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Tuberculosis and HCH!

Started organising the TB work in HCH.
It's a mammoth work with hordes of multi-drug resistant tuberculosis patients.Trying hard not to think too hard about the challenges that are going to come my way once I get started.It's amazing just how much of involvement each of these individual would need.Have roped in Mukesh from CH to help me out.He already has an extensive field experience in tuberculosis.
Started off with preparing my colleagues and getting a register started with the patient details.Have segregated a room in the out-patients that is going to serve as the clinic on wednesdays.We will need a lot of grace from the Lord even as we get deeper into the work.Today I met a patient who was well into the third year of the drug,having lost his family to the disease,being supported by the hospital entirely.
There are a lot of patients who are potential MDRs.
A huge number of cases are from the adjacent Saharanpur district of UP.
A month back,one of the patients walked into the OPD with government drugs in a loose paper which looked nothing like the RNTCP drugs.Yesterday ,the Hindustan Times had an article on spurious drugs which were confiscated from the government stores in UP.I wonder how they are going to compensate the population who have been victims of the drugs used.
Sometimes,I think all of India's administrative problems would be solved if corruption could be taken care of.It is just everywhere and it is frightening that in most places in India it is a norm.
Some of the challenges that would come my way would most probably be
patient compliance,
Cost of the drug,
XDR,
Infection control,
Drug tolerance,
Difficult topography,
Psychosocial problems,
government net-working....
and this could just be the tip of the ice-berg!

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