A criminal silence

A criminal silence

It is surprising that in a country like India, with huge proportion of such cases, not many awareness programmes have been arranged to mark the Day

World Hepatitis Day is celebrated every year on the 28th of July, on the birthday of Nobel Laureate Professor Blumberg who discovered Hepatitis B.  

It was in 2010 that the World Health Organization made World Hepatitis Day one of only four official disease-specific world health days.  

Previously an International Hepatitis C Awareness day was celebrated by the patient groups of the European and Middle Eastern regions on 1st October in 2004, but some other groups were having different dates for the same. World Hepatitis Alliance declared 19th May as the first World Hepatitis Day in association with the patient groups in 2008.  

The date was finally changed to 28th July after the adoption of earlier declaration in the 63rd World Health Assembly in the month of May 2010. It was titled as the World Hepatitis Day with an aim to focus on raising awareness at the national and international level. 

Millions of people across the world have been taking part in the World Hepatitis Day, with an aim to raise awareness about viral hepatitis, and to call for access to treatment, better prevention programs and government action.  The theme for World Hepatitis Day 2015 is ‘The prevention of viral hepatitis’ with a campaign strap-line ‘Prevent hepatitis: It’s up to you’.

There are more than 400 million people living with hepatitis B and C worldwide, about 1.4 million die due to these infections every year. Unfortunately many more get infected at the same time. Prevention of further spread of the viral hepatitis is possible through better awareness, services that improve vaccinations, blood and injection safety and infection control training of health professionals. 

It is surprising that in a country like India with huge proportion of such cases, not many awareness programmes have been arranged to mark the Day.  Apart from the health secretary of Maharashtra directing health institutions in the state to organise awareness events on the day, rest of the country seems to be in a slumber including Jammu and Kashmir.  

Kashmir valley is one of the places worst hit by Hepatitis C infection, already declared as an epidemic by experts. One often reads about hundreds of positive cases in some villages of Kokernag area like Magam, Sonabarie, Sagam, Zalangam and list goes on. Unfortunately in some villages, more than 50% population has tested positive. Similarly many villages have been tested positive in Shopian, Kupwara, Lakdakh, as are some areas in downtown Srinagar.  Recent screening done in Sagam village in Kokernag has revealed more than 11% positive out of 400 samples taken.  Strangely, the results are being covered up had it not been for a dedicated journalist who broke the news. The SKIMS also collected samples in village of Sonabarie few months ago. It is alleged that the results are being covered up and not made public for unknown reasons. It is feared that more than 80% of the sample may be test positive.  Similarly it has also been alleged that SKIMS covered up the results of screening done in Zalangam village few years ago and hence those testing positive were kept in the dark and not provided with any treatment leading to complications in many.  

In spite of commendable media pressure, apart from some damage control exercises, the health authorities have completely failed to take any proper action on ground.  Tall claims were made of releasing crores of rupees for the treatment of those already infected but no one knows what happened to the money.  Recently few hundred patients from village Magam were offered treatment but nothing is being done about rest of the thousands of positive cases or to prevent people getting infected on daily basis. No work whatsoever has been done by the health department to find the reason for the epidemic or how to prevent further spread of the infection. Doesn’t it look like another scam which is being covered up? 

Since the change of the government in the state, a criminal silence has been maintained by the new health ministry.  The minister of state for health did visit Kokernag constituency   but did not care to utter a word about the ongoing epidemic of Hepatitis C. Similarly the new director health services Kashmir has either not been updated about the problem or has decided not to bother.

The World Hepatitis Day could have been used for creating awareness about spread of infection and also seek help from various national and international organisations to deal with this hopeless situation.  Instead of organising awareness campaigns, health authorities are busy stigmatising people who have been infected.  While going door to door in Sagam village few months ago, the health workers were patronising people by suggesting that screening and seeking help will affect the marriage prospectus of their daughters. Surely health workers were directed by their superiors to create fear, so that poor villagers do not demand any help.  Subsequently when a screening camp was organised under media pressure, people were hesitant to come out for screening, fearing stigma.  Allegedly another reason for cover up was that highlighting this epidemic can affect the tourist rush to Kokernag, hence poor lives are less important than non-existent tourist flow to Kokernag garden. Similarly the doctors working in the area are being discouraged to get people tested, supposedly it brings bad name to the health department.  So here are we preventing hepatitis by denying the facts for false pride…….Prevent hepatitis: It is up to you? 

One wonders whether the health authorities are there to safeguard people’s health or play politics with appeasement policies at the cost of poor lives.  One would have expected that the department will organise awareness programmes not only within the health department but also involve schools and other departments. It is amply clear that most people are acquiring this infection from the health facilities run by state due to lack of training of staff, poor accountability and lack of sense of responsibility.  Infection control and sterilisation practices are rare and same instruments and syringes are being used on multiple patients.  Unfortunately there are allegations that even hospitals like Government Dental College which is seat of learning for budding dentists and treats thousands of patients each day, does not follow any sterilisation procedures and same is the case with other hospitals around the state, not to speak of private dental clinics and peripheral health facilities. 

Health is a serious issue and cannot be done away with being irresponsible, may it be doctors, nurses, allied staff or health officials and administrators.  There is still time that this epidemic can be checked before it is too late. Acceptance of the problem, awareness of general public, training of staff and accountability of concerned are some of the steps required to curb further spread of this epidemic.  Creating a stigma among people just to shun away from responsibility is criminal and surely not a solution.  Let us pledge on this World Hepatitis Day to work towards controlling the further spread of hepatitis C infection as prevention is always better than cure. The state and health authorities need to take appropriate steps to help those who have already tested positive and stop further spread of infection.