The death of more than 100 children in Bihar's Muzaffarpur district due to Acute Encephalitis Syndrome ( AES) has exposed the sorry state of Bihar's healthcare system.
The out break of AES is not a new phenomenon in this region with outbreaks reported as early as 1995. According to 2017 paper published by Lancet ,AES cases peak between May and June which is also lichi harvesting season in the district.
The paper based on the survey of 390 patients with a age of 4 years says that the illness was associated with toxicity from litchi comsumption and absence of an evening meal among children.As per the paper recommendations minimising litchi comsumption among young children,ensuring children eating evening meal and implementing rapid glucose correction for children suspected with AES can preven deaths.The third recommendation could have been achieved if the state has functional primary health care facilities.According to 2016 WHO study based on 2011-12 NSSO data ,Bihar had just three allopathic doctors and four nurses per 100,000 people against an all India average of 34 and 32.The NASSO data revealed that out of 1000 persons who were treated for an ailment in Bihar between Jan to June 2014,764 availed the facilities of a private doctor against 57 in primary health cares,81 in government hospitals and 98 in private hospitals.The all India figures are 504 for private doctor/clinic,170 and 241 for government and private hospitals and 85 for primary health centers.There is severe shortage of health infrastructure in the state.
Statistics from RBI on state finances show that Bihar has not even been honoring its budgetary commitments regarding health spending.Every year temporary encephalitis wards are set up in regional medical colleges ,patients are treated in shared beds,ward floors and temporary measures like sanitation drives and epidemiological studies etc are taken but once the disease wanes by September ,the government and health dept falls back on previous routine till the next outbreak.
Even heat stroke patients are unable to get proper treatment in Bihar health centers.More than hundred people have died of heat stroke which could have been prevented if the primary health centers could administer basic treatment in time.