Hepatitis C has spread its fangles in Foos Mandi village and other areas of Mansa district but the Health Department seems to be unaware of the alarming situation there. DailyPost Special Correspondent Simranjot Makkar did a ground reality check and found that the situation is worse than expectation. He shares the observation on the enormity of the problem:
A couple of years after all the members of his family were diagnosed positive for Hepatitis C, Roshan Lal is still deprived of the treatment needed to cure the ailment. Once a carpenter by profession, he is now a MNREGA labourer who barely can work as his legs swell and he finds it hard to stand on his own.“My wife, my son and I, all three of us are suffering from Hepatitis C, I left my work and now I hardly earn anything, life is no less than hell for us”, said Lakhwinder.
The 40 year old big hearted man is afraid of nights, as the unbearable pain doesn’t let him sleep. “My wife ice-messages my legs for an hour which relieves my pain and I sleep for an hour, then I get up and do the same to my wife so that she can get some sleep. It continues the whole night, these nights haunt us”, said Roshan.
Roshan and his family are among the latest cases of Hepatitis C patients in the village where 70 per cent (according to the villagers) of the people are said to be ailing from the disease. Foos Mandi, a small village of population of over 1200, near Sardulgarh of Mansa district has been suffering from the disease for over past two decades; unfortunately the administration continues to sleep. But the working class and agricultural communities are bearing the brunt of this complex crisis, one that involves lack of political will and resources.
Balwinder Singh, Husband of Davinderjeet Kaur, Sarpanch of village Foos Mandi, himself is suffering from the same disease. His brother died of the same affliction a few years ago. “Every other home of our village is affected by this disease, causing deaths of many, I think around 90 per cent of the people in our village are positive, only the ones who haven’t got themselves checked are safe, they too will face the reality once they get themselves diagnosed”, claimed Balwinder.
The incubation period for Hepatitis C is two weeks to six months. Following initial infection, approximately 80 per cent of people do not exhibit any symptoms. Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomitting, abdominal pain, dark urine, grey-coloured faeces, joint pain and jaundice.
The following list provides a limited example of primary prevention interventions recommended by WHO: Hand hygiene: including surgical hand preparation, hand washing and use of gloves; Safe handling and disposal of sharps and waste; Provision of comprehensive harm-reduction services to people who inject drugs including sterile injecting equipment; Testing of donated blood for Hepatitis B and C (as well as HIV and syphilis); Training of health personnel; Promotion of correct and consistent use of condoms.
The standard of care for Hepatitis C is changing rapidly. Until recently, Hepatitis C treatment was based on therapy with interferon and ribavirin, which required weekly injections for 48 weeks, cured approximately half of treated patients, but caused frequent and sometimes life-threatening adverse reactions.
Recently, new antiviral drugs have been developed. These medicines, called direct antiviral agents (DAA) are much more effective, safer and better-tolerated than the older therapies. Therapy with DAAs result can cure most persons with HCV infection and treatment is shorter (usually 12 weeks) and safer. Although the production cost of DAAs is low, the initial prices are very high and likely to make access to these drugs difficult even in high-income countries. Much needs to be done to ensure that these advances lead to greater access to treatment globally.
Whole belt around Ghaggar suffers
Foos Mandi is not the only village near Sardulgarh where the prevalence of Hepatitis C is so high. The whole belt around the Ghaggar river is suffering from the same disease for almost two decades, or even more. Aahlopur, Lohgarh, Veera Badhi (Haryana, prevalance is as high as in Foos Mandi), Meerpur, Bhagwanpur Heengna, Sadhuwala all lie in the same basket.
A study conducted by PGMIER, Chandigarh, has revealed that the prevalence of Hepatitis C in Punjab is almost 7 per cent as compared to national prevalence of 2.9 per cent, but according to the survey conducted by Paryaas Welfare Charitable Trust, the prevalence in these villages is as high as 40 per cent, which is not only alarming but is fatal too. An old lady, sitting on the edge of a Charpai (cot), with moist eyes waiting for a message from her son Kuldeep as his 25-year-old pregnant wife Sukhwinder Kaur of SaduWali village is admitted to Rajindra Medical College and Hospital Patiala. Kuldeep is a labrourer and earns around Rs 200 a day. Family claims that her chances of survival as per the doctor are very faint; the couple has a 2.5-year-old daughter and she is into her 9th month pregnancy.
Most of the youth of the village run away from getting themselves checked, and a phobia of being diagnosed positive has overpowered the whole village. Jatinder Kumar, a student of Class XII of Government Senior Secondary School Sardulgarh, feels the same. “I don’t want to get myself checked because I know I will be diagnosed positive and then I won’t have the courage to live with it, It happened with my brother, It will happen with me”, he said. The elders of the village have a different perspective to the problem. They claim that it is hard to get their children married once they are found positive, so it is better not to get them checked. On the other hand, Most of the people who already are suffering from the disease hardly have any money for the treatment, citing this as one of the other main reaons. Economically weaker, the villagers don’t want to get themselves checked.
