Tetanus care facilities at stake
A small broom stick pierced her hand when Ajufa Begum in her 60s was sweeping the floor of her shanty. Days rolled by as usual with Ajufa not caring for the wound.
It began on the fifth day of the incident when her body temperature soared high. On the twelfth day, she got stiff jaws, unable to utter any words.
Family members soon took her to Madaripur district sadar hospital from her home in Kalkini upazila, but doctors could not figure out what Ajufa had contacted.
Sent to Dhaka, she was diagnosed with tetanus--a bacterial disease marked by rigidity and spasms of the voluntary muscles--at Dhaka Medical College Hospital.
DMCH lacks an isolated ward to treat tetanus patients. So Ajufa was sent to Infectious Diseases Hospital (IDH) in Mohakhali where she got admitted on April 28.
The elderly woman is now almost cured and waiting to get back home.
Ajufa Begum is lucky enough to receive proper treatment in the capital city. In rural Bangladesh, 80 percent tetanus-affected people die, either due to prejudice of demonic possession or lack of treatment facilities.
Experts say many tetanus patients in the country, especially in rural areas, die prematurely because of absence of tetanus treatment facilities at upazila and district hospitals.
The government also does not know how many people die from tetanus across the country every year, they said. Tetanus deaths are also highly underreported, they added.
National Professor Dr MR Khan has recently said tetanus deaths go underreported, as patients usually do not go to hospitals due to the prejudice of evil spirit.
Dr Mohammad Amimul Ehsan, a consultant at IDH, said tetanus patients have to be treated in isolated wards, because it is a highly contagious disease.
Any person with an open wound that bleeds is likely to get tetanus, he said.
Tetanus germs have also high resistance capacity--they can stand boiling for as long as 40-60 minutes and heat for one hour, he said.
Regarding lack of tetanus treatment facility, Dr Ehsan said Mohakhali IDH was the lone hospital in the capital which had separate wards to treat tetanus patients.
Therefore public and private hospitals usually send these patients to IDH, he added.
Dr Ehsan said 447 tetanus patients were admitted to Mohakhali IDH between March 2010 and December 2011, and of them 137 died.
Over 80 percent patients came from rural areas, he added.
Mohakhali IDH, set up in 1972, is better equipped compared to other government infectious diseases hospitals, he said, but it has a mere 35 beds for tetanus patients.
The IDH also does not have an ICU and CCU, though tetanus patients often have cardiac arrests while undergoing treatment.
From January to late May this year, 120 tetanus patients got admitted to the hospital, while 40 of them died, Dr Ehsan said.
According to health directorate sources, at present the government is providing three tetanus vaccines to newborns--first dose at one and half months age, second one at two and a half months, and the third and final one at three and half months.
And each woman is provided with five tetanus vaccines between 14 and 49 years of age to prevent delivery-time tetanus infection.
Many experts however suggest that the government frame guidelines in providing tetanus vaccine so that every child can grow up without having the potential risk of tetanus.
According to Dr Ehsan, a person can get lifelong immunity from tetanus, if he or she receives five tetanus doses.
The government can arrange it, he said, as it already has the infrastructure which has been used to run country-wide immunisation programme.
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