‘Most of these tragic deaths could have been prevented’
“THE true character of a society is reflected in how it treats its children” said Nelson Mandela. The tragic deaths of children in Muzaffarpur and other districts of eastern Bihar is another proof that India needs to do more for its children. This ‘do more’ can start with saving them from preventable ‘hypoglycemic encephalopathy’, improving their nutritional status, providing preventive and promotive health services and provisions for curative healthcare when they need it. The deaths in Muzaffarpur could be termed as a sum total of the political and societal failure on most of these fronts. Acute encephalitis syndrome (AES) is a name given to health conditions caused by a range of causative agents, including viral and bacterial infections (then termed, encephalitis) as well as non-infectious causes (encephalopathy).

Prevention and control mission:

For a country aspiring to be a superpower and sending missions to Mars, if children have only litchis to eat and have to sleep without a meal in the night, it is tragic and shameful. If sleeping empty stomach exposes them to the risk of a deadly disease, it is also a matter of public health. It is a societal obligation and moral responsibility of the elected representatives and governments to intervene. To tackle the challenge in a sustainable manner, the immediate step has to be the launching of the AES prevention and control mission with sufficient funding. Considering such mission would need multi-sectoral coordination, it can be directly under the Prime Minister’s Office (PMO) and Chief Ministers’ Offices.

More specifically, in context of the ongoing outbreak, the governments (union and state) need to ensure that the supplementary nutrition programme, including mid-day meal, are provided uninterruptedly, even during school holidays. There should be a provision for sufficient supply of ration through the public distribution system for the affected communities and public awareness campaigns on the importance of meals at night, especially for the undernourished children.

Need for research:

Alongside, there is a need to increase research on AES in India to understand the pathology and determinants and to design evidence-based programmatic interventions. The Standard Operating procedures (SOPs), for the prevention and treatment of AES, need to be updated and re-enforced at community and PHC levels. The elected representatives at all levels have to take responsibility, be accountable and lead these initiatives in affected areas. One of the consensus areas is that AES in eastern Bihar is affecting malnourished children, and this demands renewed focus on improving nutrition. In 2005, the Bihar Government had launched ‘Muskan: ek Abhiyan’ to increase immunisation coverage in the state. The initiatives catapulted Bihar from amongst the worst performers in immunisation coverage to a success story. Bihar can do the same for AES as well.

Read more: https://www.tribuneindia.com/news/sunday-special/perspective/-most-of-these-tragic-deaths-could-have-been-prevented/791790.html

- The writer is a senior public health expert
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