300 children die of Japanese encephalitis in Odisha's Malkangiri, govt "undermining" depth of disease: Top doctor

Dr Sylvia Karpagam

By A Representative
Dr Sylvia Karpagam, a well-known Karnataka-based public health doctor who works with marginalised communities, has claimed, quoting local activists, that more than 300 adivasi children have died in Malkangiri, Odisha, in the past two months due to the deadly Japanese Encephalitis (JE), as against just 32 deaths claimed by the state government.
These deaths, says Dr Karpagam, only suggest state government failure to responded to the emergency, adding, instead of fighting the disease, the government hired experts in order to “minimize” the responsibility of the government.”
Dr Karpagam, in an unpublished article distributed by the National Alliance of People’s Movements (NAPM), says, “Safe and effective vaccines are available to prevent JE”, and the World health Organization (WHO) has recommended that JE vaccination be “integrated into national immunization schedules in all areas where JE disease is recognized as a public health issue.”
Contending that the state government has not done anything of this kind, Dr Karpagam says, “Of those who survive JE infection, 20%–30% suffer permanent intellectual, behavioral or neurological problems such as paralysis, recurrent seizures or the inability to speak.”
Noting that the expert committee set up by the state government makes “no mention of how they went about ruling out JE”, Dr Karpagam wonders if it carried out “IgM Elisa tests on all the children”, and if yes then “what are the findings?”
The public health doctor says, “Confirmatory laboratory testing is often conducted in dedicated sentinel sites, and efforts are undertaken to expand laboratory-based surveillance. Case-based surveillance is established in countries that effectively control JE through vaccination.”
Dr Karpagam also wonders why the expert committee is blaming JE on the consumption of seeds of Bana Chakundi plant. He asks, “This plant is being eaten throughout the year and probably by all families; why are the deaths happening now?”
Insisting that five urine samples out of 121 children who died is “hardly evidence”, Dr Karpagam says, the committee, under Dr Jacob John, is “twisting facts” and “misrepresenting”, adding, “Without having the baseline data, this expert committee cannot make an absolute statement that some cases were due to diet induced encephalopathy and not as a result of JE.”
Referring to the suggestion of the expert team that that “children and their parents have to be advised not to consume raw Chakundi beans”, Dr Karpagam says, “Where is his evidence? To expect a community to break a long tradition, without adequate evidence and basis, amounts to abuse of expert position.”
Dr Karpagam queries, “Why has this expert group not made any comment on the state of disarray and dysfunction of the anganwadis in the area? Have they made any attempts to find out if these children have been receiving adequate foods?”
Meanwhile, an NAPM statement on JE deaths says, “We are indeed shocked that the ‘Team of Experts’ sent by the Centre has tried to absolve the Government of all responsibility by attributing the deaths to consumption of some local seeds (Bana Chakundi) and not to JE and governmental delay, thereby blaming the adivasis themselves for the deaths!”

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