By Purusottam Singh Thakur,
On October 2, Gandhi Jayanti, when members of Gandhi Foundation, Khariar, visited the local Primary Health Centre to distribute fruits and bread to patients, they found a family from Bichhnapali Village admitted in the hospital for diarrhoea. The epidemic, which had started three months earlier, had not yet stopped in Nuapada District. Out of 52 deaths in the district, three were in Khariar.
Children have been the major victims. So much so that in the last three years, the infant mortality rate has increased from 78 per 1000 to 91 per 1000 children, against the state average of 69.
Pratima Majhi, a 9-year-old girl of Khadupani Village in Nuapada District died of diarrhoea in Boden PHC on June 21. Her mother, Khira Dei, was affected simultaneously and was admitted in the headquarters hospital at Nuapada. Her diarrhoea stopped but the child in the womb died and her situation became complicated. She was sent to Mission Hospital in Khariar. A Caesarean was done and the baby was delivered. “I had to spend over Rs 10,000,” says Khira.
Over 50 persons developed diarrhoea in Khadupani due to contaminated water. Villagers were using water from a small well, temporarily dug alongside a pond. There was no other source.
“Water quality of three tube wells in our Gauntia Pada is not good. A yellow layer of an oily substance accumulates at the top if a bucket of water is left for some time,” says Harmani Majhi, daughter-in-law of Chandni Dei, who died of diarrhoea on July 10. Khadupani is the home town of Duryodhan Madhi, who was Orissa Health Minister in the BJD government.
Nuapada is not the only district which was hit by diarrhoea. The story is the same for the whole of undivided Kalahandi-Bolangir and Koraput, known as KBK. Raygada in particular was badly affected.
"When diarrhoea did not stop and my health deteriorated, my family repeatedly called up the staff of Shikarpai Health Centre. Neither the doctor nor the health worker turned up. First, my family took me there in a taxi but when I did not get well, I was taken to a private doctor in Raygada. The doctor took Rs 700. My sons then fell ill and they were hospitalised,” says Shirpati of Satpai village in the district.
"I had to spend around Rs 6000 for the treatment of the entire family. Now I am in debt. I have borrowed the money from a local money lender who gives money on 50 paise rate of interest to a rupee," he adds. Asked how he will repay the amount, he replies that it will take him years.
Satpai is one of the remote villages where diarrhoea spread. There are many such, which have absolutely no communication. One has to hire a vehicle in case of health complications. But that requires money, which many people do not have in this part of India.
The epidemic broke out in mid-July last year. "Some 2050 people were affected by diarrhoea this year. Of them, 41 died till the last week of September," says Dr Benudhar Naik, CDMO, Raygada. The unofficial record says it is more than a hundred.
"In 2007, some 7800 people were affected by diarrhoea and 90 lost their lives," says Dr Naik. "Lack of safe drinking water, connectivity and lack of awareness are the factors responsible for the regular outbreak of epidemics. The health department is helpless," he admits.
When this reporter visited the district in the first week of August, seven deaths had already been recorded and at that point of time the CDMO said, "the situation is under control."
Six blocks were affected by the epidemic in 2010. They were and lack of access, endemic poverty was a reason.
Dr Roy of Sarvodaya says he spoke over the phone to a senior state-level officer of NRHM and complained about the apathy, and the officer expressed helplessness. When asked why he was not taking action, he pleaded staff shortage and no funds. “And you know the reality, how difficult it is to suspend or dismiss even a 4th class employee in government service.”
"It is not just the contaminated water and inaccessibility, rather it’s endemic poverty which prevailed here. They have no access to safe drinking water and the food as well. They are still forced to take contaminated food like mango kernel and seeds of tamarind, roots and poisonous mushrooms."
Poverty prevents people from seeking treatment for other ailments too. This reporter witnessed this in person when he accompanied the Sarvodaya team to Huder Village. Another problem is shortage of doctors. After the spread of the epidemic, the government appointed 408 doctors on an ad hoc basis in Orissa, but reports said the joining rate was very poor. The heavy workload was cited as one reason. Malaria is endemic in the area. Kashipur, Singapur, Bisam, Cuttack, Gudari and Raygada. After the situation seemed to be going out of control, there was a furore in the media and the Chief Minister asked Health Minister Prasanna Acharya and the Health Secretary to go to the district and monitor the situation.
Prasanna Acharaya blamed contaminated water and inaccessibility, among other factors, in his report submitted to the government.
Another distress factor was that most of the deaths occurred at night. Night patrols were pressed into service to provide medical assistance, the report said. Inter-departmental coordination was the need of the hour and Acharya proposed this in his report.
Some doctors, along with paramedical staff were sent from other places including Bhubaneswar and Cuttack. Temporary health camps were organised in some places and lives were saved. Some private doctors remarked, “When there is no power, no connectivity, nothing, how does the government expect the government doctors to perform.”
Ravi Das, a 70-year-old social activist shared his experience in Baliguda Village of Gudibali Panchayat. “There are 40/45 households in Baliguda Village and almost all are very poor. There is a tube well but defunct, which was repaired after one person died."
He adds, “When the villagers informed the staff at the nearby temporary camp set up by the government about a patient who was seriously ill and requested them to send a vehicle to transport the patient, they did not immediately respond. By the time the vehicle came, it was too late and the victim had died.” Ravi Das said apart from bad water
A Woman in Khadupani Village in Nuapada District collecting water from a chuan.
Patients affected by diarrhoea recovering at a health centre.
An affected villager carries the medication (drips) bottle along.
Apart from bad water and lack of access, endemic poverty is a cause for the disease. There is also a severe shortage of doctors in this village in OrissaDiarrhoea, still a major killer
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