Monday, September 27, 2010

Fever, fear, plague Amravati

September 17:

An outbreak of viral fever, including the swine flu, has claimed in a month about 35 lives at Warud, an orange producing belt hundred km from here in Amravati district.

Seven of these deaths have occurred in 24 hours, rattling the sluggish rural health system grappling with a heavy rush of patients and acute medicine shortage rooted in recent policy changes.

At least eight deaths, health officials confirm, are due to Type A-H1N1 virus or swine flu, which the World Health Organization (WHO) says is in its post-pandemic period. Significantly most of the deceased are adults.

“There is always a brisk flow of patients during this season,” Dr Pramod Poddar, who heads the Warud rural hospital, said. “But this year due to a combination of factors, the mortality has shot up.”

The 30-bed rural hospital is thrown out of gear, with a sudden increase in its Out Patient Department. “We are operating a daily OPD of 400-500 patients,” Dr Poddar said. The scene at the private clinics is no different. Late diagnosis in some cases, where patients came late to the hospital in the advance stage of fever with adult respiratory distress syndrome (ARDS), resulted in some deaths, he said.

Heavy rains this year have triggered outbreaks of viral fever and water-borne illnesses across Vidarbha. More than 25 patients admitted from various parts of the central India, including neighbouring districts of Madhya Pradesh and Chhattisgarh, the government medical college and hospital (GMCH) at Nagpur have died of swine flu since the beginning of monsoon, authorities said. But Warud is the latest hotspot.

The outbreak of viral fever is compounded by a severe paucity of medicines, local MLA Dr Anil Bonde, an MD in Medicine himself, said. “The situation was avoidable,” he said.

The medicine crunch reported at the rural hospitals and primary health centers in at least 14 districts in Maharashtra has arisen out of the changes in drug purchase rules earlier this year.

The government terminated its earlier decentralized purchase policy citing corruption, but did not place orders for procurement of the essential drugs in the past four months, pushing the PHCs and rural hospitals into a state of coma.

“The rural hospital did not have even Paracetamol (the commonly available anti-pyretic analgesic,” Dr Bonde said. “We had to provide all the essential drugs from the funds we raised,” he said.

Officials said they had been begging for medicine supply in view of the steady increase in the number of patients this year particularly due to heavy rains. “In some cases, paucity of medicines was fatal.”

The health minister, Suresh Shetty, had reportedly instructed the chief surgeon of Amravati to go for local procurement of medicines. The chief surgeon denies having any written orders for local purchase. The district collector was instructed to release Rs 20 lakh from the district plan for the health exigency. But sources in the know at Amravati said it took him a month to get the technical clearance.

Even as the rural patients continued to pour in, the union of Warud journalists ran a campaign to raise collections and self-contributed to that fund. A few days ago, the district guardian minister Rajendra Darda, who holds the industries portfolio in the Ashok Chavan-cabinet, visited Warud and promised help but the structural problems have not yet been fixed, health authorities said.

The medicines to the rural hospital are being bought from the Rs 3.5 lakh collected from the people of Warud and public representatives, local MLA, Dr Anil Bonde, said. An MD in medicine himself, Dr Bonde said the fund is also supporting the ambulance service.

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