Children of a lesser State
In the rural heartland of eastern Uttar Pradesh (up), it is difficult to find that criminal called Japanese encephalitis (je). je is transmitted from infected pigs to humans by mosquitoes. So I decided to track down villages with piggeries (pig-keeping is a survival profession here). Travelling from Gorakhpur city to Sardar Nagar block, I found villages with pigpens but no reported je cases. There were villages with je cases that had no pigs. No village I went to had reported more than two cases of je, called mastishk jvar (brain fever).
Perfect name: it signifies the nature of this rare disease. Most people develop immunity to the je virus naturally after catching the infection from a carrier mosquito. But not all. In the 'not all' people, it reaches the brain.One out of three such people die. Up to half the affected get maimed.
In the villages there is a tranquillity that gives no clue to what follows:
Baba Raghav Das Medical College (brdmc),
Nehru Hospital wards 1, 6 and 10.
Most people diagnosed with je in eastern up and western Bihar come here. Ward 6 is on eternal boil. About 100 patients, 200 parents and relations, and 50 staff: 8 junior doctors, 4 more senior, about 10-12 nurses (talking, making notes, adjusting an iv needle, administering saline, glucose).
Bed 41. Harikesh, 14, on it. Two doctors and two nurses are trying to revive him. After about 15 minutes, they give up. About 40 people seated on nearby beds look on sideways, from the corners of their eyes, hoping that by not turning, they would ward the same fate off their ward. Around bed 41 it becomes deathly quiet; from beyond comes the raucous philharmonic of medical mayhem, of epidemic beyond grasp.
The dead child's uncle carries the body out, face expressionless, body shuddering. He goes to get a death certificate.
I return the next day, I watch another child die on the same bed. Already, it seems easier. Most beds have two children sprawled on it, each connected by a narrow plastic pipe to a pouch of fluid, metal stands hovering over bedsides. More than a dozen children die every day.
Sporadic cases in the villages. Horror in the wards. How many patients manage to reach brdmc ? How many deaths have no names/addresses in hospital records? How can a rare disease kill so many? Who's responsible?