Death Of Over 100 Kids In Bihar Is Due To Criminal Negligence

This photo taken on June 17, 2019, shows Indian children suffering from Acute Encephalitis Syndrome (AES) at the government-run Sri Krishna Medical College and Hospital in Muzaffarpur district in the eastern state of Bihar. (Photo by STR/AFP/Getty Images)

The death of over 100 children in Bihar in a fortnight will be a blot on India’s health record. These deaths could have been prevented through communication and medical intervention at the right time. This reflects badly on the medical infrastructure available in Bihar and other poverty-stricken areas in the north.

On the one hand, India claims to be an attractive medical destination for the world and on the other, hundreds of children die every year.

Most of the children who lost their lives in this year’s death wave were below 10. The government says that 103 children have so far died. But the numbers may be far more. These children died due to acute encephalitis syndrome (AES), according to doctors.

This is not the first time that children have succumbed to AES. Between 2000 and 2010, over 1,000 children succumbed to the infection in Muzaffarpur district alone. This year too, the deaths have been from the same district.

That begs the question as to why the government did not step in to prevent the deaths? AES, which leads to swelling in the head, is well-documented. That the disease strikes during summer is also well known, but there has hardly been any government intervention.

What led to the rise of AES? Experts say it is mainly due to toxins found in lychees. Though the exact cause has eluded researchers, experts have pinned the blame on a deadly cocktail of heatwave, malnourishment, and binging on lychees on an empty stomach.

The cure is as simple as the administration of glucose at the right time. This was not done.

Had the health authorities in Bihar acted in time, the lives of over 100 kids could have been saved. Children could have been told to stay indoors during heatwave conditions, the issue of malnourishment could have been addressed and proper communication could have prevented parents from letting their children into lychee orchards.

2017 Lancet study recommended minimising lychee consumption, ensuring an evening meal and implementing rapid glucose correction for suspected illness. What were the Bihar health authorities and government doing for two years? This is criminal negligence.

When malnourished kids binge on lychees on empty stomach, there would be a sudden fall of glucose or hypoglycaemia. The body uses its glucose reserves. Malnourished children have no such reserve. Giving artificial sugar could have saved the children, but the treatment window is narrow. A delay of even half an hour can be fatal.

Urban kids too have fallen prey to AES. But most children who died due to AES were from the poorest of the poor, mainly the Mahadalit community, including Musahar and scheduled castes; malnutrition due to poverty is to blame.

The Bihar government had geographically-specific data on malnourishment, the communities involved and the prevailing heatwave condition in the area, and, of course, on lychees. So what was the state’s health minister Mangal Pandey and his department doing?

There are serious questions on the medical infrastructure too. At the government-run Sri Krishna Medical College and Hospital in Muzaffarpur, three kids are forced to share a bed; some are made to lie on the floor.

And what has made matters worse is the acute shortage of doctors, unavailability of key medicines, and lack of nursing staff and beds. The hospital lacks facilities and funds to tackle the AES crisis. Is Bihar in the 21st century?

Union Health Minister Dr Harsh Vardhan and Mangal Pandey have promised a separate building for paediatrics with 100 beds – something that could have been done way back in 2010 when AES claimed lives in the district.

This wave of death will be followed by the customary visits of Bihar CM Nitish Kumar, other ministers, and loads of promises. And there will be another wave next year.

India’s vision for the future of the health sector is ambitious indeed. The reality is different- very, very different.