BMC doctor dies of Extremely Drug-Resistant TB on Monday

A senior doctor working with the Brihanmumbai Municipal Corporation (BMC) died of Extremely Drug-Resistant TB (XXDR-TB) on Monday. Dr Suresh Tulshiram Waje, 46, breathed his last in the Sewri TB Hospital, the very place where he had been treating TB-afflicted patients for the past two decades.

Waje had contracted drug sensitive pulmonary TB in 2010, for which he took medication for six months and was cured. Senior doctors at the hospital said that his disease relapsed in a dangerous manner in 2013. "In 2013, Waje was diagnosed with a more potent multi-drug tuberculosis (MDR-TB). The bacteria in his body had evolved and become resistant to the initial five drugs – Streptomycin, Isoniazid, Ethambutol, Rifampacin and Pyrazinamide, that he was being treated with," said a senior doctor. "In January 2014, he developed resistance to MDR-TB drugs," said the doctor.

He was slated to be a rare case of Extremely Drug Resistant TB (XXDR-TB), as he had become resistant to three drugs, Moxiflox, Clofazimine and Clarithromycin of the six new drugs that were included in his modified regimen.

Dr Waje, who had been serving in BMC's TB programme for the past two decades, had worked at multiple dispensaries across the city. "He used to check and consult at least 30 to 40 TB patients every day for the past ten years," said another senior doctor at the hospital.

Dr Waje had served as a consulting doctor at BMC TB dispensaries at Nawab Tank in Mazgaon, Dadar, and later at Sewri TB Hospital.

Since 1999, 190 employees have been infected with TB at the hospital, of which 82 have died. On an average twelve employees in Sewri TB Hospital contract TB every year, of which five employees die, which means that two in every five infected employees in the hospital die of the infection. "At the moment, up to 17 workers have contracted multi-drug resistant TB in the hospital. Additionally, eight nurses, one clerk and two doctors are also reeling under TB infection at Sewri TB Hospital," said Pradip Narkar, secretary, Municipal Mazdoor Union (MMU).

Doctors said that this is the second incident of a doctor falling prey to the infection in the hospital. In 1998, Dr S Ghormade (52) had died of a TB-Diabetes co-infection in the hospital. "Doctors require a good working environment. Most of them, working in pathetic conditions, are under stress. Also, having nutritious food is a primary requirement for maintaining adequate immunity," said Narkar.

Dr Waje, like Dr Ghormade, was a diabetic patient and was also suffering from depression. He was a habitual alcohol drinker and had been sent to an ashram in Virar for de-addiction treatment. Diabetes and alcoholism had compromised his immune system.

For the last one month, he was in hospital, but nurses said that he was non-co-operative when it came to treatment. "He had dropped at least twelve kilos of weight as he refused food most of the times. His general condition was poor. He refused medication. He was counselled, but he did not budge. He refused permission when we asked for his x-ray to be taken or other tests," said a treating doctor.

Dr Ravi Nanavare, medical superintendent, Sewri TB Hospital said, "His condition deteriorated rapidly. Both his lungs were spoiled. He entered kidney failure and later succumbed. He had not been taking his medicines in the past two weeks."

He is survived by his wife and two daughters.