At least 60 children, many of them encephalitis patients, died in a Gorakhpur hospital last week, 30 of them in the past four days. Reports have described a shortage of oxygen supply to intensive care units in Baba Raghav Das Medical College Hospital where the children were admitted — the UP government has denied that the cut in supply was the cause of the deaths. But encephalitis has been a scourge in Gorakhpur for nearly 40 years — and it has not been addressed by successive governments with the urgency it deserves.
According to conservative estimates, 25,000 people have succumbed to it since the disease was first reported in the area in 1978 — more than 50 of them this year, before last week’s pestilence. The latest tragedy confirms that the Yogi Adityanath government has treated the festering public health crisis in Gorakhpur — which also happens to be the chief minister’s constituency — with the same criminal apathy, even as it seems to have prioritised polarising issues, like setting up anti-Romeo squads and devising patriotism tests for madrasas in the state.
Encephalitis is a viral disease that mosquitoes transmit to humans from pigs. In most cases, it causes a mild fever and headache that recede within a few days. But one in 250 people develop high fever, severe headache and neck stiffness that exacerbates into seizures, paralysis and coma. At times, survivors are left with serious disabilities, mental and physical. In 2006, a study in the journal, Emerging Infectious Diseases, pointed out why Gorakhpur is prone to the virulent form of the disease.
An abundance of rice fields and a bowl-shaped landscape that allows water to collect in pools create ideal breeding grounds for mosquitoes. Since then, several studies and reports have highlighted the link between poor sanitation facilities, open defecation and encephalitis in eastern UP where Gorakhpur is located. Yet uncovered drains, clogged sewers and garbage-strewn streets remain a common sight in the region. Gonda, which sends a large number of encephalitis patients to the Baba Raghav Das Medical College Hospital every year, has been named the worst performing district in the Swachh Bharat Survey this year.
The hospital, itself an example of all that continues to be wrong with public health management in the country, is the only institution within a 300 sq km area with facilities to treat encephalitis and other infectious disease. Last year, Prime Minister Narendra Modi laid the foundation stone of an AIIMS at Gorakhpur. While the setting up of such an institution is welcome, encephalitis can be best combated by strengthening primary healthcare facilities. Epidemiological studies have shown that lives of encephalitis patients can be saved if they receive immediate treatment from trained doctors and are not forced to travel long distances to access medical care. Last week’s tragedy is a grim reminder to the UP government — it has work to do, it must reset its priorities.