Geetanjali Krishna: Responsibility for disease outbreak

Yesterday our watchman came to work with a shaven head. He had just attended the 13th day funerary ceremony of his sister-in-law. It turned out that she had died 15 days after contracting a fever accompanied by acute pain in her joints. "After it was diagnosed as chikungunya fever," he said, "she was hospitalised for five days and discharged after her fever settled down." However, her body ache remained so excruciating even a week afterwards that she couldn't step out of bed. "We feel that perhaps the pain was too much for her to bear, for she died some days later," said the watchman. When I asked what the doctor had listed as cause of death, he replied, "I think they just wrote that she died from complications after fever. After all, her chikungunya infection had been over for a week before she died."

The same day, I learned of another death in the locality. Again the culprit seemed to be chikungunya fever. In this case, a middle-aged relative of the neighbourhood gardener died after coming down with fever accompanied by a lingering pain in the joints. "Her family assumed it was chikungunya and gave her plenty of fluids and paracetamol," he said. It was only when her condition continued to worsen, days after she'd fallen sick, that the family became worried. "We had her blood tested, but she died before we obtained the results," he said. I asked if his family had bothered to collect the report afterwards, and he shook his head sadly. "How does it matter now that she has died," he asked. He said dengue and chikungunya had affected almost everyone in his locality. "There are few lucky homes this year in which no member has contracted either of the two infections," he said. "We're all blindly following every prophylactic that any one suggests - be it homoeopathy or Ayurveda." They were burning leaves, cardboard and indeed any garbage they could get their hands on, to keep away the mosquitoes.

The two stories made me realise that the prevalent belief is that desi remedies work better for the treatment of vector-borne diseases than Western medicine. "There's little point going to doctors, for they can give only paracetamol to treat these diseases. Whereas, a decoction of the Ayurvedic herb giloy, or the juice of papaya leaves works wonders," said the watchman. This attitude ensures that many victims of dengue and chikungunya never see a doctor, or the inside of a hospital. Consequently, it has become that much harder for hospitals to accurately estimate the toll these diseases have taken this year. Given that the majority of this year's infection hot spots are in low-income neighbourhoods where people have limited access to health care facilities, perhaps the two fatalities I'd learnt of, aren't the only ones that don't figure in the official death count.

As I had the house mopped with neem and citronella oil, having read online that they repel the genus Aedes, I reflected on a recent petition on the online platform Change.org, in which signatories are demanding better civic infrastructure as an inalienable right. It brought to mind an unspoken rule in the army, where an outbreak of malaria is deemed the responsibility of the commanding officer, for it implies that standard cleanliness and hygiene requirements aren't being met. It is too late for the families who have lost their loved ones to vector-borne diseases. But for those of us who have survived the outbreak this year and lived to tell the tale, it is time to demand that the government and the municipality take responsibility for the dengue/chikungunya outbreak this year and clean up their act.