Malaria has been a problem in India for centuries. According to 2014 WHO report, there were 1.6 million confirmed cases of malaria in India and 400-1000 deaths annually.
The biggest burden of malaria in India is borne by the most backward, poor and remote parts of the country, with >90-95 per cent cases reported from rural areas and <5-10 per cent from urban areas; however, the low malaria incidence in urban areas may be due to almost non-existing surveillance. From 2013 to 2014 the number of deaths due to malaria has increased from 400 to 600.
On World Malaria Day, which is observed on April 25, Curofy- India’s largest community of doctors conducted a poll asking doctors what they think is the main culprit behind malaria related deaths in India lack of awareness, lack of health care services in rural India, incomplete treatment or unhygienic living conditions.
Out of 1300 doctors who participated in the poll, 32 per cent said that increase in deaths due to malaria is because of unhygienic living conditions. Malaria is a vector borne disease which proliferates in unclean places with standing water. With open sewage system and non-existing waste disposal in our country, spreading of diseases due to filth is unsurprising.
“There is only so much that the government can do,” said Dr PK Jha, senior consultant, internal medicine, Medanta. “People have to take care of themselves also like keeping their surroundings clean. Self-prevention is the best way to beat malaria. Wearing long sleeved clothes, using mosquito nets and repellents in the peak seasons are small things that keep in check the spread of malaria.”
23 per cent of the physicians said that the deaths are due to lack of healthcare in remote pockets of the civilisation. In a country where there is only 1 doctor for 1700 people, physicians have adequate demand in a city close to all the amenities. But there are very few doctors who practice in rural areas where it is actually needed. This has created a shortage of healthcare services in remote areas.
Indian population is also largely unaware of the spread of malaria and ways to tackle it. 26 per cent of the doctors supported this saying that the cause of these deaths is lack of awareness.
Commenting on this Dr Shailesh Sahay, senior consultant internal medicine, Max Gurgaon said, “Most of the people know that malaria is caused due to mosquitoes but they don’t know how it presents itself. If the patients is living in an endemic area or has been to an endemic area and contracts fever he/she should contact the nearest physician within 24 hours. Late detection leads to complications which can affect the vital organs.”
Only 18 per cent think that incomplete treatment which leads to drug resistance is the culprit behind malaria related deaths in India.
The government has come up with many schemes including Swacchta Bharat Abhiyan and an active programme to stop open defecation. With time we will know how successful and effective they have been.