Kerala's poor health exposed

Pioneer News Service | Kochi

Two months after the first case of the killer fever chickungunya was reported in Kerala and with authorities scratching their heads whenever asked about the identity and details of the ailment, the various shortcomings in the infrastructure of the respective health departments stand exposed.

The State which was once hailed internationally as a model in healthcare has now lapsed into a condition where killer fevers are creating panic.

The public health care system in the State has gone for a toss before and after the disease, experts say. For a State that had garnered much praise for its achievements in the field of health by having achieved almost all the parameters set by competent authorities, the present situation may have come as a surprise.

But as experts point out that the health index is a poor indicator of the state of public health in Kerala. Public health in the State is lagging behind in many aspects, with authorities often at their wits' end on queries related to details.

"I believe that this epidemic is going to spread faster and more dangerously into even rural areas. The Government is wrong-footed and the measures taken to curb the epidemic now are inadequate," said PK Sivaraman, former additional director of Health Services.

Sivaraman, who has served at the helm of the Health Department, is sure that the lack of a Public Health Act is affecting the State's public health sector adversely. "The law that is now in practice is the Travancore-Cochin Public Health Act, which was formed before Independence. The move by the department to enact a new provision was thwarted many times," said Sivaraman.

Besides the weaknesses in the system, the dismal record in keeping the environment clean and hygienic is seen as a key factor for the incidence of epidemics. The water-bound Cherthala area of Alappuzha district has long been known for the prevalence of mosquito borne diseases like filariasis.

Located on the banks of the Vembanad lake, small canals, inlets and muddy pools, whose brackish and stilted water is carpeted with African weeds, the area is a fertile breeding ground for mosquitoes, tackling which has been a major health task for decades.

"In places like Alappuzha, which have huge water bodies, the only possible method of control is biological check. Only in other places, methods like fogging will be successful," he said.

"The State must have learnt from the prevention drive we had undertaken in 2003, when dengue had spread throughout the State. But chickungunya is more dangerous as mosquitoes spread faster," said the former additional director.

The callous attitude towards public health is also evident from the way the State Virology Institute lab in Alappuzha was handled by the Government, alleges the former officer.

"About Rs 10 million was sanctioned by the Centre then, but the time-lag of the department made the amount lapse, even before the amount could be transferred to the bank," he added.

As in most cases, lack of political will in handling the situation was very much in evidence. Most of the time, the Health officers are left perplexed with no law or penal action available while handling the individuals, who are behind the contamination of local areas.

Also, over the years, Primary Health Centres (PHCs) in the State had grown weak with their main job being that of referring the patients to taluk or district hospitals, instead of providing curative support at the village level itself.

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