Mumbai, urbs prima, the financial capital, where possibly the difference between the rich and poor is almost as stark as the nation’s capital, New Delhi, has a sorry tale to tell. Its public health is fast deteriorating, having reached close to a crisis situation. Praja, a non-governmental organisation that monitors education and public health has just released this White Paper on Mumbai's public health.
Dengue Cases up by 265 % in 5 Years, 17,771 Cases in 2017 Alone, Mumbai Public Health’s Story Dismal
Shockingly, despite this state of affairs, municipal councillors asked only 45 questions in the past five years on TB, compared to 68 questions on naming/renaming of hospitals/health centres/cemeteries in the same period. Salient points of the White Paper:
- Dengue cases have risen by 265% in five years, from 4,867 cases in 2012-13 to 17,771 cases in 2016-17.
- In 2016-17, nearly 18 people are estimated to have died every day from tuberculosis (TB).
- Directly Observed Treatment, Short Course (DOTS), the flagship government programme to tackle TB, has seen a dramatic drop in enrolment, decreasing from 30,828 in 2012 to 15,767 in 2016.
- Nearly 1 in 3 deaths due to diarrhoea in 2016-17 was of children aged 4 years or less.
- However, Public Health Committee Councillors did not ask even a single question on diarrhoea in the past four years.
Dengue cases have seen a massive rise of 265% in Mumbai in the last five years. Cases of dengue in government hospitals/dispensaries have increased from 4,867 in 2012-13 to 17,771 in 2016-17, as per RTI data.
TB cases have also seen a rise from 36,417 in 2012-13 to 50,001 in 2016-17, the data procured by the organisation revealed. Nearly 18 people are estimated to have died each day from the disease in 2016-17. However, DOTS, the flagship government programme to tackle TB, saw a dramatic drop in enrolment, decreasing from 30,828 patients in 2012 to 15,767 patients in 2016. At the same time, the percentage of defaulters in DOTS centres has increased from 9% in 2012 to 19% in 2016.
“The BMC needs to step out of denial mode and tackle the ongoing health crisis head on. The same goes for other governmental authorities, who must step up to the challenge and ensure a healthier city,” Shivali Bagayatkar, Project Officer at Praja Foundation, said.
This is in spite of the fact that Mumbai’s health budget for 2017-18 (Rs. 3,312 crores) is only marginally lower than the Thane Municipal Corporation’s total budget for 2017-18 (Rs. 3,390 crores).
Each year, Praja commissions a household survey to Hansa Research to incorporate the perspectives of citizens. This year, the survey was conducted with over 20,000 households. The survey found a significant difference between cases of various diseases registered in various government hospitals and the total estimated number of cases of the diseases. For instance, while dengue cases in government hospitals/dispensaries were 17,771, the total estimated number of cases as per the survey were as high as 1,09,443. The corresponding figures for malaria were 11,607 cases and 90,703.
Commenting on the findings, Milind Mhaske, Project Director of Praja Foundation, said, “The continuing increase in cases of major diseases such as these indicates that various authorities in Mumbai have much to worry about. Such findings coming from India’s financial capital indicate that we have a long way to go towards achieving goal 3 of the Sustainable Development Goals.”
Srinivasan Raman, Executive Director of Hansa Research said, “Such a huge discrepancy indicates that the Brihanmumbai Municipal Corporation has a long way to go when it comes to maintaining a proper health maintenance information system (HMIS). If various government authorities do not have access to accurate figures about the prevalence of various diseases, how can they evolve appropriate strategies to tackle them?”