The history repeats itself in the backward district of Odisha, with around 100 children being severely affected by malnutrition and Japanese Encephalitis, leading to multiple deaths. Earlier this year, over 19 Juang tribal children succumbed to death from acute malnutrition in remote interiors of Nagada hills in Jaipur district over a period of three months. Additionally, around 60 undernourished children hit by the Acute Encephalitis Syndrome (AES) caused by the Japanese Encephalitis (JE) virus, a vector-borne viral fever that attacks the brain, were also reported dead in the tribal-dominated Malkangiri district within two months. Maximum children dying due to this disease are below 8 years of age. The speculations are ripe that the death toll will increase, considering the fact that many children are still suffering from fever.
Fiinovation reviews that the Malkangiri district, which belongs to the backward KBK (Koraput-Balangir-Kalahandi) region of Odisha is not witnessing this appalling situation for the first time. Many deaths have been reported in the past four years including 38 in 2012 and 11 in 2014 in this district.
In the last few years, many other states like Uttar Pradesh, West Bengal, Bihar, Andhra Pradesh and Northeastern states have also been reporting regular cases of JE and it is also spreading to other non-endemic regions. Kolkata reported 21 deaths in July this year, wherein last year around 200 people have succumbed to the disease. Year 2013 has been the most dreadful year as 1000 deaths were reported across India.
As per the World Bank estimates, India is not only one of the highest ranking countries regarding the number of children suffering from malnutrition, but also comprises the highest number of underweight children. The 2015 Global Hunger Index (GHI) report has also ranked India on 20th position with GHI score of 29.0 (“serious situation”) amongst the countries suffering from grave hunger situation, just ranking behind Afghanistan and Pakistan. Although, the Indian GDP has increased by 50% since 1991, still more than one third of the malnourished population is still living in India. Even the RSoC (Rapid Survey on Children) conducted by the Ministry of Women and Child Development in collaboration with UNICEF on children below 3 years, revealed that 38.7% of them are stunted (low height for age), 29.4 per cent of them are found to be underweight and 15% are considered wasted (low weight for height). The significance of RSoC data also holds lot of significance considering the fact that the Sustainable Development Goal 2.2 is committed to end all forms of malnutrition by 2030.
Apart from malnutrition, the death outbreak is also related to poor hygiene and sanitation as the Acute Encephalitis Syndrome (AES) caused by the Japanese encephalitis (JE) virus is spread through mosquito bites. The virus is transmitted to humans from pigs as they act as reservoir of the germs through the bite of mosquito known as Culex Vishnoi. The disease has gripped more than 21 villages in various districts including Kalimela, Korkunda, Pandripani etc. As per the district health officials, the disease has spread as epidemic due to water logging in paddy fields which act as good breeding grounds for carrier mosquitoes.
The Malkangiri district comprises 1,045 villages covering under the Tribunal Sub-Plan (TSP) of government, which lays emphasis on the integrated development of tribal areas. Still, the majority of population lacks basic education and falls below the poverty line and the tribal communities are dependent on subsistence agriculture, including shifting cultivation. The callous attitude of government is witnessed from the fact that even after the recurring deaths, it has not taken up the vaccination drive in the state on the right time to control the disease. It will not be exaggerating to say, that in this regard, even the Central government has failed to take any concrete steps. Not only the village lacks the specialized medical facilities like MRI scan machine, required for diagnosis of the disease. The district and state level authorities failed to take preventive measures like segregating or culling the animals like pigs or distribution of medicated mosquito nets.
The district also lacks adequate number of doctors. It has only 57 doctors over 37 hospitals against the sanctioned number of 115. Over 2000 positions of doctors are lying vacant and many other severely affected districts like Korkunda doesn’t even has a single doctor. The vaccination drive was started in India in year 2006 after the disease outbreak was registered in Eastern UP and Bihar and was distributed freely to the districts affected by the disease. Looking at the gravity of the situation, the vaccine was also included under the Universal Immunization Program (UIP) in the 181 districts affected by the endemic. But, it seems Odisha has been neglected. As per the Annual Health Survey of Registrar General of India, only 29.6 percent of Malkangiri’s population is covered under the immunization programme creating an emergency situation.
The Central and state government has come up with various programs like mid-day meal schemes, Integrated Child Development Services (ICDS), the National Rural Health Mission and Public Distribution System for eradicating malnutrition and improving the health of mothers and children under 6 years of age by providing health-care services, providing food and spreading awareness. Till date, around 34 million children between 0-6 years of age and 7 million pregnant mothers have been benefited by the ICDS program.
Fiinovation urges that corporates should come forward to contribute their CSR funds in projects related to hunger, poverty, malnutrition and sanitation by promoting preventive health-care services and educating the weak and marginalized so that they can take preventive actions against the diseases. Additionally, they can also make contributions towards the ‘Swach Bharat Kosh’ set-up by the central government promoting sanitation and safe drinking water.
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