The Japanese encephalitis virus and enterovirus cannot be tackled unless the administration cleans up its act, observes Sonal Matharu
“We are doctors. When we see the children die, we don’t feel good. Please repair the monitors of ventilators,” pleads K P Kushwaha with the technician. Kushwaha is the head of paediatrics department and occupies a modest room in the Baba Raghav Das medical college in Gorakhpur district of Uttar Pradesh. I notice the helpless look on the technician’s face. The senior doctor who has served in the hospital since his internship days knows that chances are bleak that the technician would receive money for the repair work. Nonetheless, he asks the young man to make a note of the payment.
Poor administration and the alleged corruption in the hospital has made things difficult for doctors dealing with the brain fever epidemic that strikes eastern Uttar Pradesh with regularity. As people keep walking in and out of the doctor’s room, I gather that the doctors and nurses buy their own soaps to wash hands. The doctors pay the sweepers extra money from their pockets to clean the hospital corridors and wards. Then there are young medical students who cannot concentrate on work; they tell Kushwaha they are depressed and that have not been home for any festival since they joined the medical college in 2007.
As the doctor politely tries to convince a medical student to stay back till the current epidemic is over, I got an idea of the severe manpower crunch in the hospital. The place not only needs a whole posse of doctors and nurses, it also needs enough sweepers to keep the entire hospital clean.
Each year, beginning July, parents start pouring into the hospital, with unconscious children dangling from their arms, suffering from the deadly brain fever. Few survive. Many of those who do develop permanent physical and mental disabilities.
As the fever cases shoot up every year, the state and Central governments announce expanding infrastructure in the hospital. Various committees are formed and ‘action plans’ prepared, but the basic problem remains as it has for the past 33 years—poor hygiene and sanitation. Commuting in the small town of Gorakhpur, it is hard for me to ignore clogged open drains outside shops and homes, running parallel to congested roads.
Sanitation in the villages is worse. In the villages adjoining the town, I could see people wash, clean and defecate in the open. This dirty water contaminates the water table and the same groundwater is then drawn through hand-pumps for drinking. It is then not surprising that the region is now facing a new public health enemy called enterovirus, a water-borne virus that causes brain fever and shows the same symptoms as the vector-borne Japanese encephalitis virus.
As the policy makers talk about ambitious plans for treating those suffering from the disease, I fail to understand why they ignore the simple preventive measures to avoid brain fever cases from surfacing every year in the region.
Rural development minister Jairam Ramesh recently announced that a team would be sent to Gorakhpur to study the sanitation and water quality there. He said Japanese encephalitis spreads because of poor sanitation. How many more studies are needed in the region when the cause of the malaise is staring one in the face? After three decades of the epidemic, what is needed is some action on ground.
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