COVER STORY
JITENDER GUPTA
TOO NEAR , TOO FAR Sushmita Nishad , 13 , of Manbela lives only 10 minutes from BRD Medical College . Her father Manoj took her there too late , after she had fever and delirium for several days . The disease left her partially disabled . area surrounding Gorakhpur . This is why the middle class and poor , as much as the elite , don ’ t want their children to grow up here . For the wealthy , the dream is to migrate overseas ; the poor want to catch a train to a big city .
Worse , Gorakhpur isn ’ t alone . It just offers us a metaphor for the abysmal state of children ’ s healthcare in India . Those chilling scenes from BRD find eerie echoes all over the map . In Nashik , tragedy befell 187 babies last year in the district hospital . Calcutta cannot forget September 2013 , when 35 children died in five days in eastern India ’ s biggest paediatric hospital . Deaths at GB Pant paediatric hospital in Srinagar hit the headlines in 2012 . None of them were in reality only ‘ events ’ occurring within a tiny time-horizon ; they were markers of a general process of decay , punctuated by seasons of death . As exemplified by Uttar Pradesh health minister Siddharth Nath Singh ’ s infamous remark that “ children die every year in August ”.
Thus , the State ’ s abdication is almost naturalised . What ’ s worse is that many of these deaths are from curable or preventable conditions . Gorakhpur is notorious for typhoid and malaria . But there ’ s also the dreaded Japanese Encephalitis ( JE ), a viral infection spread by mosquito bites that kills 25 per cent of those infected , and permanently disables another 25 per cent . Two crore more Indians live in JE-prone zones of
14 OUTLOOK 2 July 2018 eastern UP and beyond . The disease loves children ; the more undernourished , the more susceptible they are .
JE is one of many diseases now classified under the broad umbrella of AES , or acute encephalitis syndrome . “ JE accounted for 10-15 per cent of the total AES cases that came to us last year ,” says BRD principal Ganesh Kumar . AES refers to any patient with high fever and delirium , a dangerous condition that requires urgent hospital care . Indeed , many common viral and bacterial infections such as typhoid , malaria , dengue or tuberculosis can end up as AES . BRD did not confirm this , but neonatal encephalitis may have caused a fourth of infant deaths last August .
Tracing the JE story is one way to diagnose the larger sickness . JE has a vaccine , but Gorakhpur ’ s health administrators say infections would keep pouring in even if they vaccinate all children in
Infant Mortality Rate ( IMR )
UP
64
India
41
Availability of doctors
Paediatricians at CHCs in UP
Required |
773 |
In position |
154 |
Source : SRS
Shortfall (%) 80.1 town — which they haven ’ t . BRD is the lone big public hospital for at least six nei ghbouring districts , and the only one with expertise to treat AES within a 350-km radius . “ We are equipping primary health centres ( PHCs ) so BRD gets fewer AES patients . We hope 2018 will be better , but it depends on the number of cases ,” says Gorakhpur ’ s chief medical officer ( CMO ) Upendra Tripathi . An oddly equivocal statement , coming just