A bench of Justices Sanjiv Khanna and B R Gavai in today’s order, said “This is a serious concern. Deaths cannot keep happening. We need answers.”  Further, the bench directed the Bihar government to file an affidavit on the adequacy of medical facilities, nutrition and sanitation and hygiene conditions in the state. The apex court also asked if policy initiatives are in place. The court said that there were reports about villages where no children were left. Evoking instances of similar problem faced in Uttar Pradesh (UP), the Supreme Court questioned how UP coped with the situation.

Stating that negligence by the State is violative of the Right to Life guaranteed under Article 21 of our Constitution, the petition read, “Right to Life is sacrosanct fundamental right guaranteed under Article 21 of the Constitution of India. This Hon’ble Court in catena of judgements has accepted it has highest in all fundamental rights. The present act of negligence by the respondents who are ‘State’ within the framework of Indian Constitution has resulted in the death of hundreds of young innocent lives. This continuing act of negligence on the part of state is consistently violating the fundamental right to life guaranteed under Article 21 of the Constitution of India.”

The petitioners further contended, “This year i.e in 2019, the epicentre of the said disease is Muzaffarpur in Bihar where more than 126 children have lost their lives in the past one week. Media reports shows that there is acute shortage of doctors, medical facilities, intensive care units and other medical equipment in the hospitals in nearby areas and children are dying in hospitals due to lack of required facilities.”

The PIL also pleaded before the SC to direct the government for arranging 500 ICUs and 100 mobile ICUs and further direct all private medical institutions in the affected area to admit and provide free treatment. It even sought a compensation of Rs. 10 lakhs to the surviving family members of the deceased who have died due to the negligence of the state machinery.

The SC order comes on a day when the Chief Judicial Magistrate’s court in Muzaffarpur has also ordered a probe against Union health minister Harsh Vardhan and Bihar health minister Mangal Pandey in the matter.

Symptoms of Acute Encephalitis Syndrome (AES) include high fever, convulsions and extremely low blood sugar levels. Among the factors said to trigger the syndrome are malnutrition. There were more than 44,000 cases and nearly 6,000 deaths from encephalitis in India between 2008 and 2014, said a 2017 study published in The Indian Journal of Medical Research (IJMR).

The petition was filed considering the rapid increase in the number of deaths of children, mostly in the age group of 1 to 10 years, in the past few weeks with the latest figure being 152 of which 130 alone are from the Muzaffarpur.

The next hearing is scheduled on July 5, 2019.

Related Articles:

1. Why the Silence? Death of 100 Children by Encephalitis in Bihar
2. Govt has Forgotten The Country’s Children
3. Citizens Protest in Delhi after more than 100 Children Die of AES in Bihar

The post ‘Deaths cannot keep happening, we need answers’: SC to government on Encephalitis deaths appeared first on SabrangIndia.

Japanese encephalitis comes in the form of amassive epidemic. While Bihar and Uttar Pradesh are known for pathetic health services, India as a whole needs to ponder over the fact that, without a robust  health and education services, India can not sustain itself as a growth story. 

Both these states along with other states like West Bengal, Rajasthan, Maharashtra, Madhya Pradesh, etc have a heavy rural population but the medical fraternity does not work, or even want to work, in the villages. Over 75% of our rural population has about 32% Primary Health Centers. Of these, may be less than 20% of them have beds.

Rather than responding to this enormous rural crisis when the first aid too does not reach to the needy resulting in untimely deaths due to even very ordinary ailments, the government of India has cleverly provided a new ‘mantra’ imported from United States highly commercial health services where they are beyond the reach of the common people. This insurance culture may be good for the urban middle classes but can not replace the need for an accessible health services. The problem with the insurance culture is that your access is directly related to your premium and in the rural India if people have got health insurance, the private doctors use them heavily even for the ordinary services and if they suffer from bigger issues then it is beyond their reach.

I think that the concept of Mohalla clinic in Delhi meant a great revival of health services and Aam Admi Party need kudos for the same. State governments in India need to invest heavily in the health and education sector and make health an absolutely uncompromising issue. Every year, we see hundreds of children dying of various diseases and we have seen how in the medical college of Gorakhpur, the hospital did not have the oxygen cylinders and beds for the patients. 

Unfortunately, doctors as well as their associations have rarely spoken about this. Most of them dont even want to serve in rural areas and take it as punishment posts. After abusing all the subsidies for poor, the doctors who qualify from the subsidised medical colleges do not show any keenness to serve the poor. You cant imagine those who spend crores of rupees, paying, hefty donation fee in the private medical colleges, to serve the poor. Most of them would like to complete it at the earliest and get a visa to serve their colonial masters abroad.

