The Hindu : Other States / Bihar News : Kala Azar spreading among Musahars in Bihar

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Wednesday, Sep 15, 2004

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Kala Azar spreading among Musahars in Bihar

PATNA, SEPT. 14. Kala Azar or Leishmaniasis is affecting Musahars the most in Bihar, Action Aid International India, an NGO working among the flood-affected Musahar settlements in Darbhanga district, has found.

"In the course of our survey, we have found many cases diagnosed with Kala Azar in Musahar (a Scheduled Caste) settlements in Darbhanga district," said Pushpendra Kumar, Regional Manager, Action Aid Patna.

Lachhman Sadai from Kewatgama village has spent a total of Rs. 22,000 on treatment for himself and his son. He borrowed the amount from the local moneylender, who charged an exorbitantly high rate of interest of 100 per cent per annum. He used to work as an agricultural labourer, but has been unable to work for the past two years.

He now depends on money sent by his other son, who is a labourer in Punjab.

"The disease is most prevalent among the Musahars because of their poor living conditions," said Dr. Prabhat Kumar Sinha from the Rajendra Memorial Research Institute of Medical Sciences, which conducted research on the disease and also has a 50-bedded hospital in Patna that offers free treatment to poor patients.

"People have stopped responding to the drug that the government used to provide free of cost through the Primary Healthcare Centres (PHCs). This shows that the disease has developed a resistant strain."

"Now a costlier drug is required for treatment," said Dr. Sinha.

Shiv Kumar, a five-year old boy from Bataua village, lost his father and grandfather to the disease and has now been diagnosed with it himself. His grandmother, a casual labourer, has spent Rs. 2,200 on treatment but to no avail.

Action Aid's relief and rehabilitation work among the Musahars includes organising medical camps for the Kala Azar patients.

Mr. Pushpendra said that the camps would not only pay for the costly treatment, but also for relatives to stay with the patients during treatment.

"Long-term sustained efforts are needed to tackle the disease," added Dr Sinha. Kala Azar spreads through sand-fly bites and is endemic to the area. Cases rise during times of floods. ``The poorly ventilated mud houses take a long time to dry, and are fertile ground for diseases to thrive,'' said Dr Ajay Kumar of the Indian Medical Association.

While Kala Azar and tuberculosis are more serious as their detection and treatment is a costly, time-consuming affair, even ordinary illnesses like dysentery can be fatal for want of adequate food and medicines.

``The government healthcare system has totally failed on the peripheries, forcing the poor to depend upon costly private practitioners or quacks,'' said Dr Kumar, adding that it was a vicious cycle that needed to be broken.

Due to the floods, access to even such private clinics was severely limited. Boats plied on what used to be roads till two months back, and the fares were out of reach for the poorest, he added.

"While there was a systematic failure, individual doctors from the government healthcare system had extended all possible support to relief work," said Javed Ameer of Action Aid's emergency Relief team.

The local civil surgeon and doctors from the Primary Healthcare Centres provided medicinal supplies, including iron and folic acid capsules, ORS and Vitamin A for the relief teams to administer in remote areas. Action Aid's relief work included distributing essential vitamins to the malnourished, especially women and children, Mr. Ameer added. -- UNI

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Kala Azar spreading among Musahars in Bihar