Sunday, March 21, 2010

distress migration

Two of the emergencies seen by us yesterday highlight the tragic plight of migrants - the nowhere people in our country. These are not from across the international border, though they do cross various borders in search of a living and for survival : the border between their village and the city; the one between states; the one between cultures; the one between the familiarity of one's own home and the unsure, unstable one of a new and unknown place, among new and unknown people; the nebulous line between being very vulnerable and being extremely so.

The first was an 8 year old boy brought by his parents with a history of a dog bite on his elbow eleven days ago. The parents had moved from Shahdol in MP to Kota in Bilaspur district of Chhattisgarh, to work in a brick kiln there. The contractor assured them nothing would happen, they could use some local herbs to treat the wound, which they did. They, of course, were not aware of the dangers of a dog bite and the need for anti-rabies vaccine. Now, eleven days later he reached our clinic, with frank rabies. There was nothing we could do, except explain the disease and the prognosis to the parents and urge them to keep him comfortable for the few days he has left before he dies. This for a young child who is bright and alert and in full possession of his faculties. The parents left our clinic at Ganiyari, weeping and trying to comprehend what had happened.

The second was a patient seen at one of the outreach clinics at Semariya. I
was at the clinic and a man rushed in with his wife in his arms - she must not weigh more than 25 kgs. They are from that village and had migrated to Kanpur in Uttar Pradesh to work in a brick kiln. She fell ill 10 days ago, and when he ran out of money giving her IV drips there and she did not improve, they came home. She had not been eating now for four days. She was in shock with cold hands and feet and a barely recordable BP. She had severe pneumonia and sepsis and was gasping for air. After resuscitating her and starting antibiotics for the pneumonia, I sent her to Ganiyari for admission - she is there on oxygen and under further investigation and treatment. She probably also has TB as well as sickle cell disease, apart from being severely malnourished.

Two families of migrants, two families with severe illnesses, two families whose health is no one's responsibility.

1 comment:

  1. Ramani, the tragedy of incidents like the rabies infection you mention is that they are completely preventable. Given an environment where workers were not made to feel so vulnerable, the boy's parents would have likely sought early treatment and refused to accept the cynical assurances of the brick kiln contractor. It is at least reassuring to know that Jan Swasthya Sahiyog's health education outreach work has prevented other such tragedies from occurring among vulnerable communities.