Jajarkot pandemic and some home truths

Published on Apr 25 2015 // Health, Opinion

By Deepraj Sanyal

The seasonal flu and swine flu that gripped the remote Mid-western district of Jajarkot is coming under control after nearly three weeks, claiming 27 lives and leaving thousands infected, according to the government accounts. The authorities say that it will take about one and a half more weeks to completely bring the disease under control. But the fact that it took over three weeks and the mobilisation of doctors, paramedics and health volunteers to contain the diseases speaks of the pathetic condition of the State’s response mechanism and preparedness in the face of such outbreaks of diseases.

It is really disheartening to state that the State’s response to this epidemic has been very tardy and ineffective at that. This is not the first time that the disease outbreak occurred in Jajarkot. It was nearly over six years ago deadly outbreak of diarrhoea claimed the lives of more than 230 people in the district. It seems the State, the communities and the civil society and we, the people, have learnt very little from that tragedy in 2009 in handling such emergencies. Despite the improved health facilities and wider outreach of health services in the district compared to 2009, the response to the flu outbreak in 2015 has been lacklustre.

The Jajarkot episode speaks it all – how insensitive we are. That we fail to learn from our shortcomings, are not bothered at all until the last hour and ill-prepared to tackle disasters. Our response to disasters is patchy at best and reactive than rational. Although the 2009 cholera epidemic was a wake-up call, our governments at the centre and the local level have never woke up. It is only after some lives are lost or property worth millions is damaged that we come to grips. And, this sort of belated response to a disaster is ubiquitous in all calamities – perhaps, it is characteristic of our collective amnesia.

In the first instance, as an evidence of our lack of seriousness, it took precious three days to establish that the ‘mystery’ disease that gripped Jajarkot was swine flu. It was confirmed only after the samples collected from the patients were flown to and tested in the Central Health Laboratory in Kathmandu that swine flu was confirmed. The disease was not identified at the outset because the local health labs are either under-funded or unmanned, so, are as good as useless. This shows that there is no well-equipped health laboratory in the region. The presence of such lab would have saved many lives, cutting the response time of the medics.

Moreover, there is an acute shortage of doctors, medicines, and other health facilities in Jajarkot and for that matter in the outlying districts. The situation has not much improved since 2009 despite the districts of the region having favourable climate for the outbreak of bacterial and viral diseases and thus the high risk. This may be the reason why the region is under the attack of one or the other diseases every year. It is said on an average 100 people from the region are dying every year from gastrointestinal diseases which can be prevented. To add to this, there is lack of public awareness on health and hygiene due to illiteracy, poor sanitation, malnutrition and inadequate community response mechanism to deal with such emergencies, in Jajarkot and other remote parts of the country.

Despite the country witnessing such disease outbreaks at one place or the other each year, there is lack of timely response and the required logistics to tackle the situation. The State should have adopted extra precaution in the wake of the outbreak of swine flu in neighbouring India in January this year, considering the high number of seasonal migrant workers who go to India from the Mid-western and Far-western region. It may be that the disease was brought by some migrant worker returned from India. Had there been stringent quarantine checks at the transit points on the Nepal-India border, the infected people would have been identified and segregated for treatment.

The bodies concerned should always be on their toes to prevent the spread of the disease to neighbouring districts. There are already reports of swine flu cases in Rukum, Surkhet and Kalikot. They should swing into action promptly to take preventive steps even if the disease is found to have spread to other areas. But in the case of Jajarkot, the State bodies have been found wanting on both fronts. There was an utter lack of sensitivity as medicines and medics were not dispatched on time in the affected areas.

Disasters and epidemics can occur any time anywhere, especially in a country like ours which is vulnerable to such calamity given its geographic, ecological, climatic, and social conditions. It is needless to say that at times of disasters, it is not only the responsibility of the State but the obligation of all – the civic society, NGOs and INGOs, the community-based organisations and the general public to extend a helping hand to ameliorate the situation. The media has a paramount role at such times whether that be through responsible and accurate reporting of the situation or through spreading public awareness among the lay people how to keep safe from the disasters.

In this connection, it would be apt to recall here that the lack of seriousness on disaster preparedness in our country is evident from the fact that the Disaster Management Bill is yet to be tabled in the Legislature-Parliament, despite the draft of this bill being finalised way back in 2008. The key feature of this Bill is that it focuses on community-led interventions – considered a more effective approach to disaster management. Rather than trying to oversee every aspect of the disaster preparedness and management from the centre, the Bill also enumerates measures in which the local and national disaster management programmes could be better coordinated. Had this Bill been enacted, the latest disaster to hit Jajarkot could perhaps been better handled and many lives could have been saved.

Nepal is exposed to most types of disasters including earthquakes, floods, landslides, droughts, storms, avalanches, hailstorms, fires, epidemics and ecological hazards. A wide range of physiological, geological, meteorological and demographic factors contribute to the vulnerability of the country to disasters. The likelihood of one or the other disaster type hitting the country is high throughout the year due to this situation. In this context, it is high time the authorities wake up to the Jajarkot epidemic and put in place all that is required, including the institutional structures, legal and policy frameworks and emergency preparedness, response and relief mechanisms, to prevent and mitigate such disasters. But is the government, and are we, listening? Credit: National News Agency

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