Mystifying the plague

MEDIEVAL afflictions were not restricted to Beed, Surat or other
parts of India hit by the plague last fortnight. They showed up
in the blinkered reception of the news in several supposedly
informed quarters in the country, and other nations as well.

Take the case of the mainstream Indian press. For several
days immediately after the dreadful disease, in epidemic form,
was recognised at Surat, a collection of imagery and phraseology of the Black Death, generated over the centuries since its
,occurrence 650 years ago, was tritely touted to create the first
impression that the outbreak was uncontrollable, anyway.

Some exemplars of more eminent international media also
fimured this approach, conjuring up suggestions of imminent
wansfer of plague from this land to other shores, along with
dw corollary assertion that any successful handling of the malaly by India would only "be a matter of sheer luck". Given
dwir influence, little wonder that the dark
kar raised by them gripped even national
gwernments as several countries, in quick
mccession, went beyond the elementary
pwautionary measures and sought to slam
dwir doors shut to trade and traffic from
India.

Two truths Were glossed over in this
11"er reception. First, the plague is not
confined to India alone. The bacilli which
cv,Lse it can be found in other parts of the
Oahe, ranging from the Americas to Africa
mad Asia. According to WHo, annual death
ftures due to plague outside India have crossed the 100 mark
swery year since 1986. In the us itself, distinguished for having
dw highest per capita expenditure on public health, outbreaks
46 the plague have been recorded for each year during 1985IM albeit with very few cases of infection and death.

Which brings us to the second aspect, that, despite being
dwhful, and displaying all its known inefficiencies, India's
public health system did perform in curbing the plague from
whieving the ravaging, devastating form known to history.
Amerting this aspect is essential if one has to recognise and
gnd the dire warnings actually sounded by the outbreak.

These were more about the conditions of Indian cities that
axwe environments where the possibilities of diseases actual
become dead certainties. Not only Surat, but even its more
glittering, larger counterparts such as Bombay and Delhi, and
others across the country, have become fast-expanding
cesspools of squalor and mass ill health. Poor living conditions
for exploding populations, combined with stagnant public
amenities - especially as far as the provision of safe drinking
water and adequate systems of refuse disposal are concerned
- have made large parts of urban India a living nightmare.

As a result, most Indian cities are home to carriers and vectors of not one, but a number of diseases, both new and old.
Thus, the '80s witnessed the fresh resurgence of malaria and
tuberculosis, supposedly brought under control long before. A
new strain of the cholera-causing bacteria, Vibrio cholerae, was
first noticed in Madras in Oct 6ber 1992. Today, it is a public
menace in almost 2 dozen Indian cities. The spread of the
plague this time was also accompanied by reports of unidentified fevers from a number of towns in
Gujarat, Maharashtra and even Delhi.

It is a moot point whether such urban
degeneration is merely a matter of governmental failure. Environmentalists as well as
a few urban planners have pointed to a
wider social breakdown that may have to be
redressed for any lasting solution. They
have repeatedly pointed out this to be a
direct outcome of the pattern of industrial
development promoted since the '50s, and
aggressively pushed in recent years.

Lopsided in the regional sense, it is
premised on the ready availability of a large migrant
workforce, congregating in a few pockets of opportunity.
Viciously uneven in the distribution of profits, it has forced
this workforce to exist in abysmally unhealthy living and
working conditions.

These circumstances have created large numbers of communities and individuals in urban India, totally alienated from
the responsibilities of public welfare, looking upon it entirely
as a mere governmental chore rather than a matter of civic
participation. A reminder of this trait was provided by Surat.
Among the first to flee that city were many of its private medical practitioners, leaving the task of treating the plague victims almost entirely to their counterparts in the state health
service.