ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846
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A Preventable Loss

A sense of urgency must infuse measures in dealing with acute encephalitis syndrome.

It is said that there is no tragedy in life like the death of a child, because things never get back to the way they were. If this is so, what is to be made of the deaths of 153 children

(official figure) due to acute encephalitis syndrome (AES) in Bihar’s Muzaffarpur district in the past few months? According to reports, this disease has afflicted the district since 1995, and between 2010 and 2014 has killed nearly 1,000 children. Just the knowledge of this should have set the nation into passionate and massive efforts to wipe out the disease or at least control it on an urgent footing. Instead, year after year, the media and public sphere witness a set routine. Pictures of hollow-eyed parents holding the limp and lifeless bodies of their children are benumbing. On the other hand are the reports speculating on the causes of the disease. The political class and ruling dispensations, especially at the state level, reel out explanations and statements that give no indication of consistent and strategic measures to ward off the health tragedy. It has been no different this time around.

What is however more appalling is that the doctors who have visited the district over the years and medical researchers have repeatedly pointed out that it is not difficult to prevent the deaths. The consumption of lychees by the children is being blamed for the deaths but it has been shown that this is so only in the case of children who suffer severe malnutrition. The consumption of this fruit per se by those who do not suffer malnutrition is not seen to be a health issue. It has also been found that the administration of glucose in the first four hours of the onset of the symptoms is a crucial factor in saving lives. However, on both these counts—malnutrition and the availability of glucose and trained doctors in the primary health centres (PHCs)—the state government has hardly shown any sense of urgency over the years. Nothing can be more illustrative of this than the fact that the Sri Krishna Medical College and Hospital in the district does not have a virology lab or adequate number of paediatric beds. In such circumstances, the condition of the PHCs—the first port of call—can only be imagined.

There are a number of aspects why this and other similar tragedies in different states occur—the example of the over 70 deaths of babies in Uttar Pradesh’s Gorakhpur district in 2017 comes to mind immediately. In that case, while the state government said that the deaths were due to infection, there were reports that the babies had suffocated due to lack of oxygen cylinders resulting from the bills not having been paid to the supplier. Incidentally, Gorakhpur district has the highest incidence of Japanese encephalitis in the state.

The common factors across states where children die in large numbers even after being admitted to hospitals are: the nutritional status of the patients, the poverty of their families and the pathetic level of facilities available in these hospitals. Health activists have cried hoarse about the urgent need to equip PHCs with life-saving medicines, medical machinery, and doctors and nurses. It follows that this can happen when there is allied infrastructure to support this state of affairs, including basic decent living conditions for the medical staff. This calls for an engagement by the governments concerned in ensuring these conditions. Down the years, there have been continual warnings of the public health system decaying and dying due to lack of funds and the fattening of the private hospitals. Apart from this, more importantly, it calls for special and particular strategies to deal with the malnutrition of the impoverished families. The Bihar government must strategise to deal with the high number of stunted (under five years), wasted and underweight children in the state and specifically in the district.

News reports on the visits of central and state ministers and politicians to the Muzaffarpur hospital said that there were angry responses from patients’ families and many of them demanded that these visitors should go back. The families were assured that the number of paediatric beds would be increased and a virology laboratory provided. Of course, the moot point is why this was not done all these years. The anger of patients’ families against what they see as negligent authorities is not peculiar to Muzaffarpur or occasioned only by conditions there.

It is clear that the poor feel desperately angry and neglected when it comes to provision of health services. The anger is often directed at doctors too because they are perceived to be part of the unjust system. The public sphere and especially its prominent part, the media, must reflect this sense of injustice and anger; not merely report on incidences of violence against doctors or demonstrations against visiting political leaders. Even the death of one child that could be prevented is a shame that we must feel strongly about and must move us to act.

Updated On : 15th Jul, 2019

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