Sevantee Ghosh, a medical doctor from Kolkata, has been working with MSF’s hepatitis C project in Meerut, Uttar Pradesh, since January 2017. In this piece, she looks back on a year of treating hepatitis C.
I have been working at the clinic in Meerut from the day it opened. The assessment we had done prior to opening the clinic had indicated that Meerut district was one of the hepatitis C hotspots. But nothing could have prepared us for the numbers we are seeing now.
Since opening the clinic, we have screened 2711 patients and initiated 1198 on treatment. Being the only facility in the district that provides free hepatitis C treatment, we receive patients from all over the State. We have entire families receiving treatment at our facility. Although there is a scarcity of data about the prevalence of hepatitis C, as there is no notification or surveillance system for the disease, we often hear from patients that large number of people in their villages are affected. Local media reports suggest that some villages have up to 80% of people infected, which is very alarming to hear.
Hepatitis C is a liver disease caused by exposure to infected blood. In a region like Meerut, where healthcare facilities are not easily accessible, people still go to traditional healers and informal practitioners. We don’t know what kind of medical equipment is being used and whether it is getting properly sterilised. That’s why, in addition to providing medicines at our clinic, health education plays a vital role. We tell patients how the disease spreads and what they can do to protect themselves and their families.
In the past year, we have seen how hepatitis C is much more than a disease. It affects many other aspects of patients’ lives. There are young women who are not able to get married because they have hepatitis C; young men want to go out of the country and start businesses but they are unable to secure visas because they have hepatitis C.
So for me, the best day is when we can give the patient their ‘cured’ certificate. As a doctor, I look forward to it as much as a patient does. I remember a 60-year-old man from Bijnor who was diagnosed with hepatitis C over five years ago. He had started treatment but had to drop out midway because it was so expensive. He was able to resume treatment last year with MSF, as we provide the treatment for free. When he was cured, he told me, “I was not sure I’d live to see this day.”
Like him, a lot of patients are waiting for treatment but the prices are proving to be a hurdle. For example, a 12-week course of treatment cost can be as much as Rs 36,000 which could be what a person living below poverty line earns in one year. And many of our patients are so poor that they cannot afford to be diagnosed – let alone pay for treatment. Imagine the financial strain that families are under if more than one person is infected?
There is an urgent need to scale up access to this testing and treatment in the public sector. Ideally, a public health programme like HIV or TB that offers a free testing and treatment in each district needs to be there, so that people are not prevented from getting this lifesaving treatment for financial or geographical reasons.