Epidemics, people and politics: Words fail to contain

While the entire nation was kept at hold on the issue of government change and fight for ministerial berths, a murmur of agony was strewn over the air that hundreds of villagers were dying of diarrhoea and cholera in remote Mid-western and Far Western Nepal. The districts of Rukum and Jajarkot have been the worst hit though the epidemic so far has spread over to eleven districts taking a toll of about 200 precious lives. It was indeed a big shame on our political leaders and those at the helms of power that they were so callous and unmindful of the interest of people at the grass roots who were dying for

the lack of very basic amenities like, access to potable water and community health services. The incidents were no less embarrassing to the international community in Kathmandu who have poured in huge sum of money for improvement of social service sectors over the last several years and yet the results are far from satisfactory.

Hardly taken a respite following the formation of the new coalition government, Premier Nepal lost no time in providing prompt response to the aggrieved people by personally rushing to the disaster areas with the much needed medical supplies and personnel. A record high number of 350 health personnel are mobilized on duty providing medicare services at 74 health camps. This is over and above the cash grants provided by the government to the bereaved families. The relief operation has been substantive and commendable. But the only question is will it be just a one-time response or is going to lead to formulation of long-term solutions?

The loss of human lives from untimely deaths and that too, from preventable diseases, occupies a place of less importance than the agenda of state restructuring or sectarian politics of profit and loss. Comparatively, during the black Saturday bush fire in Australia on seven February, 2009, the same number of lives was lost as in Nepal. But the difference was in the scale of national concern and impact. The whole of Australia shuddered and grieved over the devastation. Relief measures were rushed to the sites on a national emergency scale. The Australian government opened the stacks of state treasury as never before in support of the relief operations and a Royal Commission of Inquiry was instituted. But because this is Nepal, we are taking the event passively as locations are in distant places, away from the sight of NGOs and INGOs.

Wrongly or rightly, the focus of the political leaders has been more on political empowerment of communities rather than on social empowerment that can have long and enduring impact on the quality of living of the people. And social empowerment comes from community’s access to health, sanitation and education, food and shelter that contribute to improvement in the standards of living. To these effects, the government can make profuse use of capacities of national and community level information media, widen the access to media outlets at the village levels and strengthen the capacities of the village level health posts.

In view of the complexities involved in undertaking any effective relief program of enduring nature, the attention of the government is drawn on the following:

The government should constitute a high level Inquiry Commission to undertake an in-depth study into the circumstances that led to the spread of the epidemic in the remote villages only. Second, the condition of environmental sanitation including the vulnerability of sources of drinking water could be monitored and quality of water clinically tested. Third, launch a crash program that would provide access of the people to domestic toilets at free of costs as gift of the Loktrantik government to them.

Fourth, the location of health posts, their service worthiness, the status of supply of medicines and health personnel should

be monitored as these

variables will have important bearing on the availability of services to the

people when needed.

Fifth, trace out the absentee public health employees during the time of the epidemic from their duty in health posts and punish them for their breach of service code. This should also include, offering suitable rewards who were at the epidemic spots providing relief to the patients with even scanty resources at hand.

In fact, an independent inquiry into the causes of the epidemic in the affected districts will prove invaluable as it will reveal the weaknesses and problems apparent in the community based public health and rural development system currently in place in the areas rendered vulnerable. The study will also enable the government to launch comprehensive preventive measures in the crisis districts so that the deprived poor people of the remote areas are made secure from the recurrence of water-borne diseases in the future. Side by side, due priority should be given to the dissemination of scientific awareness about the pattern of communicable diseases, environmental and community sanitation over the media and education outlets so that people become knowledgeable of the pattern of communicable diseases, the germ theory, etc.