Why the Silence? Death of 100 Children by Encephalitis in Bihar

Written by Sabrangindia | Published on: June 17, 2019

A hundred children have reportedly died because of the criminal negligence of government hospitals in Bihar. Despite its predictability, government, local hospitals ill-equipped to handle the encephalitis deaths and, the media silence on the issue is deafening. Equally shocking is the callousness of the opposition on this whole issue. So far, the issue has not even been raised in the legislature, nor has any party demanded the resignation of the Bihar Health Minister, MangalPandey who belongs to the BJP!

Encephalitis in Bihar
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!