MFCM033: Some comments on Anant Phadke's paper on %22Discussing Tuberculosis Control - Why?%22.pdf

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Some comments on Anant Phadke1s paper on "DISCUSSING
TUBERCULOSIS CONTROL—WHY? (mfc bulletin 108 DEC ’84)

(1)
I agree with his stand on this issue.that any discussion
in mfc has to be directed towards achieving a socio-economic
and political change. I do feel the importance of working
with social movements o In traditional trade union movements
or even mass movements health issues arc conspicuously absent.
Even among the most politicised workers the level of health
awareness is very low. This is to some extent true with regard
to leadership too. Political awareness and health awareness do
not go hand in hand. This existing gap must be somehow bridged,
and I see that mfc members can play a role in it.
Along with studying the problems involved in implementing the
NTP in a backward country like India, it will be good to study
the reasons for relative success in some States (as it was
mentioned in the last issue of mfc bulletin) in spite of
backwardness—both economic and social. By this I don’t mean
to say that TB can b<_ eradicated within the existing social
and economic backwardness of the country. As Anant says what
is important is to analyse how far this ’backwardness’ is
genuinely the cause for1 total failure of any health program
whether it be TB, Malaria or Leprosy.

—Anne, Ducasai, Bihar
(2)

a. NTP is based on the assumption that all cases will be fully
diagnosed, namely radiologic-ally as well as bacteriological ly.
We should question this assumption.

b. As a result of this assumption success of the NTP is
necessarily based on availability of expertise at’the village
level. If a modus operandi could be worked cut, we can
reduce the dependance on experts.
c. To ensure compliance- and reduce default, it is necessary
to hand over the treatment and follow up to the people,
represented by any local organisation like Gram Panchayat,
Farmer’s association, Mahila Samaj or other voluntary
body. These bodies should never run short of drugs.

do Modus operand! for diagnosiss My suggestions for discussion—
Ideally every suspected case should have an x-ray and sputum
examination..
It is customary to accept a diagnosis with only an x-ray
cr even flucrescopy.examination.
If none of these two examinations are easily available?
A suspected case (cough more than two weeks, fever
and loss of weight) there is n-‘ improvement after
diethylcarbazine, he should be given Isonex and
thiacetazcne (cr ethambutol)
Rifampicin cr Streptomycin should be reserved for
those diagnosed by x-ray or fluoroscopy.
V ikj o r> +-

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T A1

i\ur, Bombay

P’. t.G. . . . 2

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a.Wc should be (and mostof us are) concerned with all the
people whc arc exploited and were/are/wculd be/may be patients
of tuberculosis.
b.Efforts of millions of ordinary people are required for
socio economic and political revolution, a part of which
would be in the direction of preventive, curative service
to the would be and present victims of tuberculosis in various
ways.

I

c*Cooperatives of1 anti-exploitation 1 persons can and should not only
only produce and distribute rational and low cost drugs but
every possible commodity. These products with minimum or no
clement of oxpl citation should replace the present products
(of multinationals or otherwise) full of exploitative element.
Grahak Panchayat, mfc members, Lok Vidnyan Sanghatana and all
of us who oppose exploitation should use these products when
required and should popularize them. Working class organizations
should be made aware of thpse and persuaded to jcin us in
boycotting wherever possible the imported, smuggled and. other
commodities full of exploitative elements.
d. In my view, which I have formed frcm my experience and associa­
tion with exploited sections (we also belong to the same but in
less tragic and pathetic manner) such alternatives shall (a) •
create source of income or alternate source of income; (b)
increase the fighting and resisting capacityespecially during
strike/lcck cut; (c) concretely create confidence in one’s cwn
potentials; (cl) give a clearer vision of how commodities full of
exploitative element are tentacles of capitalist octopus with
millions of tentacles; (o) continually train individuals to
overcome the temptations which have beautiful appearance or
utility but most inhuman and•exploitative element; (f) to a
small extent curb actual exploitation much in action today. For
example, chikki of ground nuts and jaggery manufactured by a
workers’ cccpcrative.(i) can fetch money; (ii) increase strength
cf working class; (iii) create confidence in that group of
workers about their potentials (prevents them frcm going for
matka, liquor, gambling, movies of bad taste etc.); (iv) chikki
can act as a substitute for Cadburry
similar chocolates and
every, time one eats it one learns that chocolates are harmful
though tempting and
capitalists exploit us through such
products; (v) TV and radio advertisements can be rendered use­
less and ineffective by such substitution; (vi) curb the exploi­
tation and harmful effects thrust upon us through chocolates;
(vii) working class solidarity can develop with other exploited
sections. Such many and even more appropriate examples can pe•
given eg. , soap pr.wdor, taiuum powder, prickly heat powder etc.

e. As a whole all those whc manufacture, distribute, popularise,
use, will’ be sharing a certain degree cf confidence and satis­
faction of participating in ever growing concrete action-movement
against exploitation, commercialization and vulgarization
cf value system.

f. All of us whether medicos, pharmaceutical graduates, pharma­
cologists, paramedics, non-mediccs, working class organizations,
grahak panchayat and all progressive groups can aim at and
accomplish such a broad alternative, the part cf which would
be as mentioned earlier—11 anti-tb activities”.
—S J Kashalikar, Bombay

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