It came as a rude surprise to Phillip Duah when he read in the paper last month that the city planned to close two local tuberculosis clinics–one in East New York and one in Far Rockaway. Duah is the director of the East New York center (actually located in Brownsville), but had heard nothing about the proposed closure.
Sid Dinsay, spoksperson for the Department of Health, said the potential cuts reflect a calculated decision to shift resources from two part-time “underutilized clinics” in Brooklyn and Queens to “neighborhoods with greatest need.” The Department of Health plans to open a new clinic in Jamaica, Queens.
Yet Duah says it’s too early to declare victory in Brownsville. In fact, he said, cases in Brooklyn seem to be on the rise. “All through the ’90s, [the incidence of TB] was going down,” he said. “Now we’re seeing a small increase–maybe 10 percent.” In 2003, the Brownsville clinic served approximately 20 patients with active or suspected TB, along with 200 patients with the more common latent TB infection, a total of 6,211 client visits.
Statistics for 2003 are not yet available from the Department of Health or U.S. Centers for Disease Control and Prevention, but Duah is not the only one who has noticed a rise. Mark Torres, senior public health educator at the Charles P. Felton National Tuberculosis Center at Harlem Hospital, said he’s also seen a slight increase in 2003, the first since he started nine years ago, particularly among new immigrants infected abroad. But Torres is reluctant to draw firm conclusions without another year of data.
The mid-year health cuts, part of an across-the-board 3-percent cut proposed by Mayor Bloomberg, drew ire from Councilmember Christine Quinn, chair of the council’s Committee on Health, and Speaker Gifford Miller at a press conference last month. They pointed out that while TB has dropped nationwide, the city’s rates are still double the national average.
“We’re gearing up for a rumble,” said Jeremy Hoffman, Quinn’s legislative director. The council is also concerned about a $445,000 cut to child health clinics, though Jordan Barowitz, a spokesperson for the mayor, said it would not affect service.
Closing the TB centers could have a more obvious impact, advocates warn. Directly Observed Therapy (DOT), in which staffers visit patients to make sure they stick with their drug regimen, has been a formidable weapon against TB, but depends on the proximity of clinics to their patients. “Better medication, better follow-up, and DOT,” said Torres. “As long as we keep those three strong, we shouldn’t have a problem.”