News of scores of children dying from Encephalitis has gripped the media. As this article goes to print, 140 deaths have been already reported in Bihar, 114 in Muzaffarpur alone. These cases have not happened overnight. If one just looks back, Encephalitis is a conspicuous recurring phenomenon hitting Bihar before the monsoons, and Uttar Pradesh after the monsoons. This year, all previous records in terms of number of deaths have been broken and the number is still rising. Bihar Chief Minister Nitish Kumar eventually visited the afflicted children in hospital after sustained reports of government apathy.
Bihar Health Minister, Mangal Pandey, was caught on video asking about the India-Pakistan World Cup match cricket score amid a press briefing by Union Health Minister Harsh Vardhan to find ways to cope up with Acute Encephalitis Syndrome (AES) deaths. Pandey was seated right next to Vardhan. According to news reports, cases have been registered against Harsh Vardhan and Mangal Pandey for not spreading awareness about AES prior to its outbreak. Nothing much would probably come out from this with blame put on the ‘system’, which can drag on for months. Some are attributing it to eating Litchis, but looking at the visuals of the undernourished children and their poor parents battling for two square meals, how many of them get to eat Litchis is anybody’s guess. Litchis any way at best can be a trigger, not the cause for AES.
Over the past several months, media has been periodically showing the pathetic state inside various hospitals. Lack of doctors, lack of beds, multiple children afflicted with Encephalitis on the same bed, lack of medicines, air conditioners not working, no electricity from eight in the morning to late evening, doctor attending to patients with lights from mobiles, so on and so forth. In the instant case, reporters are interviewing doctors about electricity cuts, not about reasons for the AES, its prevention and cure. Politicians naturally avoid such questions, given lack of domain knowledge and with interests focused elsewhere, including coming Vidhan Sabha elections.
Nitish Kumar was booed during his hospital visit but remained nonchalant. The Bihar Government can hardly be absolved of default but It is also a fact that Nitish is more in media crosshairs because he refused to accept the single vacancy for his political party offered in the Union Cabinet. Had this not happened, he would have probably not been hounded in this manner. It may be recalled that in 2017, 60 children undergoing treatment at a Gorakhpur hospital, Uttar Pradesh, died because of lack of oxygen supply, with evidence showing that the hospital and State Administration ignored reminders and requests from private firms that supplied oxygen for payment of outstanding dues; but the Chief Minister was not hounded by media so intensely.
In the case of AES, the National Human Rights Commission (NHRC) issued notices to the Centre and Bihar Government when the death toll had reached 126. The toll has already reached 140 and is rising. There is no denying Encephalitis is ‘also’ linked to malnutrition and excessive heat. The 2018 Global Nutrition Report showed India houses 24% of world’s malnourished. With 46.6 million stunted children, we are home to 30.9% of all stunted children under five years of age – highest in the world. Notably, India is not on track to achieve any of the nine goals adopted by the World Health Organization in 2012-2013 to reduce all forms of malnutrition by 2025. TV news reports food being given to children under treatment for AES in hospitals is pathetic. For that matter, from time to time, media has been showing the crap being fed to children in many schools in the name of free mid-day meals.
Despite AES hitting specific districts annually, awareness programs and preventive measures are ignored because lives are cheap in India and it doesn’t affect the high and mighty. 100-200 deaths really don’t matter – that too in the poor and very poor categories. As for excessive heat, this year high temperatures were predicted months in advance. But the heat generated by elections was so intense that issues like the need for AES awareness were not anywhere in the reckoning. Now that monsoons are delayed by about 15 days, temperatures are likely to remain high. For that matter, temperatures next year are predicted to rise by another two degrees compared to this year.
A significant issue is that of prevention. As per available information vaccine for prevention of Encephalitis is available in India. So why has an immunization program not been put in place by the Centre and the concerned States? Arguments against this include the quantum of population and the costs, but then hasn’t India in the past undertaken nation-wide vaccination programs for preventing polio? In case of AES, it is limited mostly to certain districts of Bihar and UP, so where is the problem of numbers and costs? If States are ambivalent, certainly, the Centre cannot absolve itself of blame.
Chairing a recent meeting of Niti Aaayog, Prime Minister Narendra Modi has stated that making India a US$ 5 trillion economy is achievable with everyone’s cooperation. No doubt it is possible. However, such an economy without due emphasis on healthcare and nutrition would be a shame. India’s investments in healthcare have always been miniscule. Besides, investment figures by themselves are of not much help if the ‘system’ of execution remains flawed. We can’t keep hiding behind the cover of ‘faulty system’ form one issue to another. Healthcare and nutrition are even more important with the recent UN report that India will surpass the population of China by 2027. Regrettably, none want to discuss population control, which perhaps is equally, if not more, important than discussing ‘one nation, one poll’. Ironically, some have even been calling for producing more children.
Prakash Katoch is third generation army officer hailing from Himachal Pradesh. He is former Lieutenant General from Special Forces and post-retirement has published over 2100 articles on international affairs, geopolitics, military, security, technical and topical issues besides authoring two books. He is active in seminars at both national and international levels.
So nice to read