Fight the H1N1 flu with facts, not fear

My dear students, friends and colleagues,

The title “Fight the flu with facts, not fear” of this post is borrowed from an excellent report entitled, “To fight flu, facts not fear” (30 July 2009, Indian Express, Pune edition), written by Anuradha Mascarenhas, one of Pune’s outstanding journalists.

On Saturday, 8 August, we took our daughter for screening, since she had high fever for two days. I reached the municipal dispensary at 9.30 am. The Dr Dwarkanath Kotnis Memorial Municipal Dispensary, locally called Gadikhana, is located in the heart of old Pune city, near Mandai (the old market area). This was two days after August 6, the 64th anniversary of the dropping of the A-bomb on Hiroshima by the USA.

While waiting, I spoke with some civic employees. One of them was upset that some well-off people seemed to look down upon the civic dispensary. He felt rich folk wanted the government to allow private doctors and hospitals to treat the flu, because they did not want to mix with poor people and get treated in government hospitals. A rickshaw driver also told me that a lot of “shrimant” people, who were his customers, resented that they had to wait in queues at the govt hospitals.

This is a reflection of the sad state of public health in India. The rich have their private hospitals and the poor have to fend for themselves in govt hospitals. I have stayed in Britain and marvel as well as envy the wonderful National Health Service, which even the free-maketeering Thatcherites were unable to dismantle. This is a topic of debate and I want your comments on this point.

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When my wife and daughter arrived, we went to the first floor. There were around 50-60 persons waiting in two queues. One queue started near the staircase, at one end of the corridor. Here two clerks were issuing case papers. After you got a case paper, you stood in another queue to meet the doctor.

I did not go in, but my wife said the doctors were deciding, whether to take the throat swab or not and send you to Naidu Hospital for testing, on the basis of whether you had come in contact with a positive patient or you had certain symptoms.

So, on the basis of the screening, our daughter was sent home with some medicine. This “testing protocol” seemed inadequate. The next day, 7 August, I heard the government and doctors felt the H1N1 virus was getting “entrenched in the local community” and, therefore, anyone having the symptoms should be sent to Naidu Hospital for a throat swab and test. This is the proper way, but I do not know whether it is being done.

The other impression one gets is that the municipal doctors may not be sending you for the test because, they say, it is “expensive”. If you insist that a test be done, they tell you that the test costs Rs. 10,000 and not everyone who asks for it will be tested. This naturally makes people anxious. Fortunately, our daughter’s fever lasted for two days and has now subsided.

Deepthy Menon, Mumbai Bureau chief, Times Now, was also down in Pune covering the flu. I could not go to meet her, since I am a heart patient and did not want to risk going into the crowded Naidu or Sassoon Hospital areas.

This makes me wonder: I hope our journalists are taking proper precautions while covering the flu, since they are going into crowded areas where there a large number of patients, some of whom maybe carriers. I wish that my students and colleagues keep their health while covering this difficult assignment. This is part of the job, an occupational hazard.

As I was touching up this post, I spoke to Deepthy (an SIMC alumni) and she told me that she was at home with a cold. She had none of the three key symptoms (a sore throat and cough; a running nose; breathlessness), but since she was covering Naidu and Sassoon Hospitals in Pune, I told her she must point this out to the doctor and ensure she gets tested. I called her again, Wednesday, 19 August. She's at home, tested negative for the flu, recovering.

Journalists like doctors, nurses and other care-givers fall in the high-risk vulnerable groups. Take care.

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I think many newspapers in Pune, especially TV channels (my bugbear), more so the Marathi vahini like Star Mazha and IBN Lokmat, are adding to the scare by repeatedly showing photos of people in masks and long queues. This frightens citizens into a panic. Can’t they display comforting visuals? Also the copy and the sound bytes are hyped up and the headlines scream out at you.

