That touch of healing

The effects of the Gujarat earthquake on the bodies and minds of the survivors would remain long after the state itself has achieved some semblance of normalcy. In time, homes will be rebuilt, infrastructure reconstructed and the shattered economy put back on track, but the people who have lost limbs, suffered kidney failures, been rendered paralysed, or have to live with the agony of having lost a family member or close friend, will bear the scars of that fateful morning, carry the memory of it, to their graves. Even the great relief of actually surviving the quake cannot offset this painful reality. It demands, first of all, extreme empathy from administrators. Sometimes, overwhelmed by the large numbers of people who need attention, they can display cruelty and callousness that undermine even the good work they are doing.

The only way to ensure this does not happen is to make provision for every eventuality. Of utmost importance is the need for a health management blueprint that parallels the broader crisis management plan. It should not just account for every victim and the various health interventions he/she would require, but map the affected communities which may need care in the future. A plan of this magnitude cannot be conceived in Delhi or Ahmedabad alone, it would have to reflect decentralised, area-based requirements. In other words, the situation demands a three-pronged response, one that caters for the immediate, medium and long terms. The most urgent health concerns are obvious. To ensure that epidemics don’t break out by immunising people against diseases, following proper disinfectant procedures, providing potable water and so on or, in case outbreaks do occur, have the means to battle them at hand. The Union health minister rather prematurely dismissed the possibility of such an eventuality, but his optimismis belied by recent reports of gastroenteritis having broken out in parts of Bhuj district.

Those who have the money and the contacts to get their injured family members treated in hospitals in Mumbai and Delhi are fortunate, but the great number of the injured will have to be catered for locally. Since the local health infrastructure has all but collapsed, with public hospitals, health centres, and clinics reduced to rubble, more mobile hospitals of the kind some foreign agencies brought in would certainly be required. And not just during the relief operations but until a proper health network is reestablished. Paraplegic care in the state would also need to be shored up, given the numbers who have lost their limbs, many of them young children who would require more long-term care. Finally, there is the not so obvious but equally vital aspect of dealing with the psychological consequences of the disaster by catering to the mental health of the people. Quite clearly, Gujarat cannot be left to grapple with this enormous task alone. International health agencies have shown exemplary concern, and thisis heartening. But finally it is the whole nation, with its significant reserves of health personnel, which must engender this healing on a mass scale.