Encephalitis deaths: Lapses behind Bihar's brain fever horror
Ten more children died of Acute Encephalitis Syndrome (AES) in north Bihar's Muzaffarpur district on Monday, taking the fortnight's toll to 103.
Eighty-five deaths have taken place at Sri Krishna Medical College and Hospital (SKMCH) and 18 at Kejriwal Hospital.
Locals claim the actual toll could be higher as many from remote villages fail to make it to Muzaffarpur hospitals.
Many of these lives could have been saved but for a series of lapses on the part of authorities responsible to contain the seasonal outbreak that grips kids aged 1-10 years, India Today TV has learnt from multiple sources.
MEGA PROJECT STUCK
The first lapse was a delay in implementing an ambitious project announced by the Centre in 2014 when a similar outbreak killed 379 children.
Union Health Minister Dr Harsh Vardhan had then visited SKMCH and announced a 100-bed super-speciality facility that's still incomplete. During his visit to SKMCH on Sunday, Vardhan said it will be functional in six months.
In 2014, he had also announced a 10-bed facility for treatment of children. It has also not seen the light of the day. Had this facility been established, many affected kids could have received the first treatment before being referred to SKMCH or Kejriwal Hospital.
Another lapse was a weak awareness campaign. Encephalitis deaths in Muzaffarpur and adjoining places such as Sitamarhi, Motihari, Sheohar and Vaishali have been an annual feature for the last three decades.
The exact reason behind the disease remains a mystery with experts blaming various factors - from excessive heat and humidity to consumption of litchis.
Doctors only provide symptomatic treatment. So, awareness during the March-July period, when temperatures soar, becomes a key among rural population. However, the state government could not carry out an intensive awareness drive this year as most officials were busy with the April-May general elections.
Family members of affected children maintain that there was no awareness campaign which could have alerted them.
On Monday, a complaint case was filed in the chief judicial magistrate's court in Muzaffarpur against Vardhan and State Health Minister Mangal Pandey by social activist Tamanna Hashmi. The petitioner said that the Centre and the state have failed to carry out any awareness drive this year in Muzaffarpur and adjoining districts and also did not set up any research centre to identify the reason behind the AES outbreak. The court will hear the petition on June 24.
Minister in-charge of Muzaffarpur, Shyam Rajak, said, "Despite the elections, district officials were conducting awareness campaigns about this disease. There is a need for more campaigns and awareness drives and we have issued instructions in this regard."
SKMCH Medical Superintendent Dr Sunil Shahi said that the facilities are not enough to deal with the crisis. He said inadequate beds pose a major challenge to cater to the large number of patients.
"Looking at inadequate facilities at SKMCH, the Union Health Minister has cleared a 100-bed Pediatrics Intensive Care Unit. In the meantime, we are using 16 ENT beds to deal with the crisis," he said. "There are no good facilities here. Had the facilities been good, she would have never died," Sunil Ram, the father of one girl that died, told ANI.
NO GORAKHPUR LESSON?
Only a couple of years ago, Gorakhpur in Uttar Pradesh was in the grip of Japanese encephalitis that has killed thousands of children over four decades.
When the Yogi Adityanath government took over, Japanese encephalitis was the biggest health challenge in eastern Uttar Pradesh in 2017.
More than 500 children died that year in Gorakhpur and its neighbourhood. Altogether 14 districts of the region were in the grip of Japanese encephalitis. In August 2017, many children died at BRD Hospital leading to huge political furore.
The government opted for desperate measures and launched Action Plan 2018 in collaboration of the World Health Organisation (WHO) and Unicef.
A massive vaccination drive and a robust health and sanitation campaign were launched. These measures seem to have worked for Uttar Pradesh - cases dropped by about two-thirds in 2018. Since both eastern UP and north Bihar share almost the same geographical hot and humid climate, a favourable ground for the spread of Japanese encephalitis and AES, the measures adopted by the Yogi Adityanath government could have helped the Nitish Kumar government in checking deaths.
The Bihar government also has a standard operating procedure (SOP) laid down in 2015 in consultation with Unicef.
The SOP mandates that grassroots health workers including auxiliary nursemidwife (ANM), accredited social health activists (ASHA) and anganwadi employees have to conduct household-level survey to check if any child has symptoms of Japanese encephalitis and AES.
The efforts brought down the death toll. 2012 saw the highest number of deaths (424) due to the disease also called 'chamki' fever.
In 2013, 2014, 2015, 2016, 2017 and 2018, the numbers were 222, 379, 90, 103, 54 and 33, respectively.
But it has seen a spike this year, clearly showing that the SOP was not followed strictly.