Monday, September 27, 2010

Fever, fear, plague Amravati--II

Fifty-year-old Nirmala Pawar is fatigued, anemic, and tired of sickness over the last fortnight. “For a week,” she says, “I am unable to work on farms.” Which in turn means her husband has to work extra or hire a hand for Rs 120 daily, given this year’s un-abating rains. “For three months, it’s been work, work and work.”

In Surali village of Amravati’s Warud tehsil, Nirmalabai is taking a typhoid dose intra-venous at a private clinic run in his home by Dr Rajesh Fate. Alongside is a 60-year-old Ramkisan Kadu, who, like her, looks tired, and wrought in tension.

“It’s a double blow,” Kadu, a farmer from the neighbouring Kurali village with suspected typhoid, says. Farm expenses shot up three fold this year. Now come the health expenses. He says the families like him are mortgaging gold and silver to buy health care. He has done it. “I am old, but can’ stop working,” he says.

By the evening, both of them will return home, to come here the next morning to take another dose of medicines.

“What to do!” he doctor says. “There is no room at the rural hospital at Warud.”
The 30-bed hospital in the tehsil town is overflowing with patients; waiting list is growing with every passing day; and the daily OPD (out patient department) has swollen to 500. Private hospitals in this small town are choc a bloc with patients.

Rural Amravati, the home district of President Pratibha Patil, is exploding with a deadly combination of viral infections and influenza. Rains have taken a break, but humid weather has unleashed a wave of health exigencies unseen before. At least 45 patients from a cluster of 15 villages in the orange county of Warud have died in a month, even as the rural hospital and the primary health centers lacked medicines.

Now, after the damage is done, the health machinery has woken up.

At least ten of these deaths were due to swine flu, health officials say. In Warud, a separate 10-bed ward has been set for the suspected swine flu (H1N1) patients. As reported by DNA earlier, medicine paucity only aggravated the problem – a fact admitted by health minister Suresh Shetty on his visit here last Saturday. On the night before his visit, Warud rural hospital got two trucks load of medicines, enough to see through the next several months, when infections will have died.

Tens of patients queue up for medicines at the rural hospital’s pharmacy. Some of them are waiting to be admitted, but there’s no space.

But why small infections are proving fatal? The health machinery is still studying the cases and the pattern of flu. Rural doctors say poor nutrition and a declining immunity is turning peasants and labourers vulnerable to viral fever.

“Most patients have poor nutrition standards,” says Dr Poddar. “Viral fever can’t be so deadly, but if the patients’ immune system is weak it could become fatal.” This year, he says, many of those who fell sick worked in double shifts. Demand for farm hands spiraled with pest and weed infestations due to incessant rains.

What has foxed the health machinery is that all 45 deaths are of adults. Children along with pregnant women are among the risk groups.

Neither the government hospitals nor the private ones record patients’ weight, a key to calculate the body mass index that could give significant insight into their nutrition standards. But as Dr Poddar suggests rural adults are eating lesser.

In Surali, Dr Fate agrees. “I see a constant decline in nutrition standards among the villagers, particularly women,” he says. “I have never seen such an outbreak in this part in the 20 years of my practice,” he says. “Most patients come late to us,” he says. They’ll try home remedies; then take analgesics, and when nothing works, come to them, he says. “Most of them pay no heed to their fever because their farms need more attention.” Like Nirmalabai, who says, she had fever for a fortnight, but she had no time to see a doctor, until she collapsed two days ago.

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