Bihar Encephalitis: Lychee or Govt Apathy, who is responsible?

While the children are dying day in and day out since last one month, the number of deaths has increased rapidly in the last week. However, it was only after 5 days and 50 deaths, that the Bihar health minister reached Muzaffarpur to take stock of the situation. Bihar Chief Minister Nitish Kumar has announced an ex-gratia of Rs 4 Lakh each to families of the children who died of Acute Encephalitis Syndrome (AES) in Muzaffarpur. He has also given directions to the health department, district administration and the doctors to take necessary measures to fight the disease.

However, the Union Health Ministry has promised to provide all possible help to Bihar to deal with this disease. At the same time, a team of 7-member Central Investigation Team was sent to Muzaffarpur, which is finding out the reasons for the disease. A high level meeting was also organized on this issue. Union Health Minister Harsh Vardhan, Health Minister Ashwani Chaube, Bihar Health Minister Mangal Pandey, besides Union Health Secretary Preeti Sudan, joint secretary, love Agarwal joined the meeting.

It was decided in this meeting that in addition to ways to deal with this disease, emphasis should be made on creating awareness, proper arrangements should be made for treatment in Primary Health Centers and activation of Aasha workers to inform people about the disease. At the same time, Union Health Minister Ashwani Chaube said that successful efforts were made to control encephalitis earlier too.

In 2014 too, such enciphalitis outbreak was contained in time. However, it is also important to note the apathy of the system here. How our system, our leaders put elections above the lives of innocent children. Ashwani Chaube in his statement said that the officers were busy during the elections. Because of this, the awareness program could not be run on the prevention of this disease and the treatment of sick children, due to which the disease is wreaking havoc in the state.

Along with several opposition leaders, the general public of Bihar has also expressed its anger on the Bihar government. Many people protested outside Health Minister Mangal Pandey’s house and demanded compensation. With this, they have alleged that the emergency services in hospitals have not been made available so far. It should also be arranged as soon as possible. The worst affected districts in Bihar due to this disease are Sitamarhi, Shivahar, Motihari, Betiya and Vaishali districts. Since the condition of the hospital is not good in these districts, everyone has to come to Muzaffarpur for treatment. Almost all hospitals of Muzaffarpur are thereby filled with patients.

If a child is constantly suffering from high fever, one must check whether it is encephalitis or not. In some other symptoms, the child’s body becomes stiff, the eyes become red, due to weakness the child is repeatedly unconscious, the body is numb. It is also possible that if you pinch the babies, they will not feel it. Whereas in general fever, this does not happen.

What do the doctors say?

Doctors say the chances of the encephalitis outbreak are more in the summer season. If you look at previous cases, most of the deaths due to this disease occur in the months of May, June and July. It is not that the cases of deaths of children from this fever has only increased this year, Some doctors are also saying that children who play in the scorching heat, do not drink enough water are prone to this disease. According to the figures of June 10, 44 students were admitted in SKMCH in one day alone. Of which 25 children died.

According to doctors, all the children who are suffering from this fever are between 5 and 10 years old. SKMCH Superintendent Sunil Shahi told the media that till June 13, 137 (one and thirty-seven) children were admitted in the hospital. Of which 50 children died.

The doctor of SKMCH said that when children’s immunity is weak, they can not bear the sunlight and sunrays. Even when there is a shortage of water in the body, children quickly fall prey to hypoglycemia which means lack of sugar in the body. In many cases, the body also lacks sodium in the body. However, many doctors deny this theory.

According to the data of SKMCH, the highest number of deaths was reported in 2012. The death toll was 120 deaths. In 2013, there were 39 , 90 in 2014, 11 in 2015, in the next year i.e. in 2016 4 deaths, 11 deaths in 2017 and 7 children in 2018. But the figures are growing this year.

Meanwhile, a lychee theory or litchi scare has also crawled in the state. Muzaffarpur is known as a land of litchiees in India.

According to the Union agriculture ministry, 3,00,000 metric tonne of lychees were produced from 32,000 hectares under cultivation in Bihar in 2017. Some health experts believe that it is the lychees that are causing encephalitis in Muzaffarpur. Even union minister Ashwani Chaube has seconded this theory.

In a 2017 article published in The Lancet, the oldest and unarguably the most prestigious medical journal, researchers had concluded that the deaths were not due to infections or pesticides (present in crops). According to the researchers, lack of food (missing dinner) combined with toxins hypoglycin A and methylenecyclopropylglycine (MCPG) present in lychee seeds was the cause of the illness. The delay in taking children to hospital and thus administering and correcting glucose levels was the cause of death.

The cause of death in children is hypoglycaemia — low levels of glucose in the blood. These children are from the poorer sections of society. Malnourishment is rampant. The children spend the day in lychee orchards eating lychees — sometimes unripe or half-ripe ones too. The children return home in the evening and sometimes skip dinner. This leads to night-time hypoglycaemia. Extra glucose is stored in the liver and is released when sugar levels dip in the blood.

However, in the case of Muzaffarpur children because of malnourishment along with skipping dinner, there is no extra glucose in the liver. So instead, sugar toxins are secreted making the disease so deadly.

However, unanswered questions remain: since the first Muzaffarpur epidemic of 2011, there have been six-month-old victims. Surely, they couldn’t have eaten litchis? Some doctors also reject the litchi theory.

Well, so far nothing could be ascertained as the exact cause of the deaths. But here is a thought. Why did the government not provide enough healthcare support? Children from many districts in Bihar are dying due to encephalitis. But advanced hospitals and facilities are not available in their own districts so they have to rush to Muzaffarpur. However, by the time they end up in hospital in Muzaffarpur the critical time is passed and the chances to save these children decrease.

If the government had taken steps in time, the families, the schools, the parents would have been aware of the symptoms and causes. Is winning election more important than dying children? Who is responsible for the deaths of these children then? the litchis or the government?