Saurabh Sharma

Lucknow: Healthcare services in the Indian state of Uttar Pradesh, which shares the maximum number of seats (80) in the 543-member Parliament, are under scanner yet again after the deaths of more than 80 people due to a malaria-like mystery fever in the Bareilly division, and of more than 70 children who have died at the Bahraich district hospital over the last six weeks.

While these are reported deaths from only two district divisions, several patients have succumbed to fever and other seasonal ailments in other districts like Shahjahanpur, Badaun, Sitapur, Pilibhit and Lakhimpur Kheri.

Questions were raised about the healthcare infrastructure of UP over a year ago as well when more than 60 children had died within a week, allegedly due to shortage of the medical oxygen at the Baba Raghav Das (BRD) Medical College in Gorakhpur, which was then the constituency of the monk MP, Yogi Adityanath, who went on to become the Chief Minister of the state.

Uttar Pradesh health minister Siddharth Nath Singh has said that main reason behind the high casualty rate is that people take their sick kin to quacks before bringing them to government hospitals, the Indian media reported.

The chief medical officer (CMO) at the Bahraich district hospital, Dr A K Pandey, while informing that the recent deaths of 70 kids were due to birth asphyxia, pneumonia, infections, encephalitis and other diseases, says, “There is nothing to worry about… yes, the deaths are unfortunate, but look at the flow of patients here. We have patients from adjoining districts as well.”

Bahraich district hospital also serves as the closest tertiary care centre for patients from Shravasti, Gonda and other adjoining districts that lack specialised healthcare facilities.

Pandey says that the cases of vector-borne diseases have been on the rise because of the heavy rainfall received across the state since August, which would have caused water logging. “Be it encephalitis or malaria, cause is almost the same,” he adds.

Ask him to compare the situation at Bahraich with what transpired at the BRD Medical College last year, the CMO denies any parallels between the two, claiming this as an entirely different circumstance. He maintained that the district hospital is trying its best to save lives, but every bed has two-three kids because of the high inflow of patients this season.

The ‘mystery fever’

The ‘mystery fever’ as it is called by some is nothing but another vector borne disease spread across both eastern and western UP districts. The state health minister, while on a visit to Bareilly last week, had ordered that every death be investigated to assess the cause.

Though late, the state’s health administration seems to have woken up, after the health minister took notice.

Health director, UP, Dr Padmakar Singh says they have started to take measures to contain the situation. Teams from both, the Centre and the state, have been deployed to check the situation in the affected districts, he adds.

“Mosquito fogging, spraying of larvicides and distribution of medicines which prevent from falling prey to such diseases are being done and within few days, we will bring the situation under control,” he asserted.

The worst affected districts are Badaun and Bareilly where the hospitals are flooded with patients complaining high fever, severe cold and other ailments. According to Bareilly chief medical officer (CMO), Dr Vinit Kumar Shukla, the district hospital is overcrowded but they have provided treatment to about 1500 patients so far and the situation is under control now.

It may be mentioned that quick action followed the suspension of few health department officials, including the Malaria officer, in Bareilly by the health minister Siddharth Nath Singh a few days ago.

‘Prevention is key’

According to Dr R N Singh, who has been fighting to curb the rate of Encephalitis cases in the Gorakhpur region, both people and government are responsible for these deaths. Dr Singh stresses that if it is the government’s duty to clean the garbage, then the citizens are equally responsible to maintain cleanliness. Going back to old lessons spread through Doordarshan ads, Singh reiterates, “If people do not allow water to lodge, there will be no mosquito breeding, or threat of vector-borne diseases.”

“This is similar to the case(s) of encephalitis. The gist of story is prevention. If people stay alert, nothing like this will ever happen, and I have proved this with my Holiya model village which witnessed no deaths (due to vector-borne disease) and everyone is leading a disease-free life because of prevention,” he says.

A state without doctors

Overcrowding of patients is one part of the story while the other remains understaffed government hospitals across the state.

As per the the Rural Health Statistics (RHS) that accumulate figures upto 2015, Uttar Pradesh had a serious shortage of doctors at the primary health centre (PHC) level, which is considered the backbone of health services. The state in 2015 had 2,300 vacancies against 4,509 sanctioned positions for doctors at the 3,497 PHCs.  The report also mentioned that the community health centres (CHCs) in UP were short of 2,608 medical specialists against the required 3,092 surgeons, gynaecologists, pediatricians and other experts.

The infant mortality in Uttar Pradesh during 2015-16 was 64 deaths per 1,000 live births, according to National Health Family Survey. The figures are strikingly close to strife-torn African nation Mauritania whose IMR is 65.

Opposition calls for action

The opposition, Samajwadi Party (SP), is not missing its chance to target the BJP government on the sorry state of health affairs. Citizen welfare is of no concern to the state government which has its focus on elections, says SP spokesperson Abdul Hafiz Gandhi. Recalling the death of hundreds of children at the BRD Medical College in Gorakhpur, he says the government has not learnt lessons from past and people continue to suffer.

“The ministers of the government are busy organizing caste based conferences without paying heed to what is going on in the state. Mysterious diseases are wreaking havoc in the state and the government should now act consciously to contain the situation,” says the spokesperson.

Nothing to panic, ‘under control’

Rakesh Tripathi, the Uttar Pradesh BJP spokesperson, tells Asia Times that the government is now handling this outbreak with serious care and that more “attention” is being given to cases at the primary health centres.

“The government will very soon launch an awareness drive at primary level, because people reach out to a quack first, which only deteriorates the case. We are trying our best and preventive measures are already being taken by the government. There is nothing to panic and the situation is very much under control,” stresses Tripathi.

-With inputs from Gopal Giri and Rahul Arora