INDIA-HEALTH: MALARIA BIG KILLER IN COUNTRYSIDE

By Pratap Chatterjee Reprint | | Print |

PRATAP CHATTERJEE

SATIA, INDIA, Feb 4 1995 (IPS) - EVERY EVENING A GROUP OF CHILDREN QUEUES UP AT THE SCHOOL DISPENSARY IN THIS REMOTE HAMLET IN EASTERN INDIA, TO GET TREATED FOR MALARIAL FEVER.

MOST OF THEM ARE BETWEEN FIVE AND NINE YEARS OLD AND BELONG TO THE LOCAL PAHARIYA TRIBE, ONE OF THE COUNTRY’S MOST ENDANGERED INDIGENOUS GROUPS. THEY ARE AMONG THE 100 RESIDENT PUPILS OF THE VILLAGE SCHOOL, RUN BY A NON-GOVERNMENTAL BODY.

IT IS A RARE DAY WHEN THERE IS NO ONE TO TAKE THE CHLOROQUINE TABLETS DISPENSED BY LUCY KAVUKATT, A CATHOLIC NUN FROM INDIA’S SOUTHERN STATE OF KERALA.

THIS EVENING SHE SHIVERS A LITTLE AS SHE HANDS OUT THE MEDICINE TO THE SHAWL-CLAD CHILDREN.

“I TOO HAVE MALARIA TONIGHT,” SHE SIGHS. KAVUKATT HAS CAUGHT THE MOSQUITO-SPREAD DISEASE TEN TIMES SINCE SHE CAME TO LIVE IN SATIA A YEAR AGO.

OVERLOOKED BY AUTHORITIES, A SILENT EPIDEMIC OF MALARIA IS SWEEPING THE COUNTRYSIDE IN THIS CORNER OF INDIA IN THE EASTERN STATE OF BIHAR, ONE OF THE MOST BACKWARD IN THE COUNTRY.

CHILDREN AND PREGNANT WOMEN ARE THE MOST VULNERABLE, SAY MEDICAL EXPERTS. GROWN UPS DEVELOP IMMUNITY OVER THE YEARS.

THE CHILDREN AT THE VILLAGE SCHOOL ARE GETTING USED TO LOSING A CLASSMATE AT REGULAR INTERVALS, AS A CHILD WHO DOES NOT COMPLAIN ABOUT THE FEVERS, FALLS TO THE KILLER GERM.

PRABIR CHATTERJEE, A DOCTOR IN THE TOWN OF PAKUR, SOME 30 KMS AWAY, REVEALS THAT TESTS FOUND MORE THAN THREE FOURTHS OF THE 236 LOCAL MALARIA CASES WERE CAUSED BY THE PLASMODIUM FALCIPARUM PARASITE.

IF NOT TREATED PROMPTLY, THE P. FALCIPARUM GERM TRAVELS THROUGH THE BLOODSTREAM TO THE VICTIM’S BRAIN, CAUSING CEREBRAL MALARIA, WHICH CAN BE FATAL.

THE INDIAN GOVERNMENT CLAIMS TO HAVE TAMED MALARIA WHICH MADE A RESURGENCE IN THE 1970’S. HALF A CENTURY AGO, AN ESTIMATED 75 MILLION INDIANS HAD MALARIAL FEVER EVERY YEAR AND 0.8 MILLION DIED FROM THE DISEASE. BUT, BY THE MID-1960’S, MALARIA WAS NO LONGER FATAL.

TODAY, ABOUT TWO MILLION CASES ARE DETECTED YEARLY. MORE THAN A THIRD OF THESE ARE CAUSED BY P. FALCIPARUM, WHICH WAS ONCE FOUND ONLY IN THE NORTHEAST AND AREAS INHABITED BY TRIBAL COMMUNITIES IN THE EASTERN COASTAL STATE OF ORISSA, ALONGSIDE BIHAR.

ACCORDING TO THE WORLD HEALTH ORGANISATION (WHO), THE P. FALCIPARUM PARASITE IS BECOMING RESISTANT TO ANTI-MALARIA DRUGS. THE NEW DELHI-BASED SCIENCE AND ENVIRONMENT MAGAZINE ‘DOWN TO EARTH’ REPORTS THAT INDIAN FALCIPARUM STRAINS FIRST SHOWED DRUG RESISTANCE IN THE 1960’S.

