Pink Of Health

Expert Interview Dr. Premalatha Ramaswamy retired Head of the Department of Paediatrics, Vanivilas Women's and Children's Hospital Bangalore Medical College and Research Institute

1. What is the major cause for disease amongst the patients admitted to Vanivilas Children’s hospital in Bangalore?

Dengue infection. It is an utterly preventable disease since it is a water borne infection. In 2015 dengue cases across the country surged to 99,913, and in 2014 40,571 cases were reported of which 137 were mortalities. In 2016 6083 cases were reported of which eight mortalities were recorded and in the first six months of 2017 dengue cases recorded in Karnataka alone stands at 759 according to online report of National Vector Borne Disease Control Programme of the Directorate General of Health Services Ministry of Health and Family Welfare, Government of India ( Manpower resources and money are lost to utterly preventable diseases. But most tragically we are losing lives.

2. What are the primary causes for this epidemic?

Lack of medical infrastructure – like ventilators and blood supply – which is a priority for Dengue patients implies other in-patients may have to forgo scare medical infrastructure. This puts an enormous strain on health care infrastructure. Easier to prevent mosquito breeding. Dengue is a vector borne disease and the virus breeds only in fresh stagnant water. Sewerage drains and storm water drains are getting stagnated by solid waste. This blocks drainage causing breeding of this deadly virus. The infrastructure design of sewage needs a relook given the lack of discipline in disposing solid waste. Gastroenteritis used to be the epidemic in the 1970s and 1980s. This has now been addressed through WHO intervention of ORS… we could treat child mortality. We still get cases from slum areas that are lacking in water and sanitation infrastructure.

3. Please give us a holistic view of the disease, - its cause and consequences.

Cluster of cholera cases also occur from slum areas. These diseases dent children’s development by contributing to 5% loss of bodyweight. It leads to loss of appetite which triggers malnutrition and lack resistance triggering relapse / recurrence. Less food means less energy stored in the body so the body cannot discharge essential functions. Not only ill health but school dropping out because of relapses means children lose out on education too. This perpetuates poverty over the next generation. Children lose the curiosity to learn impairing mental development. That apart children lose immunity leaving them prone to other opportunistic infections like flu, cough cold, etc.

4. What are the other public health implications triggered by callous solid waste management and inadequate water and sanitation?

Girl children are prone to urinary tract infection because of inadequate water and sanitation. It can cause urinary incontinence and bowel and bladder dysfunction especially in school going girls. This causes emotional problems like anxiety, stress and unwanted obesity – eventually diabetes and hypertension in adulthood. Eating disorders are not far behind with lifestyle disorders. Failure or lagging behind in studies inevitably leads to rise in school drop-out rates … leading to the vicious cycle of poverty. Children from slum areas lack both water and sanitation as well as traditional means of neonatal care.

As told to Malini Shankar