Indian healthcare sector neglecting other illnesses during corona pandemic

Spike in other infectious diseases feared

Politics

April 22, 2020

/ By / Mumbai



Millions of children across India have not received any vaccination for over a month now (MIG Photos/ Varsha Singh)

Rise in tuberculosis sparks fears among healthcare professionals in India that the government’s single-minded focus on Covid19 could backfire in tackling other diseases.

Over 114,000 cases of tuberculosis cases were recorded in India during the second half of February, sending alarm bells ringing amongst healthcare experts in the country and forcing the Union health ministry to remind the state governments that while focusing on the battle against Covid19 pandemic, they should not ignore other infectious diseases.

TB is indeed one of the biggest killers in the country, afflicting nearly 2.7 million in India, more than a quarter of the worldwide incidence of the disease. While the health ministry was right in warning the states, unfortunately, it seems to have not been heeded. Across the entire nation, practically all other healthcare interventions, including critical measures like immunisation and preventive measures against other diseases have nearly been disbanded for over a month as governments put a single-minded focus on the coronavirus pandemic.

An evidence of this can be seen in Behrampada, one of the largest slums of Mumbai located in Bandra East. Home to mainly Muslims, the slum is a hotbed of all kinds of diseases and has been a focus of not only the municipal corporation’s health teams, but also several NGOs that render a variety of services – ranging from providing basic healthcare to booster immunisation programmes that are regularly given to newborn babies at regular intervals.

Doctors For You (DFY), an NGO that provides medical care to vulnerable communities, is one of the several organisations active in Behrampada and several other slums of Mumbai. One of their key activities has been to provide the booster doses to newborns in the slums where people are not only illiterate and hence unaware of the importance of continuous immunisation interventions, but also cannot afford normal healthcare. Often, this part of the population also falls below the radar of the local authorities, leading to a significantly higher incidence of all kinds of illnesses, severely impacting longevity of life and other healthcare indicators.

However, even DFY has had to cut back its activities in Behrampada and other parts of Mumbai. “Normally, we deploy a team of three persons for carrying out immunisation-related activities. This team is able to provide immunisation services to about 2,500 children every month. However, we have had to completely stop this intervention,” Dr Vaishali Venu, president of DFY, tells Media India Group.

And as the lockdown is expected to continue for at least another 10 days, the number of kids missing out on the booster doses provided by this single unit of doctors will be nearly 4,000. Not just for the DFY team, but immunisation programmes overall have come to a halt as neither the state nor private or even the NGOs are providing this critical assistance, leading to a serious risk for children all over the country and indeed in many other countries around the world.

The world health organisation experts say that diseases like polio or measles may stage a comeback in vulnerable countries as over 13.5 million children have already missed out on vaccinations for polio, measles, yellow fever and meningitis since the programmes were suspended in many nations.

In India, the healthcare challenges go beyond covid19, TB, meningitis or measles. The number of kids falling prey to diarrhoea and pneumonia in India is higher than in any other country across the world. India also tops the list of 15 countries in which maximum number of children fall prey to these preventable infections, according to the 2019 Pneumonia and Diarrhoea Progress Report Card released by John Hopkins Bloomberg School of Public Health and International Vaccine Access Centre. An estimated 233,240 Indian kids below the age of five, died of either of the two infections, according to 2017 figures.

The suspension of all medical services besides covid19 has become a serious issue for many doctors and medical experts. “The vaccination has taken an absolute backseat. We had our medical team, who used to go everyday on to the field, in the slums for the immunisation programmes. But after March 22, everything has stopped as most of the health professionals have chosen to stay indoors. In spite of BMC having their own immunisation facilities, along with our team, and many other similar teams, we are able to achieve only 59 pc. Our team is absolutely not going from March 22 and now it’s been a month,” says Dr Venu, who goes on to highlight another major activity that has suffered since the lockdown began.

Slum dwellers are most vulnerable to all kinds of infectious diseases

Malnutrition is a very big problem in India. Now all the services have been shut down. Dr Venu says that they can give counselling on the phone only to those who are on their list. But the nutrition supplies have been stopped. Even for polio, the vaccination drive has come to a halt since March 22, says Dr Venu.

“Because of the precautions that the government is taking for corona, which is absolutely necessary, the rest of the services are suffering out. So the TB medicines that were given one at a time, as we monitored the developments and then prescribed the next medicine. But now we are giving one month medicine. Now many of the patients have to go out to get the medicine. With the transportation being affected many of the patients are not getting their regular supplies. Those patients are suffering,” cautions Dr Venu.

As all available hands in the healthcare sector have been put to tackling coronavirus, other programmes and interventions have been suspended or decreased significantly. For routine activities, it would not have mattered a lot, but healthcare and non-urgent interventions, this approach could perhaps be justifiable. But for fighting serious illnesses such as polio, human papillomavirus, cholera and measles, it is a risky strategy. Mankind has worked very hard in controlling and eliminating a number of illnesses that had been its bane for centuries. In 2016, India completed five years without a single incident of polio, a key landmark for the country to be considered polio-free. This was a singular achievement as historically, India had the dubious distinction of topping the list of nations with polio patients. Though there is no immediate risk of polio staging a comeback, the interruption of administration of booster doses to children could pose a threat of return of the illness. If in winning the battle against coronavirus, India begins to lose the war against communicable diseases, it would be a pyrrhic victory indeed.

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