Doctor contracts TB on the job but KEM won't grant mandatory leave

KEM told the resident doctor that he could take leave from work, but his pay would be docked. File pic

Doctors at government hospitals put their own health on the line when they treat tuberculosis (TB) patients, but when they fall prey to the dreaded disease, they are not even allowed to take time off to recover without a pay cut.

A resident doctor at KEM Hospital discovered this after he contracted TB at work in July, but the hospital refused to grant him the mandatory 70 days of paid leave promised by the state government last year.

Not the first time
This is not the first time that a resident doctor has been refused TB leave. Last year, around 4,500 doctors had gone on strike to demand paid leave for TB treatment, and in November 2015, the state's Directorate of Medical Education and Research (DMER) finally issued a circular declaring 20% or 70 days paid leave for doctors who contract TB. Even after this, however, the Maharashtra Association of Resident Doctors (MARD) has received 3-4 cases where they had to intervene to help doctors get their leave sanctioned.

Unpaid leave
Most of the medical colleges claim they haven't received the circular yet, and refuse to grant the leave. In this case too, KEM told the resident doctor that he could take leave from work, but his pay would be docked.

Also read - Health before marks: JJ Hospital students stay away from TB ward

When the student doctor pointed out that the DMER had mandated 70 days paid leave for TB treatment, the hospital responded with a letter that stated: ‘In this regard we have not received any such GR notification laid by government, and neither has it been communicated to us. Despite it, we considered his leave and have granted 12 days of earned leave and 11 days of leave without pay.'

"The state government had promised us that any resident doctor who contracts TB while performing their duty will be given special paid leave for 70 days. Now the hospital claims there is no such special leave for TB, even though the government circular published in 2015 clearly sanctions it," said Dr Sagar Mundada, president of MARD Central.

High risk
TB is a highly communicable disease that is notoriously hard to treat. As per the treatment protocol for TB, a patient needs to take DOTS treatment continuously for almost a year, and it is recommended that those infected stay in seclusion for six months or so. However, the DMER circular only allows doctors about two months of leave. If doctors are forced to return to work before this minimum recovery period, it could prove dangerous for them and for others. A break in the treatment course could result in the development of drug-resistant TB, and the doctor could even pass on the disease to his colleagues and patients.

"A resident doctor has to work around the clock. They often ignore their meals and health. So, often we see that resident doctors fall prey to TB. If they don't take proper care then their health will deteriorate further," said a senior doctor from the pulmonary department of KEM hospital.

KEM responds
Dr Avinash Supe, dean of KEM Hospital told mid-day that while they have received the circular from DMER, they are waiting for a Government Resolution for confirmation. "Until we receive the GR, we can't give the 70 days of paid leave. We do grant leave, but it is not paid. We are waiting for the GR," he said.

DMER says
However, DMER director, Dr Pravin Shingare said that there is no need for a GR, as the directorate is already granting 80 days of leave to students who approach them. "A GR is needed for new rules and regulations, but leave for TB patients has already been provided, so there is no necessity of a GR. Students need to approach us for leave through the dean of their college," he said.

Just excuses
However, according to Dr Mundada, this is merely an excuse to deny doctors their right.

"Whenever we approach colleges with the plea to grant the special leave to resident doctors, they say that they haven't got the letter yet. They ask us to seek permission from DMER. They are just looking for excuses to avoid giving leave."

17: Number of resident doctors at KEM Hospital who have fallen prey to TB since 2012.