It has been weeks now since the Gorakhpur Incident was reported. Some images are etched into my mind, and I know that they will haunt me for ever. Impulse or compulsion, I had to pen my thoughts, express my anger, helplessness and a concoction of other emotions, all through this post.
In a nation that constantly cribs about “who eats what” and ‘who wears what’, the immense silence that had loomed post the deaths of 64 infants due to acute encephalitis syndrome (AES) is uncanny. Well, could be counted as mourning. Though the social media, and news agencies have been on their toes trying to increase the national reaction about such a tragic incidence, it seems like the death of children in some part of the nation (from unknown families-if I must add) has nothing to do with ‘us.
While some callously point out that deaths due to AES happens every year, I ask what have we done to prevent it? I thoroughly support Sreemoy Talukdar in saying that we are failing to look at the real issue here.
For those who are unaware, AES is characterized by acute onset of fever and clinical neurological manifestation that includes mental confusion, disorientation, delirium, or coma. The disease has a long history in India. As mentioned in a research journal (published in The Annals of Neurosciences, Sep 2016), titled ‘Acute Encephalitis Syndrome in India: The Changing Scenario’, authored by Sourish Ghosh and Anirban Basu, “The history of AES in India
Endemic regions of various viruses reported to cause AES in India.
has paralleled with that of the Japanese encephalitis virus (JEV) since the first report in 1955 from Vellore, Tamil Nadu. The first outbreak of JEV was reported in Bankura district, West Bengal in 1973. Thereafter, sporadic cases of AES and outbreaks have been the leading cause of premature deaths due to the disease in India. Based on various surveillance reports and outbreak investigations, Joshi et al. classified the history of AES in India into 3 phases: (a) period before 1975 when a few cases with JE aetiology were identified; (b) between 1975 and 1999 when more JEV cases were reported with frequent outbreaks that resulted in the development of JE endemic regions near the Gangetic plains and in parts of Deccan and Tamil Nadu; (c) between 2000 and 2010, a dramatic change was observed in the AES scenario, which saw the rise in non-JE outbreaks mostly caused by viruses such as Chandipura virus (CHPV), Nipah virus (NiV), and other enteroviruses.”
While the article on Firstpost supports the statements with many other stats, that emphasize the fact that healthcare is highly neglected in a country that has nuclear power, satellite launching capabilities and so on. While the media digs on the issues like unavailability of oxygen, the negligence of the hospital authorities and the coverups that followed, the statement by UP Health Minister SN Singh that “August is the month when a lot of infections and vector-borne diseases and AES (Acute Encephalitis Syndrome) cases comes into BRD.(read the full article here)”, sounds lame and inhuman.
So, assuming that it happens every year, surprisingly instead of witnessing a decrease in number, are the numbers shooting up? And it is not that the Ministry of health hasn’t issued directives. According to Annual child health report for 2015-16, “Vaccination against Japanese Encephalitis (JE) is provided in selected endemic districts.” But, in reality the JE shots have rendered ineffective in the case of AES. In a report related to rising child deaths in Malkangiri district, Odisha in Nov 2016, it was reported that, “of total 313 cases, 161 children have been diagnosed with AES and the rest with JE.”
Don’t blame it on the healthcare practitioners, as the disease itself seems to be a mystery, with around 100 pathogens that trigger it, the West Nile virus, dengue virus, Chandipura virus and chikungunya virus, bacteria like Streptococcus pneumoniae, Orientia tsutsugamushi, and Haemophilus influenzae, to name a few.
Each year hospitals have a hard time arranging beds other equipment and even doctors to handle the sudden flow of patients. My question here, are we falling short of trained healthcare professionals? If so, how do we raise the number and if not what is the real reason?
At the end, investigations point out that this particular incident was the result of violation of protocols that inadvertently led to inadequate oxygen supply which caused the death of all those innocent infants, and to think that some of them were not even named. All we can do now is offer our heartfelt condolences to those parents and try to ensure that such incidents aren’t repeated.
This is Satrangee Parachute signing off with the ardent prayer that political, religious or vested interests of individuals shouldn’t come at the price of human lives.
