05 August 2009

Swine Flu in India

The first swine flu death in India of Rida Shaikh a 14 year old school going girl in Pune has initiated a public health debate. As of 31 July 2009, World Health Organization in its 60th update indicates that there have been 1,62,380 cases and 1,154 deaths. The news reports of 5th August 2009 indicate that in India there have been 574 cases of which 470 have been discharged and there was one death. There have been 154 cases in Maharashtra of which 104 are from Pune and 22 from Mumbai/Thane.

In this pandemic, there is a demand that private hospitals be allowed to treat. This is a public health problem and whether you like it or not, its treatment is available at designated public facilities. The moot question is the quality of care (state of hygeine) is not good in these facilities. This leads to another pertinent question. Why has this happened? If you create a system where people who can act as a pressure group to ensure quality have nothing to do with this system then it would degenerate. Let us not wait for such epidemics to set our house in order. We should have a stronger public health system.

Another point that emerges is are the care providers of Rida Shaikh, who was first taken to a private clinic and then to the public facility where again there was delay because the first blood test report was done at a private hospital. One may not hold the providers neglecting the child's care, but it does call for some systemic evaluation and improvement.

This incident, as in all health related ailments, reiterates two things. We do not know when we will fall sick. If sick, we do not know when we can get better. It is for this that unregulated private care givers is definitely not the answer.

A state of epidemic has been declared in Pune and Satara districts of Maharashtra. As per this, the state can enforce treatment on people unwilling. It can also seas premises like schools and other public places to prevent the spread of diseases.

The World Health Oragnization has a Swinflu portal Pandemic (HINI) 2009 that is updated regularly. There are guidelines for individuals, communities, and national authorities. The most important being the frequently asked questions on What can I do?

To protech yourself:

• avoid touching your mouth and nose;
• clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching the mouth and nose, or surfaces that are potentially contaminated);
• avoid close contact with people who might be ill;
• reduce the time spent in crowded settings if possible;
• improve airflow in your living space by opening windows;
• practise good health habits including adequate sleep, eating nutritious food, and keeping physically active.

It is difficult to distinguish between a common seasonal flu and swine flu. The typical symptoms are fever, cough, headache, body aches, sore throat and runny nose. In India, there are specified public hospitals where this can be treated. The only place in Mumbai (which is 160 kilometers from the epidemic declared area) is Kasturba Hospital on Arthur Road - Phone: 230 83901/92458/00889). This can be treated, but it should be done under medical advise. DO NOT PANIC.

If you think that you have the illness then:

• stay at home and keep away from work, school or crowds;
• rest and take plenty of fluids;
• cover your nose and mouth when coughing and sneezing and, if using tissues, make sure you dispose of them carefully. Clean your hands immediately after with soap and water or cleanse them with an alcohol-based hand rub;
• if you do not have a tissue close by when you cough or sneeze, cover your mouth as much as possible with the crook of your elbow;
• use a mask to help you contain the spread of droplets when you are around others, but be sure to do so correctly;
• inform family and friends about your illness and try to avoid contact with other people;
• if possible, contact a health professional before traveling to a health facility to discuss whether a medical examination is necessary.

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