When the constitution of India was being written with a sacrosanct and holistic vision of having a healthy, wealthy and peaceful nation, health was something that got immense priority. Healthcare is a sector which is the fulcrum of governance in any kind of system. You can hold education, you may hold employment, you may hold social security, but you can’t compromise with health otherwise it directly impacts the social fabric, social peace, economy and geographical balance and has the capacity to drag the system to collapse. But, in India, we have managed to make ways for tweaked rules in the regulation and management of health care services.
The media has brought society to a boiling point with its intense coverage of the crisis taken place in Muzaffarpur of Bihar where more than a hundred children have died. There is a confusion in the actual cause of the disease because there is scope for both: the spread of toxin hypoglycin A and the flavivirus. Hence, to look into the case, we need to understand the causes of occurrence and the impact of both these crisis-carriers.
In 2017, a delegation of Indo-US Doctors confirmed that the mysterious sudden death of several children in Muzaffarpur region is a result of methylenecyclopropylglycine, MCPG, which is also known as toxin hypoglycin A. It is a toxin which is found in fruits like Litchi and decreases the glucose level of undernourished children to an alarming stage overnight. The heavy scarcity of glucose in the body causes several mental disorders and deaths. While the flavivirus which is the cause of Japanese encephalitis gets into a human being from animals like pigs. If a mosquito bites a pig having this virus, it will be infected and then if it bites a human being, the virus will enter into the human being. It takes some time for symptoms to manifest and the general symptoms are fever, mental disorder or throat lock and in severe conditions, it may also cause death.
Muzaffarpur is not a place which can be ignored when you look at Bihar in terms of business, agriculture or social capital. It has its own history of getting the first democratic state Vaishali as a neighbour. It is directly connected with the capital city Patna and at a distance of hardly two hours. But yet, several children are dying in front of our eyes. The whole system has been a spectator. It triggers many questions in the minds of those who are concerned even if they are far from the region.
Here are some important questions I’d like to discuss:
- Can this clamouring of people, the media, the union and state governments office holders and on-ground operating doctors and health department solve this issue immediately?
Clamouring does not appear pragmatic and several similar situations in history suggest the response is negative to this question. Bihar has a population of 100+ Mn which is not managed by customised rules and hence if an emergency at one place has not been controlled, questioning fingers will of-course be pointed towards the system which is put in place.
We need to think of systemic solutions based on the learnings drawn from cases like this. The energy which is being spent on producing echoing ground reports, social media posts, staunch attacks of state and central governments must be utilised and deviated towards formulating a comprehensive and robust system which may ensure secure existence of even the poorest of poor in future.
- Is the Government of Bihar providing enough resources to the healthcare system?
While in Bihar, my first-hand experience is that it shares a system of exploitation and not collaboration. I think this has become evident in the Muzaffarpur case. The Japanese encephalitis breaks through multiple ways but it is basically caused by a flavivirus, which can affect both humans and animals. The virus is passed from animals to humans through the bite of an infected mosquito. Pigs and wading birds are the main carriers of the Japanese encephalitis virus. So, its absolutely clear that the high-risk areas in terms of this virus effect, sanitation and vaccination has to be upheld.
The government needs to realize that along with making beautiful and air-conditioned big buildings in the health department headquarters, the progress of working conditions on the ground is a major issue to fight epidemics.
- Is the healthcare system solely responsible for the Muzaffarpur incident?
This incident may be jointly caused by the toxin hypoglycin A and the flavivirus and hence there is a rapid generation of patients. But, it also indicates that we have simply ignored a community which is undernourished to an alarming extent.
- Why is Bihar struggling to keep basic healthcare facilities intact and what are the solutions?
This is the toughest job to do. Not because solutions are very tough to find but because people are adamant about picking on the solutions. To address the issues of health care services in Bihar, we need to do the following things immediately:
- A radical infrastructural change
- An appropriate number of human resources of both the first line as well as support staff
- Intensifying the awareness campaigns and social monitoring of health care services delivery
After the appeal for a boot in security for doctors across the nation, the government is all set to make stricter laws for them to remain secure. Keeping the fact in mind that the medical sector is one of those rare sectors which is completely managed and led by medical professionals, a question remains unanswered “Will medical professionals give up corruption and stand up to the stature of ‘next-to-God’? ”