Civil Surgeons and other senior health officials from districts of Jharkhand had a day long review meeting at RIMS on Wednesday. The meeting was chaired by state Health Secretary K. Vidyasagar. Other senior officials of the state's health department were also present including the Director of RIMS, NRHM etc. State Health Minister Rajendra Prasad Singh, addressing the senior health officials said that all out efforts should be made to improve health facilities in rural Jharkhand. source-ranchiexpress.com
Malaria without fever, its most obvious symptom, is baffling patients and healthcare experts in Jharkhand alike, Rajendra Institute of Medical Sciences (RIMS) doctors have reported.
Cases of dormant malaria without any of its known symptoms are occurring in the southern belt of the state. Some 200 patients from districts like Khunti, Simdega, Gumla and West Singhbhum in one year, complaining of repeated diarrhoea, leg cramps and even jaundice were diagnosed with malaria despite their not exhibiting classic symptoms of high fever and chills.
"In June 2012, over 50 jawans who had been engaged in Naxalite combat in Saranda came to us. They didn't have fever but complained of unease, headache and nausea. Initial pathological tests did not reveal much. As symptoms did not subside, a series of clinical tests confirmed malaria," RIMS director Tulsi Mahto told The Telegraph.
Usually, malarial symptoms flare up between 10 days and four weeks of the infection. But not always. Mahto stressed the malarial parasite can stay dormant inside the human liver for four years without showing symptoms.
"Ever since we treated the Saranda jawans, the RIMS administration has been given standing instructions to check the presence of the vector-borne parasite among patients from Jharkhand's southern districts," he added.
Recently, the Khunti double tragedy was a copybook case of malaria with suppressed symptoms. This April, the deaths of two minor trafficked girls from Khunti — Jaymani Gudia and Jyoti Mariam Horo — caused a sensation when even their autopsy reports could not clarify the reason. Finally, forensic reports divulged both girls were suffering from malaria.
State malaria officer P. Baskey explained how malaria could occur without fever.
"A person's immune system may sometimes suppress the full-blown symptoms of the disease. In some cases, parasites Plasmodium vivax and Plasmodium ovale can remain dormant in the liver for several months up to about four years after a person is bitten by an infected mosquito. When parasites emerge from hibernation and invade red blood cells, we term it relapse," he said.
Baskey said that those in malaria-prone areas reporting cramps in legs, headache, minor cold and cough or even dizziness should go for proper clinical investigations.
"If it is malaria and is undetected for a long time for lack of proper diagnosis, it causes much internal harm to the patient," he added.
Last year, the London School of Hygiene and Tropical Medicines, UK, in association with National Institute of Malaria Research, New Delhi, started a study in Gumla and Simdega on malaria among pregnant women.
Researchers confirmed they came across no less than 30 women who exhibited no malarial symptoms. Amazingly, the women never complained of ill health. "But, they tested positive for the malaria parasite after series of clinical tests," said a research fellow.
Neena Valecha, the director of the New Delhi institute, and Irene Kuepfer, her London-based counterpart, told The Telegraph that the research would continue for three years.
"We can comment on the findings only after the full tenure," Valecha said. source-telegraphindia.com
The hospital dishes up food for over 1,000 patients everyday in a dirty kitchen without supervision. Hospital superintendent S.K. Choudhary, who made surprise kitchen inspections on August 12 and 14, didn't like what he saw.
On August 12, when Choudhary saw workers cooking mounds of food without supervised by nutrition experts, he reportedly asked the cook about their whereabouts. On August 14, when he made his second visit to the RIMS kitchen around 10.30am, he saw the situation was the same.
Then, Choudhary reported his concerns in writing to RIMS director Tulsi Mahto and health principal secretary K. Vidyasagar.
The report has caused a furore.
Speaker Shashank Shekhar Bhokta, who inspected the RIMS kitchen on Friday, has reserved his comments. Though RIMS director Mahto refrained from saying anything, health minister Rajendra Prasad Singh spoke candidly to The Telegraph.
"Even under manpower crunch, which has been put up before me as an immediate excuse for lapses, one can't compromise on hygiene. I will visit RIMS on Saturday and discuss with hospital authorities on how to improve the situation," the minister said.
The RIMS kitchen has some 15 employees, including cooks and helpers, who work on shift basis. Officially, there should be a dietician to instruct them on healthy cooking as well as a supervisor to monitor quality of food cooked as well as hygiene.
"I have observed some serious lapses and have pointed out the same in my report. This is an internal matter," Choudhary told The Telegraph. "We send inspection reports to seniors from time to time."
Being a part of the institution, the superintendent obviously didn't want to tom-tom his role as a whistleblower.
"This is a large institution and such gaps are often observed during inspections. We will improve conditions," he said, the unsaid message being "don't sensationalise it".
But the irony is that on August 16, the doors of the kitchen, which otherwise used to be open, were kept shut "for outsiders".
The Telegraph team found more lapses in food distribution at the four-storey hospital. Though officially RIMS has six trolleys for distribution of cooked food, only two or three are used.
When a trolley arrives at the respective corridors, nurses inform attendants of the patients concerned to go and collect food. Hospital staffers don't distribute food.
Sanjay Kumar, an attendant of a patient admitted in the surgery ward, said they all help each other unload food from the trolley. "Ideally, the food trolley should come to wards and be distributed by hospital staffers," he said. source-telegraphindia.com
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