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Sewri TB hospital staff wear single-use masks for a week

Despite the growing scare of multi-drug-resistant tuberculosis, the hospital management has been putting cost-cutting over protection of staff

Even as the central and the state governments are busy containing the spiralling TB situation in the state, staffers at the city's only TB hospital in Sewri - perhaps the most vulnerable to tubercle bacilli - are being made to wear single-use disposable masks for days altogether. They were initially asked to don the masks for a whole fortnight, and after protests, hospital authorities grudgingly decreased the stipulated duration to a week.


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"The box in which the masks are kept clearly mentions that they are disposable and shouldn't be worn twice, but we have been told to use each mask at least for a fortnight. Using this mask would only spread the infection, and we have informed the authorities as much, but they simply asked us to use it for a week instead," said a senior nurse from the hospital.

The masks were given to the nurses and ward boys working for the hospital after members of the employees' union made repeated presentations to authorities requesting that basic items like masks and gloves be given to them, to prevent transmission of the disease from patients to employees.

Their relief at the arrival of masks was short-lived, when they were told to repeatedly reuse the disposable masks.

"It was only after a lot of persuasion that the employees were given N-95 masks. But after we got the masks, we learnt that they were for one-time use only. When we brought this to the notice of the authorities, they told us that we could use each for 10 days, which was later curtailed to a week. We are so glad that we have at least got the masks and the nurses are adjusting to the situation," said Pradeep Narkar, secretary of the municipal mazdoor union.

According to the union, in the past 5 years, 29 staffers of the hospital, including one nurse, succumbed to tuberculosis. "

At present, 14 employees are suffering from multi-drug-resistant (MDR) tuberculosis. Some 170 posts are vacant in the hospital and therefore the existing staff-members have to work overtime, resulting into greater contact with TB patients.

Acting on our request, the authorities have proposed that a high-protein diet - including 2 eggs, 200 grams milk, two bananas and two slices of bread - be provided to the employees, so that they have high immunity levels," added Narkar.

Double filter masks
Realising that the employees were being exposed to a greater risk of infection by using disposables masks repeatedly, the authorities ultimately consulted the Hospital Infection Society, which suggested that the staff be given double filter masks, which are cheaper.

Dr Rohini Kelkar, vice president, Hospital Infection Society of India, said, "Though it is advised that the N-95 masks are worn once, it is not a practical option for our hospitals. The TB bacteria's transmission is through a droplet, and the masks are most required when one comes in direct contact with the patients' sputum. We have suggested that the staff at the hospital be given surgical masks with filters, which will possibly arrest the transmission."

Officialspeak
A senior official from the administrative department of the hospital said, "Each mask costs us Rs 70: if the employees start using one mask a day, the cost would run into lakhs for just a month. Thus we have asked the nurses to wear the masks only when they are attending to patients in the ward, so the purpose of keeping infection at bay is met."

Expertspeak
Dr Pratit Samdani, physician at Breach Candy hospital, said, "Using any kind of mask for a week will only add to the transmission. The hospital is only facilitating the spread of the disease. Any mask, if used for a longer period than mentioned, will lead to accumulation of moisture, which supports the growth of bacteria."

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