NMMT driver faces uncertainty after losing eye to black fungus

A CONTRACTUAL driver of the Navi Mumbai Municipal Transport (NMMT), who used to ferry Covid-19 patients, lost his vision due to mucormycosis after contracting Covid, and is now facing mounting debt after the corporation stopped paying his salary.

Sanjay Mhaske (44) ferried Covid-19 patients in an ambulance briefly last year. He contracted the virus in February this year. Mhaske last reported on duty on February 11. After developing pneumonia, he was admitted to a private hospital and put on oxygen support. He was also administered remdesivir. A diabetic, Mhaske eventually started complaining of jaw pain in the hospital and his eyes also started to swell and redden.

“The hospital discharged him and asked us to visit an ophthalmologist. The ophthalmologist referred us to a neurologist. Finally, we went to DY Patil Hospital, where he was admitted and diagnosed with mucormycosis. But after a few days, they referred him to JJ Hospital. They said they can’t arrange for amphotericin injection,” wife Priya said.

Mhaske was enrolled under the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) in JJ Hospital in March, where he was treated for nearly two months. The hospital provided anti-fungal medicine liposomal amphotericin B for six days and asked the family to purchase it for next 34 days.

“I sold my jewellery first. Then my husband’s colleagues collected money. Also, I borrowed money from relatives. I spent Rs 8 lakh over medication,” Priya added.

Still, the doctors, due to the delayed diagnosis of the infection, could not save his right eye. A surgery was conducted to remove it to stop the fungus from reaching the brain.

Mhaske’s struggle with the treatment and drugs brings forth the larger hurdles that Covid-19 patients, and those with secondary infection like mucormycosis, face. While Maharashtra government notification allows free medication and treatment for all mucormycosis patients under the MJPJAY, Mhaske had to pay for amphotericin vials for 34 days.

JJ Hospital Dean Dr Rajesh Mankeshwar said they can only provide amphotericin vials to patients if they have it in stock. “We did a renal profile of the patient and advised him plain amphotericin, but he insisted on the liposomal form since the plain one can affect kidney. Therefore, he was asked to procure it,” Mankeshwar added.

After discharge, Mhaske requires three tablets of posaconazole every day. Though the state government has authorised district collectors and civil hospitals to provide medicines to patients based on prescription, Mhaske has been struggling to procure them.

“The NMMC hospital in Vashi gave the tablets once and said they won’t give it again. We then came to the Thane civil hospital. They also gave the tablets once, but today, they refused,” Mhaske said as he waited at the hospital.

On Monday, he was turned away from the Thane civil hospital after waiting for five hours for the medicine. “We did not get fresh supply of posaconazole. Whatever stock we have is reserved for admitted patients,” said Vijay Kumar Menda, chief pharmacist at the Thane civil hospital.

Besides, the NMMT has not responded whether Mhaske can resume work in another capacity after he informed them that he cannot drive following his eye surgery. “I worked at the corporation since 2009. But when I fell ill on duty, I did not receive any care,” he said.

Navi Mumbai Commissioner Abhijeet Bangar said, “We have issued guidelines to our officials to issue medication to mucormycosis patients. Posaconazole is not short in supply. Arrangements will be made for him,” Bangar said, adding that the NMMC can post Mhaske in clerical jobs. “The amount spent on treatment can be reimbursed,” he said.

“We have introduced a policy of free mucormycosis treatment. It is up to districts to implement the policy properly,” said Dr Sudhakar Shinde, CEO of MJPJAY and chairman of the committee that drafted notification to cap rates of mucormycosis treatment.