On the other hand, a heart-warming story entitled, “Swine flu work in process” (IE, Pune, 9 August 2009) by Anuradha Mascarenhas educates us gently. She has described in detail the hard-working scientists and technicians of the National Institute of Virology (NIV), Pune, doing their job quietly. This is the kind of patient, routine, groundwork that goes on – nameless, faceless and unsung.

(Their work reminded me of my early days in Maharashtra Herald as a sub-editor from 1983 onwards. Subs correct grammar and spellings, touch up the body, iron out the creases and wrinkles, give an eye-grabbing headline and place the story where it will surely be read as soon as the reader picks up the morning paper. But the subs remain – nameless, faceless and unsung.)

By putting human names and warm faces to the “scientific” detectives at NIV tracking down the deadly virus, Anuradha has made accessible and credible what is hidden from the public, behind a veil of needless official secrecy. But nowhere has she glorified the scientific workers and created “celebrities” out of these diligent government servants, whom it has currently become fashionable to malign.

Let us thank Dr. A. C. Mishra, Director, NIV, and Dr. M. S. Chadha, Deputy Director, NIV, with their sincere team as well as the competent government authorities, for permitting Anuradha to write this report. I have covered the NIV beat and I know what it means to have public-minded scientists cooperating and collaborating with journalists in order to educate the public.

I have watched Anuradha blossom into an outstanding journalist, first at Maharashtra Herald and then Indian Express, both in Pune. She is a gold medallist from the Department of Communication and Journalism, University of Pune. I am proud of her as a colleague and wish her all that she deserves. Click here for her stories on the IE website.

Anuradha’s stories serve another public purpose. On behalf of the people of Pune, her stories are an open way of thanking the NIV team for their hard work and sincere efforts – beyond the call of duty and the monthly pay-packet.

Easy it is to criticise government officials. But difficult it is to say a good word when they do a fine job, in adverse circumstances against what Dr Margaret Chan, D-G, WHO, calls a “capricious” virus. By her stories, Anuradha says “Thank you!” to the scientists on our behalf.

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Another journalist who is doing excellent work educating the Pune public, rather than driving them into hysteria, is Vinita Deshmukh, editor of the weekly Intelligent Pune (iPune). She was a recipient of the Chameli Devi Jain award for Outstanding Woman Mediaperson for 2008-09.

The iPune has written about the work being done by government hospitals in Pune, "Kudos to Naidu Hospital" by Piyush Kumar Tripathi (31 July - 6 August 2009, iPune). This piece appeared when there were 59 cases (256 cases by 10 August) in Pune and even before the first death due to the H1N1 virus took place in Pune on 3 August.

At a time when most newspapers were criticising the government for its response, the iPune report shows how the Naidu Hospital doctors, nurses and staff are rising to the occasion and boosts their morale.

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Here are some links that you may find useful.

First, the swine influenza link on the NIV site, which leads you to other important links and documents. You can also call NIV on two phone numbers during the day. But make sure do not trouble them needlessly. They are busy doing our work day-and-night.

Second, the guidelines on the World Health Organisation (WHO) site. I found the FAQs, especially “What can I do?” most valuable. Navigate this site and unearth treasures here.

Third, the general information section on the H1N1 flu at the website of the Centers for Disease Control and Prevention (CDC). Here I found “What to do if you get flu-like symptoms” factual and hence reassuring. This site also has a wealth of facts and figures.

Four, we have the site of our Ministry of Health & Family Welfare, Govt. of India. Please follow the instructions given here. There is also offcial data on this site. If you want to make our elected representatives answerable to the people, this is a site to monitor.

Since a lot of us are probably wearing masks, Rujuta Teredesai sent me this useful WHO advice on wearing masks. Click here.

These are some of the websites and pieces I talked about in the beginning of this post that will help us “Fight the H1N1 flu with facts, not fear”. Let us hope that, with facts and figures getting the upper hand, the man-made panic and the media-fed frenzy subsides.

Drink lots of water and wash your hands - two simple precautions we all must take. Take care.

Your support is my strength.
- Joe.

Pune, India, Monday, 10 August 2009, the day after Nagasaki Day.