Stop TB Partnership

Urgent need to implement TB infection control practices at Sewri TB hospital

Regulations will lead to safer environment for health care workers and patients

October 15, 2015 - In September, Sewri TB hospital informed a national newspaper that it would be ensuring regular supply of N95 respirators for use by its personnel. The hospital plans to order 5000 respirators every fifteen days, ensuring 10,000 by September end and another 10,000 by October.

Over the years, workers of Sewri TB Hospital who have occupationally acquired drug-resistant TB (DR-TB), have developed symptoms of active disease and become critically ill. According to the news report published by Daily News & Analysis (DNA), in March and July of 2015, nearly 200 employees of Sewri TB Hospital have developed TB since 1999, and several of them have died.

The negligent behaviour of the Brihanmumbai Municipal Corporation (BMC), Central TB Division and the Ministry of Health towards transmission of tuberculosis (TB) in health care settings to both patients and health care workers (HCWs) is disturbing, especially given that investment in infection control measures is much lower compared to the cost of diagnosing and treating drug-resistant TB cases, not accounting for the cost to the patients and their families.

For healthcare staff in India, lack of access to N95 respirators in government facilities, where care and treatment is being provided to patients with TB is a key concern. The shortage of personal protective equipment including N-95 respirators and the lack of implementation of infection control practices at the Sewri Hospital has led to increasing number of deaths.

The BMC is the government body responsible for ensuring that the Sewri TB Hospital receives a regular stock of 12,000 N95 respirators per month for the use of healthcare workers. However, several acute shortages of N95 respirators have been repeatedly recorded in the hospital. Responding to public pressure and protests (Letter from civil society, Protests by Sewri Hospital staff), the Sewri hospital authorities announced in September that they would purchase N95 respirators every 15 days. They however appealed that BMC provide a stock of 72,000 respirators for six months to ensure sustainable supply.

"We welcome the move made by the Sewri Hospital to procure N-95 respirators for their staff. A regular supply of respirators for health workers and surgical masks for patients is crucial for reducing the risk of transmission and safeguarding public health. The hospital must also ensure the actual uptake of the respirators by the entire staff- including nurses and class 4 workers, and not just the doctors," said Blessina Kumar, Chair of the Global Coalition of TB Activists

"Infection control must be seen as part of public health TB services. RNTCP should not only issue guidelines on infection control for respiratory infections but also ensure that they are implemented. Availability of Personal Protective Equipment like N95 respirators is crucial to protect frontline healthcare workers treating TB/DR-TB patients," said Dr. Anant Bhan, Researcher, Global Health and Bioethics.

"It is not enough to run campaigns with Bollywood celebrities; we want real action on the ground from the BMC. I have worked as a DOTS provider and I know the risks of acquiring TB faced by healthcare workers. BMC has still not provided required number of respirators to Sewri TB Hospital," said Loon Gangte from the Delhi Network of Positive People.