Preventing tuberculosis deaths in India  NOV 16 2010

In the New Yorker, Michael Specter reports on tuberculosis, the world's deadliest infectious disease -- worldwide, more than 5000 people die from it every day. In India, misdiagnosis and improper treatment result in tens of thousands of unnecessary deaths a month and even new genetic screening machines might not help matters.

Since late 2009, the hospital has had one unique asset: a piece of equipment called a P.C.R., which can multiply tiny samples of DNA and analyze them. The device is not as fast as the GeneXpert, but it can examine the genetics of virtually any organism, including tuberculosis. The hospital's machine, which was purchased with money from a government research grant, has never been used. "The hospital has had this for months," Mannan said. "But nobody knows how it works." We were standing at the door of the virology lab, where the new P.C.R. Cobas TaqMan 48, made by Roche and sold for roughly fifty thousand dollars, was resting on a shelf, still wrapped in its shipping material.

How could that be? I was staring at a machine that could alter, even save, the lives of scores of the people who were sitting nearby in the gathering heat. Mannan said nothing, though his anger was palpable.

[...] "It's a nice lab," Mannan said when we left. "Beautiful, actually. But if the doctors used it properly that would interfere with their private practice."

I asked what he meant.

"It is simple," he said. "If patients are treated at the hospital, they won't need to pay for anything else."

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