While the officials do not discount other causes like sex work, men who have sex with men (MSM) and infected mothers passing it on to their children during childbirth they feel that private labs should be brought under the scanner to check the spread of such communicable diseases.
Dr A.S. Pradeepkumar, additional director of health services (PH) says that cases of Hepatitis B have doubled compared to last year. Clusters of such cases were mostly found in Malappuram, Kozhikode and Kollam according to him. Other places, where many cases of hepatitis B were reported are Changnacherry and Pathanamthitta.
In the case of Kottayam district, most cases have been identified in Athirampuzha panchayat, says District Medical Officer Dr N.M.Aysha Bhai. Precautionary measures such as awareness camps to educate the people about this disease were held in the Kottayam Medical College Hospital. Infected patients were transferred to different hospital and vaccinations were given to their relatives, she said.
The lack of awareness about the disease is also hampering the initiatives to check the spread of the disease. Kottayam District Medical Media Officer Domy.J feels that camps were not effective as people were not interested. “They thought that it was a water borne disease and not a blood-borne disease”, he said.
“All want to undergo tests and get vaccinated. But we do not have the budget to give vaccinations to everyone and moreover we have only vaccines for children below five years,” says Domy. Some officials feel that tackling Hepatitis B was an issue that needed a state level planning and response. But no protocols were put in place.
Reacting to the allegations against the private labs by the government medical authorities, a micro-biologist of a private lab said, “We do not re-use medical instruments due to fear of losing our jobs. It’s the government hospitals that follow such unsafe practices. They accused us to save their skin,” the micro-biologist alleged.
Clinical pathologists who work in premium private labs such as DDRC, Dianova and Premier say they use only auto-disposable syringes. They also follow strict safety guidelines and diligently use incinerators to destroy used needles. The medical waste is collected by an IMA-led agency IMAGE (Indian Medical Association Goes Eco-friendly).
Dr Punnen Kurian Venkadathu, Director of Tropical Institute of Ecological Sciences (TIES), Kottayam feels that there could be some truth in allegations by the government health authorities. “Some private companies sell recycled syringes in bulk for a song to these private labs. If an auto-disposable syringe is sold for Rs.2 each in the market, these private companies will recycle the used syringes and sell it for 50 ps each,” says Dr Punnen.
Accreditation of clinical labs is not at present mandatory in the state. A lab can be set up if you have certification from a local body. While many of the premium clinical labs have opted for the voluntary accreditation programme under the National Accreditation Board for Testing and Calibration Laboratories (NABL), several others that operate in rural areas and towns do not have them. The proposed Kerala Clinical Establishments (Registration, Regulation and Accreditation) Bill now plans to make the accreditation mandatory and also has provisions for grading the labs.