Our country, desperate to be a superpower, keeps diverting funds to arms and defence needs, grandly neglecting the people whom these are supposed to protect
The numbers don’t match. The numbers of deaths don’t match. We don’t know how many have been sick with dengue this year. We don’t know how many died specifically of this disease. What we do know is that dengue has been growing in India over the decades, and has taken on epidemic proportions now. Around the country people are dying from this mosquito-borne disease.
The National Vector Borne Disease Control Programme puts the dengue figure at 32,000 cases across India till September 2013, including around 100 deaths. Kerala tops the charts, with almost 7,000 cases of dengue. States like Karnataka, Delhi, Gujarat, Maharashtra are pretty badly affected as well.
This is not a surprise. It is, in fact, an annual phenomenon. Last year, about 240 people had died of the disease as the country tried to deal with around 50,000 cases of dengue. So why are we so woefully incapable of dealing with routine mosquito-borne diseases like dengue and encephalitis that kill hundreds in our unfortunate land every year?
This year too, encephalitis has attacked thousands, especially in northern India. It has killed around 320 children in Uttar Pradesh alone. Unlike dengue, a disease that does not discriminate between the rich and poor or the young and the old (something we recognised when filmmaker Yash Chopra died of dengue), the UP strain of encephalitis seems to be the disease of the poor.
Primarily the disease of poor children. Hundreds of children from poor families die of it each year, year after year. Underprivileged, malnourished children with low immunity levels. They die because their bodies are too weak to fight, their parents too powerless to protect them, the healthcare system too inadequate, the state too disinterested in the lives of the poor. We don’t even know what this disease in UP is that kills hundreds of children every year. For years, we called it Japanese Encephalitis. Now we are content simply referring to it as the ‘mystery disease’, some form of encephalitis.
These regular, unnecessary deaths from preventable diseases show the terrible state of public health in India. The state is supposed to reduce the population’s exposure to disease through routine preventive measures like sanitation, vector control and awareness drives among citizens. The state is supposed to provide healthcare for those who are struck by these diseases. The state is supposed to pay attention to public health. Sadly, we do not have the comfort of belonging to a state that cares for public health.
In a country with 1.2 billion people, where every infectious disease has the potential to become an epidemic, where crowded living in unsanitary conditions in unplanned urban habitats breeds vectors like dengue or encephalitis-bearing mosquitoes, the government does not take public health issues seriously. This is not just alarming, it is criminal.
Policymakers and healthcare providers need to try and understand what affects our health and why, they need to try to influence the social, cultural and economic determinants of health and disease, they need to be interested in making the delivery of health services adequate and efficient. This does not happen in India. Public health is sorely missing from our development infrastructure. Our country, desperate to be a superpower, keeps diverting funds to arms and defence needs, grandly neglecting the people whom these arms, military equipment and firepower are supposed to protect.
It is not difficult to pay a bit of attention to public health and get huge returns. Diseases like dengue, encephalitis, malaria, chikungunya or filariasis are spread by mosquitoes. And simple, well-known measures to eliminate the breeding of mosquitoes would save hundreds of lives. Like putting covers on water containers and septic tanks, cleaning rubbish, using larvicides. Even an old-fashioned, simple oil drip on water tanks helps – the thin film of oil on the water prevents mosquitoes from breeding and kills larvae.
Earlier there was a tradition of fumigation, of using mosquito nets, of bio-control in public places. Fish like Tilapia that eat mosquito larvae were released in ponds, thereby dramatically controlling disease-bearing mosquitoes, as well as providing nourishment to people. There are ways of releasing these fish (which we breed anyway in India) into a local ecosystem, and I am no expert. But I suspect that if villagers were given free Tilapia, a delicious and much loved fish, they could farm it as an extra crop, while preventing deadly diseases like dengue, encephalitis, malaria and chikungunya. The governmental fog machines for fumigation need to be brought back more regularly, they only seem to appear when dengue or other mosquito-related deaths hit the headlines. And that too in the cities. Mosquito nets have worked wonders in parts of Africa, another part of the world reeling under the attack of mosquito-borne diseases. Shouldn’t we too distribute mosquito nets and other repellents among the vulnerable population? After all, mosquito repellents are a booming business here – shouldn’t some of it go towards the benefit of the less privileged?
We need to take public health more seriously. We, as citizens, need to know more about these diseases and how to deal with them. We, as individuals, need to seek treatment at the onset of these diseases. Hospitals need to be equipped to deal with such large scale attacks of mosquito-borne diseases. The government needs to be more responsible. Civil society needs to be more vigilant. It is unbelievable that year after year we continue to allow institutionalised neglect to routinely kill children, the poor, the disempowered and the less informed in our overpopulated, overburdened democracy.
Antara Dev Sen is Editor, The Little Magazine.
Email: sen@littlemag.com
