Grappling with Dengue

According to WHO, approximately 40 percent of the world’s population, mostly those living in the world’s poorest countries, are at risk of malaria and <g data-gr-id="40">mosquito based</g> vector diseases. In this subset of <g data-gr-id="41">vector borne</g> diseases comes dengue. Every year, more than 500 million people become severely ill with malaria. Most cases and deaths are in sub-Saharan Africa. However, Asia, Latin America, the Middle East, parts of Europe and two of the Pacific countries are fast catching up. A quick public health primer: Dengue and most strains of dengue are both preventable and curable. Children and senior citizens are particularly vulnerable to dengue. What do you make of India’s under-performing, poorly-funded, leaky public health system, smothered by high population and appalling sanitation? Tons of newsprint has been devoted to that. But what about the swanky “we care for you if you give us all your cash” private healthcare system in India? Surely, that will save you when the day comes? 

Well, as it turns out not for seven-year-old Avinash Rout whose parents jumped to death from the terrace of a four-storey building in South Delhi. Just hours earlier,  Laxmi Chandra and Babita had buried Avinash after he succumbed to dengue in a Delhi Hospital. Avinash had passed away after a traumatic 24 hours when the parents failed to get a bed for their son in two of Delhi’s top hospitals. By the time they did get him to a hospital, it was too late for the family from Kendrapara in Odisha. After a night in the hospital, doctors declared Avinash dead at around midnight. That there is nothing more agonising than seeing the death of your own child is an emotional reality no one should face. That the death was a preventable one must have been truly soul-crushing. 

According to news reports, Laxmi Chandra and Babita took little Avinash to Moolchand Medicity and Max Saket. Both of these hospitals reportedly turned away the seven-year-old who by then was in critical condition. The pretext offered was that the parents should consult a bigger hospital. As to how both the hospitals happen to be small hospitals defies all logic or reality. Even if one were to accept that they were turned away due to capacity constraints, the larger question that emerges is why do capacity constraints only emerge for patients from the <g data-gr-id="45">low income</g> households. Both Laxmi Chandra and Babita were not particularly well-off or affluent. Despite coming from such a low-income <g data-gr-id="46">back ground</g>, they decided to get the best treatment available for their only child. It is ironic that in doing so they were faced with a Hobsons choice, at least in hindsight. Going to a government hospital with a critically ill child is something that the couple were averse to for all the hospitals whose doors they knocked on were private institutions. Not a single government hospital figured in their list of priorities. According to Municipal Corporation data, 1,259 cases of dengue have been reported in Delhi till September 5, this year, with over 400 cases in the first week of this month, Press Trust of India reported. But while the Municipal Corporation claims that only 29 people have died of dengue between 2010 and 2014, the Delhi government puts the figure at 1,221 during the same period. So clearly there is a chasm in perceptions as to how pernicious dengue can be. As of now the fight against dengue can be summed up thus. There is no clear strategy to tackle this menace.