Spreading swine flu
The epidemic that has gripped Jajarkot district in Mid-Western Nepal for the last three weeks, claiming 25 lives, as we suspected, is no 'mystery' illness. It is swine flu, lab tests in Kathmandu now confirm. It was not identified at the outset because local medical labs, underfunded and undermanned, are as good as useless.
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This is shocking. The climes of the Mid-West are considered favorable for bacterial and viral diseases, which is the reason the region is regularly under the attack of one or the other pathogen. The 2009 cholera outbreak, also centered on Jajarkot, had claimed 300 lives. Since then, every year, 100 people from the region have been dying on average from gastrointestinal diseases alone. It is thus appalling that there is not a single, well-equipped pathological lab in the region. Such a lab would have saved countless lives by cutting response time of the medics. Or would it?
The ground realities in Jajarkot are more complicated than what gets reported in Kathmandu. Yes, there is an acute shortage of doctors, a shortage that is put in sharp relief in the event of a potentially lethal epidemic like swine flu. But even the few doctors who are willing to go to the affected areas are often stranded at Khalanga, the district headquarters.
They cannot go to remote villages like Paink and Naya Bazaar without, at the least, some provision to feed themselves and a place to lie down at night. This was one reason behind such a high death toll in 2009. The same sad tale is being repeated in 2015. Despite the country witnessing such epidemics at one place or the other every year, the logistics needed to mount a credible response is simply not there. But in Jajarkot there is no time to sit back and plan. For now we will have to do with emergency measures, which, if done right, can still be quite effective. The virus responsible for swine flu is a strange beast. If its victims are effectively treated, and as soon as first symptoms appear, under a percent of those infected die, but delay the response by a couple of weeks, and the death toll can jump to as high as 50 percent—especially in a place like Jajarkot with its dismal health care facilities.
It is important to ring-fence the virus before it starts hopping across district and zonal borders. It has already been spotted in the neighboring Rukum district in the last week. The government seems to have been caught off the guard. It is now dispatching more Tami-flu tablets which relieve flu-like symptoms to Jajarkot. A team from Nepal Army also visited affected areas on Sunday on an exploratory mission. Again, the most effective way the army could help would be in providing food and shelter to the brave doctors who are ready to go to swine flu hotspots like Garahakot and Naya Bazaar. It is vital that medics reach these far-flung places soon if we are to check the spread of the dangerous H1N1 virus that has in the last one year claimed 18,000 lives around the world.
