Delhi's annual dengue epidemic is taking a deadly toll – in the process making a mockery of the tall claims of 'Swacch Bharat,' good governance and development by Central and State Governments that govern India's capital city. While the Delhi Government admits to 15 deaths, the actual count is likely to be higher, while several thousands are affected by dengue.
Compounding the crisis was the callousness of privatized health care. Tragically, two small children Avinash Rout and Aman Sharma died of dengue after being denied admissions in a series of private hospitals. Avinash's parents, traumatized by the loss of their son, committed suicide. Their suicide and the deaths of Avinash and Aman finally triggered a response from the hitherto apathetic Delhi Government, that ordered some belated measures.
It is well known that dengue cases peak during the monsoon months in Delhi. In spite of being forewarned, the Government, MCD and NDMC took no adequate measures to prevent, contain and cope with the epidemic.
Dengue epidemics are primarily an urban phenomenon; poorly planned urban growth, unregulated construction sites, poor drainage, congested colonies with poor civic amenities create ample breeding grounds for the Aedes mosquito. Contractualisation and casualization of the MCD services has meant that an abject failure to check homes and colonies to get rid of stagnant fresh water breeding grounds. The strength of the MCD staff responsible for inspecting and treating dengue and malaria breeding grounds is far short of what is needed. These workers are overworked, often denied salaries for months on end, denied gas masks, ear plugs or uniforms to protect them from mosquitoes and during fogging operations, and forced to handle poisonous substances like temefos granules and liquid, BTI, methylene, pyrethrum and malathion with bare hands.
Much is being made of the shortage of hospital beds. In reality, a network of local health centres equipped with laboratory facilities to monitor platelet counts could have coped ably with the bulk of the cases, requiring hospitalization only in the worse cases and averting the crisis entirely. In the absence of such basic facilities, hospitals overflow with patients. Public hospitals are eroded and emaciated by privatization, and their services are stretched to their limits. Private hospitals greedy for profits subvert their obligation to admit poor patients in EWS beds, while sucking other patients needlessly into the system with unnecessary tests and hospitalization. Private laboratories blatantly charge exorbitantly for tests.
One of the key promises of AAP Government of Delhi was to ensure access to health services for all Delhi's citizens. But in health as in other public services, the AAP Government is unwilling to challenge or change the privatized system of health care. In fact the Government has slashed allocation for municipality-level health care. The share of allocations in the Delhi Government's 2015-16 health budget to counter vector-borne diseases was nearly halved (from 9% to 4.8% of the total health budget) from 2012-13. Not only that, the Delhi Government reduced its demand for funds from the Centre from 260 crore in 2012-13 to 42 crore this year. Not to be outdone in callousness, the Modi Government allocated just 17 crore this year to Delhi from 50 crore in 2012-13.
The apathy and callousness of Governments and policies of privatization have needlessly cost lives of people due to a disease which is both preventable and curable. The Delhi Government must urgently ensure that private hospitals comply with obligations to give free beds and treatment to EWS patients, and to ensure free sample collection and testing for suspected dengue cases.
Above all, it is imperative that the lessons of this year's dengue epidemic be learnt well to ensure that the crisis is not repeated against next year. Central and State Governments must ensure a network of well-equipped health centres across the city; and in fact all over the country. The two-tier system of health care (steeply-priced private health care for the rich and poor public health facilities for the poor) must be dismantled, and the Governments must invest to strengthen public health care systems, including not only hospitals and health centres but robust mechanisms to prevent and control epidemics.
No more Avinashs and Amans must be left to the mercy of cruel profit-driven health care systems.