The Indian Medical Association(IMA) has called for an all India strike against the ‘attack’ on doctors even when the doctors in West Bengal reached an amicable solution and called off their strike. We support the demands for the security of the doctors and the people have no right to physically assault the doctor. Even if they have complaints, it is time for IMA and medical fraternity to put their in house disciplinary mechanism stronger. There is another factor which is of a serious nature. 

The sympathy of the doctors – – politically–with the dominant right wing is a matter of serious concern. Medical ethics calls for doctors to be above partisan nature and serve the patient irrespective of their caste, gender, and religion. 

Most of the time, the IMA has behaved politically and is a group of people who are mostly against the politics and policies of social justice and inclusion. We have not forgotten when the doctors in All India institute of Medical ( Manuwadi) sciences ( AIIMS) in Delhi had launched a campaign against the government policy of reservation at the higher level initiated by late Arjun Singh, who was the HRD Minister in the first UPA. We saw the worst form of casteist slogans by these doctors who started ‘Youth For ‘Equality’ campaign which actually was Youth for casteism and caste supremacy. Ofcourse, Delhi chief minister Arvind Kejriwal and many others of kinds have been in the forefront of supporting such initiatives though they might claim that it was just a thing which had happened and now Kejriwal support reservations for SC-ST-OBCs.

If the IMA is an association which help the doctors and raise their issues then it must explain as why it failed to get Dr Kafil Khan, who was being penalised for serving the poor round the clock when children were dying because of the failure of the medical system. We have not heard a single statement even today from IMA regarding the continuous harassment of Dr Kafil Khan, by the Uttar Pradesh government even today.

Can the IMA tell us what has it done with regards to discrimination faced by tribal doctor Payal Tadvi who was killed by the continuous harassment and indignation from the savarna doctors in Mumbai last month. A few days back, a talented Doctor in Chandigarh medical college too faced caste based discrimination but the IMA remain silent on the issue. In fact, it is mostly the organisation to protect the savarna interests of the doctors. It cant speak for a doctor who faced harassment because he was a Muslim or SC-ST-OBCs.

Before I conclude, I would share my own experience at a Medical college in Delhi. The incident relates to a  six year old. One of my illustrious friend teaching in a prestigious medical college invited me to share my thoughts on Medical Ethics with his students. There was another person from abroad. I was asked to speak for 10 minutes. I had done an investigation into the case of deaths of several Safai Karmcharis in Delhi. I narrated what the family members of the deceased informed me that the doctors did not even touch the body of these people who were brought to RML. I also narrated a story from Uttar Pradesh where in a PHC in Balia, the sweepers would do the basic surgeries as doctors wont touch. Even in the medical colleges, most of the time, it is the sweeper who is asked to touch the dead bodies. I may be wrong that all doctors would not do but whereever these things happened or are happening, are wrong and must be condemned. I just said that a doctor has to rise above the caste, class, religion, nation, gender prejudices and unfortunately in India, they still suffer from them. I also spoke about Praveen Togadia’s alleged statement long back, when he called medical fraternity to not to treat the Muslims. There are many who now calls that all those ‘anti nationals’ have no right to be treated. This is purely political rhetoric and doctors would do well to rise above them. Now, as soon as I said this, a senior stood up from his seat and came to the podium, snatched my mike and said that I would not be allowed to speak. He said, ‘ we are not here to listen to these rubbish. ‘pataa nahi kaha kaha se bulaa dete hai logo ko’. I said let me finish but he did not allow. Unfortunately, our organisers too could not do anything. I did not say anything but realise how deep rooted caste and religious prejudices have entered into the medical profession.

If we celebrate the medical profession as great achievement of modern science which saved people from life threatening diseases then can we say that our doctors and scientists are humanists and rationalists whose only interest is to serve humanity and propagate the idea of rationality. That caste system is an artificial creation by human being which goes against the spirit of people being born freely and equally in rights and privileges. That some people are better than others while many others are inferior is a concept of deep rooted prejudices which existed in our society and people need to be given special treatment to bring them to the level of others. That social justice is not a dirty word and merit not the monopoly of a few twice born communities would the true spirit of humanism and must be embraced by medical as well as science fraternity.

Yes, we do agree that no doctor should be humiliated or assaulted as many treatment succeed and many fails. If the efforts are made sincerely but if not then people have a right to lodge complain and accountability need to be fixed. Indian medical science suffer a crisis because of the hegemonic caste supremacists are converting it a tool to spread their hate propaganda. If the doctors or would be doctors fall in this trap then they will lose good will of the people as well as violating the medical ethics too which ask them to rise above narrow partisan interests of people’s identity and treat them equally.

