Lip service to tribal care

The issue of public health has been finding a place AP’s power corridors for the last few days as a rare feature. It is debated, albeit, feebly, thanks to the knee-jerk reaction triggered by Chaparayi, a tiny village with 344 Kondreddy tribals in the remote Rampachodavaram Agency in East Godavari district.

Death of 16 tribals has woken up the AP government to the miserable public healthcare in Agency areas. The government has vowed speedy action and all measures to prevent tragic deaths of tribals which occur around this time every year. All it has done is do some grand posturing and declare a war on mosquitoes, albeit with meagre funds, inadequate strength of doctors and lack of facilities to reach out to the needy in time. What the tribals face is common knowledge. Yet, Health Minister downplays severity of issue, claiming deaths were due to consumption of contaminated water

The death of 16 Adivasis due to viral fevers made the government wake up to the alarming health conditions in the Agency area spread over six districts in the State.

Poonam Malakondaiah, Principal Secretary (Medical and Health) has declared “health emergency” in the village after a visit. Chief Minister N Chandrababu Naidu held a review on the health of tribals.

His son and Panchayat Raj Minister Nara Lokesh, along with Health Minister Kamineni Srinivas, declared a “war on mosquitoes” after a review meeting in Amaravati. The declaration seeks to introduce an Act for checking the spread of mosquitoes as well as their elimination.

The first death was said to have occurred on May 29, but it went unreported. It took nearly three days for the news of death roll to reach the outside world from Chaparayi, highlighting the poor status of communication linkages between the Agency areas and the administration. Among the victims were three children aged below 5 and two lactating mothers.

The government with an army of medical and health personnel under its control is yet to zero in on the cause of deaths even 10 days after the incident. The Health Minister rushed to conclude that it could be due to consumption of contaminated food at a village feast.

This claim was widely disputed by Adivasi activists. Pasupuleti Balaraju, who served as Tribal Welfare Minister in the previous Congress regime, said death and disease are not limited to Chaparayi alone. The whole agency reels under viral fevers with not less than 50 deaths in the jurisdiction of the five Integrated Tribal Development Agencies during the current season.

According to Midiyam Babu Rao, a medical practitioner by profession and former Lok Sabha Member from Bhadrachalam (ST reserved) representing the CPI (M), the entire agency tracts are endemic to the deadly plasmodium falciparum (PF) malaria.

But the tribals are denied the latest lab facilities like RDT (rapid diagnostic test) for early detection of the disease for want of funds. The conventional slide method takes up to 72 hours for diagnosis but the results are not accurate.

Babu Rao demanded that the government provide RDTs in each and every PHC in the agency and medicated nets to at least two members in each tribal family to insulate them from a female anopheles mosquito causing PF malaria. In addition, tribals, afflicted by viral fevers, are badly in need of nutritious food comprising eggs and daal. But the Adivasis get to consume only PDS rice which contains nothing but carbohydrates.

Acute shortage of doctors stares at the tribals in their face. There are only 17 doctors in 32 PHCs falling under 11 agency mandals in East Godavari district.

In fact, each PHC, as per the guidelines, shall be equipped with a physician and gynaecologist and the area hospitals should have six specialists catering to different disciplines such as orthopaedics, ophthalmology, gynaecology, cardiology, nephrology and physiology.

The tragedy at Chaparayi brings under the spotlight issues such as inaccessibility for want of proper roads, lack of safe drinking water and sanitation and poor health infrastructure in the Agency which constitutes around 10 per cent of the AP’s total population.

Chaparayi is located at the top of a hill and one has to reach there by trekking another two hillocks from Gurthedu, 15-18 km away. The proposal to build a road for 5 km linking the habitation is a dream that fails to become a reality for tribals. Consequently, one has to trek up to the village or go by jeep in this stretch.

The AP government allocated Rs 6,758 crore under health and family welfare in the annual budget for 2017-18 while the share of public health in the allocations accounts for Rs 413 crore.

Although micro-level data is not available to suggest the spending on family welfare and public health in the Agency, ground realities reveal that it is a pittance. A sum of Rs 1,754 crore has been set apart for rural water supply and sanitation together. Sanitation is due to receive hardly Rs 101 crore. The young minister Lokesh now owes a reply on how he will wage a war on mosquitoes with the meagre allocations.

By G nagaraja