Wednesday, 23 September 2015

Healthcare (Dengue Crisis) in India | Solutions and Examples

"In any free society where terrible wrongs exist, some are guilty; all are responsible.” 
- Rabbi Abraham Joshua Heschel

Why in news?
  • Many reasons - recent one Dengue deaths in New Delhi
  • In most health indicators we are behind South Asian neighbours, other BRICS nations and, for some indicators like child immunisation, sub-Saharan Africa. 
  • Improper coverage of news - Buried inside a national newspaper on April 12 this year was the heartrending story of a tribal in Odisha who allegedly felt forced to sell his two-month-old son for Rs 700 to buy medicines for his sick wife.
Who is responsible?

    • the state and Central governments, 
    • municipal corporations, 
    • private hospitals, 
    • public health functionaries,
    • negligent householders
    • careless construction workers who let water stagnate for mosquitos to breed. 
    Solution


    • Systemic reforms even after dengue dies seasonally.
    • Effective prevention or early and appropriate healthcare
    • Mosquito breeding will become even more intense as temperatures rise with climate change. 
    • Well-coordinated prevention measures that link multiple civic services, government agencies and community organisations; 
    • Efficient surveillance systems that help in forecasting and monitoring;
    • Concerted clinical care strategies that intelligently draw upon the combined resources of public and private providers. 
    • Regulation, planning and coordination. 
    • Strengthening of both rural and urban primary health services. 
    • Whether it is the initial assessment and care of fevers, chronic care of high blood pressure and diabetes or ensuring adherence to tuberculosis treatment, frontline health services can provide most needed healthcare. 
    • Many patients with viral fevers do not require investigations and treatment at large hospitals — indeed, they run the risk of unnecessary investigations and inappropriate treatment if they do. Triage and referral guidelines will help primary care facilities to steer only the persons who need advanced clinical care to large hospitals. 
    • Timely and effective risk communication to the public. 
    Examples
    • Thailand is a hyper-endemic country for dengue and experienced high numbers of deaths some years ago has now controleld dengue remarkably well. Mehtod--> 
      • Prevention measures
      • Application of a standardised clinical management protocol. 
    • Tamil Nadu, too, is endemic for dengue but its well-organised public health services are geared to cope with the challenge. 
    • Mohalla clinics proposed by the Delhi government
    Conclusion
    • Else, terrible things will continue to happen to innocent children, expectant mothers, poor tribals, disabled persons — and to your family and ours. We will all be responsible when such terrible wrongs happen.
    Dengue Map of World (Source Indian Express)


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