The Human Rights Forum (HRF) views with extreme concern the serious health crisis in the Agency area of East Godavari district. In what is reflective of the precarious situation, 16 adivasis from a single village – Chaparai of Boddagandi panchayat in Y Ramavaram mandal, located in the jurisdiction of the Rampachodavaram ITDA of the district – died over a period of three weeks (from the last week of May to June 22). All 16 belong to the Konda Reddy tribe classified as Particularly Vulnerable Tribal Group (PVTG). Chaparai is an exclusively Konda Reddy village with a little over 300 residents.
A four-member HRF fact-finding team visited the Rampachodavaram Agency area including Chaparai on June 28, 29 and met doctors and medical personnel and local residents. We believe that most, if not all these deaths at Chaparai were due to falciparum malaria. In fact, our view is that there is a malarial epidemic sweeping the 5th Schedule region stretching from Paderu division in neighbouring Visakhapatnam district through the Rampachodavaram and Chintur Agency areas of East Godavari district. The government is seeking to obfuscate this reality by trying to pass off the Chaparai deaths as due to adivasis having eaten rotten meat at a marriage gathering and also because of consumption of contaminated water from a local hill stream. This is clearly not the case. A reprehensible attempt is also being made to portray the adivasis as being ignorant, superstitious and unwelcome of medical intervention. This narrative is being pushed to gloss over official failure.
Governmental infrastructure in the area is so poor that deaths at Chaparai only came to light on June 23 and were then played out prominently in the media. As usually happens, government personnel were rushed to the village and those down with fever and other medical ailments were admitted to the Rampachodavaram Area Hospital and the district hospital at Kakinada. Significantly, 24 of the 30 adivasis of Chaparai admitted at the Rampachodavaram hospital tested positive for malaria. This should have been a wake-up call to the government to at least then initiate anti-malarial steps, both short and long-term, in a meaningful and holistic manner. This did not happen and they, all the way from the Minister for Health to district health officials, continue to lie brazenly about the cause of deaths.
The adivasis have not had access to proper health and medical care. Even the minimum anti-malarial operations were not undertaken at Chaparai. The first round of alphacypermethrin (ACM) anti-larval spraying was to have taken place in April but happened only in the last week of May. There was also no distribution of mosquito nets, not just in Chaparai village but in all villages of the two panchayats of Boddagandi and neighbouring Kanivada. Five of the seven borewells in Chaparai are coughing up discoloured water that is unfit for consumption. Though the Konda Reddys had brought this to the notice of officials at the Janmabhoomi programme several months ago, nothing was done.
Shockingly, there is no community health worker (CHW, now being called accredited social health activist-ASHA) in the village since 2007! The absence of this frontline health worker, the basic health unit in the village, since over a decade is indicative of gross official neglect.
Moreover, there is no regular multi-person health assistant (female), also called ANM, for this area since May 24 when the existing ANM was transferred to Kutravada and additional charge was given to the Kanivada ANM. This ANM and the MPHA (male) are therefore heavily burdened since they have a jurisdiction of 24 villages in two panchayats in what is a hilly and difficult terrain. Pertinently, if there had been a CHW in the village or at least two fully functional ANMs and two MPHA (male), so many deaths could have been avoided. In fact, on the day the HRF team was at Chaparai, the government had still not appointed a regular ANM for Boddagandi panchayat!
Having failed on all these fronts, the government is consistently trying to play down the extent of the crisis, wilfully misrepresenting cause of the deaths and resorting to temporary adhoc measures. All that the administration seems to be doing is drawing up contingency plans and putting out statements of intent. Very little is being done on the ground.
This has happened in the past and has only resulted in adivasis succumbing to these preventable and treatable diseases with fatal regularity year after year. If the nature of the crisis is not even acknowledged then how can suitable preventive steps be taken up to ward off future outbreaks?
Clearly, the existing medical and health staff in the 5th Schedule region has to be doubled and personnel recruited on a permanent and not temporary or contractual basis. The salary of ASHAs has to be increased to Rs 6,000 per month and they must be given proper training and paid on a regular basis. Mosquito nets have to be supplied to all households immediately and all adivasi habitations must be provided with potable water. A permanent protected water facility has to be installed in Chaparai as was done in some of the villages that flanking the Maredumilli-Gurthedu road. These are preliminary steps. A lot more needs to be done to ensure food security for the adivasis.
It may be recalled that over 4,000 tribals died of falciparum malaria in Visakhapatnam Agency in the summer of 1999, over 2,500 of the same ailment in the summer of 2005 and well over a 1000 in 2011. The deaths were because of inefficient and insufficient medicare, lack of access to clean drinking water, malnutrition leading to enfeebled resistance to disease, poor protection from mosquito bite, atrocious public hygiene and pathetic health intervention by successive governments. The negligence of the State in its minimal administrative and welfare responsibilities was the proximate cause of these unconscionable deaths.
That neglect is still evident in the East Godavari Agency now. Urgent steps are called for to provide substantive medical care combined with nutrition and clean drinking water.
(HRF general secretary, AP&TS)
(HRF secretary, AP&TS)
Those who died at Chaparai:
1. Pallala Seemamma w/o Devireddy.
2. Pallala Chittamma w/o Tammireddy.
3. Pallala Kannmreddy s/o Tammireddy.
4. Pallala Komamma w/o Ramireddy.
5. Sadala Bujjibabu s/o Raghavareddy.
6. Kondla Vijaya Kumari d/o Abbayireddy.
7. Pallala Borramreddy s/o Lingareddy.
8. Bachchela Lakshmi d/o Bhumayya.
9. Pallala Tammireddy s/o Pandurreddy.
10. Pallala Ramcharan Reddy s/o Bobbilireddy.
11. Chedala Mottireddy s/ o Ramaiah or Ramireddy.
12. Pallala Chittamreddy s/o Ramireddy.
13. Andala Sanjeeva Reddy s/o Komati Reddy.
14. Pallala Ammamma w/o Mottireddy.
15. Pallala Somamma w/o Abbayireddy.
16. Pallala Lingareddy s/o Ramireddy.