A Symp­tom of the Rot Within

Tehelka - - THE INCONVENIENT TRUTH -

ITarun Sehrawat’s death ex­poses the sick­en­ing truth about the con­di­tion of pub­lic and pri­mary health­care that

ex­ists in ru­ral In­dia

F TARUN SEHRAWAT’S tragic death helps us put paid to the mean­ing­less nos­trum that sim­ple peo­ple’s ill­nesses re­quire sim­ple reme­dies, then it will at least have served some larger pur­pose. In fact, noth­ing could be fur­ther from the truth. In re­cent months, it has come to our knowl­edge that a num­ber of young jour­nal­ists cov­er­ing events in south Bas­tar have fallen prey to acute febrile ill­nesses of life-threat­en­ing in­ten­sity. Not all th­ese episodes could be re­li­ably as­cribed to malaria, or in­deed, any spe­cific di­ag­no­sis. Sim­i­lar episodes have oc­curred among para­mil­i­tary forces posted in this re­gion. Th­ese ill­ness episodes are im­por­tant be­cause they are in­dica­tive of the kind of mi­lieu in which the or­di­nary cit­i­zens of th­ese ar­eas, with the same rights and en­ti­tle­ments as you or me, live out their lives — their in­fancy, their preg­nan­cies, and their old age — all of them pe­ri­ods of spe­cial vul­ner­a­bil­ity. It is in th­ese cir­cum­stances that women face the prospect of an anaemic labour with­out ben­e­fits of the pos­si­bil­ity of Cae­sar­ian sec­tion, should the need arise.

In­dica­tive, but of what? The com­mon oc­cur­rence of th­ese se­ri­ous ill­nesses shows that ap­pro­pri­ate con­di­tions ex­ist for the trans­mis­sion of dis­ease — that there are am­ple re­serves of dis­ease-caus­ing or­gan­isms in the com­mu­nity, as well as large pop­u­la­tions of pathogen-trans­mit­ting vec­tors. For ex­am­ple, in the case of cere­bral malaria, this would mean that there are large re­serves of Plas­mod­ium fal­ci­parum in the com­mu­nity, as well as large pop­u­la­tions of Anophe­les species to trans­mit the dis­ease. It would also mean that rou­tine pub­lic health epi­demi­o­log­i­cal sur­veil­lance to de­tect — and re­li­ably re­port — lev­els of pathogen in the com­mu­nity is not in place. It would also mean that en­to­mo­log­i­cal mea­sures to de­tect and con­trol vec­tor pop­u­la­tions are ab­sent. The same story is re­peated, dis­ease

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