KARACHI, March 23: After having worked very hard as a construction worker for more than 20 years, Fida Hussain is about to succumb to the ravages of tuberculosis. Classified as a clinical case of MDR (multi-drug resistance), Fida, according to his elder brother, is less than forty years of age.
He was diagnosed with tuberculosis nearly three years back when an area doctor upon suspicion referred him to the Ojha Institute of Chest Diseases. There, he was given medicines which seemed effective and the patient soon started feeling all right. This prompted him to discontinue the medication.
After that whenever past symptoms occurred, Fida took the easy way out: He would produce old prescriptions at the chemists’ shop, purchase some of the medicines and swallow them. The practice, however, could not last long. His symptoms stopped responding to the medications.
Thereafter, his numerous stays at various hospitals proved useless and his condition kept on deteriorating. Now Fida is poised to be part of a figure, representing the number of deaths caused by tuberculosis in a given year in Pakistan.
Roshan, a 24-year-old housemaid is another case in point. She was recently divorced after she failed to produce a child during six years of marriage. Roshan is suffering from tuberculosis of the uterus and requires extensive treatment before she is able to reproduce.
According to renowned gynaecologists, tuberculosis is a contributing factor in more than 30 per cent of patients seeking medical treatment for infertility.
With about 250,000 new cases of tuberculosis emerging in the country each year, countless sagas of human sufferings and related miseries are bound to remain unheard.
Pakistan, according to the World Health Organization, is the sixth leading country in terms of its tuberculosis population. We are also home to 44 per cent of TB cases in the entire eastern Mediterranean region. Such rankings are obviously not a source of national pride.
In the year 2001, the government declared tuberculosis situation as ‘national emergency’ and started off with implementing DOTS (directly-observed treatment strategy) as the foremost tool in controlling the disease. Under DOTS, which if implemented properly can ensure 95 per cent success rate in curing tuberculosis, the emphasis is on constant monitoring of the patient so that he takes medications on a regular basis.
This strategy would also reduce an overwhelming number of MDR TB cases, which are not only difficult to cure, but also require a lot of money — Rs250,000 to Rs300,000 to be precise for each patient.
With an existing prevalence of 1.5 million cases with some sort of tuberculosis, the programme for spreading DOTS coverage to 100 per cent patient population by 2005 would require miraculous happenings, keeping in mind that at present only one in four or five new TB cases is ever diagnosed.
According to the manager, Sindh TB Control Programme, Dr Ghulam Nabi Kazi, less than 20 per cent of TB patients in the country are receiving proper medical care. The WHO has a more alarming news: in the year 2000, Pakistan had less than 10 per cent DOTS coverage for TB patients. Rest of the 80 per cent cases are either approaching the faith-healers or relying on alternatives.
According to the director, Ojha Institute of Chest Diseases, Dr Ashraf Sadiq, only specialized medical doctors can provide effective therapy against tuberculosis with DOTS being the methodology.