MALARIA IS CONVENTIONALLY CURED BY QUININE, BUT EXPERTS AT THE WHO’S INDIA-BASED SOUTH EAST ASIA OFFICE SAY THIS IS NOW INEFFECTIVE IN BURMA. THEY WARN THAT UNLESS HEALTH AUTHORITIES ACT FAST, QUININE RESISTANCE WILL ARRIVE IN INDIA IN FIVE YEARS TIME.

CONVENTIONAL TREATMENT IS CHEAP, BUT CURING P. FALCIPARUM CASES CAN COST UP TO 161 DOLLARS PER PATIENT, MORE THAN TWICE THE ANNUAL PER CAPITA INCOME OF BIHAR. THE PAHARIYA TRIBALS ARE AMONG THE POOREST IN BIHAR AND EARN ONLY A FRACTION OF THIS.

INDIAN HEALTH AUTHORITIES ON THE LOOKOUT FOR CHEAPER AND RELIABLE REMEDIES FOR P. FALCIPARUM STRAINS ARE PINNING HOPES ON MEDICATIONS EXTRACTED BY CHINESE SCIENTISTS FROM THE QUINGHAOSU PLANT.

MALARIA OUTBREAKS HAVE BEEN COMMON IN SATIA AND THE SURROUNDING AREAS FOR THE LAST 30 YEARS, SAYS CHATTERJEE WHO HAS CAUGHT MALARIA HIMSELF THREE TIMES IN THE PAST YEAR AND HAS SEEN CLOSE FRIENDS STRUCK DOWN BY THE PARASITE.

“TRIBAL AREAS ARE THE WORST AFFECTED BY MALARIA,” SAYS AN EXPERT AT THE NEW DELHI-BASED NATIONAL MALARIA RESEARCH CENTRE. THEY BEAR THE BRUNT OF OFFICIAL NEGLECT, WITH SHODDY BASIC HEALTH CARE FACILITIES AND IRREGULAR SPRAYING OF INSECTICIDES TO KILL MOSQUITO LARVAE, HE ADDS.

LATE LAST YEAR, INDIA’S HUMAN RIGHTS COMMISSION ORDERED THE ORISSA STATE GOVERNMENT TO COMPENSATE THE FAMILIES OF 125 CHILDREN WHO DIED OF MALARIA IN PHULBANI DISTRICT. IT RAPPED THE GOVERNMENT FOR NOT PROVIDING MEDICAL CARE AT THE RIGHT TIME.

STATE HEALTH INVESTIGATORS CONFIRMED THE DEATHS AFTER THE COMMISSION ORDERED AN INQUIRY ON A PETITION BY A LAWYER BASED ON NEWS REPORTS OF 400 CHILD MALARIA DEATHS IN PHULBANI.

CHATTERJEE VISITS THE SATIA SCHOOL ONCE A MONTH. BUT IF THERE IS AN EMERGENCY, THE PATIENT HAS TO TRAVEL TO THE BIG HOSPITAL IN HIRANPUR 15 KM AWAY.

EVEN THIS DOES NOT STOCK ESSENTIAL VACCINES BECAUSE IT GETS ELECTRICITY ONLY FOR A FEW HOURS DAILY AND REFRIGERATION IS NOT POSSIBLE. THE HIRANPUR CLINIC ALSO DOES NOT HAVE A TELEPHONE.

NATIONAL HEALTH AUTHORITIES WOKE UP TO THE SERIOUSNESS OF THE PROBLEM ONLY LAST OCTOBER AFTER A BIG OUTBREAK OF P. FALCIPARUM MALARIA IN THE WESTERN DESERT STATE OF RAJASTHAN CLAIMED HUNDREDS OF LIVES.

THE NATIONAL MALARIA ERADICATION PROGRAMME (NMEP) BEGAN LARGE- SCALE RELIEF OPERATIONS, A LARGE PART OF WHICH COMPRISED SPRAYING DDT, BHC AND MALATHION TO GET RID OF THE DISEASE-CARRYING MOSQITOES.

ALMOST HALF THE NMEP’S ABOUT 35 MILLION DOLLARS ANNUAL BUDGET IS USED FOR BUYING INSECTICIDE. BUT MOSQUITOES ARE FAST BECOMING IMMUNE TO THESE CHEMICALS AND THE NMEP IS NOW EXPERIMENTING WITH LARVICIDAL BACTERIA AND TWO FISH SPECIES WHICH EAT THE MOSQUITO LARVAE.