PHA-Exchange> Malaria in Rajasthan

[Claudio]

From: sanjai sharma 
 Malaria in Western Districts Of Rajasthan
It was hard to think of Malaria spreading in epidemic proportions specially in the arid and dry desert districts of Rajasthan but the ecological changes brought about by the Indira gandhi canal project  along with population migrating to and fro from these areas in times of drought and coming back from cities with malarial parasite contributed in exacerbating the problem till it broke out in epidemic form in 1994.Following the epidemic the Rajasthan state government formed an expert comittee to give recommendations.

 Our association  began the training of workers engaged with its members on taking thick and thin blood smears of people having fever and coordinating with the government for checking the slides for malaria .This is being followed up through visits to the operational areas of the trainees to see if they are facing difficulties at any stage and helping them overcome the hurdles. The visits have brought to light that none of  the recommendations given by the expert committee set up by the government to streamline the  malaria eradication programme  have been implemented. This fact is alarming keeping in view that an epidemic like situation can develop any time in this state where more than 80% of the population is living in a chronic drought situation and that carriers of Malaria are not being identified and treated. 

 It was shocking to find that for the last three years the state of Rajasthan which has 32 districts is being supported by the World bank for  an "Enhanced Malaria control Programme" that too covering only some blocks in 10 districts mostly belonging to the southern tribal inhabited districts.What happens to the remaining 22 districts(specially the western districts where the epidemic first broke out)? 

With the help of its members and with whatever resources were available our asociation did fact finding of whether there are drug distribution centers and fever treatment depots functional in the western districts. It was found that the government staff had not even heard of such things which are so important for early detection and prompt treatment of carriers.

We organized a state level meeting of NGO's and Government  directorate. This meeting was attended by about 100 NGO's and members of the expert committee on malaria. The governments helplessness was adequately exposed.

We intensified the media advocacy efforts which at the moment have got started as small press conferences at district block level.

All this needs to be done rather fast before the problem worsens in the coming months.

Early case detection and prompt treatment will be the area of emphasis. As many training as possible will be held to be able to identify latent carriers.

We sent fact finding teams of doctors to the divisions .The teams came back with replies that were alarming and so 3 divisional level workshops were held to sensitize NGO's and help them develop links with the government to be prepared and take actions to avert a catastrophe.

50,000 leaflets were distributed amongst select opinion makers for taking preventive measures.

Now the government is caught in the midst of Malaria epidemic.

During two more assessment visits to the western districts our team in July /August the first signs of  the imminent epidemic and deaths was communicated to the Government and the local Chief medical officer of the districts.

They cried for help they needed lab technicians to take slides. We have been training technicians in taking blood smears.

Our organization ( RVHA) is making all-out efforts to pressurize the government to release adequate amount of medicines which can be lodged with RVHA member organizations and they are trained about protocols The real gap is the distant hamlets scattered allover where outreach is difficult .

Mobile teams are the need so that villages can be covered.atleast visited and medicines dropped with school teachers panchayats or other people who are willing to help out. regular monitoring is also a must along with health education, vector control and active surveillance.

The World Bank aid  through the state government will not be able to take care.

Of the situation. the only thing the government is doing at the moment is to suppress all news about deaths and spread of the epidemic.

 

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