The Riverine Areas of West Bengal

village-giripara.jpgResearchers from the Indian Institute of Health Management Research launched a report on the health situation of communities in the Sundarbans of West Bengal State yesterday. The According to the IIHRM team, led by Dr Barun Kanjilal, Sundarbans are a unique bioshpere of islands of mangrove forests in the river delta just south of Kolkata in West Bengal State, India.

The study conducted as part of the Future Health Systems Consortium examined the health and health care situation of the over 4 million people living on 54 of the 102 islands in the Sundarbans. Some of the key findings on health status include –

  • General morbidity rate is higher that the state average
  • There is a mixed burden of communicable (e.g. diarrhoea) and non-communicable diseases (e.g. coronary health disease) and injury (e.g. snake bite)
  • Mental health problems are higher than expected
  • Half of the children <5 years of age are malnourished
  • Women have a higher burden of disease than men

These health issues must be viewed in light of the findings on health systems –

  • Most care is delivered by informal providers known as rural medical practitioners (RMPs)
  • Utilization of maternal health care is low
  • Child immunization rates are lower than the state average
  • There are serious shortages of public health facilities and trained human resources

These conditions were worsened by the effects of Cyclone Aila.

dscn7031sm.JPGThe team recommends developing what they are calling Basic Health Guard Units (BHGU) at the village level, which includes improving the skills of RMPs who were frequently found to prescribe inappropriate and even harmful medicines. In particular the BHGU should provide appropriate and timely treatment for common communicable diseases such as diarrheal diseases, respiratory infections, kala-azar and malaria.

India generally and West Bengal specifically are not highly endemic for malaria, which is usually seasonal.  Malaria deaths may be decreasing but continue to occur. Outbreaks result “from weaknesses in malaria control measures and a combination of factors, including vector breeding, low implementation of personal protection and weak case detection.”

Even in low endemic areas vigilance is needed to prevent, detect and treat malaria if elimination is going to happen.  If these proposed BHGUs bring better malaria diagnosis and treatment to the grassroots – or in this case the mangrove roots – West Bengal will be closer to eliminating malaria.

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