AES health crisis in Bihar:
- Bihar has seen deaths of over 150 children in Bihar from Acute Encephalitis Syndrome (AES) this year.
- Most critical analyses of AES handling in Bihar have found serious faults with the state’s healthcare system.
- The sudden outbreak of AES, along with the weak medical infrastructure, ignoring preventive measures and other healthcare programmes, worsened the AES impact.
A draft administrative framework to deal with medical health emergencies:
- There are examples where states in India have taken the primary healthcare seriously, and followed up on preventive healthcare programmes comprehensively.
- States like Bihar can learn from their example.
- Some of the the inadequacies in healthcare could have been offset, even compensated for, by rapid administrative action.
Declare a public health emergency:
- The first step should be to declare a public health emergency within the affected region with immediate effect.
- This would mean that the state healthcare and other concerned agencies, including the district administration and disaster management authorities, will pool their minds and resources.
Constitute a Group of experts:
- A group comprising representatives from such organizations should be constituted and be headed by a dedicated administrative officer with the requisite expertise and experience.
- The Group will be a largely autonomous body with defined administrative and financial powers.
- This Group will come into operation within 24 hours of the declaration of the emergency.
- It will take full control and responsibility for ensuring prompt life-saving medical services, including essential nutritional supplements.
- It will take necessary decisions and coordinate efforts, including putting in place research work, and additional infrastructural support from within the state and outside it.
- Mandate: The Group’s mandate will be all-inclusive, which includes:
- Dissemination of information (by means of the media and field health workers) on the disease
- Raising general awareness on government nutrition and hygiene programmes
- Taking precautionary measures
- Obtaining and sharing of diagnosis-treatment protocol
- Taking feedback on the treated patients
- Disbursal of compensation to the unfortunate victim’s entitled kith and kin speedily.
- Blueprint for vulnerable areas:
- A blueprint of the suggested administrative mechanism can be kept ready by each state, with various functionaries nominated and notified. This can be done in districts with a poor public health record.
- The Group will conduct periodic mock drills in a professional manner, particularly in more vulnerable areas.
- The Group must also organise frequent field visits to see all arrangements work flawlessly.
Reorganize working of the existing government hospitals to include privately-run units:
- Another significant policy measure would be to reorganise working of the existing government hospitals, particularly at the primary and middle level.
- As health centres across most states have adequate built up space and other infrastructure available, a part of the same can be leased to private hospital chains.
- Privately-run units:
- In normal times, these privately-run units will provide regular, on payment, healthcare.
- Indeed, such private medical centers with their enhanced medical capacities in place can be recognized and co-opted under the Ayushman Bharat Yojana.
- In health emergencies, these units can be commandeered to attend to the emergency.
- The reorganization of health centers, besides substantially adding to the existing health services at literally no cost to the government, will also help to generate a healthier work culture.
Monitor functioning of health centers:
- It is of utmost importance that the functioning of such reorganised health centres be closely and professionally monitored.
- They should also be monitored by the local community and panchayati raj institutions.
Fill medical staff vacancies with contractual appointments:
- It may also be useful to urgently fill the perennially existing vacancies at health centers.
- This can be accomplished in most healthcare institutions, particularly in remote rural areas, through the contractual appointment of doctors and para medical staff by from amongst retired personnel (both civil and military).
- India and its governance system must adopt fresh approaches.
- The ideas and models discussed above are practical and tested.
- A crisis like the AES outbreak is not merely a medical battle, it must be seen as an administrative mission.
GS Paper II: Governance