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India’s nutritional problem
Deaths due to Japanese encephalitis preventable
NEARLY 50 per cent of Indian children are underweight and more than 70 per cent of women and children have serious nutritional deficiencies, including anaemia, according to a report by UNICEF. India is at the bottom of the world’s maiden nutrition barometer along with countries like Angola, Cameroon, Congo and Yemen. The report draws attention to India’s ill-fed underbelly and exposes the failure of several schemes to address healthcare issues among the poor.
Prime Minister Manmohan Singh described the abysmal nutritional record as a national disgrace. One of the primary reasons for the state of affairs is the fact that India’s spending on health is abysmally low. Only 1.67 per cent of the GDP has been earmarked in the 12th Plan. The report warned that India is likely to miss the Millennium Development Goal on child mortality. Nothing illustrates the tragic consequences of such health deficiency more than the large number of deaths of children year after year in Uttar Pradesh due to Japanese encephalitis. It is a vector-borne disease which afflicts a large number of children during the monsoon season in the eastern part of UP.
About 12 districts around Gorakhpur in eastern UP are specifically affected by Japanese encephalitis. The origin of the virus is traced to Japan, but it was eliminated in Japan long ago. This year over 370 children died in the affected areas during the monsoon months. This viral infection has been recorded from 1978 onwards. The annual death record has been well over 200.
The mosquitoes are the carriers of the virus, and they breed in stagnant ponds and are also incubated in the underbellies of pigs. There are a number of piggeries owned by certain traditional pig owners who make a living by rearing them. There are also a large number of stagnant ponds. The largest of them is seen just outside Gorakhpur town.
The virus infection was eliminated in Japan many years ago, systematically getting rid of the pigs by compensating the owners. Likewise, the infection has also been completely eliminated in Thailand and Malaysia. The Government of Uttar Pradesh has not considered any scheme of compensating the pig owners to get rid of the problem.
The only effective way to prevent this virus is to vaccinate children under 10 years of age, and three doses are to be given during a period of 30 days. The total number of children in the 12 districts of Gorakhpur division were said to be around 75 lakhs. Unfortunately, the laboratory at Kasauli is the only source of supply that can produce only 4 lakh vials, The result is that a large number of children were left without vaccination.
When I was the Governor of UP, the figures of deaths due to Japanese encephalitis were brought to my notice. I visited the affected areas in July, 2005, and held a meeting with officers, the local MLA and MLC, both paediatricians. I also visited the district hospital and saw the children under treatment. I was told by the doctors that about 40 per cent of the children who survived were likely to become mentally or physically deficient for life. What was more disconcerting was the fact that during my visit to hospital, I found a large number of pigs roaming in the compound of the hospital itself.
On return to Lucknow, I discussed the matter with the Chief Minister and senior officers and also wrote to the Minister of Health, Government of India. A team of doctors was arranged by the Ministry of Health, Government of India, which also arranged the import of vaccines.
A very large pond exists just outside Gorakhpur town. Apart from the elimination of piggeries in the 12 affected districts of eastern UP and the filling up of shallow ponds in the region, the only way of tackling the annual occurrence of encephalitis was to vaccinate all the children well ahead of the monsoon season. Once the children fall sick, they have to be treated properly and given nutritious food. The consequence of nutritional deficiency in India is fully reflected in the large number of cases of death due to Japanese encephalitis. The fact that this year also there were over 360 deaths due to the same virus infection shows that the preventive steps are not properly being implemented.
In the matter of health, whether it pertains to women and children or other vulnerable sections of society, the Poorvanchal region of UP was lagging behind as pointed out by various surveys. The large number of quacks functioning as doctors throughout the state came to notice in September 2006 when a census was carried out by the Health Department of the state government. While the number of qualified doctors in the state was 12,383 which was indeed a small number for a population of around 17 crore, there were as many as 32,245 quacks. There were no efforts by the government to stop the quacks from functioning possibly because of the fact that they provided at least some minimal health facilities to the people.
According to a report, that the serious Japanese encephalitis affliction in Poorvanchal had compelled the Central government to take note of it. The Central Health Ministry had reportedly requested the Intelligence Bureau (IB) to prepare a report regarding the state of the infection in eastern UP. The IB has officers functioning in all the districts of the country and they are in a position to prepare a comprehensive report by making field enquiries. The IB has reportedly sent several teams to different districts such as Balrampur, Basti, Gonda, Bahraich, Siddhartha Nagar and Gorakhpur. All these districts are in the north-eastern region of UP and adjacent to Nepal. The region is intimately connected with the life and times of Gautama Buddha.
Unusually, a few cases of casualties due to Japan encephalitis have been reported from the coastal region of Odisha. The Director of the Regional Medical Research Centre based at Bhubaneswar has reported that the children afflicted by Japanese encephalitis were mainly from Kendrapara, Jagatsinghpur, Balasore and Jajpur. The total numbers of 117 cases have been reported as victims of Japanese encephalitis from these districts. The Odisha government is yet to take all the steps needed to ensure that this viral infection does not become an annual affair.n
The writer is a former Governor of UP and West Bengal.
