(63 children have died in Gorakhpur’s BRD Medical College and Hospital over the past five days amidst a rush of patients in peak encephalitis season from July to October. This article was originally published on 22 February 2017 as a part of The Quint’s Uttar Pradesh election coverage and is being republished from the archives.)
At the Gorakhnath temple, there is an unending stream of devotees through the day, content with making their earthly offerings and happy that their prayers would be answered by the 11th century saint interred there. About eight kilometers north of Gorakhpur town, the flow of anxious men and women into the building that houses the encephalitis ward at the BRD Medical College and Hospital is equally – if not more – heavy.
The first is an abode of Hindu spirituality in the northeastern corner of Uttar Pradesh while the second is a dark chamber where infants every year – between July and October – fall prey to the deadly Japanese encephalitis virus.
Every year, no less than 500-600 infants from all the 13 districts of eastern UP, six districts of western Bihar and some parts of the Terai region in Nepal perish because of the ravages of a virus which knows no religion or caste. Infants, irrespective of the fact that they are Hindus or Muslims, belong to the upper or lower castes, are struck by the disease which looms over these areas with the onset of monsoon.
The Deadly Visitor in Eastern UP
Death brought by this foreign strain of deadly virus has been ceaselessly and faithfully visiting and revisiting the eastern UP districts since 1978 when it penetrated the lives of people – mostly country folks – leaving in its wake destruction, as successive governments – both at the Centre and the state – have failed to banish the scourge.
The desperation of encephalitis patients and their families in Gorakhpur is reflected in eight-year-old Abha Sharma’s condition as she lies on a bed in BRD Medical College’s ICU ward; her tiny face covered with bandages while the beep-beep of a machine by her side keeps a count of her breaths.
Belonging to Gurwalia in eastern Uttar Pradesh, she has been in the hospital for 25 days and was referred to Gorakhpur by a district hospital after she showed symptoms of high fever and vomiting. As she breathes unevenly, she is under the watchful yet weary eyes of her elder sister – 14-year-old Kajal. She has been staying in Gorakhpur alone, living in the hospital, with occasional visits from her parents and other members of the family.
Working in BRD Medical College, Dr Bhupendra Sharma estimates that the annual death rate of encephalitis in the city is 18% to 25%, with nearly 25 cases of admission between July and October when the disease is at its peak. The moisture in the foothills of Terai creates a conducive environment for the virus to grow, inadequate drainage system becomes breeding grounds for mosquitoes and a lack of awareness about hygiene compounds the problem.
Encephalitis, Not an Election Issue
But despite being a permanent fixture in Gorakhpur for nearly 40 years now, encephalitis and its prevention is not an election issue in the city. Open drains, waterlogged streets, pools of dirty water on the roads, piling and stinky mounds of garbage and whizzing mosquitoes are a common sight in the city – even outside the encephalitis treatment department in the Medical College complex.
Political parties in Gorakhpur would rather capitalise on fault lines based on religion or caste, rather than address an annual epidemic which claims thousands of lives every year.
Dr KP Kushwaha is the former principal of BRD Medical College and is widely considered to be a respected authority on encephalitis in India. As he sits on a cane chair at the veranda of his house a few kilometers away from the Medical College, he recounts how in Delhi when a case of encephalitis was reported in 2013, vaccinations were given to every child in the area. It was a response to a disease on ‘war footing.’ In Gorakhpur, there is an enemy, but no one to launch a battle cry against it.
“In Gorakhpur, there is no movement for civil amenities. People will fight for other things – they will erect a temple, a road, but they will not fight for cleanliness, electricity or drainage. And unless these things are not in place, encephalitis is not going to go away. You talk about sanitation, you talk about clean roads, people don’t vote for that. Due to illiteracy and education, people are voting for their immediate gain.”
A Faint Hope
In September 2016, Rahul Gandhi in a roadshow in Gorakhpur had accused the Narendra Modi government of ignoring encephalitis in the city. Earlier in the year, Prime Minister Narendra Modi had laid the foundation stone for an AIIMS in the city. But encephalitis in Gorakhpur is not public health crisis limited only to the district. The city sees a steady stream of patients from districts in eastern UP, Western Bihar and Nepal.
If healthcare in far-off districts – which are often the first line of defence against diseases like encephalitis – is not improved, will more medical infrastructure in Gorakhpur help?
“Jab tak aap periphery treatment of encephalitis (which is in the districts) ko theek nahin karoge, jitney bhi AIIMS bana lo, kuch nahin hoga. Only if encephalitis is managed in earlier stages, it will bring down the mortality rate and there will be less deaths.”
In a dark ward in BRD Medical College, Manturi and her son Govind would have benefited if a hospital in eastern Champaran, Bihar would have diagnosed encephalitis earlier.
In Gorakhpur, for one-and-a-half months, Govind is in a precarious condition; breathing and eating through a machine as the beep-beep of the Draeger monitor plays out in the background. Dressed in a pink saree and speaking softly with a voice reflecting her exhaustion and desperation, she says her son is getting better. “He is being fed, at least.”
Hope is a constant in the encephalitis ward in the BRD Medical College. It is expressed in the eyes of Yashwant Yadav, a teacher from Brahmpur block in Purnaha village, who has admitted his two-and-a-half year old son, Ajit three days ago. In another ward, Kajal still watches her sister sleep; Abha’s prescription papers and medical reports neatly kept in a pile at the corner of her bed.
“She’s getting better”, she insists as she gently covers her sister with a yellow blanket.