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The Pandemic in Bihar


Nearly 126 children have died of Acute Encephalitis Syndrome (AES) in Bihar over the last two weeks.  Since over another five hundred  are still in hospital,  the death toll is likely to rise.

However, even as eight to ten children have been succumbing to the disease each day in the last two weeks,  the Janata Dal (United) government led by Nitish Kumar seems to be at a loss on what to do.  In a way,  more worrisome than the actual affliction is the indifference of the authorities.   The National Human Rights Commission has sent notice to the Central Home Ministry and the Bihar Government about this culpable negligence.  Voluntary organizations staged a strong protest in front of Bihar Bhavan in Delhi, against the utter inefficiency of the state's health administration.

The spread of AES with huge casualty among children unravels a pathetic picture of Bihar,  known to be far backward in socio-economic respects.   The main cause of such contagious and deadly diseases,  is the dire poverty – that denies even an evening meal to satiate hunger - causing extreme malnutrition .   The incidence of the malady is more acute in Muzaffarpur where litchi fruit grows more. 

In the local Sri Krishna Medical College alone,  there were over 90 children dead.  Over 300 are under treatment in the thospital.  If litchi fruit is eaten into empty stomachs,   its toxic ingredient will cause a serious fall in blood sugar level and lead to encephalitis.   Experts say that in extreme hot weather,  virus,  bacteria,  fungus and other germs,  plus toxic chemical elements will cause encephalitis.   The first bout of AES and deaths were reported in Bihar in 1995.  Between 2010 and 2014 alone,  thousand children had died.   Following this,  researchers from Christian Medical college,  Vellore and the Centre for Disease Control and Prevention, Atlanta,  USA,  who went after the cause of the death,  discovered that a combination of litchi toxin and undernourishment were the factors that raised the death rate in Muzaffarpur.    The main reason is  that undernourished have go to bed without dinner,  but after eating litchi fruit.

It is the government's attempt to absolve itself of the guilt by blaming the fruit,   based on this that results in the disease spreading so widely and recurring every year.   Nitish failed to do anything to have a nutrition scheme of providing one square meal (dinner) for the children,  at least in areas with higher rate of incidence of the disease.  The disease could have been solved by ensuring dinner for the families,  intensifying the awareness to reduce consumption of litchi fruit and by facilitating quick and easy access to glucose to be taken when the patients' sugar level goes down.  But no efforts in this direction were made by the Bihar government in the period so far.

The authorities were not able to put in place even the primary facilities for either  disease prevention,  or for its treatment.   In the primary health centres of Muzaffarpur,   from where the malady has been reported for the last ten years,   they did not have even glycomerter used for measuring blood sugar levels.  In Sri Krishna Medical College,  which is fifty years old,  there are not even enough beds in its pediatrics department.   Nor does it have a virology lab.  When deaths start happening,  every year they would put up temporary encephalitis wards,  and make some urgent cleaning exercises.    And in September,  when the hot weather softens and the state moves to colder spell,  the government would also retreat,  like the disease.

It is this convention that brought matters to this sad a situation.  When things appeared to get out of hand,  now chief minister Nitish Kumar and Central Health Minister have arrived in the scene.   Back in 2014 also,  when AES had occurred,  they had reached Muzaffarpur.   Although the required action was promised at that time, nothing happened after that.   This time,  when the minister arrived two weeks after the tragedy struck,  he was accompanied by the local MLA and state urban development minister Suresh Sharma and central deputy minister Ashwini Choubey.    It became stuff of social media troll sonn thereafter that when the central minister was at the press meet, the other two were dozing off and one of them woke up and asked for the score in India-Pak cricket match – which speaks enough for the way authorities deal with the matter.

Paradoxically enough,  it is by covering these terrible child deaths in Bihar,  that in West Bengal the doctors en masse went on a national strike in response to violence by irate relatives of a patient who died.   That was even fo1llowed by some arm-twisting by the  Centre and governor before the chief miniser.   The mainstream media who gave undue coverage for the Bengal case,  closed  their eyes to the inefficiency of the Nitish-Modi regime in Bihar.   The Centre and the state have to pay the heavy price for this grave action deficit,  not by blaming litchi  but by rectifying governance.   Failing that,  pandemics will recur where regimes become a tragedy. 

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