TB patients refusing treatment in Kenya will be detained –new isolation policy

By Gatonye Gathura

Patients with tuberculosis who refuse treatment will be detained, says a new TB isolation policy launched by Kenya’s Ministry of Health

In 2016 High Court Judge Mumbi Ngugi declared it unconstitutional to confine TB patients in prisons for non-treatment.

She had ordered the practice be stopped immediately and the Ministry of Health to come up with a clear and humane policy to attend to such patients.

On Thursday the Ministry launched the National Tuberculosis, Isolation Policy 2018 which says TB patients who refuse to take medication as advised by the clinician will be detained but as a last resort.

However such patients will be detained in a custom build facility at the hospital and not in jail as had been the case previously.

“Patients who refuse treatment, must be made aware, in advance, that continued refusal may result in compulsory isolation,” says the policy.

The policy was launched last week by the head of Preventive and Preventive Health, Dr Peter Cherutich.

Dr Cherutich said it will enable promotion of human rights, protect the dignity of the patient and the public from the infectious disease.

He called on county government to adopt the TB isolation policy and plan to construct and equip isolation facilities for TB and other infectious diseases in their respective counties.

But a layman’s look at the requirement for such a facility, as indicated in the policy document, suggests the cost may be beyond the affordability of most hospitals in Kenya.

The policy further says such an incarcerated patient still retains the right to refuse treatment and consequently will not be forced to take any.

“If isolated patients refuse treatment, their informed refusal should be respected, as they no longer present a public health risk,” says the policy document.

Forcing such patients to undergo treatment, the document says would be a repeated invasion of their bodily integrity.

“However, the right to health of other members of society cannot be ignored.”

Of the estimated 85,000 TB patients put on care last year about 4,250 may have absconded treatment becoming a threat to public health.

Patients who refuse to adhere to treatment against competent medical advice, with uncontrolled metal illness or in a religious faith which does not allow medicines will be isolated to protect the public.

Such a patient while in an infectious state will not be allowed any visitors while in isolation.  Non-infectious patients will be allowed one visitor at a time but both will be under protective clothing including face masks.

Defending the revised policy the ministry says it is based on the Harm principal which states that all persons are free to act as they choose as long it does not affect another non-consenting person. “The principle justifies involuntary isolation.”

The ministry also quotes the World Health Orgasnisation’s interpretation on the matter.

“WHO suggests that interfering with freedom of movement when instituting quarantine or isolation for a communicable disease such as TB could be legitimate.”



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