Don’t Blame it on Litchi: State is Culpable for Death of Malnourished Poor Children in Muzaffarpur

By Mohammad Sajjad

Every year, in late May and early June, as the temperature rises above 40 degree Celsius with westerly winds, followed by humidity with easterly winds, we get horrific news of the death of dozens of children in Muzaffarpur, the “Litchi bowl of India”. Despite its precise predictability (and being quite localised), we find criminal unpreparedness of the government. The half a century old Shri Krishna Medical College Hospital (SKMCH) of Muzaffarpur does not get prepared in infrastructural terms to handle the situation. Its paediatric ICU remains awfully neglected.

Despite being independent India’s one of the earliest medical colleges to have been set up by private initiative (later taken over by the government), it is yet to have clinical branches of postgraduate courses. It, therefore, suffers from an acute shortage of medical personnel, besides other infrastructure.

Since 1995 this tragedy has been visiting upon Muzaffarpur children. In 2014, there was a relatively larger number of deaths. The newly formed Modi-led NDA in 2014 sent it’s Union Health minister Dr Harshvardhan to Muzaffarpur. He made many tall promises; persuaded some of the parents to agree to let the doctors obtain samples of the dead children. It was claimed to have been sent to some specialised laboratories. Nobody knows what happened to that thereafter.

This year, again, the Union Health Minister visited Muzaffarpur. There were almost similar promises repeated. This visit was after a fortnight of the tragedy began. He was accompanied by the local town MLA, Suresh Sharma, (who is also Minister of Urban development in Bihar), and Ashwini Chaubey (Union Minister of State for Health). Both were found sleeping while Dr Harshvardhan was addressing the press. This utter insensitivity outraged social media. The media blacked out the black flag protests demonstrated by the people against the visiting ministers.

The Kejriwal Hospital in the city of Muzaffarpur, managed by a Marwari charitable Trust, earlier known mainly for providing low-cost maternity related treatments, went on to expand itself to start paediatric care as well, after 2014. Local newspersons tell us that the death rate of the admitted child patients of AES (Acute Encephalitis Syndrome), supposedly caused by litchi, in the Kejriwal Hospital, is far much lower than that of the SKMCH. While every third child admitted in the SKMCH is said to be succumbing to death; as against it, in the Kejriwal Hospital, only the seventh one is unfortunate, this year.

The doctors say that administering dextrose with alacrity to the affected children is quite helpful. Yet, there is acute unavailability of dextrose in the government hospitals in the rural hospitals of the Community Development Blocks as well as in the urban hospitals.  

The doctors also say that notwithstanding the mysteries about the disease, once the treatment is done in accordance with what is done for the AES, they do get big success in saving the lives.

It is locally observed that only certain parts of Muzaffarpur (viz., the Community Development Blocks of Baruraj, Motipur, Minapur, Katra, Aurai) get more affected with this. Only the poor, malnourished children (mostly from low castes), fall prey to this. Well-nourished children don’t get affected, says a study of Current Science[1]. Unfortunately, even the media is not exposing the criminal failure of the government on this aspect.

The point to be noted here is that despite forewarning, extremely awful neglect of infrastructure for paediatric care and lack of immediate preventive measures of the government prevail there. These are the biggest causes. The government, every year, hides behind the mystery of the disease linking it with litchi fruits and does not confess the malnutrition as the prime cause.

The globally renowned health journal, Lancet (vol. 5, April 5, 2017), had also recommended: “rapid glucose correction”[2]. Yet, the government did not make this available in its hospitals. Each Block has got government hospitals. By April, these hospitals should have been supplied with adequate stock of dextrose. But this did not happen.

However, few more pertinent questions arise here:

  1. Why did not the Indian Council for Medical Research (ICMR) carry out follow-up studies (about the summer neurotoxin) in Muzaffarpur, during May-July of the years subsequent to 2014, to verify and establish findings, and to lay down Standard Operating Procedures (SOP) for prevention and management of the disease?
  2. Why did not the Bihar Government undertake annual public awareness campaigns in April-May around the Litchi orchards?
  3. Why did not the media decide to wake up this year and “discover” something which is an annual tragedy in Muzaffarpur and adjoining districts between May-July every year?

Lack of Public Protest

Shockingly, since the affected ones are mainly from the poor low castes, it does not outrage either the people or the national media, in a manner as to expose the wilful unpreparedness of the government. Supposedly to save the honour of Rajputs, a ‘Karni Sena’ came out in Muzaffarpur in January 2018 against the screening of the fiction-film ‘Padmavat’ and the armed, violent mob, vandalised a cinema hall[3].