Costly treatment has been an undeniable burden for most people in this agriculturally rich but poverty-stricken region. According to Balwinder Singh, he spent Rs 3.5 lakh on the treatment , in which he got 14 injections of Rs 14,000 each, which for a poor man is unaffordable. Many NGOs and sometimes Health Department have organised medical camps but of no use since these camps only diagnose the patients and the patients are asked to approach private hospitals for treatment. According to officials of Health Department, the treatment has been advanced and they no longer use injections for this treatmenr, however some medical stores and doctors do exploit the patients which cannot be denied but the new treatment purely includes tablets and they cost around Rs 30,000.
Free treatment in civil hospitals
In what has come as a sigh of relief for the people of the whole Mansa district, the Punjab government announced to treat Hepatitis patients free of cost in the civil hospitals from June 17. It would be most helpful for the poeple of Mansa district as the prevalence of Hepatitis C patients is far more than that of the state Survey by an NGO
In a survey conducted by Paryaas Welfare Charitable Trust in 2014, out of 473 samples collected from six villages of Sardulgarh, which included Foos Mandi and Ahloopur villages, 183 were found positive. According to Kaka Uppal, president of the NGO, almost 38 per cent of the people from Sardulgarh are found positive. “Prevalence of Hepatitis is high in this belt because of use of infected needles and surgical instruments by quacks and unqualified dentists, contaminated water which ultimately leads to dental problems”, claims Uppal.
Root cause according to villagers
Everyone living around the Ghaggar belt has an opinion that the root cause of the disease is the contaminated water which flows in the Ghaggar river, on whose banks these villages are situated. Villagers of Foos Mandi have no different opinion. Villagers get the drinking water from the water works supply, which has a deep 450 feet bore to provide water to the village, whereas the villagers demand the water to be supplied from the distributaries (Nehri pani) to them. The water supplied in the village is not portable as heaps of muds and other dust particles can be seen with naked eye. The contamination is such that taps of many houses got blocked and most of the storage tanks got filled with mud and other particles.
Health Dept’s carelessness/ denials
Sprinkling the salt on the burn, the Civil hospital of Sardulgarh, denies admitting the fact and claims it just to be a rumour. According to Dr Sohan Lal, who holds the charge of senior medical officer, denies of having any record of Hepatitis C patients survey but claims to have conducted medical camps in the nearby villages of Sardulgarh. Being unable to answer the questions of Daily Post, he called a private lab technician Parmod Kumar.
However, Dr.lal claimed that according to medical science contaminated water cannot be a reason for Hepatitis C, sharing drugs and needles, being stuck by infected needles and having sex, specially with a person who is HIV infected or has STD can cause Hepatitis C. He also claimed that on a birth of a child, a mother can pass it too but the chances are as less as 3-4 per cent. He said that contaminated water can cause other Hepatitis but not C, so Ghaggar cannot be blamed for it, whereas Kaka Uppal, preisdent of Paryas Welfare counterfeits Dr.Lal stating that when only the villagers drink contaminated water, they face dental problems which eventually lead them to Hepatitis C
The attitude of the Health Department in dealing with the situation does not result merely in poor care on occasion, it results in denial of care itself. The villagers not only blame the Health Department of being careless but they feel that the NGOs and other trusts whichclaim to have helped them organise medical camps have actually looted them. Rimpy Brar, a resident of Sardulgarh, claims that rather than organising free check-up camps, these NGOs should run free treatment camps. He allegedly said that these camps where free check-ups are done, eventually land up the patient with private doctors advised at these camps who have tie-ups with these NGOs, ultimately resulting in exploitation of the poor patient. “There are many poor farmers who got themselves checked from these camps, they were sent to private doctors in Bathinda where they were asked for Rs2-3 lakh for the treatment. Since the patients did not have that amount of money, they took loans from local lenders, and rest is known to all of us”, said Brar.
Hepatitis C (according to WHO), key facts
Hepatitis C is a liver disease caused by the Hepatitis C virus: the virus can cause both acute and chronic Hepatitis infection, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness. The hepatitis C virus is a bloodborne virus and the most common modes of infection are through unsafe injection practices; inadequate sterilisation of medical equipment; and the transfusion of unscreened blood and blood products.
130-150 million people globally have chronic hepatitis C infection.
A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer. Approximately 5,00, 000 people die each year from Hepatitis C-related liver diseases. Transmission injecting drug use through the sharing of injection equipment; in health care settings due to the reuse or inadequate sterilisation of medical equipment, especially syringes and needles; the transfusion of unscreened blood and blood products; HCV can also be transmitted sexually and can be passed from an infected mother to her baby; however these modes of transmission are much less common.
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