Amid Drug Shortage, Bhopal Gas Victims, Children Miss TB Doses For Days

Victims of the Bhopal gas tragedy of 1984, which is one of the world's worst industrial disasters, and their children are now facing a new challenge - a shortage of drugs to treat tuberculosis at government DOTS centres. What makes this crisis even more acute is that studies have shown that people who were exposed to the gas that leaked from the Union Carbide plant are twice as likely to die of the disease, which also affects the lungs. 

The severe shortage of the drugs at DOTS or Directly Observed Therapy Short Course centres, where the medicines are given for free, is expected to affect more than 1 lakh tuberculosis (TB) patients in Madhya Pradesh, of which 12,000 are in Bhopal. The shortage is being faced by many other states as well. 

Experts told NDTV that people face a high risk of treatment interruption and of developing resistance, which would increase the risk of the disease spreading in the community of gas victims. They said that the victims' exposure to methyl isocyanate, 40 tonnes of which leaked from the Union Carbide India Limited pesticide plant in Bhopal, caused multi-systemic injuries and damage to the immune system, leaving them especially vulnerable. 

The state's junior health minister said the government will look into the issue and arrangements will be made immediately.

'Take Double Dose'

Nusrat Jahan, a victim of the Bhopal Gas Tragedy who suffers from tuberculosis, has not taken her medicines for nearly 15 days. Ms Jahan said that, even before she stopped getting medicines, she had to consume two to three extra pills per day to attain the necessary dosage as the doctors at DOTS centres have been forced to give formulations meant for kids to adult patients in recent weeks. She, and several other victims, said they cannot afford to buy the medicines. 

Normally, a four-drug fixed-dose combination (4FDC) - Isoniazid, Rifampicin, Ethambutol, Pyrazinamide - or a three-drug fixed-dose combination (3FDC) - which leaves out Ethambutol - is given to patients. Doctors said missing multiple doses can lead to symptoms resurfacing or the treatment having to be restarted. 

"I have not received medicines in the past 15 days. There is numbness in my hands and feet, I have fever and I am in a lot of pain. I am a gas victim and my condition is now so bad that I can't even do any work. Before this, they gave me TB medicines meant for children and told me to take a double dose." Ms Jahan said.

Pushpa Rajput has been fighting tuberculosis for some time now and she, too, has not been getting medicine for a month. She said, "There is no one in the house except my husband, I cough blood and there is a lot of pain in my chest. I am having difficulty breathing. I have not received medicines for a month and they say they have no stock."

'Feeling Helpless'

Asif Khan said he has been going from one centre to the other to get medicines for his wife. "My wife is suffering from TB. She was undergoing treatment at Jawaharlal Nehru Hospital and also underwent surgery. She was getting medicines for the past six months but it has been 15 days since her last dose. Every day, they say there is no medicine and doctors have also told us that there is a possibility of the problems she had resurfacing if she does not get her medicines," he said.

Two of Shahid Khan's daughters are battling TB and they have also not got their medicines for nearly 10 days. "My two daughters have been diagnosed with TB and I am not getting medicine. There are white patches in their lungs and they are coughing. What can I do? I am feeling helpless. I can't go to the centre every day my family is dependent on my daily wages," Mr Khan said.

Gas victims affected by TB in Bhopal have written a letter to the state government and said the shortage began over a month ago. 

"We have written a letter to the state government about the shortage of medicines and have also demanded that TB medicines are made available to all gas victims and their children through the process of local purchase due to their non-availability in these DOTS centres," said Rachna Dhingra, who works for Bhopal gas tragedy survivors.

Government's Take

Minister of State for Health, Narendra Shivaji Patel, said, "Our honourable PM Narendra Modi has decided to make India TB-free by 2025. We will get what you are saying investigated and will not let such a situation arise. We will make arrangements for medicines immediately."

A government doctor, Dr Anil Jain, said, "We have received an order that the medicines will be made available through local purchases. We do have a schedule for giving paediatric doses to adults and are giving medicines accordingly."