With around six lakh people living in 3,500 tribal hamlets of 11 mandals, the Visakhapatnam Agency is one of the biggest tribal regions in Andhra Pradesh. Though endowed with scenic beauty, recurring seasonal diseases and inadequate healthcare facilities are the bane of the region.
Lack of access to safe drinking water, unhygienic surroundings and absence of proper communication facilities puts the tribal people to health risks. The tribal patients of many hamlets have to walk long distances to reach the sub-centres.
There are two Area Hospitals at Araku and Paderu, two Community Health Centres at Chintapalli and Munchingput, 36 Primary Health Centres (PHC s) and 204 Sub Centres for the 3,500 tribal villages. Several villages do not even have road connectivity and ambulances cannot reach them.
The failure of the authorities concerned to initiate preventive measures before the start of the epidemic season is resulting in the outbreak of seasonal diseases such as dengue, malaria, diarrhoea, typhoid and viral fevers apart from anthrax, NGOs working in the tribal areas allege.
No protected water
The lack of transportation facilities, to over 1,000 villages in the Agency is one of the major reasons depriving tribal people of medical facilities. There is no protected drinking water facility to nearly 1,000 villages and the borewells and gravity schemes, which were damaged, are not being repaired, they say.
“Though the State government had announced upgradation of the 36 PHC s, making them 24/7 PHC s last year, no additional doctors, nurses or other staff have been sanctioned to enable them function round-the-clock,” says P. Appalanarsa, general secretary of Girijana Sangam.
“At least two additional doctors, nurses and pharmacists are required for each PHC as they would perform duties for eight hours a day as per government guidelines. But, no additional staff has been recruited this year,” he says.
“It’s mandatory to appoint specialist doctors at the Area Hospitals, but except one or two areas, there are no specialists in other areas like gynaecology, orthopaedics and general medicine. Contrary to the announcement of the Chief Minister, no dialysis centre and a Malaria Research Centre had been established in the Agency area,” says Mr. Appalanarsa.
The two Area Hospitals have one ambulance each, and when a critical case has to be shifted to the KGH in Visakhapatnam, the plight of other tribal patients can be imagined. It takes no less than 10 hours for an ambulance to shift the patient to the KGH and return to the Area Hospital.
Shortage of drugs
“There is an acute shortage of drugs at the hospitals in the Agency areas. The Health Assistants are not being given adequate supply of chloroquine tablets, forcing the tribal people to walk for several kilometres to collect them from the PHC s. Adequate number of blood test kits are not being supplied to the Health Assistants in a bid to play down the incidence of malaria, alleges Praja Arogya Vedika (PAV) convener T. Kameswara Rao.
Hundreds of tribal people took to the streets at Araku on July 5 this year, expressing their ire at the officials for the unhygienic conditions prevailing in the mandal headquarters and in their villages. On that day, the body of Vanthala Lakshmi, who had reportedly died of dengue, was brought back to her village after treatment at the King George Hospital (KGH).
That was the fourth dengue death in the Agency till then this year, according to the PAV team, which had gone there to conduct a health survey. “We explained to them that lack of hygiene was not the cause for dengue outbreak. The mosquito species, which aid the spread of dengue and malaria, breed in fresh water,” recalls T. Kameswara Rao, convener, PAV.
The PAV submitted a memorandum to the Collector the next day demanding setting up of a dengue confirmation test centre at Araku Valley to prevent exploitation by private diagnostic centres, which are charging ₹1,000 for each dengue test, opening of counselling centres to create awareness among people and to give them confidence, extensive spraying of malathion, steps to improve sanitation and filling up of the vacancies of doctors and paramedical staff at the Community Health Centres (CHC s) at Araku and Paderu and at the Primary Health Centres in the Agency.
“Though an unusually high 95 dengue cases have been registered from January to July this year in the Agency, there are no confirmed cases of dengue deaths in the Agency so far,” Kimudu Leela Prasad, Additional District Medical and Health Officer, told The Hindu .
“The incidence of malaria has shown a steep decline to 1,200 from January to July this year, compared to 3,500 cases during the same period last year. This shows a 59% decline in malaria cases,” he said.
Dr. Leela Prasad attributed the increase in dengue cases to migration of people and rapid urbanisation of tribal areas.
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Blood samples of patients, suspected to have dengue, are sent to the Virology Lab in the King George Hospital.
The number of patients who tested positive for dengue is: June - 214 (of 651 samples tested) and July 558 (of 1486 samples tested).
The proliferation of dengue and viral fevers, between June and October every year, sees a surge in the demand for platelets.
The demand for platelets has doubled last month as against the normal requirement of 50 units a day and we are unable to meet the surge in demand, says P. Kamala Devi, Chief Medical Officer, Rotary Blood Bank.
