Monsoon fever, festering sewer

Flooding by design might be the Bengalurean’s impending disaster this monsoon. But beyond this exterior manifestation of a deep malaise called apathy lie a health crisis, a recurring threat that puts thousands at risk. Water-borne and fatal, the diseases by design are heading for the next kill.

The dreaded Dengue has already spread its tentacles. Riding big on a readymade, welcoming mix of stagnant waters, unhygienic environs and a civic system that is often late to respond, Dengue has struck deeper this time. Till date, over 700 cases have been confirmed both in the city’s core and its outskirts.

In terminal mess, the city’s faulty, inefficient, clogged drainage system is designed to keep excess water stagnate on roadsides and low-lying areas. If this is not an invitation for mosquitoes to breed in millions, what is? The monsoon will make this worse, and the diseases are bound to spike far beyond manageable limits.

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Just recovering from election mode, the state government and the Bruhath Bengaluru Mahanagara Palike (BBMP) have no choice but to act fast. The damage inflicted by the pre-monsoon showers has been a warning too dire to ignore.

Beyond pamphlets

Beyond drains, public behaviour often aids mosquito-breeding. And this is exactly where the BBMP has decided to put its spotlight on. Over 40,000 information pamphlets are being supplied across the city to educate people on prevention and cure, as the Palike’s Chief Health Officer, Dr Manoranjan Hegde informs.

To keep a check on mosquitoes in all BBMP zones, the Palike has begun a survey. “As part of the survey, insecticides like Larvicides are being sprayed in all mosquito-prone areas including lakes, storm water drains and garbage prone areas. There is mosquito fogging done every evenings,” says Naveen Kumar, the Palike’s Deputy Health Officer.

Also in progress in slums, schools, colleges and other government institutions are door-to-door awareness camps on water-borne diseases and how to keep the surroundings clean. Free tablets are being distributed at government hospitals to treat symptoms of flu and the identified diseases.
Although expansive, can a city of Bengaluru’s scale afford to rely only on last-minute fire-fighting? “The city needs a very good disease surveillance system,” notes Dr Prashanth, Assistant Director (Research) at the Institute of Public Health.

Trend-mapping

Past outbreaks of Dengue, Chikungunya and other water-borne and communicable diseases should be geographically identified and mapped. “You need to see the patterns from year to year to help plan and prepare better.”

For instance, low-lying areas are where storm water end up and stagnate. If more disease outbreaks are reported from such areas year after year, targeted responses can be planned. “Right now, we don’t have any such surveillance or data. There is a need to study past responses and their results,” explains Dr Prashanth.

The Palike, he adds, needs to invest on the geographical mapping. “Models such as the Centre’s Integrated Disease Surveillance System is already there. However, this information is not mapped.”

Coordination lapses

But this holistic, comprehensive approach mandates well-structured inter-departmental coordination, an area where the city has been seriously found wanting. “The Palike and the Health & Family Welfare departments work independently with absolutely no coordination,” notes Vijayakumar S Seethappa, co-convenor, Karnataka Janarogya Chaluvali.

The two agencies are mandated to ensure good water quality and sanitation. “They are supposed to be quality regulators. But the Palike health setups are all understaffed. Doctors have no support staff. When there is an outbreak , they do fire-fighting. There is a complete collapse of the system,” says Seethappa.

This systemic collapse is too apparent. Open plastic tanks, coconut shells, exposed concrete tanks and ripped tyres are everywhere, letting water stagnant and help mosquitoes breed. Indoor plant containers with stagnant excess water could also turn deadly if mosquitoes are not deterred by window mesh nets.

Garbage link

A clear lack of a systematic garbage disposal system in residential areas across the city could aggravate the crisis.

Since door-to-door collection and segregation of source have largely remained slogans with mighty loopholes, garbage black spots have mushroomed all over. Once the rains intensify, these garbage mounds are destined to turn disease-generating cesspools.

Incomplete storm water drain desilting work could also worsen the scene. Several stretches have been left untouched both in the city’s core and the periphery.

Residents say the least that the Palike could do is to undertake fogging of the drains at regular intervals. But fogging operations, always inadequate, have virtually disappeared from the city.

As if these silted, encroached drains were not bad enough, garbage – truckloads of abandoned plastic containers – are dumped into stagnant sewage pits. Even a light rain fills the small containers, dramatically altering the health status of all areas on either side of the drain network.

Medicine stocks

The city does have a wide network of private clinics to share the BBMP’s burden. But they come at a cost too high for the urban poor.

On the drug availability too, the concerns are aplenty, as Seethappa informs. “The distribution of medicine is very unscientific. The same stock goes to every district regardless of the season,” he notes.

Patients are often left to fend for themselves as health centres declare medicine shortages. “The government should stock medicines based on seasonal and geographical demands,” suggests Seethappa.

“Any lapse will only leave the poor patients at the mercy of the private sector. Their out-of-pocket expenses will be immense.”

(Inputs by Rakshitha R)