Patients suffering from extremely drug-resistant tuberculosis (XDR-TB) are being held in a fenced ward at Brooklyn Chest Hospital in Cape Town, raising difficult questions about the balance between public health and individual rights. A two-meter fence was recently erected around the unit to discourage patients from leaving, though doctors currently lack legal authority to force anyone to stay or take medication.
Since September 2006, 60 XDR-TB patients have been admitted to the facility. Twenty have died, and none have been cured or discharged. The hospital previously obtained court orders against four repeat absconders, but one has since died and the remaining three fled again. Individual court orders are expensive and slow, leaving hospitals largely dependent on patient cooperation.
South Africa's health department reported 391 XDR-TB cases between January and October 2007, a sharp rise from 74 in 2004. Treatment costs roughly 100,000 rand per patient and can require up to 24 months of hospitalization, compared to about 400 rand for standard TB care. Around 120 drug-resistant TB patients fled Eastern Cape hospitals in a single recent month.
Officials say legislative changes are under review to allow a broader mandatory-isolation framework. "It is a very awkward situation," said provincial TB official Dr. Krish Vallabhjee, noting that patients who refuse treatment face death.
Historical summary. TurkishPress restated this wire report, first published in January 2008, in its own words.