Muzaffarpur, Bihar: “The doctors working in Muzaffarpur, particularly at Sri Krishna Medical College and Hospital [SKMCH] and Kejriwal Hospital [Kejriwal Matri Sadan] are at a major risk. People are losing their kids. Who will control the outburst! How can anyone concentrate and work if they feel sceptical about their safety!,” asked Dr Amar Kant Jha, a faculty member and former principal of Patna Medical College and Hospital (PMCH). As the toll of dying children continues to rise owing to Acute Encephalitis Syndrome (AES), medical practitioners in Bihar’s Muzaffarpur are increasingly worried after their safety at the workplace. The medical fraternity has demanded enhanced security arrangements for medical professionals safeguarding them from irate mobs. Dr JP Mandal, who is presently deployed at SKMCH, said that several attendants accompany a patient. “We are working under serious threat perception. Only one spark is needed; one infuriated attendant is potent enough to enrage the entire mob present,” he said. <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">He revealed young practitioners are being wooed by private hospitals in metro cities owing to the lack of security. “We cannot deny medical services to the masses because of our incompetence in providing a safe working environment to the medical fraternity in our district headquarters,” he added. <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Last week scores of medical professionals took to the streets to protest against the lack of security at workplace after <a href="https://www.telegraphindia.com/states/west-bengal/nrs-medical-college-junior-doctors-assaulted/cid/1692258" style="text-decoration:none;"><span style="font-size: 20px; color: rgb(17, 85, 204); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: underline; text-decoration-skip-ink: none; vertical-align: baseline; white-space: pre-wrap;">two junior doctors were assaulted</a><span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> in Kolkata. At the same time, the doctors at SKMCH and Kejriwal Matri Sadan were tackling the outbreak of AES in the region. Of the 12 districts identified by the state government as AES-prone, it is rampant in Muzaffarpur, Sitamarhi, Vaishali and East Champaran. A cursory glance on the map reveals that Muzaffarpur is at the centre, flanked by the districts affected by AES. Over <a href="https://www.moneycontrol.com/news/india/bihar-encephalitis-deaths-three-more-die-of-aes-in-muzaffarpur-toll-reaches-139-4125941.html" style="text-decoration:none;"><span style="font-size: 20px; color: rgb(17, 85, 204); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: underline; text-decoration-skip-ink: none; vertical-align: baseline; white-space: pre-wrap;">139 children have reportedly died</a><span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> since the first case was reported on June 1. <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Bihar Chief Minister Nitish Kumar on June 17 took stock of the AES and heatwave situation in the state but any decision to ensure a safe and secure working environment for physicians, including women, is yet to be taken. <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">While the authorities at SKMCH claim they are leaving no stone unturned in their bid to treat the AES patients—most of them children—they fear that they risk being exposed to another Bengal-like possibility because of the lack of proper security measures. Owing to the increasing footfall in SKMCH, 110 police personnel were deployed on Wednesday. Police personnel were deployed at all the four paediatric Intensive Care Units (ICU) while a few police personnel guarded the office of senior hospital authorities. <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Presently at Kejriwal Matri Sadan, no police personnel have been deployed. A police official at Nagar Police Station said, “We had visited the hospital. Since no politicians are visiting the hospital and few patients are admitted, so we didn’t deploy police personnel.” <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Risk on personal security of doctors concerned looms large as Medical Superintendent of SKMCH, Dr SK Shahi, accompanied with his 36 colleagues toils continuously to manage AES. “Policy-level decisions need to be taken as far as the safety of hospitals and medical professionals are concerned. Government of India must brainstorm about a comprehensive policy framework ensuring doctors’ safety. Patients remain our top priority, but security [of doctors] is a prerequisite,” he told <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: italic; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Firstpost<span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">. <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The doctors in the state also have to deal with a shortage of staff as well. Dr Shaligram Vishwakarma, President of the Bihar Chapter of Indian Medical Association, while demanding for increasing security measures revealed there are only 4004 doctors in Bihar to serve a population of 9.9 crore. “Among this 4004, only 3500 doctors are working. We can not expect from doctors to cater to this population.” <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">He also demanded for central security forces to ensure the safety of working doctors. Tackling AES Addressing the media in the state capital this week, Bihar Chief Secretary Deepak Kumar claimed the state government is working hard to tackle the menace of AES. The press conference was attended by bureaucratic bigwigs including two additional chief secretary rank officials. Deepak Kumar said the government is trying to ensure free ambulance and medical treatment to the patients suffering from AES. He said the cost if incurred, will be reimbursed by competent authorities. <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">He added that the state government in deciphering the role of socio-economic status in the spread of AES on a large scale. He said specialised data collection teams would visit the kith and kin of those slain by the murderous AES. Interestingly, the specialised teams will employ no medical professionals and will consist of social workers only. <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">In the wake of AES-related fatalities, Bihar Chief Minister Nitish Kumar had announced an ex-gratia of Rs 4 lakh each to families of those deceased. Directions to the Health Department, district administration and doctors, were also given by the CM to take necessary preventive measures to stall the spread of the disease. <span style="font-size: 20px; color: rgb(0, 0, 0); background-color: transparent; font-weight: 400; font-style: italic; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">(With inputs from Umesh Kumar Ray)