At Lok Nayak Jai Prakash Narayan Hospital's fever ward, Devshree's 13-year-old daughter Khushbu has been lying on a bed also occupied by another patient for the last three hours.
She is visibly in pain and is waiting for a doctor to announce if she has caught dengue or chikungunya, the two mosquito-borne diseases which are keeping doctors busy this season in Delhi. Khushbu has high fever and joint pains.
“We reached the hospital at 7.30 am and since then we are running around for one thing or the other. It took two hours to make the pass, then again two hours standing in line for blood tests. Now, we are waiting for the doctor to come and check her,” says Devshree, a resident of northeast Delhi's Bhajanpura.
With vector-borne diseases breaking out every year, questions arise on the national capital's preparedness and health infrastructure. Patients sharing hospital beds or lying in the corridor, hospitals denying treatment, staff shortages: these are familiar stories almost every year when a disease like dengue – or chikungunya, this year – strikes.
So far, this year 18 people have died of chikungunya, which has struck the national capital the first time as an epidemic after the 1960s. At least 13 people have succumbed to dengue. Even malaria has claimed two lives this season in the city.
According to the Centre's Integrated Disease Surveillance Programme, the number of cases of Chikungunya so far reported in the capital is 3,358 – about three times the figure of 1,057 given out by the municipal corporations in their weekly report about a week back. Similarly, there is a spurt in dengue cases, which totalled 2,926 till September 13 – even if the municipal corporations put the figure at 1,158 cases till September 10.
Surender, waiting for a doctor to examine his wife who is lying on an adjacent bed, says, the doctors don’t even reach the patient. “Doctor patient tak pahunchta hi nahi hai.” “I stood for hours in the line for getting her blood test done. There is only one person managing the tests and giving reports,” he says.
Lok Nayak Hospital medical superintendent Dr J C Passey says, “Even our own staff is down with either dengue or chikungunya. So at times there is a shortage of manpower but we are managing from other departments".
While family members narrate their ordeal, a well-built man deployed as a marshal by the hospital enters the ward and orders them to get off the patients’ beds. “Sab attendant bed se neeche,” he shouts.
Devshree, who had managed to squeeze herself into the little space available on the bed already occupied by two patients, quickly stands up. “Isn't this wrong? How are we supposed to keep standing for hours,” she asks.
Pawan, the marshal, says family members are not allowed to sit on the beds as the patients feel uncomfortable – and also because some other patient in need can be “adjusted” there.
Dr Vijay Gurjar, senior resident doctor, geriatric medicine at All India Institute of Medical (AIIMS), says in the last few years nothing has been done about increasing the number of beds or space in hospitals across Delhi.
“Another reason for overcrowding in Delhi hospitals is that there is a huge rush from NCR areas also. We recently got a case of a 65-year-old woman from Ghazibad who had high fever and severe joint pains. She came to AIIMS on a bus from NCR with the help of two people. We asked her why she didn't go to a nearby hospital, and she said because there is no facility,” says Gurjar.
Despite having dealt with the dengue crisis last year, when Delhi saw 15,876 cases and 60 deaths – both figures the highest in two decades – the AAP government's health department has been slack in gearing up for this year’s vector- borne disease season.
Apart from Delhi government, it is should be a matter of concern for the municipal corporations also that diseases which are preventable are affecting, and killing, so many people.
The corporations were lax in carrying out their mandate of checking mosquito breeding before the outbreak. They had been delaying fogging drives too. “There are lots of breeding sites in every area. There was no fogging done even in AIIMS and it was only after employees caught dengue that they conducted the drive last month,” Gurjar says.
The drives have intensified now, with Aam Aadmi Party ministers and Municipal Corporation of Delhi councillors spreading awareness on sanitation. The Delhi Health Minister is conducting regular hospital inspections and a plan to increase the number of hospital beds has been announced.
Blame game
But it took 10 chikungunya deaths for the various authorities to consider the vector borne diseases a priority, amid a political blame game. After the first death was reported due to chikungunya, the Delhi government put the onus on Lieutenant Governor Najeeb Jung and Centre for the outbreak even as Chief Minister Arvind Kejriwal and his ministers were criticised for “missing” from the capital. Only the Delhi's Tourism Minister Kapil Mishra was in the city then. Even Jung was abroad.
Kejriwal took to Twitter washing his hands off the crisis. “CM and ministers left with no power now, even to buy a pen. LG and PM enjoy all powers with respect to Delhi. LG abroad. Question them for Delhi,” he said.
There is no denying that the Delhi administration – be it the Lieutenant Governor or the Chief Minister's Office – was caught off guard by the chikungunya outbreak this season. Before Delhi this year, the last suspected ‘chikungunya death’ in the country was reported in 2006 in Kerala. But an investigation later by the National Vector Borne Disease Control Programme into the death revealed that chikungunya was not the cause.
Both chikungunya and dengue have the same source: the aedes aegypti mosquito. Chikungunya, however, is not considered fatal and doesn't have complications like the dengue ‘haemorrhagic fever and internal bleeding, doctors say.
“But it gives severe pain in the joints. Most of the patients who have died were old and had other health issues which got aggravated due to the disease,” Gurjar says.
Delhi has been seeing chikungunya cases over the years but not in such endemic proportions. The last outbreak in the national capital was in the 1960s. "The nature of the virus is such that it lies low for many years and then strikes as an epidemic. In African countries it comes after every five to six years,” he says. Cooperation from the public and awareness on prevention has to be increased if Delhi wants to fight these diseases.
“Often we see cases where people don't allow our domestic breeding checkers (DBC) to enter their houses and threaten them. In developed and some of the developing countries, if you don't allow the municipal workers to check breeding, you can be prosecuted,” says Dr D K Seth, director, hospital administration at Hindu Rao Hospital, which comes under North Delhi Municipal Corporation.
“The other problem is that there are a lot of slums in Delhi which do not have piped water supply round the clock, and they store water. Now, we cannot ask people not to store water and they don't allow us to put any insecticides or pesticides in it," he adds. What do we need to do to win the war against vector-borne diseases? “The only solution is: Do not allow mosquitoes to breed,” says Dr Seth. Hope the government, the civic agencies, and the public listen.