In the name of cow, a huge mob can come out. But nobody comes out on the streets to protest against the callousness of the governments in matters of health, education, governance, water-crisis, etc.

Historically, otherwise notably famous for fierce anti-colonial street mobilizations, and anti-Congress socialist-leftist, peasant mobilizations, and also Naxalite assertion during late 1960s and early 1970s, and having elected many Socialist stalwarts such as Acharya Kripalani (1888-1982)[4], Ashoka Mehta (1911-1984), George Fernandes (1930-2019)[5], Muzaffarpur failed to see such mass protests against the Shelter Home horror in 2018[6], as much as they remain outrageously and criminally mute on the death of malnourished poor children, more because of the state neglect and less because of the litchi fruit.  

Ironically, fiction and grossly distorted histories cause outrage, whereas the facts and reality of rapes and brutalities and state neglect on the front of health do not.

These groups were assertive in showing Muslims their place in the early months of 2018 when there was a series of riots across Bihar, including in Muzaffarpur, followed by a tour of RSS chief Mohan Bhagwat in Muzaffarpur in February 2018[7].

Muslim women came out on the streets of almost every town; in Muzaffarpur and also eventually assembled in Patna on April 15, 2018, following the call of Maulana Wali Rahmani, general secretary, All India Muslim Personal Law Board, to perpetuate the un-Quranic instant triple divorce[8]. They had taken to streets in 1985-86 as well, to get the Shah Bano judgement upturned through parliamentary legislation.

The very same women did not get any call from any cleric or other community leaders to come out on the streets against the kind of brutalities the girls of shelter homes across Bihar were subjected to, nor did they come out against this health-related callousness of the state. Even the CBI has been buying time to submit the charge-sheet. The CBI has also failed in exposing the land-mafia politicians and bureaucrats who are suspected to have kidnapped and killed Navruna[9]. In Muzaffarpur, the CBI seems to be losing its credibility because of these glaring instances. Overall, Bihar has seen a big rise in crime in recent years.

Shockingly, even the political opposition has not staged any significant mass protest to expose the callous unpreparedness of the government to minimise the mortality. Nobody has asked for resignation from the Bihar health minister, BJP’s Mangal Pandey. Nor have the opposition spoken out inside the legislature.

RJD’s Tejashwi Yadav was so very fond of tweeting against Nitish Kumar. He too seems to have just ignored the state apathy. He hasn’t visited Muzaffarpur as yet. The Union Minister of State for Health, Ashwini Chaubey is getting felicitations in Buxar (from where he has been elected to Lok Sabha in 2019) and in Bhagalpur (his home turf).

The Indian Medical Association (IMA) can see lots of problems in TMC ruled West Bengal but no such fault in the NDA ruled provinces! Sadly, the IMA was mute on the death of children in the Gorakhpur Medical College as well. Unfortunately, the Gorakhpur tragedy ended up with communal victimization of a Muslim doctor who had intervened to rescue the children.

The doctors having a private practice in Muzaffarpur earn incredibly a lot of money. They don’t feel a social responsibility of spending some amount on charitable welfare, cleanliness and beautification. The localities of private nursing homes in the city of Muzaffarpur (Juran Chapra) are the dirtiest parts of the city. These high-earning doctors never felt like funding dextrose to the government hospitals of the rural Community Development Blocks. 

This exposes our collective degeneration, as a society, which has vitiated the polity and governance to the extent that only caste and religion-based hatred, and only an urge to perpetuate misogyny and conservatism, provoke us to stage our street-protests and demonstrations.

This is perhaps the biggest tragedy of our times!

[1] https://www.independent.co.uk/news/world/asia/india-lychee-toxin-deaths-children-muzaffarpur-bihar-aes-a8957086.html

[2] https://www.thelancet.com/action/showPdf?pii=S2214-109X%2817%2930035-9

[3] https://www.business-standard.com/article/current-affairs/padmaavat-karni-sena-vandalises-cinema-hall-in-bihar-s-muzaffarpur-118011801363_1.html

[4] https://www.rediff.com/news/column/why-j-b-kripalani-needs-to-be-remembered/20181124.htm

[5] https://www.rediff.com/news/column/how-best-to-remember-george-fernandes/20190131.htm

[6] https://www.rediff.com/news/column/the-shocking-silence-of-muzaffarpur/20180802.htm

[7] http://twocircles.net/2018mar07/421518.html

[8] https://www.rediff.com/news/column/saffron-green-nexus-indias-muslims-must-be-wary/20180415.htm

[9] https://www.bbc.com/news/world-asia-india-46029992

Note: Its abridged version was carried by the Rediff.Com, June 16, 2019.

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