It was only after 50-year-old Dariya Kanwar died that her family discovered she had contracted swine flu. A resident of Solankiyatala village in Jodhpur district, Kanwar, who died on January 12, is among 54 people in Rajasthan who, until Monday, have succumbed to the disease.
“Nobody told us my wife had swine flu. We came to know about it only after her death. She had fever earlier this month and her condition worsened over the next 7-8 days before she was admitted to a hospital in Jodhpur. She breathed her last the second day in hospital. There are no facilities for swine flu testing near our village and health officials told us to go to Jodhpur for treatment,” said her husband Chandan Singh.
His village is around 100 km from Jodhpur, the district headquarters, and Chandan is among dozens who have to travel long distances before they can be tested for swine flu.Data collated by the state health department shows that a total of 6,117 tests were conducted this year (in the first 22 days of January), of which 1,414 samples tested positive. This is 23 per cent of the total samples. Given the contagious nature of the disease and such large numbers, the state is staring at a major crisis. Further, the lack of adequate diagnostic centres is not helping the situation. Late reporting of cases puts more people at risk of infection.
Up-to-date data is not available nationally. However, according to data available with the Integrated Disease Surveillance Programme until January 13 this year, 49 people died of the disease across the country, and 1,694 cases were reported. Rajasthan topped the list with 31 deaths. Punjab with six deaths is a distant second. Gujarat, which borders Rajasthan, reported 128 cases and two deaths. In 2018, 14,992 cases and 1,103 deaths were reported in the country.
In wake of the crisis, Rajasthan Health Minister Raghu Sharma has instructed officials to take action against staff absent from duty. The government has also started a screening campaign for the disease where a door-to-door survey is being conducted to identify patients with swine flu-like symptoms.
Within Rajasthan, Jodhpur is the worst affected accounting for 20 deaths this year. As per a health department map of the infected areas in the district seen by The Indian Express, as of January 16, merely four days after Kanwar died, Shergarh reported four more cases. People living in adjacent areas such as Phalodi, Balesar and Osiyan, have also been affected.
A big reason for the high incidence of swine flu in the state is the lack of testing facilities. There are no facilities to collect blood samples at primary or community health centres. “Blood samples can be collected at district, sub-divisional and satellite hospitals. At present, there is no system of blood sample collection at the PHC or CHC level,” Ravi Prakash Mathur, additional director, rural health, Department of Health and Family Welfare, told The Indian Express.
“The testing labs for swine flu are mostly at divisional headquarters and patients often have to cover a lot of distance before being diagnosed. This delay can result in infecting people around the patient. The delay is also putting the life of the patient at risk,” said Narendra Gupta, state convenor of the Jan Swasthya Abhiyan, a collective of various organisations and NGOs working on public health.
The health department currently has 12 laboratories with swine flu testing facilities at hospitals under all seven medical colleges in Jaipur, Ajmer, Bikaner, Kota, Jodhpur, Udaipur and Jhalawar along with the Desert Medicine Research centre in Jodhpur and four other private laboratories. One private lab has also opened 50 testing facilities across the state, said Mathur. As per the Centre’s guidelines, testing for swine flu is only required for C-category patients with symptoms including breathlessness, chest pain and sputum mixed with blood, he said.