IF
COVER STORY
J a m m u a n d K a s h m i r
SMALL MERCIES IN A BLIGHTED LAND
Sometimes , a PIL makes a difference it ’ s believed half the cases are caused by scrub typhus , which can be treated with antibiotics . For JE , though , there is still only vaccination or palliative care .
“ typhus can be cured with antibiotics , deaths due to encephalitis should have halved too — that hasn ’ t happened ,” says Dr Singh says . In 2005 , JE accounted for 90 per cent of encephalitis cases in Gorakhpur and around . Once ventilators were introduced that year , mortality dropped from 1,400 to 500 . “ That ’ s where we are even today ,” Dr Singh says . Some years ago , water-borne entero virus-led encephalitis was also discovered . “ There ’ s no vaccine for that … the only solution is better hygiene ,” he says . Which is virtually an unheard-of thing .
For 40 years , governments have fought encephalitis interby Naseer Ganai in Srinagar
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HE lone children ’ s hospital in Srinagar “ has improved ”, but flies buzz close to its gates . Indoors , distraught parents operate nebulisers strapped to breathless little ones . They say the devices are “ not difficult to use ”. In Kashmir ’ s Govind Ballabh Pant Paediatric Hospital , the gap between despair and relief is narrow . Like in many other places , this hospital sets the bar so low and has been trying to overcome neglect so pervasive that almost any improvement is betterment .
Just outside the hospital , a beggar woman leans on a few attendants ’ personal belongings , while the attendants narrate their stories to her . There is a water outlet nearby , which attracts the flies . Upstairs , in the much-cleaner Ward No . 2 , children who are yet to be admitted can be found resting . Their attendants also relax , unmindful of the nurses . The Neonatal Intensive Care Unit ward is off-limits , especially for the press . One neonatal ( baby less than 28 days old ) is in the incubator .
In 2012 , the year there was an uproar after 787 babies died here in nine months , at least two babies used to share an incubator and there was one bed for every three or four children . Though things were worse in the previous years — 882 babies had died in 2009 and 883 in 2010 — it was in 2012 that the media reported extensively on the casualties . The deaths were due to lack of equipment such as ventilators and baby warmers , and the then Omar Abdullah-led government fired many in the
Under-five mortality : 28
Number of working CHCs : 70 in 2005 and 84 in 2016
Required 336
Shortfall 146
IMR in J & K : 24 Source : Rural Health Statistics , NFHS , SRS
GETTY IMAGES
UPWARD CURVE J & K ’ s IMR went down by eight points in 2016-17 , the highest fall among states in a single year
administration for staff absences and general negligence . An inquiry by the then director of the Sher-i-Kashmir Institute of Medical Sciences in Soura , Srinagar , Dr Showkat Zargar , revealed constant infighting among faculty members since 2005 . The faculty and head of department would not cooperate with each other .
“ Basic infection control guidelines were not followed and life-saving equipment such as incubators , ventilators and warmers were not maintained ,” the inquiry found . There were only six ventilators for more than 30,000 patients admitted every year . The infant mortality rate ( IMR ) in the neonatal intensive care unit was above 20 per cent . The proposal for a new children ’ s hospital with a 200-bed maternity wing in Srinagar , to make up for the rush of patients from rural Kashmir , was shelved by the government .
“ The hospital doesn ’ t stink the way it used to in 2012 ,” says medical superintendent attempt to culpable homicide ,” says Purak , former principal Mishra ’ s son . “ Imprisoning all these people only ensures their version is not heard .”
A tour of Gorakhpur rural suggests a tough 2018 monsoon ahead . In Rasulwapur village , near Khajni , two hours from town , mosquitoes and flies assail you even in peak summer . Drinking water , drawn from hand-pumps , seems at serious risk of contamination for almost no toilets have been built under the Swachh Bharat Abhiyan . An electricity transformer blew up five years ago and was never fixed . In Rasulwapur , the State is an occasional visitor .
“ Breeding grounds for encephalitis and other diseases that are 100 per cent preventable ,” says Dr R . N . Singh , a prominent Gorakhpur paediatrician . The earlier theory that encephalitis is always mosquito-borne has been junked . Now
22 OUTLOOK 2 July 2018