Dear Editor,
Yesterday I read a very worrying letter from a patient who has the deadly multi-drug resistant TB infection. This patient stated that the Ministry of Public Health has been out of MDR-TB medication for nearly two weeks. Why am I concerned? Let me tell you what MDR-TB means and how serious it is.
The term “multidrug-resistant TB” (MDR-TB) refers to TB caused by an isolate of M. tuberculosis that is resistant to both isoniazid and rifampicin and possibly additional agents. That is, resistant to at least two of the four commonly used antibiotics used.
This is a serious infection. One patient infected with this bug, without treatment and in the community coughing can cause a deadly epidemic in Guyana. That’s the reason why this infection is taken seriously in civilised countries. Infectious patients are isolated, out of public interest, many times against their wishes until they are not infectious. If an epidemic is to break out in Guyana the poor people will suffer. The rich folks and politically connected would be secured in their aristocratic enclave drinking fine wine and consuming the best prophylactic MDR-TB antibiotic while the poor masses are coughing up blood, wasting away and dropping dead in the pot-holed streets before finally being laid to rest in the jungled, serpent-infested cemetery.
This feeds into my argument of the Ministry of Public Health getting the basics right. Get a few antibiotics. Get a few antivirals. Get a few antifungals. Get a few paracetamols and ibuprofen, get bed sheets, pillows and beds among other things. Forget about the headline grabbing matters like coronary stenting and kidney transplants. Leave that for the private hospitals. They have the expertise and facilities. And also they are much cheaper.
Yours faithfully,
Dr. Mark Devonish MBBS MSc
MRCP(UK) FRCP(Edin)
Consultant Acute Medicine
Nottingham University Hospital
