WELCOME FOCUS ON THE DANGEROUS COMEBACK OF TB

Letter:
(The following write up is totally my assumption and not to harm anyone’s feelings or emotions)
A very interesting topic that caught my eyes in your paper was “Awaiting a coherent approach in the battle against TB” [NOW! issue dated 28 May 2012]. It was in fact a very good task done by the writer, who herself went and did research on the prevalent conditions of TB in Sikkim. Case of Dawa and the phase he went through really touched my heart. There are and were many people like Dawa, who are going through the same phase and few who are no longer with us because of the same problem he (Dawa) faced.
Having closely observed on the current scenario of TB & MDR TB cases in Sikkim, it can be said that TB in Sikkim is still very dangerous after all these years of research and findings. Undoubtedly, TB can be termed as a Dangerous Comeback as read in one of the papers published on World TB Day. In Sikkim, 300-400 cases of MDR-TB alone is a massive one. The problems faced in Sikkim as understood is lack of accredited laboratory where culture and DST could be done in less time and also lesser money. Though this test is done in lesser amount from STNM Hospital, the time it takes to deliver the report is very long as in Dawa’s case.
Another problem that I assume is the lack of proper knowledge and social stigma in the society. Many a times it has came to notice that the patients after starting their treatment starts feeling good and healthy as a normal people and gets lost to follow up. They even stop taking their pills and again turn smear positive. This in turn leads to higher transmission and spread of disease. Social stigma can also be considered one of the main causes of the spread of disease and deaths due to the disease. Recently, I came across a person who was confirmed MDR TB after the DST. But he refused to visit doctor and hid his disease by saying that he was food poisoned, what we say in Nepali “Kapat”. This shows that in Sikkim people are still hesitant to tell that they are infected with micro bacterium TB.
The IRL which was to be set up in Sikkim last year at the ground floor of Red building where DTC was situated, couldn’t be done owing to 18 September Earthquake. This in turn led to shifting of DTC to another building and bringing halt to setting up of IRL. The setting up of IRL would have played major role in early detection of MDR TB patients and starting of treatment. A proper counselling and awareness campaign is also a need of hour I believe. As we can see that there are various awareness programmes to curb or stop AIDS, there are hardly few programmes on TB. Here I am not saying that the awareness on AIDS should be stopped, but what I am saying is that the TB issue is equally important. The role of private practitioner like in Dawa’s case is also a matter of concern. These practitioners also prescribe drugs to MDR TB patients which are kept reserved for the Extensively Drug Resistant (XDR) TB patients. This furthermore results in resistance to more drugs.
After all these years of research in the international and national arena, TB and curbing it is still a challenge in Sikkim. Reading the articles like the one mentioned above, it has helped people like me to understand more clearly the prevalent issues surrounding TB. I hope more people will understand the disease and at least make an effort to stop the spread of TB.
Tashi Rai, Bye Pass Road, Gangtok [recvd on email]