Today was a day that could have made public health law history in Botswana. We heard that the doctor in charge of the city clinics was bringing a case regarding a non-compliant TB patient. Although the laws in Botswana, just like the US laws, allow for TB patients who are non compliant to be remanded to a some form of isolation, they are never enforced. This guy, who had MDR TB (multi-drug resistant and very lethal) was out and about and refused treatment. He was also an ex-policeman. A group of us arrived at the local courthouse (sort of like a small district court), along with a bunch of TB doctors and officials. The state's attorney came over and kind of sheepishly told us that the police did not know where the defendant was. Apparently, they served him with a warrant a day or two ago and told him to appear. He had probably slipped out of town. In the past, most of these folks are held in an isolation ward but the drs. suspected that some special treatment was at work here because he was a former cop. We were all prepared - even had our protective masks ready since this guy was highly infectious, the media was ready - reporter and cameraman. The drs. were very disappointed because they hoped to make this case a precedent and send a strong message to the community that TB is a deadly illness, particularly as it routine appears here along with HIV. They hoped to use the occasion to focus attention on how dangerous the situation is. Hopefully, the police will round him up and more likely he will turn up at some hospital soon and then be charged.
So, a no-show, but still kind of interesting to hear about the state of public health law in Botswana and I will certainly follow this case.
Came back home to put the finishing touches on a lengthy report for Muskie that has been keeping me computer bound for a while. Delighted to see that go off in the ethernet. Tomorrow we are playing golf with a visiting couple who are here to visit their Penn resident daughter and son in law. Rita Watson and her husband Jack Schmidt are other old Penn medical colleagues of Peter - amazing how many of these old connections he is finding here! A regular time warp...
Thursday, February 11, 2010
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