Public spitting thwarts TB control

Acts of spitting in public places, which is one of biggest problems in tuberculosis (TB) control, continues unabated in the city. Lack of public awareness and poor monitoring by health agencies have led to the appalling condition.

With the growing fear of contracting the extensively drug resistant (XXDR) form of TB, doctors want the civic body to step up efforts to carry out a massive public awareness campaign. After speaking with health officials of the Pune Municipal Corporation (PMC) DNA found that implementation of the rule against spitting in public places was negligible.

Dr SS Athade, health officer in charge of Zone I, said that per month, less than 30 people were fined for spitting in public places in his zone.

“Besides collecting fines, our staff has a lot of other duties too. We are given extra duties from time to time, like our entire staff is busy with election duties now. Also, just fining people wouldn’t suffice. There is a need to raise public awareness on the issue,” he said.
Dr Dinesh Bende, in charge of Zone II, said that per month nearly 50 people were fined for spitting in his zone.

Surprisingly, the law was being strictly implemented during the swine flu outbreak, and the then municipal commissioner had hiked the fine from Rs25 to Rs1,000.

“At that time, fear of H1N1 and awareness was at peak; hence the fines were being levied strictly. Now the panic has subsided. People don’t pay Rs1,000 in fine and our officers let them go for Rs100,” said Athade. Chest physician Dr Mahavir Modi explained how the bacteria that cause TB stay alive in spit for nearly one-and-a-half months.

“In sunlight, the bacteria stay alive for 6-7 weeks, while in cold areas they live longer. This is especially harmful for people whose immune system is compromised,” he said.

Dr PY Gaikwad, joint director (tuberculosis), state health ministry, also agreed that besides poor hygiene, spitting in public places was responsible for spreading airborne diseases like TB. The PMC health officials rued that even if innovative ways were introduced to check spitting, they would not be implemented properly due to lack of manpower and effective monitoring.

“We launched a drive where people had to clean up after spitting or pay Rs1,000. People chose to pay and it made a great impact. But it lasted only for a few days. Bins were placed in public places for spitting, but the initiative failed due to poor monitoring. Steps like compulsory screening of documentary on spitting are needed to make a real impact,” said a medical officer of the PMC.