowance of Rs 1500 per month," said Narkar.

Ironically, only nurses in the hospital accrue a menial 'infection allowance,' of Rs 150 (one tenth of what is being demanded), currently, while the Class four employees receive nothing.