The current incident going on in Muzaffarpur district of Bihar needs no introduction . Suddenly a small district of Bihar has made headlines for such reasons the residents would have never wanted . Why I have titled it Massacre ; you will come to know towards the end of the Article .
What happened that cases were reported of children catching ACUTE ENCEPHALITIS SYNDROME (AES) ; basically children having mental confusion , disorientation , convulsion , delirium or Coma . Initially everyone took it normally but when the nos. started rising drastically it grabbed the Eyeballs of the whole country . More than 400 cases have been reported of children being reported of BRAIN FEVER or CHUMAKI BUKHAR (Local Name) in Bihar (Muzaffarpur , Sheohar , East Champaran) with around 150 cases in Muzaffarpur only . Children dying due to Undernutrition is not surprising as every year 2.7 million die due to it worldwide ; what is surprising that we are not a poor country lacking even basic nutrition ; Oh Wait , or this presumption is wrong itself ; it seems it is . We will come back to it a bit later.
Another talk which was in the Air was this problem has occurred due to the children eating LITCHI . The reason behind this claim was found Low blood sugar level (Hypoglycaemia) in high percentage . So there is a bit of debate that this Disease is not ENCEPHALITIS but HYPOGLYCAEMIC ENCEPHALOPATHY (HE) . Actually in the latter disease only symptoms such as low blood sugar , children exhibiting Fever after Brain dysfuntction are seen ; also no increase in the no. of units of WHITE BLOOD CELLS (WBCs) per unit of Cerebrospinal fluid takes place as INFLAMMATION in Brain doesn’t occur (in contrast to ENCEPHALITIS) .
Since these symptoms were observed in this case so it can be said that Killer of the children was HE and not ENCEPHALITIS . Another proof can be seen that only Children , Malnourished children were the ones affected in this case unlike the case of ENCEPHALITIS Virus . Most of the victim children are from Orchard camping families and also this HE Disease breaks out mostly in April-July the peak of LITCHI harvesting season . So the case is simple , the children eat Fruits that grow in Orchard and since they are malnourished it leads to them falling a Prey to HE . But we all eat Litchi , don’t we ? Then why we don’t fall prey to it .
According to Research a Toxin called METHYLENE CYCLOPROPYL GLYCINE (MPCG) is found in Litchis . What it does , it dips the blood sugar level by reducing the level of Glucose in the body . For me , you or other normal people body function is capable enough to make Glucose all over again using a Reserve glucose (GLYCOGEN) stored in Liver and bring the sugar level back at normal without even we recognising it . But the malnourished children who go to bed with little or no food develop the HE disease as body runs out of Glucose , they don’t have sufficient glucose reserve due to which Liver functioning is stopped .
Normally when body runs out of Glucose , it starts transforming fatty acid into glucose but in undernourished children even that pathway is blocked , the process is stopped midway leading to body becoming GLUCOSEless . It leads to Drowsiness , Unconsciousness and Disorientation . When Fatty acid conversion is stopped , Amino acids are secreted which is toxic for Brain causing it to swell leading to BRAIN OEDEMA ; the concentration of Ions outside Brain becomes higher than that of inside and this Mismatch leads to fluid coming out causing the OEDEMA and leading to Confusions , Coma and even Death . Talking about Remedies , immediate solution obviously is to increase the amount of Glucose in the malnourished body . It can be done infusing 10% DEXTROSE restoring glucose level and stopping that toxic amino acid secretion . Along with it a 3% saline solution would be marvellous as it will help in reducing the OEDEMA of brain cells . But this infusion needs to be done within 4 hours or else we may be late in attempt to save them .
Now I think you all are slowly getting the idea why I titled it Massacre . From which Face we make claims of DIGITAL INDIA , SMART CITIES and the best of all RAM RAJYA when we can’t even follow this simple remedy of infusing Glucose among affected children . Just if this simple process had been put in place , so many children wouldn’t have lost their lives . Also it’s not the case that other facilities and doctor’s performance were very much at par , as if that would have been the case these many children hadn’t died despite being bought alive (within the 4 hour span) . This type of incident is not a new thing as 150 children died in a similar fashion in 2014 as well . Headlines were there for a few weeks but as soon as our requirements were fulfilled ; TRP for Journalists and Hot topic for viewers , we buried out the topic as well as the children and from then on only today we have remembered them . I am not saying that we should have kept mourning for these 5 years but we should definitely have taken measures to address this issue when it would have arised in future , we should definitely have improved the Hospitals on the fronts it failed in saving the lives of children back then and we should definitely have at least tried to fulfil the shortcomings in our system we found then .
