Brief History of the T.B. Clinic
Started at Chunamandi, Paharganj, in a small rented room in October 1933, “as a philanthropic institution” to serve specially the poorer sections of the community, the clinic was shifted to a comparatively spacious house near Jama Masjid in August 1934. In September 1935, the clinic was again moved to a well-ventilated and spacious building named “Hanging Bridge” near Edward Park in Daryaganj. This was the first TB Clinic in Delhi, and it demonstrated the efficacy of managing TB patients on out-patient basis in an era when no specific anti-TB drugs were available. The statistics for the period 1933-35 demonstrated the need and advantages of such care for poor TB patients who could not afford to be admitted to TB Sanatoria.
A scheme for a permanent building was formulated in 1938. The Mission authorities had approached the local government for the allotment of a plot of land in Daryaganj for erecting a permanent building for the clinic. While the local government agreed to allot a site and negotiations for it were proceeding, Delhi Improvement Trust came into existence and offered an alternative site near Kashmiri Gate, which the Mission authorities accepted. Later, with the modification of the TB Control Programmes in 1938, Delhi Improvement Trust offered the Mission authorities the present site at Karol Bagh (Arya Samaj Road) in 1940. The Mission got possession of the land on 11 March 1940. An additional plot of land was also acquired for staff quarters etc. Construction of the TB Clinic building was completed by the end of 1947. The formal opening ceremony of the new building was performed by Union Health Minister Rajkumari Amrit Kaur. In August 1949, the clinic began to admit indoor patients to its 16 observation beds. An ENT department was added the same year. Another building to accommodate residential staff was constructed on an adjacent plot of land in 1954.
When the government decided to involve NGOs under the Revised National Tuberculosis Control Programme (RNTCP), the Ramakrishna Mission Free TB Clinic was selected as the district centre for Karol Bagh. The clinic had adopted Directly Observed Therapy Short Course (DOTS) in 1996, though the RNTCP was officially launched on 28 October 1998.
The RNTCP at Ramakrishna Mission Free TB Clinic comprises the following components:
- Case finding: diagnosis of new TB patients.
- Treatment of TB patients, both DOTS and non DOTS.
- Symptomatic support to cases of TB and other diseases.
- Diagnosis of multidrug resistant (MDR) and extensive drug resistant (XDR) cases of TB by sending suspects for sputum testing using molecular methods like Cartridge Based Nucleic Acid Amplification Test (CBNAAT) and Line Probe Assay (LPA) as well as culture and drug sensitivity (culture and DST) testing.
- Treatment of MDR and XDR cases.
- Case holding: Motivation of all TB cases for continuation of treatment for 6-8 months and MDR/XDRTB cases for 2 years.
- Selection of serious patients for admission to TB hospitals.
- Examination of contacts of sputum positive patients for presence of disease.
- Providing INH chemoprophylaxis to children below 6 years of sputum positive patients.
- Screening of all TB patients for HIV and referring HIV positive patients for antiretroviral therapy (ART).
- Screening of all TB patients above 14 years for diabetes.
- Giving health education to patients, their families, and to the community at large.
- Conducting awareness programmes for tuberculosis in schools.
- Arranging painting competitions on tuberculosis for school children.
- Conducting sensitization programmes for medical officers of government dispensaries.
- Involving private practitioners in the RNTCP programme.
- The staff of this clinic consists of a District Tuberculosis Officer, medical officers, a senior treatment supervisor (STS), a senior tuberculosis laboratory supervisor (STLS), a senior DOTS Plus-HIV Supervisor, DOT providers, laboratory technicians, an X-ray technician, clerks and assistants.
- The clinic has the following facilities for diagnosis and treatment of tuberculosis:
- • A clinical laboratory for sputum examination by smear microscopy.
- • A 200 mA X-ray unit installed in 1972-3 with the help of grant-in-aid received from the Ministry of Health, Government of India.
- • Free supply of antitubercular drugs for all categories of tuberculosis patients is made available through RNTCP. Free medicines for associated illnesses in tuberculosis patients are also provided at the clinic.
As of 31 March 2018, 3 Designated Microscopy Centres (DMCs) and 6 DOTS centres were running successfully under the Free TB Clinic. The 3 DMC cum DOTS centres were located at Ramakrishna Mission Free TB Clinic and in Delhi government dispensaries at Tank Road and Anand Parbat. The remaining 3 DOTS centres were located in CGHS dispensaries at Pusa Road, New Rajinder Nagar and Dev Nagar. .
- Case finding: diagnosis of new TB patients.