Monsoon is often called as the season of death in Poorvanchal—eastern parts of Uttar Pradesh and the adjoining region for rains lead to the death of hundreds of children every year due to viral encephalitis and its cousin Japanese encephalitis – the first caused by a water-borne enterovirus and the second by mosquito bite. The symptoms of both the killer diseases are almost the same and both are marked with high mortality and morbidity among children.
Not much has changed at Baba Raghav Das Hospital in Gorakhpur since 1978 when reports of children dying of JE/AES first came. The Hospital then had less capacity – though the best in the region—then number of patients was also less, but as the Hospital was upgraded – after Congress Vice President Rahul Gandhi’s visit in 2011 following a spate of deaths—the number of patients has increased manifold as it still continues to be the best. Patients as far as from Nepal come to get their children treated here putting a huge load on the infrastructure and staff.
Japanese encephalitis and viral encephalitis diseases, broadly classified as AES, are a poor man’s diseases and affect the families of paddy farmers. But, it is not only a health issue. Of course, the present apathy and callousness of the hospital administration—if proven in the probe ordered by the State government—is nothing less than criminal negligence which needs to be dealt with in an exemplary manner.
Contaminated water, lack of proper sanitation facilities and bad personal hygiene habits are the factors which lead to children contracting the diseases. Living near paddy fields where mosquitoes breed and drinking infected water from shallow tube-wells are the risk factors as is the presence of pig farms located within the hamlets where communities live. These act as breeding sites for mosquitoes.
The patients who come here are poor and, therefore, undernourished, which even further lowers their chances of survival. Those who come from far off areas for treatment reach the hospital in a critical stage and their chances of survival are slim.
In 2012, the Centre government launched a National Programme for Prevention and Control of JE and AES on the recommendation of the Group of Ministers. The Rs 3,350 crore project was to be implemented in a phased manner. The first phase was launched in 60 most affected districts and included provision of rehabilitation for those who were left mentally retarded.
Over the years, not much could be heard of the project which was to be implemented by the Ministries of Rural Development, Drinking Water and Sanitation, Human Resource Development, Women and Child Development and Health and Family Welfare. While the focus has always remained on the achievements of the Ministry of Health and Family Welfare in this respect, no one even questions the other Ministries – which have a crucial role in preventing the diseases. They probably have forgotten about the project!
Annual deaths at the BRD Hospital are shameful. Successive governments have not paid necessary attention to address the issue is even worse. Upgrading the Hospital with additional beds or ventilators and other infrastructure can only help in treating the patients but what is required in multi-pronged strategy to fight the scourge which has now spread to 17 States across India with almost all eastern States under its grip. Awareness and quality communication are equally important to raise the levels of information and education among the community and needs to be implemented well at various levels—community, providers and policy makers themselves.
Back at the present situation in Gorakhpur, it only speaks of the systemic failure that has sniffed away more than 60 innocent lives. Whether the oxygen supplier actually stopped the flow of life-saving oxygen or whether the administration held back the payment is indicative of the weak supply chain we have even in health facilities; and speaks of the possible corrupt practices the authorities indulge in while releasing the payments. These are issues which will come out in the enquiry reports, but one hopes that the issue does not die a natural death this time round too!