BY TARA NARAYAN

IT’S TOUGH to be a baby today! From the time a baby is born it’s the target of an immunisation schedule…for tuberculosis, diphtheria, pertusis, tetanus, polio, measles, hepatitis and now increasingly from the mosquito-bite scourge of malaria, filaria, Japanese encephalitis, dengue, chikungunya and whatever else in store in the near future as mosquitoes continue to proliferate to spread disease, suffering and mercifully a quick death in Goa and in state after state.

The solution to every new scourge these days is to find a vaccine! Yet another vaccine to pump into vulnerable children and we all know that the children of the impoverished and cursed of society who leave their tattered countryside homes to seek refuge in urban slums for roti, kapda and makan and if they can get it pani, bijli, paisa…are more vulnerable. A macabre joke making the rounds is that thank God mosquitoes don’t discriminate between rich and poor and so will bite every human of the species be it aam aadmi or khaas aadmi… for promoting mindless, arbitrary and non-stop urbanisation at the cost of the natural check and balance of the good earth.

PROTECTION

ALL these thoughts passed through the mind as one listened to details of yet another vaccine being introduced by the Government of India under the National Vector Bourne Disease Control Programme to prevent five diseases i.e. malaria, filaria, Japanese encephalitis, dengue and chikungunya (a programme under the aegis of the World Health Organisation, of course). This one, however, is a specific vaccine for Japanese encephalitis, a disease the average citizen knows precious little or nothing about! Addressing a press conference on June 22, 2009, Health Minister Vishwajit Rane announced that Goa is all set to vaccinate about four to five lakh children in the age group of one to 15 years for protection from Japanese encephalitis. The vaccination campaign starts off in Mapusa on June 24 and will continue in the rest of the state till July 10. The reportedly Rs. 30 lakh Central-government funded programme will be supervised by the Directorate of Health Services.

Apparently, Japanese encephalitis is the leading cause of “acute encephalitis syndrome” in Asian countries and India and primarily affects children below 15 years in rural areas. According to Dr. Priti of the NGO PATH (Programme for Appropriate Technology in Health), which is engaged in the immunisation programme, the five year programme is in its fourth year now and has already covered ten states, Goa is the 11th state. It is true that Goa does not see many Japanese encephalitis cases, but it has been declared endemic in the state i.e. there’s enough sub-clinical evidence to say that this vector-borne disease exists in Goa. Up to March 2009, 14 cases of “acute encephalitis syndrome” have been reported and three deaths recorded. The problem with sufferers of “AES” is that at least 70 percent of affected patients either survive with long term neurologically disability e.g. paralysis, or die.

In an “acute encephalitis syndrome” situation, it means that the disease is endemic in so much as that although fatalities are few, the disease exists in seemingly healthy carriers who can transmit it. That’s why the importance of the vaccine being given to as many vulnerable sections of society as possible. As for Japanese encephalitis symptoms, they’re pretty common and can be confused with many another mosquito-based fever and flu indications. But apparently the symptom to watch out for is fever with convulsions or seizures and even coma in extremely neglected cases.

VULNERABLE AREAS

TISWADI, Bardez and Salcete are particularly vulnerable perhaps because they’re the most urbanised. Although the infection is apparently picked up from infected birds in paddy fields during the course of performing farming chores. There’s a boom in mosquito population in areas where there’s rampant construction activity e.g. Candolim, Calangute, Caranzalem, etc.

It is not far fetched to conclude that the so-called vector borne diseases become endemic wherever rural countryside is giving way to urbanisation and creating dead and half-dead agricultural fields and piles of man-made non-biodegradable garbage (the garbage of civilisation or so to speak). It’s a situation which offers fertile breeding grounds for cockroaches, flies, rats - not to mention mosquitoes - to go forth and multiply without impunity. The degradation of environment goes hand in hand with the poor quality of health in urban and semi-urban areas.

While immunisations to protect the body from all kinds of diseases have a valid brief vis-à-vis saving lives en masse with reference in particular to TB, diphtheria, pertusis, tetanus, polio, measles, hepatitis B (against which every child is immunized nowadays), the flip side is the inability of governments and health departments to see the larger picture as it is emerging. It is, of course, far easier to pump yet another vaccine instead of coming up with a long term “development and progress” master plan to eliminate the curse of say, rampant urbanisation, and the diseases which have arrived in its wake in Goa! Who makes connections between cause and effect nowadays, even when it comes to something so primary as healthcare?

THINGS YOU CAN DO TO PROTECT YOUR ENVIRONMENT FROM MOSQUITOES

1. Deal with as much of your own garbage as you can, especially your wet kitchen waste which can be easily processed into healthy, useful compost.

2. Keep your home as well as the premises outside your home free from garbage. No empty bottles and cans, coconut shells, plastics, discarded tyres wherein water can collect to offer breeding grounds for mosquitoes. If there are drainage gutters, do not use them as litter bins, get them clean and flowing with clean rain water. Remember that mosquitoes can breed in even a small amount of standing water.

3. Instead of using strong chemical disinfectants, make use of a few drops of essential oils like citronella, lemon grass, mint, eucalyptus in the water to mop floors and clean bathrooms.

4. Mosquito-net your windows. And, for double protection, get yourself a four poster bed of old around which you can fix a mosquito net. Sleeping within mosquito netting is absolutely the best way to protect yourself against sly mosquitoes which may have got into your home at night. Also, if you’re going out dining in the evening, wear a long-sleeved shirt and pants of thick fabric, also covered footwear. Many old timers bathe in water diluted with chlorine bleach (two capfuls of bleach in a tub of warm water, but be careful not to get the solution near or in your eyes. This bath has a repellent effect which lasts for several hours) or rub on Vicks Vaporub before stepping out of their homes!

5. And finally, if you think if you’ve been bitten by mosquitoes watch out for fever, headache, stiff neck, confusion…muscle weakness, loss of any movement, rash, body aches or swollen lymph nodes in the neck, armpits or groin. Japanese encephalitis, incidentally, is to do with inflammation of the brain courtesy a viral infection (from tick or mosquito bites) or some other serious viral infection. Go to a good doctor quickly.

6. Amongst the plethora of vaccines which exist nowadays, there is one which comes highly recommended for adults over 65 or anyone who suffers from chronic heart or lung disease: the pneumococcal vaccine (PPV). Over 16 lakh people worldwide die of what is called pneumococcal disease every year, according to WHO, wherein major clinical syndromes are those of pneumococcal diseses e.g. pneumonia (lungs), bacteremia (blood) and meningitis (brain). If you’re a chronically ill senior citizen or diabetic, this vaccine is worth checking out.