| Dangerous liaisons
Modified leprosy elimination campaign: Under national leprosy elimination programme two MLECs were launched in the state — first in 1998-99... and the second in 1999-2000... with the main objectives (i) to create mass awareness by campaigning about leprosy (ii) to give orientation training to all medical staff and officers and (iii) to detect suspected and hidden cases within a short period. The government of India provided Rs 6.64 crore for conducting two MLEC programmes in the 18 districts of the state.
Performance of the state on these two MLECs is detailed below: from the above reports and examination of records of 4 test-checked districts, audit observed that... out of a total population of the relevant years (777.9 lakh and 790.1 lakh), only 76.38 and 70.40 per cent population of the state could be examined for detection of suspected cases.
All the search teams issued a copy of the referral slip to the suspected case with the instruction to report to the nearby treatment centre with the referral slip for further examination, confirmation and treatment. Another copy of the referral slip along with the list of suspected cases was to be forwarded by MLEC search teams to the concerned treatment centre. But no such referral slip/list of suspected cases was forwarded by them to the treatment centres.
In the absence of the list of suspected cases, the centres were not in a position to ascertain whether or not all such cases reported to centres for examination and consequently the centres could attend to only those who appeared voluntarily for examination, confirmation and treatment. Test-check, however, revealed that percentage of leprosy suspected persons who voluntarily reported to the treatment centres along with the referral slip...and confirmation ranged between 27 to 42 per cent only, thus leaving 58 to 73 per cent suspected cases unexamined. The procedural lapses were confirmed in May-June 2001 by all the zonal leprosy officers. Government avoided mentioning in the MLEC reports the actual number of suspected cases examined in detection of confirmed leprosy cases. Scrutiny also disclosed that due to this procedural lapse only 18 and 16 per cent of suspected cases could be confirmed as leprosy patients under two MLEC programmes though GOI fund of Rs 6.64 crore was spent for this purpose.
Other points of interest: Bankura Leprosy Training Centre imparted to only 117 para-medical workers against 560 to be trained as per capacity of the centre during January 1996 to June 2001 while Rs 88.86 lakh was spent towards salary and contingencies for 20 staff including 3 MOs who were engaged in this work.
One 20 bed temporary hospitalization ward for leprosy patients sanctioned in 1982 was constructed at a cost of Rs 5.50 lakh and handed over to the superintendent, State General Hospital, Raghunathpur, Purulia in April 1988. The THW remained non-operational for want of formal government order for opening (June 2001).
Even after 19 years of MDT, the state’s achievement under NLEP was far below the target. Even these figures of achievement were overstated by various informal methods. Monitoring by controlling officers/authorities was found deficient and hence despite funds being available, the impact of the programme on the control of disease was not significant.
The matter was referred to the government in September 2001; reply had not been received (January 2002).
AIDS Prevention and Control Programme: acquired immuno deficiency syndrome is a dreaded disease not curable but preventable. It is caused by human immuno deficiency virus. AIDS case was first detected in West Bengal in 1986. Subsequently, the disease spread in the state mainly through unprotected sex practices (more than 80 per cent) and other modes of transmission through blood, blood products and from infected mother to the baby during pregnancy.
The programme mainly aimed to prevent the spread of HIV infection in the community, ensure safe blood transfusion free from HIV, Hepatitis B (HBS ag), VDRL and malaria parasite, strengthen measures to control sexually transmitted diseases, create awareness by promoting IEC network and social mobilization.
In the state at this stage only support and care services towards treatment is being rendered by one AIDS clinic, functioning at Apex AIDS Referral Centre at the Medical College Hospital, Calcutta. Two counsellors are working at HIV testing laboratory at the School of Tropical Medicine, which had detected 637 AIDS cases up to December 2000 out of 119,343 samples tested. No district-wise figure is available with the State AIDS Control Society.