Related Articles:
Why the Silence? Death of 100 Children by Encephalitis in Bihar
Doctors Strike in Bengal: Calendar of Assaults on Docs across India

The post The IMA’s obvious leaning to the right wing is a matter of concern appeared first on SabrangIndia.

Image Courtesy: PTI

The death toll in areas of Bihar, particularly in places such as Muzaffarpur, due to the deadly Acute Encephalitis Syndrome (AES) has reached 100 on Monday as per the news agency ANI. The development was confirmed by Superintendent at Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur.
Starting from January this year, an overwhelming number of 1358 children with AES have been admitted to the hospital along with Kejriwal Matrisadan.

Affecting the central nervous system, AES starts with high fever hampering neurological functions and causing mental disorientation, seizure, confusion, delirium, coma. The disease impacts mostly children and young adults. Despite being a regular occurrence since 1995, the deaths have continued and even increased in frequency.

The ‘Performance in Health outcomes’ report released by NitiAyog in 2018 had noted that Bihar, MP, Rajasthan and Uttar Pradesh are “situated at the bottom of the health index” displaying a “worrying condition” of public health in these states.

A medical geneticist Dr.DhanyaLakshmin, working at Nizam’s Institute of Medical Science, Hyderabad noted in a report published in DailyO two years back (on the outbreak of the disease in Gorakhpur, Uttar Pradesh) that there can be preventive measures to control the spread and onset of the disease. She highlighted that the disease spreads through mosquito bites. The JE virus is transmitted by female Culex mosquitoes to human beings. The virus can survive in pigs, ardeid birds and mosquitoes. She also pointed out that in a document released by the Indian Council of Medical Research, it has been stated that JE affects children below 15 years in south Indian states, whereas it affects people of all age groups in north India. It is one of the leading causes of encephalitis in Asia. UP and Bihar are the two states which have witnessed an increasing number of encephalitis-related deaths over the past few years.

The carrier mosquitoes, as she notes, survive in dirty and stagnant water, paddy fields and ditches. The spread of the disease can be controlled to an extent if the proliferation of the mosquitoes is eliminated.

Moreover, there also exists an effective vaccine for the disease since 2006. Though it’s not recommended to be given as part of the national immunisation schedule, two doses of the vaccine are recommended in children residing in endemic areas under 18 years of age.

However, what remains a matter of concern is the conspicuous silence of national and local media on the subject.

While the media is raving, virually non-stop, about the doctors’ strike in Bengal, possibly due to the political (BJP–TMC )angleto it, there has hardly been any discussion on these deaths which have reached exponentially high numbers. The Indian Medical Association(IMA), which gave the call for the nationwide doctors’ strike, appears silent on the issue as well.

In an insightful report published in Rediff, Professor Mohammad Sajjad, History teacher at the Centre of Advanced Study in History in AMU highlights the callousness on the part of both state and central governments in dealing with the issue.

Notably, poor and malnourished children are more prone to this disease. It is said that administering the drug dextrose with alacrity to the affected children is quite helpful. Yet there is an acute unavailability of the drug at most government hospitals and community development blocks. The local hospitals such as the fifty year old government owned Shri Krishna Medical College in Muzaffarpur remain ill prepared to handle the situation and also suffer from infrastructural issues despite the fact that the disease is predictable and localised.

Interestingly, in 2014, soon after its formation, the BJP government sent Health Minister Dr.Harshvardhan to Muzzafarpur. The minister, as per reports, had persuaded some parents of the children who had died, to send the bodies of the children for specialised tests. To this day, there is knowledge on what followed. And the Health minister has visited the place again!

Further, that the death rates at a Marwari charitable owned Kejriwal trust hospital are reported to be far lower!

Despite forewarnings of the disease, and globally acclaimed magazines such as Lancet prescribing a “rapid glucose correction” mechanism to combat the disease, no steps were taken by the government at any level.

The Chief Minister Nitish Kumar has announced an ex-gratia of Rs. 4 lakh for each of the death. But is that enough? Should not the government have been more prepared, more equipped? Should not the government have spread awareness on the onset of the disease. Instead the government has allowed the situation to grow out of control!

Equally shocking is the callousness of the opposition on this whole issue. So far, the deaths and the negligence have not been raised in the legislature, nor has any party demanded the resignation of the Bihar Health Minister, MangalPandey who belongs to the BJP!
This episode has shown up the priorities of the political parties, the opposition, the media and the intelligentsia!
 

The post Why the Silence? Death of 100 Children by Encephalitis in Bihar appeared first on SabrangIndia.