Medical ethics

Hospital against access to life-saving drug for TB patient as case reaches Delhi High Court

The hospital administration said the 18-year-old woman could develop ‘an additional and fatal resistance to bedaquiline, which may spread to the community’.

Officials from the National Institute of Tuberculosis and Respiratory Diseases on Monday told the Delhi High Court that providing bedaquiline, a life-saving drug, to an 18-year-old woman suffering from a drug-resistant form of TB would fail to treat her. They warned that it may cause the drug-resistant bacteria to spread in her body.

The patient, a Patna resident, has already developed a resistance to all other available drugs to treat TB. She has been undergoing treatment for the disease since 2013. Her father had moved the Delhi High Court, seeking access to bedaquiline, which is provided conditionally at six hospitals in five cities, including at the institute.

The hospital screens each patient before giving the drug and then monitors them. The woman was denied the treatment initially as she was not a resident of Delhi.

Scroll.in wrote about her plight and how her treatment reflects the failure of the national TB programme. The woman is currently being treated at PD Hinduja Hospital in Mumbai.

An affidavit filed by Vijay Bhatt, the hospital’s administrative officer, said that with an “inefficient backbone regimen” (drugs that should be taken along with bedaquiline), the patient could develop “an additional and fatal resistance to the drug, which may spread to the community and have catastrophic effects.”

The hospital administration insisted on a drug sensitivity test, which could take up to two months. A sample for the test has already been taken. “If they say this drug will not work, could they at least tell us what will cure my daughter?” said the woman’s father, who was present at the Delhi High Court. The next hearing in the case is scheduled for Friday.

Earlier, Dr Jennifer Furin, from the Global Health and Social Medicine at Harvard Medical School, had said that the patient’s previous reports are indicative enough for her to be eligible for bedaquiline. An additional test would be a “bureaucratic requirement and not in the best interests of the patient”, she had said.

The hospital has also asked the patient to try and get the drug from the manufacturer, Janssen Pharmaceuticals, which could provide the medicine free of cost to patients if the doctor provides evidence that the patients will die without it. However, in practice, it could take two to three months for a patient to get access to the drug through this avenue.

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“My body instantly craves chai and samosa”

German expats talk about adapting to India, and the surprising similarities between the two cultures.

The cultural similarities between Germany and India are well known, especially with regards to the language. Linguists believe that Sanskrit and German share the same Indo-Germanic heritage of languages. A quick comparison indeed holds up theory - ratha in Sanskrit (chariot) is rad in German, aksha (axle) in Sanskrit is achse in German and so on. Germans have long held a fascination for Indology and Sanskrit. While Max Müller is still admired for his translation of ancient Indian scriptures, other German intellectuals such as Goethe, Herder and Schlegel were deeply influenced by Kalidasa. His poetry is said to have informed Goethe’s plays, and inspired Schlegel to eventually introduce formal Indology in Germany. Beyond the arts and academia, Indian influences even found their way into German fast food! Indians would recognise the famous German curry powder as a modification of the Indian masala mix. It’s most popular application is the currywurst - fried sausage covered in curried ketchup.

It is no wonder then that German travellers in India find a quite a lot in common between the two cultures, even today. Some, especially those who’ve settled here, even confess to Indian culture growing on them with time. Isabelle, like most travellers, first came to India to explore the country’s rich heritage. She returned the following year as an exchange student, and a couple of years later found herself working for an Indian consultancy firm. When asked what prompted her to stay on, Isabelle said, “I love the market dynamics here, working here is so much fun. Anywhere else would seem boring compared to India.” Having cofounded a company, she eventually realised her entrepreneurial dream here and now resides in Goa with her husband.

Isabelle says there are several aspects of life in India that remind her of home. “How we interact with our everyday life is similar in both Germany and India. Separate house slippers to wear at home, the celebration of food and festivals, the importance of friendship…” She feels Germany and India share the same spirit especially in terms of festivities. “We love food and we love celebrating food. There is an entire countdown to Christmas. Every day there is some dinner or get-together,” much like how Indians excitedly countdown to Navratri or Diwali. Franziska, who was born in India to German parents, adds that both the countries exhibit the same kind of passion for their favourite sport. “In India, they support cricket like anything while in Germany it would be football.”

Having lived in India for almost a decade, Isabelle has also noticed some broad similarities in the way children are brought up in the two countries. “We have a saying in South Germany ‘Schaffe Schaffe Hausle baue’ that loosely translates to ‘work, work, work and build a house’. I found that parents here have a similar outlook…to teach their children to work hard. They feel that they’ve fulfilled their duty only once the children have moved out or gotten married. Also, my mother never let me leave the house without a big breakfast. It’s the same here.” The importance given to the care of the family is one similarity that came up again and again in conversations with all German expats.

While most people wouldn’t draw parallels between German and Indian discipline (or lack thereof), Germans married to Indians have found a way to bridge the gap. Take for example, Ilka, who thinks that the famed differences of discipline between the two cultures actually works to her marital advantage. She sees the difference as Germans being highly planning-oriented; while Indians are more flexible in their approach. Ilka and her husband balance each other out in several ways. She says, like most Germans, she too tends to get stressed when her plans don’t work out, but her husband calms her down.

Consequently, Ilka feels India is “so full of life. The social life here is more happening; people smile at you, bond over food and are much more relaxed.” Isabelle, too, can attest to Indians’ friendliness. When asked about an Indian characteristic that makes her feel most at home, she quickly answers “humour.” “Whether it’s a taxi driver or someone I’m meeting professionally, I’ve learnt that it’s easy to lighten the mood here by just cracking a few jokes. Indians love to laugh,” she adds.

Indeed, these Germans-who-never-left as just diehard Indophiles are more Indian than you’d guess at first, having even developed some classic Indian skills with time. Ilka assures us that her husband can’t bargain as well as she does, and that she can even drape a saree on her own.

Isabelle, meanwhile, feels some amount of Indianness has seeped into her because “whenever its raining, my body instantly craves chai and samosa”.

Like the long-settled German expats in India, the German airline, Lufthansa, too has incorporated some quintessential aspects of Indian culture in its service. Recognising the centuries-old cultural affinity between the two countries, Lufthansa now provides a rich experience of Indian hospitality to all flyers on board its flights to and from India. You can expect a greeting of Namaste by an all-Indian crew, Indian food, and popular Indian in-flight entertainment options. And as the video shows, India’s culture and hospitality have been internalized by Lufthansa to the extent that they are More Indian Than You Think. To experience Lufthansa’s hospitality on your next trip abroad, click here.

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This article was produced by the Scroll marketing team on behalf of Lufthansa as part of their More Indian Than You Think initiative and not by the Scroll editorial team.