Senin, 27 Juli 2015

Posthumously

"Senior doctor dies lonely death at Sewri Hospital after being denied leave for drug resistant TB strain by civic body BMC.

BMC count of TB cases maybe actually 400% lesser than health department’s records

49-year old Dr. Suresh Vaze contracted a drug resistant strain of TB from a patient he treated. He was denied leave for the much required treatment by BMC (Brihanmumbai Municipal Corporation) leading to his admission at the very hospital he served at. He was unaccompanied at the time of death. His wife and one of two daughters, who contracted XDR TB from Dr Vaze, were forced to leave him in May. A physician who attended to him said, Dr Vaze lost motor function a fortnight ago. He suffered organ failure and both his lungs had collapsed. “He was like a dead body. He’d stopped eating and stopped reacting to people,” said a doctor, requesting that his name be withheld. “It was painful to see a colleague with whom I worked for 15 years waste away. And what made it worse was that he died a lonely death.”

Dr Vaze who was infected in 2011, continued to work at the hospital while receiving the stipulated six month course of treatment. As per BMC policy an employee who is undergoing treatment for TB must return to work if his or her sputum tests negative for the disease – which is redundant because the subject’s test would return negative in the midst of treatment.

Dr Vaze continued to treat over 30 multi drug resistant TB cases a day and in 2012 was diagnosed as infected by that strain – rendering him immune to second line drugs. He began treatment for MDR-TB and, in keeping with BMC’s policy, was told to return to work when his sputum tested negative. He was infected with XDR-TB in April last year, a mycobacterial infection that requires at least two years of sustained treatment. The BMC would only grant him six months of leave, from which he had used up half.

In October, Mumbai Mirror ran the third of a series of articles on Dr Vaze, inducing the BMC to amend its leave policy for doctors infected with TB. The city corporation now grants medical staff full paid leave for treatment, irrespective of the duration. Since then, Dr Vaze continued to be treated at Sewri TB Hospital – he lived in the staff quarters within the precincts of the facility. His wife and 18-year-old daughter left home after they contracted the disease from him. “He locked himself up after they went away. He was depressed. He lost over 20 kilos in the last two months,” a doctor said.

“When he stopped coming to the hospital for treatment, I sent over a DOT [Directly Observed Treatment] provider to visit his home but he refused to take his medication,” said Dr Rajendra Nanaware, medical superintendent at the hospital. “We informed his wife and she visited him but couldn’t stay because she too is battling the disease.”

Dr Vaze was declared dead at 6.20 pm on Monday. His wife and daughters were present at the funeral. “The wife and daughter are responding well to treatment,” Dr Nanaware said."

Rasanya sedih saat membaca berita tersebut. Meninggal karena penyakit yang didapat saat sedang merawat pasien bukanlah pilihan kematian yang menyenangkan. Tapi sebagai seorang praktisi kesehatan tidak memiliki banyak kemewahan pilihan untuk menolak hal tersebut. Tiap saat, praktisi kesehatan dapat tertular penyakit dari pasien yang dirawatnya. Apalagi jika bekerja di Indonesia di mana skrining penyakit infeksi dan kultur organisme masih menjadi hal yang mahal. Ditambah lagi, prinsip safety first masih jarang diterapkan di lapangan. Masyarakat masih menganggap risih seorang dokter yang memeriksa pasien dengan menggunakan masker dan sarung tangan. Mereka menganggap bahwa dokter yang menjalankan konsep safety first seperti itu sebagai seseorang yang tidak sopan, tidak menghargai pasien. Akhirnya, banyak dokter dan tenaga kesehatan lain yang termakan oleh kerisihan tersebut.

Mengubah paradigma masyarakat dan praktisi kesehatan mengenai safety first merupakan hal utama yang harus dilakukan saat ini. Namun untuk melakukannya, kita harus menempuh jalan yang teramat panjang dan butuh waktu yang sangat lama. Mungkin beberapa orang yang membaca ini sudah mati terlebih dahulu sebelum paradigma masyarakat berubah. Tapi tetap saja, hal tersebut patut dicoba.

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