By Somnath Mukherji
From October to December 2010 there was an epidemic of falciparum malaria in Chhattisgarh. The state government reported a statewide total of 32 deaths in 2010. In Bilaspur, the count was 9 of which 7 were reported from the JSS hospital in Ganiyari.
The Community Health team of Jan Sawasthya Sahyog (JSS) gathered evidence of 250 deaths in the Kota block of Bilaspur district. These are the areas where JSS is not providing community health. Through a painful process of verbal autopsy, the team confirmed that 200 deaths were caused due to malaria – in one block of one district alone. One can only estimate the number of deaths statewide.
Access to better health care continue to be a problem in rural India. Hut of Shyamlal Yadav, who died of malaria. [Photo : Somnath Mukherji
What follows are some firsthand accounts given by family members, to the JSS team, where at least 1 person had died.
Shyamlal Yadav of village Rigwar had fever and headache for 3 days. He was going to the Anganwadi regularly where, it would have been his last year. He was 6 years old. When his body started turning yellow, his parents had Jharh-Phook (extricating evil spirits) done following which they took him to a quack who gave him an injection and the fever went away for a day.
On a Sunday, Anand Ram, Shyamlal’s father came back from the fields to find his son burning with fever and gasping for breath. He panicked and wanted to take him to the Primary Healthcare Centre (PHC) in Ratanpur which was 25 kilometre away. Although well connected by road the family did not have access to conveyance since the bus to Ratanpur had already left in the morning. The Sarpanch of the village was kind enough to arrange for a motorcycle.
The doctor on duty at the PHC detected malaria and asked Anand to take his son to Bilaspur a distance of another 30 kilometre. Anand had only Rs 200 with him and pleaded with the doctor to keep his son for the night while he went to arrange for the money. No such luck. As the sun was descending and the bone-chilling winter of Chhattisgarh re-establishing its grip, Anand made a last ditch effort at a private hospital to hear the same answer. Bilaspur, he had to go.
Catching the last bus, Anand arrived home with now a very ill Shyamlal at 8pm. The little boy was coming in and out of consciousness. Anand shot out of his hut like a mad man looking to find money. He managed to mortgage 1 acre of his land along with the standing Kharif crop. With Rs 8000 in hand and bated breath the family waited by the side of Shyamlal for the sun to come up. At 4am Shyamlal asked his mother for water and passed away soon after. The life of a 6 year old snuffed out due to reasons perhaps unimaginable to many frequent-flyers, broadband-users or anxious faces in the IPL galleries. While accurate estimates are available for projected GDP growth or an impending recession-recovery couplet, it would have been helpful for Shyamlal’s family to know an estimate of the time it takes for benefits to trickle down.
Three days later, Shyamlal’s uncle’s son – 1 year old Tilakram showed the same symptoms. The family was better prepared with money and had rented a car to take him from the Community Health Centre in Kargi Road to Bilaspur. The parents could not cry enough to convince the authorities to spare an oxygen tank for the breathless Tilakram. He did not survive the journey.
Sickness and death has left both Shyamlal’s and Tilak’s family in a debt of Rs. 10,000 and grief beyond measure.
Nandini and Anjali came from a landless family in village Porimohonda. Nandini was 1.5 years old while Anjali was 5. Both the sisters had fever and a PHC near the village detected both with malaria. The family was advised to take the girls to Ratanpur PHC, 35 kilometre away, which had more doctors and a malaria camp. Since Anjali was less serious, the parents started taking Nandini to Ratanpur. This went on for 4 days. Anjali on the other hand had finished the medicine given by the PHC and only her belly was swollen. But the parents thought she was better and left her behind to take Nandini back to the Ratanpur PHC yet another time. At Ratanpur again, they were shown the way to Bilaspur which was inaccessible to the parents because of its distance and the cost needed to cover it.
While still at Ratanpur, news of Anjali’s death arrived. Lacerated by panic and grief, the parents rushed back. One can only imagine the immobilizing effect of helplessness, hopelessness, angst and grief. Even before the mourning of her sister was over, Nandini too passed away in the night a week later. Bilaspur remained silently in the distance.
The parents’s lives are caught between the grinding blocks of memories and a debt of Rs. 15,000.
A 40 year old Manglu Ram Gond from village Berapat had fever for 8 days. His brother took him to the CHC in Kargi Road about 20 Kms away from his village. He was detected with malaria, given saline and asked to go to Bilaspur.
His brother rented a car and took him to the medical college in Bilaspur where he was admitted and treatment started. His brother was asked to get some medicine from outside. Out of the money, the brother called some people in his village to get money by next morning. Manglu did not wait that long and passed away in the early hours.
His brother rented a car again, this time to take Manglu’s body back to his 4 year old son and his wife who was 6-months pregnant and was also running a fever. She was taking Paracetamol from a nearby shop and suppressing her fever. By the time her brother-in-law came back, she was dead with the unborn inside her.
The brother-in-law will take the 2 acres of land left behind by Manglu to offset the expenses incurred and raise the 4 year old boy who finds himself without parents, both dead in a matter of week for reasons he might think were not preventable.
In the official records, cause for the above deaths will not be recorded as malaria; certainly not poverty, in an era of 10% growth or the inability to travel 30 Km in the age of 3G or sub-standard PHCs when medical tourism is a formidable industry.
In life and death, these people will remain statistics – half baked and malleable to be manipulated.
—
Somnath Mukherji is a volunteer with Association for India’s Development (AID). Learn about AID’s work in Chhattisgarh : http://www.aidindia.org/main/content/blogcategory/222/343/