| Other victims
Shortfall in training programme: training of the key staff is an essential pre-requisite for effective implementation of a programme. Due to lack of advance planning there was a shortfall of 60 per cent and 82 per cent in respect of training of medical officers and para-medical staff in Bardhaman district. In Birbhum, it was 31 per cent and 16 per cent respectively. In Malda only 79 per cent of MOs were trained as of March 2001.
State TB Demonstration cum Training Centre: in the STDC set up in 1960 in Calcutta Medical College and Hospital for conducting training course in BCG vaccination and sputum microscopy no advance planning was made for training to be imparted with target specifying the category and number of staff to be trained.
Expenditure of defunct clinic/idle establishment: in Birbhum district Rs 3.24 lakh was spent during 1999-2001 towards maintenance of a defunct chest clinic. In Bardhaman and Howrah districts deputy chief medical officer of health II incurred an expenditure of Rs 4.40 lakh towards salaries of two drivers remaining idle during July 1998 and March 2001.
Non-involvement of non-government organization: involvement of NGO in implementation of the programme was insignificant. In Bardhaman, Birbhum and Malda no involvement of NGO and anganwadi workers were noticed. In Howrah 2 NGOs could be involved only in February 2001.
Manpower: in the 5 test-checked districts there was shortage of 28 tuberculosis health visitors, 31 medical technologists (MT Lab), 1 MT (X-Ray), 1 pharmacist, 1 senior treatment supervisor and 20 microscopists affecting implementation of the programme. The overall position for the state was not furnished by the additional director of health services (TB).
Information, education and communication activities: successful implementation of revised national tuberculosis control programme depended on the knowledge and awareness of different aspects of tuberculosis and its control measures to the providers, users and the community at large. In the state, the state media officer was not involved in planning, organizing, monitoring and co-ordinating IEC activities. No IEC officer was appointed and the fund for remuneration of the officer (Rs 0.80 lakh received in March 1999) remained unutilized as of January 2001.
IEC activities were not taken up (March 2002) in Bardhaman district and the fund received remained unspent. In Birbhum district only 4 per cent of the fund was utilized. In Malda where RNTCP was in operation from 1999, only 65 per cent of fund (Rs 3.27 lakh) was utilized against Rs 5.56 lakh.
Other points: during 1999-2000, in Malda under DOTs, 28,122 vials of injection Streptomycin valuing Rs 1.41 lakh were handed over to the patients of category II for getting them administered from outside.
There are large number of street dwellers in the Calcutta Municipal Corporation area. Possibility of some of these dwellers suffering from TB and even dying of the disease cannot be ruled out. Pavement dwellers who pull rickshaws, work in homes, at roadside shops, and so on have ample scope of spreading the disease. As per RNTCP guidelines, patients requiring registration must have specific address. As the footpath dwellers do not have any ration cards and fixed addresses they were not covered under the programme for treatment. Thus spread of disease from them had remained unchecked.
In CMC a sum of Rs 1.16 lakh (Rs 0.95 lakh as ex-gratia for 1998 and 1999, Rs 0.21 lakh as leave salary for maternity and medical leave) was paid to the contractual staff in violation of norms.