Out of breath

After visiting hospitals and slums VIBHA VARSHNEY has found that asthma makes poor children suffer far more than their rich counterparts. And a complete lack of policy, or official action, compounds their affliction

Published: Monday 15 March 2004

Out of breath

-- The shanties in Yamuna Pushta are packed tight. A dusty and torn curtain hangs over the entrance to Sabina's house. Trunks and cupboards leave little space for Sabina and her family. A kabadiwala has spread his polythene bags and plastic ware at their doorstep. A neighbour's goats roam nearby.

"This place is very cold because of Yamuna; I shiver even in my warm clothes. Sunlight does not reach our house," she says. Her jobs at home are to wash clothes, clean utensils and fetch water from the community tap.

Sabina's father is a rickshaw-puller and her brother a kabadiwala. Sabina, who has been asthmatic since childhood, takes medicines given by a non-governmental organisation (NGO) near her home. An inhaler is an extravagance, she says. "We cannot afford it. It will cost what my father and brother earn in an entire day.'' She once persuaded her father to buy her an inhaler but some children stole it. "What a big waste," says Sabina.

She used to visit Kasturba Gandhi Hospital near Delhi's Jama Masjid for treatment. Doctors gave her tablets and syrups and told her to take steam at the hospital if there was an emergency.

No national data on asthma in India is available but the World Health Organization (WHO) estimates that 10 per cent to 15 per cent of 5- to 11-year-old children suffer from the disease in the country. A study done by the paediatrics department of National University of Singapore found that asthma is the most common chronic illness in that country in childhood. The Indian government hasn't bothered -- asthma isn't a priority.

It costs an average Rs 333 every month to buy a child's medicines for asthma, says a recent study done by S K Kabra, R Lodha, M Puranik and N Kattal of the paediatrics department of All India Institute of Medical Sciences (AIIMS). This is about one third of the monthly per capita income of the people studied.

Ten-year-old Arti needs medicines worth Rs 350 each month to prevent an asthma attack. Arti's mother Sunita, a textile factory's worker, can hardly afford them. Her salary is Rs 2,500 on which she has to raise another daughter.

Two years ago, Arti caught pneumonia and could hardly breathe. A doctor near her home gave medicines that helped her but she fell ill again the next year. "I feared Arti would die that night," says elder sister Neelu.

"At around 10 pm, Arti said she could not breathe and felt as if someone was strangling her. We had to take her to AIIMS," says Neelu. The neighbourhood doctor took Rs 350 but was of no help. That night cost Sunita Rs 1,000. She had to leave her factory in Okhla for a month and all her savings were used up. Arti risks another such night.

A narrow muddy road leads to Arti's one-room house. Around 100 m of this muddy road in front of her house is a puddle. Sunita and her daughters share the toilet with another family. Their view from the balcony is of a congested colony. Sabina and Arti can't leave Yamuna Pushta or Sangam Vihar. It's the cheapest place they can afford a home in.

Penniless and clueless
Seema Ujjain is 12 and lives in Dakshin Puri, Delhi. She suffered an asthma attack two years ago and now the attacks have become more regular. The last one left her in an AIIMS hospital bed for two days and her parents in Rs 4,000 debt. "We have to work longer and harder to repay the loan and collect money for treatment," say Seema's parents. All Seema's parents know that she is "allergic to something".

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