Years of neglect seems to have pushed Kerala towards a major fever epidemic with over 2 lakh people affected by it since the onset of monsoon this and over a hundred lost their lives till 15 June

The people in the idyllic Koorachundu village in Kerala’s northern district of Kozhikode are in a panic mode with fever claiming seven lives in the village since the onset of monsoon.

More than 10,000 of the 17,751 residents of Koorachundu are now battling fever caused by mosquitoes since the onset of monsoon this year. In fact, out of 160 cases reported in the village in the last 15 days, 88 cases have been confirmed to be dengue fever by the health authorities.

The total number of deaths due to fever in the state is 101. Out of this 32 were victims of dengue fever.

The blame game: rubber growers vs pig farms

District Collector UV Jose, who led a team of health officials to the village last week, has attributed the alarming situation to lack of proper cleaning of the surrounding by the villagers.

Jose told Firstpost that the rubber plantation in the village was the main culprit in the proliferation of mosquitoes. The half coconut shells used by the rubber growers to collect milk from the tree turn a breeding ground for mosquitoes during rainy days.

“Rubber is the main crop of the people in the village. We have been advising rubber growers to remove the collection cups or cover them during the rainy days but none paid any heed. The water-borne diseases that the village face every monsoon are a result of the negligence of the people in keeping their surroundings clean,” Jose added.

The villagers, however, are not ready to put the blame solely on rubber growers. They feel that the large-scale pig farming in the village should be blamed equally for the situation. The village adjoining a forest had as many as 27 pig farms, but 17 have been shut down following protests from the people.

EC Cheriyan, who led the protests, said the waste from the farms was being dumped in the open areas providing a fertile ground for the mosquitoes.

The local people, who had forced shops in the village to remove Pepsi, Coke and palm olein from their shelves in the late nineties — when globalisation at its peak — are continuing the protests under the auspices of an action committee formed to fight the hazardous pig farms.

"The waste from the farms that settles into the soil and water bodies for years is causing various types of fever. We have been urging the authorities to take action against this. When they failed to act we resorted to direct action forcing some farms to shut down," Cheriyan said adding that the protest was continuing.

However, District Medical Officer Dr Asha Devi said that waste from pig farms could not be singled out as the main reason for dengue as the Aedes aegypti mosquito that causes dengue fever breeds in fresh water. "The village has several ponds, lakes and open wells. They breed mosquitoes," Devi added.

This could be true since fever is not confined to Koorachundu.

Beyond Koorachundu

Officials in the health department told Firstpost that the entire state is in the grip of a major fever epidemic. The fever which has affected over 2 lakh people since the onset of monsoon had started spreading even before monsoon arrived.

A report in leading Malayalam daily, Malayala Manorama, said that a total of 11.26 lakh people have been affected by various types of fever since January. The number of the dengue cases confirmed by the health authorities till 15 June was 6,468, according to the report.

There are 21,443 suspected dengue cases in the state. H1N1 (that causes swine flu) is also assumed to be spreading at an alarming level in many parts of the state this year. The authorities have so far confirmed 743 cases in the state.

Health authorities have been raising concern about the steady spread of dengue fever in the state. The mosquito-borne disease was reported for the first time in the state in the year 1997. Subsequently, it has spread far and wide and has now become endemic in several districts, according to health activists.

The worst-affected districts this year are Thiruvananthapuram, Kozhikode, Kottayam, Kollam, Palakkad and Malappuram. Reports said that hundreds of people in these districts were visiting hospitals every day with symptoms of dengue.

A deteriorating healthcare system

Though a majority of patients require platelet transfusion for treatment, the rapid increase in the number of patients has led to an acute shortage of platelets in government hospitals. A majority of the patients depend on government hospitals for treatment.

Kerala has been witnessing a regular onslaught of epidemics, some of them banished long ago, for the last few years. Millions of people are being affected by vector-borne diseases during every monsoon for some time now. Hundreds have died across the state in the last one decade.

The major reason attributed to this is the steady deterioration of grassroots-level public healthcare system and a lack of waste disposal by local self-governments. Health activists said that the system that helped Kerala achieve a 'developed-country-like' status in public health started eroding since the 1990s when the government cut down the budget allocation to the health department.

A study by Dr D Narayana of the Centre for Development Studies, Thiruvananthapuram, found that there was an overall drop in the rate of growth in government health expenditure.

Between 1981-82 and 1997-98, the state's expenditure on medical and public healthcare services, as a proportion of total expenditure, declined from 9.62 percent to 6.98 percent.

Capital expenditure on medical and public health services, as a percentage of total capital expenditure, plunged from 9.61 percent to 1.57 percent. This forced the people to rely more on private services. The study revealed that 60 percent people living in rural areas avoided government's primary health centres, citing lack of medicines and care.

A senior doctor at Thiruvananthapuram Medical College said that the state could banish many epidemics by laying focus on prevention. The outbreak of water-borne diseases during monsoon could be prevented if the authorities had taken measures to check the spread of virus-carrying mosquitoes and created awareness among the people.

Unfortunately, the agencies concerned with these activities are not given enough funds to take any effective step, the doctor added.