In villages racked by encephalitis in Uttar Pradesh’s Gorakhpur, children play barefoot in mud, with dirty water collecting all around and garbage piled up, ignorant of the fact that their surroundings could lead them to contract the disease.
After three decades of high incidence of encephalitis cases and deaths, the Gorakhpur division of U.P. is still struggling to contain the disease that is linked to insanitary conditions and is particularly spread by mosquitoes via pigs and drinking dirty water.
Padmavati Devi, who lost her grandson Alok to encephalitis last week, says she does not know what happened to him or how he got the disease.
Speaking outside her home in Gorakhpur’s Belipar on what would have been Alok’s 14th birthday, she says: “We are poor and uneducated, what do we know about the disease? All we know is that he had a fever.”
Alok was among the children admitted to Gorakhpur’s Baba Raghav Das Medical College, where 60 children died in a span of five days starting August 7.
Just outside his home, children play in the rainwater that has collected. When asked if they know how encephalitis spreads, neighbours say they did not. “Children are children, they will play,” says one neighbour.
In Bichhiya in Gorakhpur, the home of a family that lost a five-year-old child to encephalitis on August 11 is surrounded by filth — dirty drains, faeces of goats, and chicken and trash. The grandfather of the child, Ilahi, says the family tries to keep the house clean, but the condition of the neighbourhood has always been bad. “The administration should have made roads and drains. We have no option but to dump the garbage outside,” he says, adding that he does not know how encephalitis spreads.
Lack of awareness
The lack of awareness spreads to other parts of the region as well. Shamsul Ansari from Gamharia in Bihar says he does not know what had happened to his three-year-old son, except that it was “serious”. After three days of high fever that medicines prescribed by local doctors could not control, he says he brought his son to Gorakhpur’s BRD Medical College, where the child is in the ICU. He says has not heard of encephalitis, or mastikshk jwar , or of the news on the medical college.
Dr. K.K. Aggarwal, the president of the Indian Medical Association, said that most cases of encephalitis can be controlled with better sanitation and medicine.
“About 10% of Acute Encephalitis Syndrome (AES) cases are Japanese encephalitis, which is spread by mosquitoes. This is preventable as culex mosquitoes breed in dirty water,” he said.
He added that scrub typhus, another cause of AES that is linked to lice, mites and fleas on the ground, can be “100 % managed” with antibiotics if caught in time. Another type of AES, caused by enterovirus, is linked to lack of sanitation, which can also be addressed.