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Ailing Orissa by Prafulla Das

Contaminated water sources and the virtual absence of health care claim dozens of lives in the State, now in the grip of cholera.

COME monsoon and the backward regions of Orissa are in the grip of water-borne diseases. This year too has been no different. According to official figures, 150 people had died of cholera and diarrhoea in the State as on September 15. Unofficial reports put the toll at more than 250. The reasons for the recurring phenomenon are not far to seek: contaminated water sources and the virtual absence of health care. To make matters worse, a large number of posts of doctors and paramedical staff in government hospitals are lying vacant.

According to officials in the Health and Family Welfare Department, cholera deaths were reported from Rayagada, Kalahandi, Nuapada, Koraput, Nabarangpur, Malkangiri, Gajapati and Keonjhar districts. A sudden increase in the number of deaths was noticed in early July. The number has been growing steadily since then, with Rayagada being the worst hit. The official death toll in the district was 40 as of mid-September; unofficially it was 115. Significantly, 49 sanctioned posts of doctors in Rayagada are lying vacant. Many deaths in inaccessible areas in the affected districts have not been officially recorded.

A large number of those who are affected are tribal people who live in hamlets that have no approach roads. Safe drinking water is still a dream for thousands of families here who fetch water from forest streams and rivulets. The fact that there are scores of defunct tube wells in the interior areas of the State speaks volumes about the callousness of the administration. Even as water-borne diseases spread to new areas in the second week of September and deaths continued, the Naveen Patnaik government claimed that the situation was under control.

Even as Oriya television channels aired visuals of tribal people crying over the bodies of the dead and people carrying the sick to hospitals in distant places, Health Minister Prasanna Acharya paid a two-day visit to Rayagada district, on September 14 and 15, to take stock of the situation. On the first day of his visit, two more deaths were reported from Taladal village of Kashipur block in the district.

As in the past years, the State government woke up from its slumber only after the media started reporting diarrhoeal deaths from different parts of the State and the Regional Medical Research Centre in Bhubaneswar confirmed the incidence of cholera in Rayagada.

The government apparently paid little attention to the centre's advice on the measures required to avert an outbreak of cholera. The suggested measures included chlorinating drinking water sources in areas prone to contamination and providing drinking water closer to workplaces of the people, said a senior researcher at the centre.

The Chief Minister held a meeting to review the situation. Teams of doctors were sent to the worst-hit areas in the district. The government announced an incentive of Rs.200 to people who would bring cholera patients to hospitals at night.

Review meetings

Review meetings were held at various levels, and non-governmental organisations (NGOs) were urged to help in the process of providing medical attention to people. Efforts were also made to carry out an awareness campaign to make people adopt hygienic practices and draw water only from disinfected wells and tube wells.

But the government came under fire from the opposition parties as many tube wells still awaited repair in the worst-affected blocks of Rayagada district – Kashipur, Bissamcuttack and Kalyansinghpur – even after the Health Minister's visit.

The Leader of the Opposition in the State Assembly, Bhupinder Singh, and other leaders of the Congress, who visited different areas in Rayagada, held the government responsible for the deaths from cholera and diarrhoea. It is apparent that non-availability of safe drinking water, lack of awareness about sanitation among the tribal people, and non-implementation of the total sanitation campaign are the main reasons for so many deaths.

Stock response

All the opposition parties blamed the State government for ignoring the problems of the tribal people in the interior areas. But even as hospitals, dispensaries and health camps remained crowded with patients and many were unable to reach hospitals owing to intermittent rains and the lack of roads, the government had the stock response that all possible measures were being taken to contain the spread of water-borne diseases.

Finally, the administration was forced to deploy the Orissa Disaster Rapid Action Force to transport patients to medical centres from inaccessible areas such as Madhuban in Gudari block of Rayagada. But the last-minute efforts seemed futile when news of deaths began to pour in from distant villages.

The administration did not even have the manpower to distribute bleaching powder, saline, halogen tablets and ORS (oral rehydration solution) packets in the worst-hit areas of Rayagada.

Significantly, the NGOs had not reached the cholera-hit villages even after the government's appeal to them to join medical teams. Some NGO leaders were busy soliciting help from various funding agencies even after the epidemic had claimed a large number of lives. It appeared as if they simply could not venture out of urban areas without ensuring the flow of funds. The same had happened in 2007, too.

The Orissa Adivasi Mahasabha, affiliated to the Communist Party of India (Marxist), staged demonstrations to protest against the government's failure to contain the spread of cholera.

More than 2,000 people had died of diarrhoea in the State in the past five years, said Chambru Soren, its organising secretary. He said that when the government was making tall claims about tribal development, the death of so many people due to cholera was criminal.

This is not the first time that Orissa has seen so many deaths from cholera and diarrhoea. In 2007, the State government admitted to the death of at least 178 persons in Rayagada, Koraput, Kalahandi and Gajapati districts by September 4. Unofficial reports put the toll at over 300 that year.

Rayagada, which has been badly hit by diarrhoeal deaths in the past, was in the news in 2001 when many people died of malnutrition and hunger. People in the district eat mango kernel and other inedible items during the monsoon months when they face severe shortage of food. Life becomes miserable for them because there is no work in the season.

Rayagada is not the only district where food insecurity and lack of proper health care affect the lives of scores of people. This is a common feature in several other places, particularly the seven districts in the backward Kalahandi-Bolangir-Koraput region.

Significantly, it is not just that the administration at the district level has failed to implement various development projects in the interiors of Orissa; the State government has also failed to contain the Maoist menace in these regions. The government has apparently been busy processing the applications of big corporate entities in order to make recommendations to the Central government to grant them leases to mine bauxite, iron ore and coal.

Corporate leaders who were camping in the State had little concern for the suffering people whose land and hills they were planning to mine.