Sewri TB hospital will frisk patients to curb suicides

All patients at Sewri Tuberculosis hospital, Asia's largest for the disease, will be frisked for sharp objects. This will be done so that patients do not smuggle in such objects to commit suicide or to harm anyone.

Two recent episodes at this civic hospital have spurred the need for such a screening exercise. While a patient attacked a ward boy using a sharp knife on Wednesday, a teenage patient ended his life last week. Earlier, the hospital had set up grilles on its balconies after patients had leaped to their death.

Despite the hospital's latest move to seal all possible 'suicide routes', doctors feel these measures will not help much to nip the problem in the bud.

A doctor, who did not wish to be named, said that counselling of patients is what can help solve matters. "A team of psychiatrists comes to the hospital regularly but time spent with a patient is too little.

Considering the extent of depression that each patient faces, a five-minute talk with a counsellor hardly helps," said this doctor.

An ailment like tuberculosis often islands the person socially, say doctors. The absence of support from friends and relatives coupled with physiological and mental side-effects of the disease has left doctors at the Sewri hospital helpless given the current ratio between psychiatric counsellors and patients at the hospital.

This doctor said that the depression in patients is often manifested in an emotional outburst. "Patients often tell us that they are unable to handle the side-effects of the disease. One reason for their agitation is the drug they have to take and so there is hardly much that one can do about curbing their behaviour as this drug is a must," said the doctor.

Dr Jaising Phadtare, professor of pulmonary disease and intensivist at Grant Medical College admits to the need for robust counselling for patients, especially during the first three months of treatment for multi-drug resistant tuberculosis (MDR-B).

"The doctor has to counsel the patient and make him understand the basics of medicine and its effects. For instance, the doctor must explain the need to take a particular drug at a certain time..." said Dr Phadtare. "Helping build the patient's confidence in the initial three months of treatment can go a long way for the next couple of years of treatment."

Dr Nagsen Ramraje, head of chest medicine department at Sir JJ group of hospitals, says that the prolonged course of treatment makes the patient anxious. "The anxiety is coupled with factors like social stigma and future insecurity. The side- effect of drugs precipitates depression," said Dr Ramraje.

Doctors also feel that a few things in the tuberculosis control programme need to be changed. A second-line drug, cyclocerine, is known to induce psychosis. Doctors say an alternative like tericox, which has lesser side-effect, must be included in the programme, said Dr Phadtare.