Deaths due to Japanese encephalitis preventable
NEARLY 50 per cent of Indian children are underweight and more than 70 per cent of women and children have serious nutritional deficiencies, including anaemia, according to a report by UNICEF. India is at the bottom of the world’s maiden nutrition barometer along with countries like Angola, Cameroon, Congo and Yemen. The report draws attention to India’s ill-fed underbelly and exposes the failure of several schemes to address healthcare issues among the poor.
Prime Minister Manmohan Singh described the abysmal nutritional record as a national disgrace. One of the primary reasons for the state of affairs is the fact that India’s spending on health is abysmally low. Only 1.67 per cent of the GDP has been earmarked in the 12th Plan. The report warned that India is likely to miss the Millennium Development Goal on child mortality. Nothing illustrates the tragic consequences of such health deficiency more than the large number of deaths of children year after year in Uttar Pradesh due to Japanese encephalitis. It is a vector-borne disease which afflicts a large number of children during the monsoon season in the eastern part of UP.
About 12 districts around Gorakhpur in eastern UP are specifically affected by Japanese encephalitis. The origin of the virus is traced to Japan, but it was eliminated in Japan long ago. This year over 370 children died in the affected areas during the monsoon months. This viral infection has been recorded from 1978 onwards. The annual death record has been well over 200.
The mosquitoes are the carriers of the virus, and they breed in stagnant ponds and are also incubated in the underbellies of pigs. There are a number of piggeries owned by certain traditional pig owners who make a living by rearing them. There are also a large number of stagnant ponds. The largest of them is seen just outside Gorakhpur town.
The virus infection was eliminated in Japan many years ago, systematically getting rid of the pigs by compensating the owners. Likewise, the infection has also been completely eliminated in Thailand and Malaysia. The Government of Uttar Pradesh has not considered any scheme of compensating the pig owners to get rid of the problem.
The only effective way to prevent this virus is to vaccinate children under 10 years of age, and three doses are to be given during a period of 30 days. The total number of children in the 12 districts of Gorakhpur division were said to be around 75 lakhs. Unfortunately, the laboratory at Kasauli is the only source of supply that can produce only 4 lakh vials, The result is that a large number of children were left without vaccination.
When I was the Governor of UP, the figures of deaths due to Japanese encephalitis were brought to my notice. I visited the affected areas in July, 2005, and held a meeting with officers, the local MLA and MLC, both paediatricians. I also visited the district hospital and saw the children under treatment. I was told by the doctors that about 40 per cent of the children who survived were likely to become mentally or physically deficient for life. What was more disconcerting was the fact that during my visit to hospital, I found a large number of pigs roaming in the compound of the hospital itself.
On return to Lucknow, I discussed the matter with the Chief Minister and senior officers and also wrote to the Minister of Health, Government of India. A team of doctors was arranged by the Ministry of Health, Government of India, which also arranged the import of vaccines.
A very large pond exists just outside Gorakhpur town. Apart from the elimination of piggeries in the 12 affected districts of eastern UP and the filling up of shallow ponds in the region, the only way of tackling the annual occurrence of encephalitis was to vaccinate all the children well ahead of the monsoon season. Once the children fall sick, they have to be treated properly and given nutritious food. The consequence of nutritional deficiency in India is fully reflected in the large number of cases of death due to Japanese encephalitis. The fact that this year also there were over 360 deaths due to the same virus infection shows that the preventive steps are not properly being implemented.
In the matter of health, whether it pertains to women and children or other vulnerable sections of society, the Poorvanchal region of UP was lagging behind as pointed out by various surveys. The large number of quacks functioning as doctors throughout the state came to notice in September 2006 when a census was carried out by the Health Department of the state government. While the number of qualified doctors in the state was 12,383 which was indeed a small number for a population of around 17 crore, there were as many as 32,245 quacks. There were no efforts by the government to stop the quacks from functioning possibly because of the fact that they provided at least some minimal health facilities to the people.
According to a report, that the serious Japanese encephalitis affliction in Poorvanchal had compelled the Central government to take note of it. The Central Health Ministry had reportedly requested the Intelligence Bureau (IB) to prepare a report regarding the state of the infection in eastern UP. The IB has officers functioning in all the districts of the country and they are in a position to prepare a comprehensive report by making field enquiries. The IB has reportedly sent several teams to different districts such as Balrampur, Basti, Gonda, Bahraich, Siddhartha Nagar and Gorakhpur. All these districts are in the north-eastern region of UP and adjacent to Nepal. The region is intimately connected with the life and times of Gautama Buddha.
Unusually, a few cases of casualties due to Japan encephalitis have been reported from the coastal region of Odisha. The Director of the Regional Medical Research Centre based at Bhubaneswar has reported that the children afflicted by Japanese encephalitis were mainly from Kendrapara, Jagatsinghpur, Balasore and Jajpur. The total numbers of 117 cases have been reported as victims of Japanese encephalitis from these districts. The Odisha government is yet to take all the steps needed to ensure that this viral infection does not become an annual affair.n
The writer is a former Governor of UP and West Bengal.