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Public Health in ICU: HOW DO I KNOW IT’S SWINE FLU?, By Poonam I Kaushish, 21 Feb, 2015 Print E-mail

Political Diary

New Delhi, 21 February 2015

Public Health in ICU

HOW DO I KNOW IT’S SWINE FLU?

By Poonam I Kaushish

 

Life in India is cheap, cheaper than the sky-rocketing vegetable prices. Why? Our Sarkar doesn’t give a rat’s ass about the aam aadmi! As he only translates into sterile statistics! Standing testimony to a heartless and selfish country. Wherein, a death is dismissed as, Woh mar gaya, to kya?

 

How else should one react to the death of civic and health reforms plagued by a heartless attitude, lethargy, corruption and bereft of cure and consolation. Think. It took over 800 deaths and over 12000 cases of swine flu for the Government to sit-up and take note that India was in the throes of a deadly disease. It’s answer? Said Union Health Minister Nadda, “There is no cause for panic. The situation is totally under control.” Really? You could have fooled me?

 

How? Simply, by reeling out do and don’ts, designating hospitals for treatment, testing labs, announcing preventive measures on radio and TV et al one can not wish the infection away. For that one needs medicines and vaccines easily available. A ghisa-pitta reply which fails to condone and justify the Union and State Government’s delayed action, bad planning and mismanagement. Underscoring, our cavalier, casual and churlish attitude and approach to a crisis.

 

Importantly what is left unsaid by the powers-that-be is more important. Scandalously, as I found out there is no H1N1 vaccine available in the country to prevent the ailment. Primarily, because the vaccination is normally imported in August and the stocks finish by November. Questionably, was the Government tweedling its thumbs knowing that there was no vaccine available till the disease got out of control?

 

Moreover, what is the Government doing to ensure easy availability of the vaccine specially in public hospitals and inoculating the people against this deathly flue? To aver that it has been assured supply of medicines and vaccine in a month by drug manufacturers does not cut ice. What should patients do till then? Pray to God they don’t die and others stay home to ensure one doesn’t contract swine flu?

 

More shocking, the Health Ministry confessed they would increase the  licences to chemist to import the vaccine post.  Why do chemists’ need licences to bring the vaccination? This is akin to bolting the stable door after the horse has fled!

 

Appallingly, we are fighting this pandemic influenza virus with an archaic and inadequate 112-year-old Epidemic Diseases Act, 1897 while an updated Public Health (Prevention, Control and Management of Epidemics, Bio-terrorism and Disasters) Bill, 2008 has been regaled to the administrative dust bin, as it was “too stern.”

 

This is not all.  Absurdly, while the HNI vaccination costs a mere Rs.800/- hospitals charge Rs.10,000 to diagnose whether one is suffering from swine flue.  The Delhi Government has now put a cap on the cost at Rs.4500/- but what good is this cap when there is no vaccine available? The situation is worse compounded by the fact the symptoms of the disease are the same as a normal flue and include fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue.  

 

Swine-flu is only the latest in a series of reversals in public health hazards which India has been experiencing in recent times. Chikgunaya, influenza, malaria and gastro-enteritis are spreading like wild fire. There is resurgence of Kala Azar.

 

Besides the Japanese encephalitis, viral hepatitis and protein energy malnutrition. Worse, the medical authorities continue to drag their feet. “If a child doesn’t die within five years from birth due to malnutrition and diarrhea, acute respiratory infections will get him later”, remarked a WHO official. While doctors medicate prayer to combat these!

 

More worrying, scientists have warned of the spread of malaria parasites that are resistant to the drug artemisinin, the frontline treatment against this infection, from neighbouring Mynamar into India. This would pose a serious threat to the global control and eradication of malaria.

 

The tragedy of India is the dreadful state of our healthcare systems which makes us particularly vulnerable to a disease taking on epidemic proportions. Worse, none is willing to learn the ABC of health and crisis management or finding lasting solutions. Big deal, if nearly one million Indians die every year due to inadequate healthcare facilities and 700 million have no access to specialist care as 80% of specialists live in urban areas.

 

Experts have predicted 3.75 million deaths due to cardiovascular diseases this year, out of which a whopping 2 million will die due to heart attacks or coronary artery diseases (CAD).  As it stands, we total one-third of the world’s TB cases. And is one of the four countries worldwide along with Nigeria, Pakistan and Afghanistan where polio has not been eradicated.

 

Clearly, India’s public health is in the ICU notwithstanding the Government’s cut throat projections and assertions of ‘all is well’! How can it be when consistent public investment in health is barely 1% of the GDP? In 2010 the spending was four per cent ---- less than many African countries or Afghanistan and a fraction of developed nations, which spend around 10 per cent.

 

According to the WHO, India has a national average of only 45 doctors and 8.9 beds for every 100,000 patients, with the levels far lower in the poorest States. Add to this the reputation of having the highest annual death toll due to tuberculosis, many dying from malaria, dengue and cholera, preventable and treatable diseases. The country is ranked 127th out of 177 countries in the Human Development Index.

 

An example: Maharashtra’s rural people live in densely-populated hamlets in close proximity to fowls and pigs, which they breed as additional food supplements. There is only one doctor for 28 villages with over 20,000 people.

 

Undeniable, in a country where children are sold for a mere Rs 20 by parents just to keep their body and soul together, there is near total neglect and disregard for the poor and lack of respect for human life. Two, abysmal sanitary conditions (only half of the country’s garbage is cleared), no matter Prime Minister Modi’s Swatchch Bharat campaign.

 

Three, poor health care system and no solid waste management. A number of large cities have no sanitary landfills or dumping grounds. There are over 14 lakh manual scavengers to clear human and animal excreta, no matter a legislation banning this practice.

 

What next? It is time for the Government to realize that economic reform without reforms in the health and social sectors can become a bane in themselves. In an open economy, as the present crisis shows, the entire system can crumble if these areas are weak and fragile. Example: Only 68.15 and 9.60 per cent of the urban and rural population have toilet facilities respectively!

 

India urgently, needs to overhaul our pathetic health care system and the accompanying ki pharak painda hai attitude. The Prime Minister talks of providing a transparent, responsive and efficient administration. Brave words. If his administration wants to do something it first has to start taking citizens seriously and treating them like worthwhile investments. Follow a ‘womb to tomb’ policy of keeping them healthy and get its act together. Governance cannot be infected!  ----- INFA

 

(Copyright, India News and Feature Alliance)

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