The Hindu Business Line : Bitter medicine

People were bringing their loved ones for simple treatment like cuts and bleeding left unattended, as they were busy pulling family members and possessions from the debris. All it required was to wash the cut with a disinfectant and apply a cream. Simple things would have prevented infection. This was one place we felt we could have done more," recalls Dr Niraj Uttamani of his visit to Sakinaka, where recent rain-triggered landslides killed several people.

Dr Uttamani heads emergency services at Mumbai's Hinduja Hospital and it is ironical that a simple wound was left to fester due to lack of medication as Sakinaka is no remote corner of Maharashtra. It is just a stone's throw from Mumbai's bustling Sahar International Airport. The rains that lashed the country's financial capital on July 26 not only exposed the fragile infrastructure that its 18 million residents rely on. The succession of waterborne diseases and the numbers who succumbed also bared the megapolis' skeletal medical infrastructure.

The unprecedented rains left residents on edge, as a medical emergency knocked at their door. And the steadily rising death toll had State Government authorities in a flap; ill-informed reports of an epidemic did not help matters either. Finally, the "epidemic-clause" was invoked to tighten control over the report of water-borne illnesses.

But Mumbaikars were oblivious of the flood of tribulations that were to follow the deluge, when they doggedly waded through waist-high water. "Wading through the water seemed like fun," says Smita, a young professional who had got off early from work that day. Rainy days are part of a Mumbaikar's annual calendar. But Tuesday, July 26 was Mumbai's wettest day in 95 years and Smita would know of that only the next day. The four hours she waded through floodwaters may seem nothing compared to the 15-odd hours that other, less-lucky Mumbaikars endured as they battled flooded roads to get home. But even those four hours were enough to wreck havoc on Smita's health as she went down with high fever and body ache.

"It was when my bones started to ache that I visited a doctor, who said I had leptospirosis. I had a cut in my toe through which I got the infection," she recalls. Leptospirosis is a bacterial infection that affects humans and animals. It is caused by exposure to water infected by the urine of animals, especially rats. Smita was advised the antibiotic Doxycyclin but was annoyed to find that medical shops had run out of it. This medicine had to be replaced by a stronger antibiotic, Augmentin.

"There will be a 40 per cent shortage in the normal supply of medicines in the city and its suburbs," admits J.S. Shinde, a representative of the chemists and druggists fraternity across the country. And the most sought after medicines that were running dry were Doxycyclin, anti-fungal creams, tetanus injections and anti-infective metragyl tablets, he says. And this admission from the trade comes a good 10 days after the deluge of July 26/27.

Medicines were a major casualty of the rains, as warehouses at Bhiwandi on the fringes of the city got flooded. Virtually every big name in the drug industry stores its medicines at Bhiwandi. They now stare at more than Rs 1,000 crore worth of destroyed medicines and an even greater problem of disposing them. Companies are trying to shore up production and divert medicines from other regions to meet the city's requirements.

As more cases of dengue, leptospirosis and hepatitis A get reported with each passing day, doctors feel medical care and surveillance need to be intensified. In the days after the deluge, for instance, a senior citizen was forced to break her dialysis schedule, as hospital staff were unable to reach their workplace. A large number of people thronging different hospitals in the city were faced with inadequate medicines, beds and doctors.

Even the two mobile units that Hinduja Hospital despatched to some of the worst hit areas encountered several cases of dengue, leptospirosis, diarrhoea, skin infections, respiratory problems, viral fever, abdominal pain and skin lesions, says Dr Uttamani. "Sometimes in places like Borivili people came crying for food and water and not medicines. And there were also times when our ambulance got stuck in the marshy land and people came to help us," he recalls.

As Mumbai grapples with the medical emergencies raining on it, doctors stress the need for a coherent medical plan. To fan out services to people who cannot reach or afford hospitalisation. Sometimes even a simple message that a warm water bath with soap can keep away bigger infection can do the trick, says one doctor.

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