Of late, healthcare in Odisha has been in the throes of a severe paralytic attack. Close to 120-odd deaths have taken place in the last two months, mostly children, from suspected Japanese Encephalitis (JE) in the Malkangiri District alone. And this is just an addition to the already existing healthcare problems in the state; like malnutrition, high maternal and infant mortality rates besides the crumbling healthcare infrastructure.
The dilapidated healthcare conditions in the state have been consistently churning out the image of ‘inefficiency’ from an otherwise ‘settled’ Naveen Patnaik government; that boasts of getting a clear mandate in the state for four consecutive terms.
In September, when JE started raising its ugly head in Malkangiri villages, the government tried to control the situation but the steps employed by them to curb the disease were too little too late, to say the least. The district headquarters' hospital was the only centre capable of providing treatment for JE, as the Primary Health Centres (PHCs) and Community Health Centres (CHCs) are not equipped enough to handle such a deadly disease. To make matters worse, the hospital only had only one paediatrician available against the sanctioned strength of three.
Currently, around 1,300 of the total sanctioned strength of 4,700 doctors' posts – about 27 percent – are lying vacant across hospitals in the state, as per the response of former Health Minister Atanu Sabyasachi Nayak in Assembly last March. The vacancies have remained static for the past five years. Worse, the percentage of vacancies in Malkangiri stands at 68 percent, the highest in state.
It took the government two weeks to send expert teams from medical colleges and hospitals to the region, but by then, 35 children had already succumbed to JE. Now, when the toll has reached 120 (unofficially), the experts have heuristically ruled out JE as the cause of the deaths as the last 100-odd samples sent for tests came back negative, with just one test yielding a positive.
The government statistics, however, portray a different picture. The health department statistics state that the death toll in Malkangiri stands at 93, of which 32 have died due to JE and 61 due to Acute Encephalitis Syndrome (AES).
As per the Directorate of National Vector Borne Disease Control Programme, JE death cases till 6 November, 2016, in Odisha stand at 31, the third highest in the country – preceded by Assam topping the chart with 84 and Uttar Pradesh with 56. Given the crippled infrastructure and manpower, the Malkangiri district administration, instead of shifting the first stage patients (whose immunity is very less due to a host of reasons) to better medical colleges and hospitals in Berhampur or Cuttack, kept holding them up in the same ICU. Fogging, sanitisation efforts in the vicinity and shifting of the carrier pigs out of the region has hardly helped contain the spread.
The number of deaths, however, has not been able to make an impact on the Central government. No steps were taken for implementation of vaccination programmes, even though some pockets in the state are prone areas. And now, with the recent demonetisation wave across the country, the complete government machinery is on its toes. The State’s political parties have stayed pharisaical in playing their games, keeping in mind the upcoming Panchayat elections.
Going by the health index, this has been the toughest year for the Patnaik-led government. Starting from Dana Majhi in Kalahandi district, to malnutrition deaths in Nagada of Jajpur district, the mango kernel deaths in Rayagada district and the recent fire incident at SUM hospital in the capital city, all point to the lack of willingness on part of the government to change things.
Even as the health minister resigned, owing to the growing pressure over the failure of the health care machinery, nothing has changed. Even today, the JE death count continues to rise. Reports of pregnant and needy people dying on the roads due to unavailability of ambulances continue to pour in and people in underdeveloped pockets either end up falling prey to Naxal friendliness or to malnutrition deaths.
Post the SUM hospital incident, most hospitals and nursing homes, both in government and private sectors, do not have licences to run health institutions and many are awaiting renewal despite the fact that all the case files are gathering dust in the health department.
Not many government officials, particularly district collectors and department secretaries, are willing to visit their districts and its interiors despite strict instructions issued by the chief minister.
As of today, good medical care remains out of bounds for a majority of the state. Awareness programmes do not make sense as they are not delivered in the local dialect. Uneven terrains are tagged as inhospitable – a deterrent even for ground level workers to reach at the time of need. Health schemes like Mamata Yojana and Harishchandra Yojana launched by the state government stay non-starters due to red-tapism. Funds, Central or state, remain unused, and in a state that puts bureaucrats over all else, accountability has turned utopian.
It's time that Patnaik took corrective, coercive and cohesive action to keep the state healthy first, before pettifogging about inviting investments from the world over for a ‘Make in Odisha’ conclave.