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Toll mounts as brain fever grips 'resurgent' Bihar by Shoumojit Banerjee

82 children have died in Magadh division

Bihar is in the grip of yet another lethal outbreak of viral encephalitis, which has claimed the lives of 82 children in the Magadh division so far. The latest death was reported on Sunday.

The division's only government hospital, the Anugrah Narayan Magadh Medical College Hospital, has been swamped with 383 cases of encephalitis, with an average of six cases pouring in each day.

This is the second major bout of encephalitis to strike the State since the onset of monsoon this year, with more than 50 children dying in the Tirhut division in June.

Hospital sources ascribe more than a third of the 82 deaths to the lethal Japanese Encephalitis virus.

Disturbingly, the issue has barely found any space in local dailies, whose main pages have been devoted to unwanted details of Chief Minister Nitish Kumar's ‘Seva Yatra.'

Shortage everywhere

As cases pour in, the hospital faces a severe shortage of bag valve masks (commonly called Ambu bags), supportive medicines and doctors, as some of Bihar's most indigent and illiterate communities struggle to cope with the outbreak. Power and water problems further bedevil the hospital, often at the wrong moments.

The medical ventilator rests idle without qualified personnel to man it. At least 12 children died owing to lack of ventilatory support, an informed source said, speaking on condition of anonymity.

Among those discharged, at least 190 children developed severe neurological complications leading to movement disorders, facial palsy and mental retardation, says Ajay Kishore Ravi, head of the Paediatrics Department.

An emaciated Roshni Kumari, 5, carried by her father Arjun Manjhi, flicks her eyes, straining the muscles of her larynx to utter words in vain; like several children, she lies helplessly in a dystonic state, having been struck by encephalitis.

“We have asked such cases to report frequently to the OPD, where physiotherapists are aiding them with speech therapy and neuro-vitamins...some are showing positive signs of recovery,” states Dr. Ravi.

The doctors, overworked and understaffed, prefer to analyse results in terms of statistics, percentages and “case studies.”

“Our death rate is a little over 20 per cent, which is well below the expected 40 per cent deaths in encephalitis cases,” says Dr. Ravi.

Lack of decent sanitation facilities within the hospital premises have forced women to use the open space outside as toilet. “The hospital's lavatories often do not have regular water supply. At a pay toilet, we are charged Rs.3 or Rs.4, which we cannot afford,” says Sarita Devi, as she attends to Golu, her six-year-old son.

Twenty-four days since the outbreak of the disease in August, Health Minister Ashwini Kumar Chaubey has visited the hospital just once before busying himself with Lal Krishna Advani's ‘Jan Chetna Yatra.' Till date, no concrete steps had been taken to combat encephalitis which has been recurring over the past decades.

Total breakdown

While Bodh Gaya, barely 20 km from the epicentre of the outbreak, has been kept in top order to secure the attention of royal personages, investigations by The Hindu along the fringes of Gaya district revealed a complete breakdown of preventive public health mechanisms.

In 2009, 46 children died of viral encephalitis here. A massive immunisation drive that followed in the division resulted in no encephalitis case being officially recorded in 2010. But no awareness programme or immunisation drive was carried out that year, said medical sources.

“We had a defogging drive last month after the current outbreak of encephalitis. We have given targeted children the prescribed DPT boosters. We perform our duties as and when instructions and funds are given to us,” says Surendra Chowdhary, the newly appointed District Immunisation Officer.