I feel loss of appetite, pain in joints and suffer from a sleep disorder. There are times when I don’t feel like taking medicines,” says 41-year-old Nemvung, a resident of Churachandpur town in Manipur, who is suffering from multi-drug-resistant tuberculosis (MDR-TB), which is a more deadly form of TB and the intensive treatment process is accompanied with severe side-effects. In 2013, Nemvung was detected with MDR-TB. She began treatment in Imphal, but dropped out because of the distance—the hospital was 65 km away. When her condition worsened later that year, she went to a private clinic in Churachandpur, but dropped out once again as she could not afford the medicines. An understanding doctor directed her to a clinic of Médecins Sans Frontières (MSF).
The TB division of the Churachandpur District Hospital and MSF have come together to create a model to treat patients afflicted with MDR-TB. The hospital has opened a specialised ward to admit patients, while MSF gives individualised treatment to patients at home. This arrangement solves two problems that afflict TB patients in India—non-compliance of patients for medication and generic treatment for MDR-TB.
The initiative comes at a time when MDR-TB cases are on the rise across India. The number of MDR-TB cases increased five times from 4,297 cases in 2011 to 23,325 cases in 2013, said the then Union Health Minister Harsh Vardhan, while replying to a question in Parliament in 2014. Data compiled by MSF, however, says there were about 35,000 MDR-TB cases in 2014, but only 20,000 were being treated. Yet, the Revised National Tuberculosis Control Programme (RNTCP) “claims” to have covered the country through its Directly Observed Treatment, Short-course (DOTS), an international standard for TB control.
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