Inconsequential Deaths
Inconsequential Deaths
Magnificent India

Inconsequential Deaths

Vijay Sanghvi

Jatin Jain of Rohtak had rushed to the district health centre to get remedy for his daughter suffering from acute diarrhoea in July 2004. He was given five packets of ORS (Oral Rehydration Salt). He was told three packets would be sufficient. First would stop diarrhea, second would generate enzymes for stomach stability and the third would help the child to recover. It was a standardized remedy in India in 1943 with research work at the Haffquin Institute Calcutta.

Jatin was in panic as the first day did not yield much difference though his wife and he had followed the instruction closely He looked at the packet to find that expiry date on it was January 2001. He rushed back to the health centre to complain and get a new pack. The new pack also had same expiry date. Ultimately the clerk recalled a fresh arrival. He was given new packs with explanation that there was no demand for the remedy. Hence the old stock had remained in the store.

Most people did not know that ORS is the best remedy for diarrhea a condition that takes a huge toll of children below three years. According to a UNICEF study then there were deaths of six and half lakh children every year, mostly in north India due to unhygienic living conditions. Now figure of casualty is wrapped in per cent points and not numbers. The World Health Organisation estimated 42 per cent of total diarrhoea deaths in 2017 were accounted for in two countries India and Nigeria. One study suggested one death in every 252 individuals in India.

Yet India had invented the remedy way back in 1943 and it was successfully used in 1971 in camps housing refugees from East Pakistan, area with higher incidence of diarrhoea. Not a single child death was reported in nine months of refugee camping. No measures were taken by the Indian government to improve awareness of effective remedy, particularly among poor living in slums. The government spent huge sums in advertising to improve awareness relating to AIDS or high lighting awareness of ill and evil effects of tobacco consumption in any form.

Even the annual reports of the Health Ministry did not have mention of casualties due to diarrhoea. It is not mentioned in annual reports, as one official explained because diarrhoea is not a disease but merely a condition caused by polluted water or bad food intake. Children below age of five were generally victims. Horrifying results were found by Dr. R.K. Khanna of Mumbai in 2004. He had discovered that of four victims of diarrhoea, three were invariably girls, particularly in Rajasthan. Parents did not rush to hospitals to find a remedy for girls unlike Jatin Jain of Rohtak. Dr. Khanna had no evidence to prove that poor families used this condition to allow deliberately the girls to die as they were unwelcome in the family. However the purpose of his survey was merely to find the level of awareness of the remedy among poor.

The Union health ministry had earlier bought ORS packets worth Rs. 55 crores for distribution in the more afflicted states. However it was discovered that packets remained unused at the district level health centres and rural primary centres as there was no demand either by people or due to the lack of recommendations by attending medical teams. Hence expenses were wasted. No effort was ever made to improve awareness through a different pattern of marketing or forcing few manufacturers to cut on their prices so that even poor would be induced to invest in buying the packs.

The medicine can also be blended at home with mixture of 13.5 grams of sugar and 3.5 grams of salt. But most modern mothers even in slums prefer to avoid home remedies. They would rather go in for manufactured drugs and remedies. But awareness level remains low. The best marketing methods and channels to reach even slum dwellers has been perfected by producers of tobacco including gutkha. They reached even small vendors on road sides near slums or inside slums. If they were assigned the task of distribution of the ORS packs, it would have been possible to attain maximum coverage.

A Non Governmental organization the Creative Thinkers Forum had approached few Gutkha manufacturers to undertake marketing of the ORS packs but they could not be induced to undertake social responsibility as they were already under pressure to advertise evil effects of consumption of their products. Only compulsion by the government would have induced them but the officials could not bring themselves around to use of the channel that was already condemned as vehicle of another dangerous disease of cancer. Officials were afraid that it would immediately invite heavy criticism by both political parties and social workers.

Can it be turned into a part of the Clean India campaign launched by the Prime Minister Narendra Modi since it involves priority of providing toilets in rural India to end practice of open defecation? Building toilets without availability of enough water is as hazardous as defecation in open is. Public toilets cannot be kept clean and usable without water as accumulated dirt can be the cause of more dirt and greater danger. It can be invitation to more deaths due to diarrhoea.

Diarrhea is a scourge. It needs to be tackled effectively to get out of the list of most affected nation. It has to be essential part of the Clean India campaign to make India also a magnificent land without diarrhea caused deaths. It can also ensure that no child suffers brain damage due to lingering on of diarrhea even in a mild form. Medical science says lingering diarrhoea can lcause greater damage than malnutrition.