Health : How Prepared is India?

India needs to do a lot of homework to face a potential Ebola outbreak.

After creating mayhem across West African region, Ebola has finally reached India. The issue needs immediate attention and priority in terms of combating against the lethal disease, seeing its devastating effect in past few months. Today, even if some of the 45,000 Indians living in the affected West African regions started coming back to India, there could be a potential crisis at hand. The challenge for India gets tougher in view of the fact that it still does not have any verified medicine or vaccine for treatment. We also need not to forget that India is a hugely populated country with inadequate public healthcare systems to face the outbreak.
The frightful Ebola Virus Disease (EVD) primarily affected Guinea, Liberia, Nigeria, and Sierra Leone. Earlier, out of 15,145 cases reported, 5,741 deaths occured across the globe, making it the largest Ebola outbreak ever recorded. World Health Organization director-general Marga-ret Chan said that this Ebola outbreak is the largest, most severe and complex ever seen in the 40-year history of the disease. After the disease took a dreadful toll across Guinea, Liberia, Nigeria and Sierra Leone since March 2014, WHO declared Ebola epidemic an international health emergency.

The death toll currently stands at 6,928, according to the UN health agency, with the total number of people infected with the virus surpassing 17,000. Initially, two suspected cases were found in India too, but they turned out to be negative. However, recently an Ebola positive case has been found and registered in India. Indian government recently found a 26 year old Indian man, who landed at Delhi airport from Liberia on November 10, with a certificate from the Liberian government stating that he has been cured of Ebola. The person was immediately taken to the isolation zone established by the Ministry of Health at Delhi Airport for Ebola suspects. Although his blood samples turned out to be negative for Ebola, his semen samples were found positive on 17 November. It indicates that the virus is transmittable for next 90 days and hence the Indian authorities kept the person under observation.
For a hugely populated country like India, it poses a potential challenge in terms of equipping its entire health care system to fight against the disastrous disease, providing immediate and holistic help to people across the country, developing and establishing a network of local, state-level, national and international agencies to ensure comprehensive civil defence, and most of all, arranging funds for the required facilities. Creating general awareness about the disease is also crucial-It can help in avoiding a panic situation across the nation, which can obviously occur in lack of primary information about the EVD.
First of all, we all need to understand about Ebola. Ebola Virus Disease (EVD) is basically a severe and fatal illness in humans caused by genus Ebola virus, which comprises of five distinct species. The name of the disease is based on the Ebola River in Zaire, where the virus emerged for the first time in 1976. The virus is transmitted to humans from wild animals and later spreads through direct or indirect contact of body fluids in humans.
Now, the second significant question occurs, how Ebola is transmitted. The Ebola infection transmits from human to human through direct contact of body fluids such as blood, secretions, semen and organs of infected people. However, the disease can also be transmitted through indirect contact with environments contaminated with such fluids. The incubation period of the infection is 2-21 days after which the virus starts showing its symptoms. The symptoms include acute viral illness and weakness, musclepain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver dysfunction, and in some cases, both internal and external bleeding. Low white blood cell andplatelet counts might also follow as per the laboratory reports.
Now the most important question occurs, how Ebola can be treated. Here the most potential challenge lies. Unfortunately, despite the fact that Ebola is not a new or artificially produced virus, it does not have any verified vaccine or other medicines available for its treatment. Although after analysing the need of the situation WHO allowed organisations and health authorities to use untested drugs and vaccines, the results have not been satisfactory. First of all, such untested medicines and vaccines pose another challenge of unknown side effects, and then they cannot be considered completely efficient. For example, Zmapp, the experimental drug being used to treat Ebola has so far shown mixed results. Also, limited availability of such medicines or vaccines poses another challenge of meeting the vast demands. Although various international organizations, drug manufacturers and researchers are working to develop efficient and proven vaccine and medicine for Ebola, WHO has stated that an efficient Ebola vaccine would be developed and released by early 2015.
In light of all such limitations, Indian authorities have made few significant arrangements to fight against the deadly disease. According to former Union health minister Harsh Vardhan, “the health ministry is providing technical and material support to states for preparing health facilities with dedicated isolation in wards, enabling them to provide diagnosis, treatmentand care, and infection control under proper guidelines.” He further emphasized that India has an efficient surveillance program running and it is fully prepared to deal with any eventuality.”
Seeing the looming threat, Indian health officials have set up a process with the help of the Ministry of External Affairs to identify the passengers who have recently travelled to the affected countries and screen them at the airport itself. A list of all such passengers is sent to the concerned local health divisions, which then track and monitor the health of the suspect for a month. Indian government has also made provisions of stringent surveillance and is conducting detailed medical examinations of high-risk passengers, including checking their travel history, taking their body temperature and placing suspects under isolation.
The Ministry of Health and Family Welfare has also published guidelines for EVD, Frequently Asked Questions (FAQs) and WHO Statement on its website and can be reached out by clicking the link: http://mohfw.gov.in. Also, a control room has been established where people can call to get medical help immediately. The numbers are 23063205, 23061469 and 23061302.
According to Union home secretary Anil Goswami, stringent screening checks are executed across all immigration points at air and seaports. A health screening card and advisory is also prepared for passengers. Information is being collected from the passengers arriving from or transiting through the affected countries.The authorities have also been asked to make inflight announcements regarding the virus and its symptoms.
Prime Minister Narendra Modi also discussed Ebola on priority with US President Barack Obama during his US visit. Both countries have agreed for mutual cooperation and collaboration to fight Ebola.
An advanced public health system equipped with better health care facilities, innovative techniques for diagnosis and treatment of the disease and adequate supply of vaccines/medicines to meet huge demandsis the need of the hour, but it’ll need immense funding and continuous efforts.                                                            

Anshu Joshi (The writer is a Hyderabad based freelancer)

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