Looking at future tuberculosis funding

May 26, 2002|By SAUMYA ROY, Special to this newspaper

WASHINGTON (MNS) — Seven years ago, when Ignacio Cervantes complained to his doctor in Mexico that he had chest pains, he was told he had multiple drug-resistant tuberculosis, a fatal disease for which the doctor had no medication.

"I thought I would die,'' said Cervantes.

Since then Cervantes, who was a farm worker in Mexicali, has been living in Calexico, with an apartment, food and treatment provided by the Imperial County Health Department through its tuberculosis control program.

The program is a crucial one for Imperial County because the county has regularly had the highest tuberculosis rate in the state. While 12.7 of every 1,000 residents had tuberculosis in California, 28.5 of every 1,000 Imperial County residents suffered from tuberculosis in 1996, the most recent year for which figures are available.

Elizabeth Stoller, assistant branch chief at the California tuberculosis control branch, said that there had been a $400,000 cut in the governor's budget for last year but outside grants had offset that to about $190,000.


However, this year, the grants had dried up exposing Imperial County to the brunt of the cut. She said while hardly any of the budget cut had been passed on to Imperial County last year, $23,200 would be reduced from the county's budget this year.

While the cut won't affect county programs now, local health experts are concerned it foreshadows further reductions that could result in program contractions.

‘‘This puts an additional burden on the Health Department to provide the services we need to,'' said Robin Raecker, assistant director at the county Health Department.

Yvonne Smith, director of county health services, said the reduction is a small part of the county's about-$900,000 budget for tackling tuberculosis. She said none of the services provided to patients would be reduced, but the department has introduced several measures to streamline its functions. It has introduced a new software program to track medication and travel for tuberculosis patients.

The program is important because it tracks movements of tuberculosis patients to help contain a disease that crosses the border between Imperial County and Mexicali. While the county's rate is well above that of the state, Smith said, it is comparable to that of Baja California, which has the highest incidence of tuberculosis in Mexico.

Experts attribute the yawning gap between state and county numbers to the fact that Imperial County is on a porous border with 39,000 zpeople crossing the border each day, some bringing diseases including tuberculosis.

‘‘It is such a fluid border. Besides, diseases see no borders,'' said Raecker.

She said the worst form of the disease was the kind Cervantes had, which was immune to normally used drugs. But the expensive second-line drugs needed for multiple drug-resistant tuberculosis are not available in Mexico. Patients like Cervantes are told nothing can be done for them in Mexico. Even when they get here, treating and tracking patients for TB is not easy, said Charlotte Clunn, TB controller for the county.

She said that many patients are Hispanic migrant workers who use home remedies to stay away from health workers as long as possible.

‘‘We have to convince them that we are not (the Immigration and Naturalization Service) and often that we will not charge money,'' said Clunn.

Once the victims are in treatment, the Health Department tries to keep track of them so they can be treated wherever they go and so they do not start work while they can infect coworkers.

The Health Department works with the INS so that patients can get help in Mexico when they return.

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