Friday, September 16, 2016

Debilitated in Delhi: Chikungunya and the AAP by Mukul Kesavan

We succumbed without a fight - my wife, my sister-in-law, my daughter and I - to chikungunya. It's an undignified affliction that sounds like a Haryanvi word for a chicken's virtues and feels like a preview of old age. For those of you who haven't had the pleasure, from the end-user's perspective (since we are all consumers now), chikungunya is fever plus arthritis. The fever goes away but the joint pains linger as the virus makes a leisured and seemingly random tour of your moving parts.

This is the stage that doctors with their gift for detached understatement classify as 'sub-acute', the weeks (months?) when you can't reverse your car because it hurts too much to swivel your head, or hold anything because the joint that works your opposable thumb shrieks when you try, when you learn not to casually slide off the sofa on to the floor because you mightn't be able to get up again, when you get used to thinking of your body as a drained battery that doesn't fully recharge any more.

I don't know if the incidence of chikungunya in Delhi qualifies as an 'epidemic' but the state of my household, news reports and other anecdotal evidence certainly suggest an unprecedented rate of infection. This, however, is not the view of the Delhi government. Addressing a press conference on the thirteenth of this month, its health minister, Satyendar Jain, declared that there was no 'outbreak' of chikungunya in the nation's capital and that the panic about the disease had been created by the media. He cited the hundreds of vacant beds available in the hospitals run by the Delhi government as a kind of proof that the scale of vector-borne (mosquito relayed) infections had been greatly exaggerated by the press.

One explanation for the health minister's statements could be that he believes the figures put out by the municipal corporation. The latest figure supplied by this source put the number of chikungunya infections at just over a thousand. This is an absurdly low figure which tells us nothing about the actual incidence of chikungunya. A report in the Hindu pointed out that just three of Delhi's 45 government hospitals had reported more confirmed cases of the disease than the total number reported by the civic bodies. The AIIMS, Safdarjung Hospital and the Lok Nayak Hospital had together recorded more than 1700 confirmed cases of chikungunya.

When you consider that this figure doesn't account for the cases registered by the other 42 government hospitals, or those tested and treated by private pathological laboratories, private hospitals and general practitioners, it becomes apparent that the several jurisdictions that allegedly govern Delhi - municipal, state and Central - either don't know what the scale of the problem is or don't care.

The main reason why the incidence of chikungunya is grossly under-reported is that most government hospitals don't have the facilities to do the necessary blood tests and the private pathology labs that can test for it are too expensive for the vast majority of patients. Typically, the chikungunya test costs between two to three thousand rupees... read more: