Mugwari (Sidhi), Madhya Pradesh

Jangali Kanhar’s wife and their younger son are both running high fever for the past several days. However, the daily wage labourer from Mugwari village, is yet to take them to a hospital for a check-up and medication. 

“Sab ladkiyan baccha bimar hain (All girls and kids are sick). Everyone in my family is sick. My younger son and his mother still have fever,” Kanhar told Gaon Connection. “I took them to a private doctor, Bengaliva, who gave some medicines, but there has been no improvement in their condition,” he lamented. “Being poor, I can’t afford to take my wife and son to the hospital in Sidhi, which is nine kilometres away,” the worried villager, who earns a daily wage of Rs 150-200, added.

Like Kanhar’s household, members of several other households in Mugwari village of Sidhi district in Madhya Pradesh, are sick due to high fever. In Kanhar’s mohalla alone, which has 15 households, at least 30 people have reported ‘fever’ and related ailments in the past 10 days. 

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However, rather than visiting their primary health centre (PHC) or district hospital in Sidhi, these villagers are completely dependent on Bengaliva, a local term for quacks or rural health practitioners, for treatment. Often, the medicines provided by Bengaliva provide little relief, but villagers claim they have no other option as government rural health infrastructure is non-existent. 

These reports of house after house in villages suffering high fever and not seeking proper treatment is worrisome because dengue cases are on the rise in Madhya Pradesh. As per official data, the state has reported no less than 2,500 confirmed dengue cases and at least five deaths due to the mosquito-borne disease. 

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On September 13, Jabalpur was reportedly the worst-affected district with 498 confirmed cases of dengue, 254 such cases were confirmed from state capital Bhopal, and 225 dengue cases were recorded in Indore.

The central government has also taken note of the dengue outbreak in Madhya Pradesh and recently the Union health secretary wrote to 11 states, including Madhya Pradesh, on the rising dengue cases and deaths. The other states include Andhra Pradesh, Gujarat, Karnataka, Kerala, Uttar Pradesh, Maharashtra, Odisha, Rajasthan, Tamil Nadu, and Telangana. 

The rural health system, which has just about recovered from the onslaught of the second wave of COVID-19 pandemic, is once again getting burdened by the rising ‘fever’ and other vector-borne diseases.

“It is true there has been an increase in viral fever cases. The number of patients admitted to hospitals exceeds their capacity. As a result of an inadequate number of beds, we are having to treat patients on the floor,” IG Gupta, Chief Medical Health Officer (CMHO) of Sidhi, told Gaon Connection. 

Ill-equipped PHCs; quacks provide treatment

Mugwari village, which is in the grip of a viral fever outbreak, has a primary health centre (PHC), but only on paper, complain the local residents. Hence, they have to depend on Bengaliva for all types of ailments.

“No doctor is ever available in the svasthaya kendra (health centre). Koi doctor-voctor nahi aata wahan (no doctor comes there),” Rampal Rawat, a rickshaw puller and resident of Mugwari, told Gaon Connection. “Whenever someone is sick, we take the patient to Bengaliva, three kilometres away from our village. The nearest government hospital is nine kilometres away,” he added.

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In the same village, Gaon Connection met Ramshiromani Rawat, whose family members were also down with fever, and he had taken them to Bengaliva. On being asked if the health centre in their village functions and has any doctor, he said: “Kabhi nahi (never).”

Similarly, Foolmati Kanhar, who was also sick with ‘fever’, told Gaon Connection that Bengaliva, the local jholachap ‘doctor’, had provided her some medication but there’s little improvement in her condition. “I need to go to the district hospital, which is situated nine kilometres away but there’s no other option,” she said.

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Three members of Shubham Singh’s family in Mugwari are sick due to high fever for the past few days but are yet to receive proper treatment. “We took them to Bengali and got some medicines, but they are still not completely fine. So, we will take the sick family members to Sidhi hospital in a day or two,” Singh told Gaon Connection.

Meanwhile, the fever that has spread in Mugwari may not be a regular viral fever alone. The ASHA (accredited social health activist) from the Mugwari  village told Gaon Connection that in a population of almost 400 people, no less than 30-40 people were showing dengue-like symptoms. 

‘Bengaliva’ — affordable and accessible 

“Bengaliva charges bees rupaye (twenty rupees) for a checkup and prescribes low-cost drugs, but commercial hospitals charge Rs 200-Rs 500 for a checkup and hospital-recommended medicine is quite expensive,” Rampal Rawat told Gaon Connection.

“Sometimes, the medicines given by Bengaliva react badly and we have to face the side-effects too but that’s a risk we take as we simply don’t have the money to afford private hospitals,” he added.

With rampant poverty, rural healthcare facilities in shambles and lack of education, superstition also runs deep amongst the villagers and they resort to getting treated by quacks who practice black magic. 

Ramshiromani Rawat, a farmer and Rampal’s 56-year-old neighbour, said he was a staunch believer of the ojha (quack). 

“Jab bhoot lagta hai toh daaktar k paas jaane se theek nahin hoga. Baba hi theek karte hain (If evil spirits have possessed the body, the doctor is of no use. Only a quack can come to rescue),” Ramshiromani gleefully told Gaon Connection. 

No lessons learnt from the second wave?

During its visit to the affected village, Gaon Connection learnt that the sub-health centre, which is supposed to provide healthcare to Mugwari along with Madwa and Tedwa Tola villages, did not have any doctor and the position was vacant. The health centre, which is designed to serve as many as 2,000 villagers, is run by a single nurse who, the villagers informed complained, ‘rarely’ comes to the centre.

Nityanand Mishra, a health activist and Rewa-based lawyer who practices at the Jabalpur High Court, told Gaon Connection that the traumatic experience of rural India during the second wave of COVID19 has been forgotten and the rural healthcare system hasn’t been strengthened.

“A lack of basic infrastructure prevents doctors from staying in Sidhi. They don’t go to rural areas as even district hospitals won’t provide proper accommodation,” the health activist said. 

“In the health department, many vacant posts are not being filled, and the government is not showing any interest in filling them. During the second wave, the health department hired so many people on a contractual basis and now when COVID is under control, they have all been dismissed,” Mishra said.

Also Read: Firozabad echoes with the wails of grieving mothers whose children succumbed to a mystery fever

Meanwhile, health workers warn that both dengue cases and fever cases are on the rise in Madhya Pradesh.

A doctor at Sidhi district hospital, who did not wish to be named, said: “The number of patients has doubled since last month. The hospital administration is striving to treat, but due to a scarcity of physicians and beds, not everyone can be treated.” 

Radhakishan Gupta is a private practitioner who runs a clinic in the Kuchwahi village, about 1.5 kilometres from Mugwari, told Gaon Connection that the number of fever patients had risen dramatically in the past few weeks. 

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“Earlier, I used to get between 10-15 people per day but now 30 to 40 people visit on average. Most of them suffer from viral fever,” the private doctor said.

Government response 

Meanwhile, dengue prevention efforts are underway in Sidhi and the district’s malaria officer Hariom Singh told Gaon Connection that so far, three confirmed cases of dengue have been confirmed in the district.

“We’re keeping an eye on things and will conduct (blood) testing as needed. Dengue mosquitoes breed in clean water such as the water left in tyres, coolers, and open tankers. It is the people’s responsibility to get rid of the open-sources of dengue larvae,” he said.

Also Read: With no tests and no treatment, people in rural India are dying of COVID-like symptoms