Encephalitis battle: Tied in reams of red tape

Encephalitis battle: Tied in reams of red tape (Thinkstock photos/Getty Images)

Has the battle of the Uttar Pradesh government against Japanese Encephalitis  (JE) and AES (Acute Encephalitis Syndrome) in its eastern part been lost to red tape? The answer, shockingly, seems to be yes.

Even as the death toll of kids falling to the deadly viral disease mounted to 555 up to Saturday, the health department has been busily engaging in 'processes,' admitting that "lots of things still need to be done." Sources reveal that while the state government had ordered the construction of a 100-bed hospital for AES  patients - to be built at a cost of Rs.18 crore - the tendering for the same is still on. According to government timelines, the "lenter of the ward" would be up by March 2013.

The story is the same with paediatric wards to be set up in the nine districts affected by AES. The wards are still not complete. There is thus no place where ventilators (124 of them, according to an announcement by the Samajwadi Party government in June) can be installed. Of the 22 ventilators installed at the Baba Ram Das Medical College in Gorakhpur, most are on lease from other medical colleges of the state, said principal secretary (Health) Sanjay Agarwal, who also candidly admitted that apart from statistics which show a marginal decrease in JE deaths from 5.97 per cent last year to 4.02 per cent in the corresponding period till November this year, a lot was still to be done.

The fact that the deaths have not stopped and that hundreds of kids have fallen prey to encephalitis has forced chief secretary Javed Usmani to shoot off a terse message to district magistrates of the JE-hit districts in eastern Uttar Pradesh and health officials, urging that they "ensure that no JE deaths are reported in the next season" or be ready for stringent action. In a letter to these officials, Usmani has fixed responsibilities and clearly spelt out that officials would be personally held accountable for deaths in their respective zones.

He has also directed health officials to immediately hold meetings to coordinate efforts for rehabilitation, housing, facilitation and physiotherapy of children disabled by the disease. A special mop up immunization drive has also been ordered between Dec 1 and Dec 31.  The state government had in June pressed panic buttons after 88 people succumbed to the killer disease in a 'pre-disease period' that usually begins July.

Officials admit that while AES-afflicted people had swarmed various primary health centres, hospitals, other medical facilities and the Baba Ram Das Medical College in Gorakhpur, the preparedness of the health department as a whole is still far from adequate.  The disease, which claimed more than 600 lives in the last season, peaked in areas around Gorakhpur division - Gorakhpur, followed by Kushinagar, Deoria and Maharajganj, reported maximum deaths yet again.

But while Gorakhpur basks in government attention, especially since the chief minister's visit there Oct 31, when he ordered a special unit and an MRI facility at the medical college, doctors regret that other areas are neglected. Sanjay Agarwal says immunization and deployment of immediate ambulance service and child specialists at every primary health centre have had the desirable change.

The fever tracking system in some areas has also helped, but larger infrastructural changes remain to be carried out to deal with the situation effectively. The battle against AES has been largely left to PHCs, which were still to be equipped with ventilators. "Paediatric wards are being constructed at the PHCs and by June next year I think all the things would be in place," the principal secretary said.  Since AES is largely a water-borne disease, sanitation is being given special attention, though belatedly ; the availability of potable water is a concern, an official said. Meanwhile, an awareness campaign was launched and literature distributed as part of it.

The ambulance service, which earlier functioned at a charge of Rs. 5 per kilometre, is now a free service. Though some of these measures will help, there is need for much more focus and also a "less bureaucratic attitude," say doctors. The state government also plans to utilize the Rs.51 crore funding received from the government of India for the purpose of fighting the encephalitis scourge by June 2013. While 444 cases were brought to the BRD Medical College in Gorakhpur this year, even the districts have reported 11 per cent cases, something which officials say is "encouraging enough."

Source: Times of India

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