This condition and standard of the hospitals and doctors is not a new thing , it’s been the case for the very start but has any Government tried to improve it ? We should ask this question before we gift our vote to them . Construction of AIIMS in Bihar was declared by Bihar Government in 2017 only but it’s half past 2019 and surprisingly government has not been able to even find land for it . On any demographic parameter our country’s healthcare system is forgettable . So , is the issue going on is a new one ? NO ; it’s the same disease coming from years but just got highlighted now . What boils my blood is the response of government on the issue . Bihar CM NITISH KUMAR looked least interested in the case and when Media asked questions he even threatened them . Then comes the Deputy CM of Bihar SUSHIL MODI who says “Don’t ask questions from us , ask from RABRI DEVI” .
What the FUCK is going on here ? We give Votes to these Scoundrels and this is what they give us in return , not even taking the accountability . I am not saying that when RJD was in power , they worked very well in this sector . I would just say there has been no change . But questions will be laid on those holding the office and whenever BJP/JDU spokeperson give their favorite Excuse “What was done in last 10 years” , they forget that one term has already crossed now and that the last 10 years also includes their 5 year term as well .
According to some Research work , if we look at the data of WORLD HEALTH ORGANIZATION (WHO) for poor African countries infamous for poor nutrition , it’s Sad to say but Muzaffarpur lacks even behind them . Under age 5 , nearly 48% in latter place are STUNTED (Short for their Height) and 18% WASTED (too thin for the height) as compared to 31% and 6 % respectively in the former region . In Muzaffarpur only 7.8% of children under 6-23 months of age receive adequate diet .
Even BREASTFEEDING which is considered essential for boosting Child’s immunity is at a quiet low level ; though 78% children get it in long duration , 63% don’t get it the first hour of birth which is considered very Important . It’s estimated that around 8,20,000 children can be saved each year with the help of BREAST MILK . Even pregnant women catching ANEMIA is more prominent in Muzaffarpur than in poor African countries . Every third women of middle age or Lactating age here is Malnourished having BODY MASS INDEX below normal (18kg/m2) . This is one of the biggest reason why children here are born Underweight with LOW BIRTH WEIGHT (LBW) .
Such a terrible condition in the 5th largest Economy in the world doesn’t make sense . It means the schemes running by government has failed to live even a shadow of what they promised . Schemes related to Consumption and Health sector have not at all lived . That’s why I said “It’s not a TARGEDY it’s a MASSACRE” and the politicians whom we lure with our Votes are the Murderers clapping with the hands coloured in Blood . That’s why I say that before voting take a deep look at who is going to be YOUR MP or MLA because he will be the one taking care of the problems present there . If you will just vote in the name of NITISH or MODI then this will be the result . Not a single tweet from our prime minster and the Chief minister even two steps ahead , threatening the victims only . That’s “Incredible India : MERA DESH BADAL RAHA HAI” .
There is no doubt that Issues like early marriage , poverty , illiteracy , open defecation , etc have also contributed in these data . The Children are born and grown Undernourished among mainly the vulnerable group of families and the inequality in our society is heaped upon the children . Another point is that LANCET MEDICAL had pointed the reasons for these problems (A thoughtful piece by JACOB JOHN) when similar case took place in 2014 and surprisingly the suggestions were not at all followed . The reasons and remedies would be much similar now also but will they be Worked upon ; that is the real problem . The food quality or the meal pattern children undergo here is definitely under scrutiny . Does the message even reach where it should be , answers to these Roadblocks need to be resolved and it can be resolved only using a EPIDEMIOLOGICAL and ETHNOGRAPHIC Lens to ask deep questions and then search scientifically sound , compassionate and pragmatic solutions .
JAI HIND
ARUENSH SINHA
