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India's polio free status shows the way

Mar 20, 2014

In February 2014, India crossed the three year mark wherein no new polio case had been recorded.

Lavanya Regunathan

New Delhi: The eradication of Polio in India is undoubtedly good news. It shows the possibility of achieving success in the face of seemingly insurmountable goals. It is also the right time to ask why this kind of focused strategizing is not available for other issues affecting our children. In the realm of health alone many basic and fundamental issues are not being tackled effectively. Mere lip service in terms of paper laws without implementation being more the norm.

In February 2014 the country crossed the three year mark wherein no new polio case had been recorded. This is particularly significant as the country accounted for half the reported polio cases in the world as recently as 2009.

Yet complacency cannot set in as two neighbours, Pakistan and Afghanistan, along with Nigeria are the three remaining countries where polio is considered endemic. But India, according to the UNICEF, is sharing best practices with these countries.

The fact that access to clean drinking water and sanitary living conditions are not universally available in all areas of the country makes this achievement even more remarkable and showcases what can be done with the will of the state and its policy makers. Though even this success did not come without its own mistakes and lack of coordinated efforts leading to avoidable outbreaks of the disease in the late 1990’s before the administrative machinery of the state realized the potential benefits of eradicating this disease.

The focused and time sensitive method used in India in the last decade, nearly a decade after it signed the WHO treaty to combat the disease, raises the question of why other diseases such as childhood Tuberculosis have not met with such a high degree of success. Ever since the news of antibiotic resistant strains of TB coming to light there is a renewed interest in the status of the disease in India but both the private and public sector are not strangers to allegations of half hearted measures being followed in the quest to gain control over Tuberculosis.  The WHO also has only recently redirected its focus on this insidious killer. Though childhood TB can be treated more effectively than adult TB its diagnosis is proving difficult. Further it is influenced by the proximity to adults with the disease. Since the resources are not available to measure instances of childhood Tuberculosis there is not enough information on the level of response needed to tackle the issue and so newspapers, medical practitioners and journals routinely report that adult TB cases may have actually been caused by the virus contracted in childhood but merely not manifesting its symptoms at an earlier age.

The Tuberculosis Control India website states that in India two deaths occur every three minutes due to TB.  There is hardly any data, if at all on the connotations of this for India’s children and from a more mundane point of view, the sheer numbers of children infected with the disease. This is all the more ironic because at a time when India was fumbling over the manner in which to even begin to address the problem of polio it was hailed as a leader in the developing world in  the fight against tuberculosis.

But even a child who has not had the misfortune of contracting one of these debilitating illnesses does not have access to other basic health requirements such as food, clean water and sanitation. This is of course if we are speaking for male children; with the girl child the issue of female foeticide and infanticide are even more basic problems to be overcome. Female foeticide shows no sign of abating and we are exporting this shameful social disease to our diasporas. The problem of sex selective abortion is increasing in all countries that have a significant Indian or Chinese and also to a slightly lesser extent South East Asian diaspora communities.

As quite a few of us know, according to the World Bank  2005 Report, there are more than 60 million malnourished children, i.e. nearly half of all Indian children are under nourished and they are concentrated mainly in 5 states  and 50% of the villages which account for 80% of the cases.  The rate of malnutrition in Indian children is five times higher than in Chinese children and twice that of Sub Saharan African children. The report states that “In India, child malnutrition is mostly the result of high levels of exposure to infection and inappropriate infant and young child feeding and caring practices, and has its origins almost entirely during the first two to three years of life. However, the commonly-held assumption is that food insecurity is the primary or even sole cause of malnutrition. Consequently, the existing response to malnutrition in India has been skewed towards food-based interventions and has placed little emphasis on schemes addressing the other determinants of malnutrition.” The figures seem to suggest that this is not a problem of an insurmountable scale more an outcome of apathy and lack of will. If India is set to become the youngest country by 2020 what this says of the health of our population is quite clear. Of course those with access to food have no access to information of what is actually beneficial because of lack of transparency with food standards and guides about what is actually healthy to eat and feed ones children!

With regard to water, another basic right, the UNICEF states that 400,000 Indian children under the age of 5 die due to diarrhoea caused due to lack of access to clean drinking water. This is not because they do not have access to pumps which supply ground water. It is because the area around these pumps and wells are so polluted and full of rubbish, the water either gets contaminated or the children acquire the disease from the surroundings. Pollution of the ground water due to unenforced water pollution laws and sinking levels of this water of course exacerbating the problem.

There is no point calling ourselves an emerging giant when the fundamental issue of our population, the health of our children, the future of our so called powerhouse are treated with the lack of care and foresight that is so clearly in evidence in our failure to ensure their basic right to life and health.

(Lavanya Regunathan Fischer consults on Indian law and is based in London.  Devadatt Kamat is an advocate practising in the Indian Supreme Court)

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