In recent history, India fought and won several public health crises. Always, the health emergencies posed enormous challenges to the people who faced them. But the calamities helped bring tangible changes in the way we live and work. Here’s an analysis.
From Black Death to Covid-19, several pandemics and epidemics ravaged India over the past many decades. Yet, along with the devastation they triggered, the health scares helped bring in a rethink in policies, social behaviours and even cultural practices. Already there’s a debate raging on how our fight against the coronavirus is going to change the way we make policies, live and work as a collective and perform duties as individuals. And there’s consensus that the changes are going to be strong and sustainable.
Just look at how the Nipah virus outbreak changed Kerala in 2018. It had led the state administration to take tough measures to curb the spread of the disease. As a result, it was successfully contained, with just 17 fatalities. The government implemented a bevvy of measures, from restricting the outdoor movement of vehicles to banning large gatherings. Kerala also initiated mass awareness campaigns. Civil society groups, local government and community leaders came together to work towards eradicating the virus. By June 2018, the outbreak was declared to be fully contained. Soon, the government set up new virology institutes to study similar viruses. Evidently, the experience helped Kerala tackle Covid-19 better.
What are the other similar events in the history of India, and what did we learn from these emergencies? Let’s take a look.
In 1896, the bubonic plague arrived in India via trading ships from China. Soon it would kill nearly 1.2 crore people. The disaster prompted the British to draft the Epidemic Disease Act of 1897, which would define the country’s pandemic response for many generations to come.
In 1918, one of the deadliest pandemics in recorded history happened — the Spanish flu, a deadly strain of the avian influenza virus. This was a period when World War I was on. The war turned out to be one of the major reasons why the disease spread like wildfire throughout the world. The mass mobilization of troops helped the virus to replicate itself and infect a vast population. In India, the virus was brought home by the returning troops who took part in the war.
The Spanish Flu was contained soon through a series of measures but it had claimed 1-2 crore lives by then. It introduced important changes to the Indian society. Healthcare became an important component of the Raj’s policies; better hygiene practices were introduced; and, above all, introduced the basic lessons of social distancing to the people here.
During 1968-1969, an epidemic of flu engulfed the entire world along with India, killing nearly 10 lakh people worldwide. It emerged in Hong Kong and was a strain of the influenza A virus. In 1974, smallpox started spreading in India. It hit Bihar, Odisha and West Bengal and resulted in the death of 15,000 people. But soon, within three years to be precise, smallpox was eradicated from India – in April 1977, it was confirmed that smallpox was fully eradicated from India.
Plague and after
In 1994, the city of Surat in Gujarat was hit by the pneumonic plague. Within two days, nearly 2 lakh people fled the city fearing the disease. In total, 1,232 people were infected and 56 lost their lives. This led to a lot of changes in the city’s administration, which took notice of the poor drainage system, heaps of garbage littered on the street, and the congested slums. The administration took measures to improve the urban infrastructure. In 1996, just two years after this, Surat was declared the cleanest city in India.
In 2006, there was an outbreak of dengue and chikungunya in India. Cases were reported from all across the country. Chikungunya was mostly limited to the southern states. Over 3,000 cases were reported and nearly 60 people died. Then came the dengue wave; 12.5 lakh cases were reported and 3,000 people lost their lives. The government roped in Navin Khanna, one of India’s top experts in infectious diseases, to develop a test for efficient screening. One of the major hurdles during the epidemic was that accurate tests would take weeks, and by then the patient would have lost valuable time and health (life) in many cases. By 2011, Khanna and his team of scientists developed ‘Dengue Day 1’ which could identify dengue within 15 mins. This proved to be pivotal in the fight against dengue.
Efforts, lack of efforts and health scares
Thanks to such efforts and the enhanced focus on communicable diseases, in 2008, the Centre took steps to deal with infectious diseases more successfully. It reorganized the National Institute of Communicable Diseases (NICD) to form the National Centre for Disease Control (NCDC).
In 2009, another outbreak occurred in Gujarat. It took place due to the mixing up of used and contaminated syringes. The disease was hepatitis B. Mass immunization was done to stop the spread and public awareness campaigns were held; 125 people were infected and 49 people died when the disease was declared over.
During 2014-15, an outbreak of jaundice hit Odisha. It was primarily due to very poor drainage facilities. In total 400 people were infected and nearly 50 died. During 2014-15, India also faced an outbreak of Swine Flu. Multiple states were affected. Towards the end, India had 33,000 cases and 2,000 people had lost their lives. The government undertook massive awareness campaigns for self-precautionary measures.
In 2017, India faced an encephalitis outbreak in two states. Both Uttar Pradesh and Bihar lost 1,300 children to this disease. Later, it was found that both government negligence and shortage of oxygen supply led to this dire situation, especially in UP.
Covid-19 and its impact
Today, Covid-19, which has claimed over 2 lakh lives so far in India, has pushed the country into a critical phase. Like most pandemics and health emergencies, which occur due to unchecked human intervention with natural processes, Covid-19 also calls for concise and sustainable measures in order to contain it. Already, the pandemic has brought in key changes in the form of better hygiene facilities, better waste disposal methods, better sanitation and city planning. These are very broad and have been applied to a varying degree of success across the country.
The health crisis has also shown that the emergency response system has to be kept well oiled, in order for a quick, and timely response. Delays make matters worse, puts more pressure on the system, and people pay a great price for laxity. Not just strategy, but logistics is also crucial at a time like this. The jury is out on whether we have learned the right lessons from the crisis. Our policy responses, especially from the Centre, suggest we’ve a long way to go.