Duping reports sensitive issue, complaints of dengue patients will be probed

Dr Rajiv Bhalla

Civil Surgeon

With deaths from dengue cases in Nandanpur and the city reeling under seasonal diseases, the Health Department has been on the back foot recently in terms of countering the rise in cases. While there have been five deaths in the district from dengue (Health Department maintains only two), the 261 positive cases, however, hint at a situation which needs serious action. The dry day drives and surveillance efforts by the department ahead of the season indeed have been indications of serious efforts to tackle or control any outbreak of diseases.

At a time when some private laboratories are reportedly making the most of the situation by duping patients and raking in profits, Dr Rajiv Bhalla, Civil Surgeon, Jalandhar, talking to The Tribune correspondent Aparna Banerji, dispels several myths and assures all medical help to those in need of help in the district.

The health authorities had projected a relatively relaxed year until a few months ago in terms of dengue, but now the cases almost seem set to surpass last year’s cases despite the intense drives. Where does the problem lie?

Our dry day campaign has taken off very well. Till date, the total positive patients in the district are 261. Despite the numbers being touted as high in media quarters, these are lesser than last year’s stats this very time. Since August, health teams have been deputed for the surveillance efforts involving the disease. Insanitary conditions are, of course, a major contributor to the problems. While the responsibility to maintain sanitation rests with the MC, the health authorities are indeed aware of the fact that convincing the residents to maintain sanitation in the city is an uphill job. However, intensive efforts are on across the district to identify patients and ensure their treatment and keep dengue numbers controlled.

What is the health department doing to prevent the rise in cases in the district?

The dry day drives held in the district are paying dividends. Effective challaning has also take place. The next step is stress on education and information regarding the disease among residents which people have to follow. We can do our bit but ultimately it comes down to the people to ensure that they don’t let water accumulate in any area. Besides, it’s also our appeal to people that those who like feeding birds or those having pots filled with water for plants etc. should ensure that the water is cleaned before it gets old enough for the dengue larvae to start breeding.

Speaking of insanitary arrangements – from clogged sewerage to smelly dirty wards – the Civil Hospital itself has been in the news for insanitation. How are you tackling this?

That is an aspect handled by the MS, but in any case from my side instructions have been issued to maintain sanitation at the hospital.

Amidst the rise in cases, reports of patients being duped or harassed in the name of dengue tests are also emerging. There are patients who allege overcharging by some private labs and others who even say tests from two labs don’t tally. What is the health department doing to act against such elements?

This is a very sensitive issue and we indeed need to take immediate steps to address it. Firstly, awareness is the patient’s first weapon. In some viral fevers also, the platelet counts do come down. So patients need to stop panicking and wait for the tests to confirm its dengue first as in all probability, it could be some fever. Secondly ample facilities are available with the health department to treat these diseases. We have free CBZ tests, platelet transfusion facilities, 24x7 blood bank. None of the government institutions can charge anymore than Rs 8,000 for platelet transfusions to patients. And for dengue tests, no private lab or hospital can charge anymore than Rs 600. As per a government notification released on the issue, the upper limit for dengue tests from any private facility is Rs 600. Anyone charging more is liable to legal action against them. I request all patients facing any trouble regarding the issue to call the 104 helpline whenever they are faced with duping on any of these counts.

What action is the department planning against private establishments against whom complaints regarding duping have been received?

Since the state government has released a notification on the issue, the health department shall act on any such complaint received by us now. Patients and the aggrieved parties, however, have to tell us first. We will act on complaints and probe the complaint of patients complaining of harassment. In fact, dengue and chikungunya are both notifiable diseases. If any private establishment is not informing us about the cases received by them, it is liable to action, since it’s a punishable offence.

Are you receiving the requisite reportage from private institutions on dengue and chikungunya?

Not so far. We have even put it across on the IMA that reports regarding every case of these diseases are to be sent to us. However, the number of private establishments sending us reports is minimal. While we are getting some cases for confirmation in sentinel labs, the reportage isn’t 100 per cent.

These diseases are primarily keeping the health department busy at the moment. Many other ailments have clouded the district every year in subsequent years. What plans are in place to counter them?

Next on agenda is swine flu because the lack of proper information on it often causes similar responses and panic. We have already started putting in place a strong mechanism so that health department is equipped to fight any disease in the coming months. Both in terms of medicine availability and distribution and arrangements for setting up isolation wards – all efforts are already afoot.

Apart from seasonal diseases, action under the PNDT Act remains an area which needs a lot of work in the city. Female foeticide reports emerge from time to time in the city. But there is a perception that erring centres are often let off lightly.

We have a very aggressive action in the city on under the PNDT Act. Four to five establishments have already been sealed in my tenure. We also held a meeting with radiologists of 242 centres recently. As far as foeticide is concerned, people are going to other districts to get foetuses aborted or other districts might have such a counter view about ours. However, the health authorities are very clear on the issue. No erring parties shall be spared. There is a fine of Rs 50,000 on those indulging in such activities or on centre with unregistered machines. In Jalandhar, 98 per cent deliveries are institutional. Only 2 per cent deliveries are home-conducted and half of these are also conducted by skilled workers. Areas shortlisted where more than six deliveries have been reportedly held at homes are being approached for sensitisation drives. The department is also cracking down on dais (midwives) operating in these areas.

Among expectant mothers in the district, rates of anaemia are very high and in almost all backward and slum areas, maternal health has gone for a toss. Mothers are often malnourished which also impacts deliveries. Every few months, there are deaths of pregnant women reported at the hospital which are often attributed to badly handled pregnancies by families.

Regular camps are being held in the eight urban slums in the district. Thirty two camps have been held in urban PHCs or kiosks on the issue. ANMs are also on the job to ensure the health of the expectant mothers and their progress is closely watched. Indeed, there are families which sometimes prevail over the ANMs, but that is a constant battle. The health department is making constant efforts to ensure the well being and health of mothers in the district.

Addiction is another serious problem in the district. The Civil Hospital itself is at the receiving end in terms of hooliganism incidents. Various areas also battle addiction and the lack of effective reach and follow-up is one of the primary obstacles to treat it. Is any change likely under you?

Effective efforts are being made by us to tackle addiction in the district and many have dropped the habit following treatment. However, one of the elements which is a key challenge to tackle addiction is that many youths latch on to it even after treatment. While many cases have witnessed revival, in the remaining, this scenario poses a problem. We also need effective cooperation of NGOs to ensure the rehabilitation of the addicts. Because after rehabilitation, the chances of dropping out of treatment are greatly minimised.