Samuel Beckett’s play Waiting for Godot flagged off “the theatre of the absurd” movement, which was so popular in the 1960s. Thanks to the embarrassingly obvious title, one knew from the very start that Godot or God was never going to turn up. Unfortunately, we all know that Ebola is going to turn up all over the world and India is not going to be the one exception, but that’s how our semi-comatose Union health ministry, including the health minister, is behaving.
Already a suspected Ebola case has been reported. A CRPF staff member returning from Liberia is the latest to be admitted to the Ram Manohar Lohia Hospital in Delhi. We are told the RML Hospital has 10 beds allotted for Ebola and the government has asked the Safdarjung and Lady Hardinge hospitals to reserve some beds in isolation wards in Delhi. The Kasturba Infectious Diseases Hospital in Mumbai too has made an announcement that they have reserved a ward for Ebola. The question is, a ward of how many beds? Three, five, seven, 10? We are told thermal scanners are being used at airports to zero in on patients with Ebola. And to make the case water tight, there are pictures of some health workers in full Ebola-proof hi-tech suits.
That’s a good PR exercise, but do our health authorities really believe that they are all set to handle Ebola? Come on guys, get real. As Dr Atul Gawande, world-famous surgeon from Boston, professor at Harvard Medical School and medical columnist for the New Yorker and the author of some remarkable books on modern medicine and healthcare, including, The Checklist Manifesto: How to Get Things Right, said recently, “The disease is eminently stoppable (with basic healthcare measures),” but the world’s response has been “pathetic”.
Perhaps it’s time to shock Union health minister Harsh Vardhan at the Centre with some hoary facts: we are a country of 1.2 billion people at the least. Mumbai alone has a population of 18-19 million people, the majority of them living in slums, on the pavements, in chawls or in crammed spaces. Most of these people have no option but to defecate and urinate in the open or by the railway tracks, on the rocks by the sea or wherever they can. But there is one additional fact that may have escaped all the health ministers in the country and the Prime Minister himself: India is the spitting capital of the world, with or without paan, tobacco, beetlenut or some superb and highly infected TB, phlegm is being spat out every second all over the country and what’s even more remarkable, this is perhaps the only democratic exercise shared by the super-rich, the middle class, the poor, the highly educated and the illiterate and super-poor. Which means this deadly disease, which can spread at lightning speed and is passed on through contact with bodily fluids, will have a field day in our country.
What we have on our hands is a national emergency. Yes, it’s eminently stoppable, but only if we tackle it on a war footing. When Dr Gawande speaks of Ebola being eminently stoppable with basic healthcare measures, he is referring to the US. But this is India and basic healthcare measures, even in the majority of our best hospitals, are “pathetic” or just plain non-existent.
Go to Nair Charitable Hospital in Mumbai and climb up just one storey, no more. When you turn the corner halfway up the stairs, you will be assailed by an unforgettable sight: a layered barrage of earth-red paan spittle from the day the wall was last painted.
There’s not a single notice saying, “Dear visitor, if you spit, we’ll not only fine you '500, but make you clean up your own spit.” Forget Ebola, we already have a drug-resistant TB epidemic on our hands.
If you’ve been a patient in a private or public hospital, I am sure you have noticed that the ward boy empties the bed pan, cleans it up with a bit of water and places it back under your bed. Does he disinfect the bed pan or wash his hands with a powerful bacterial killer? We all know the answer is a resounding no. Are the nurses any better? At the most, marginally. We have a long, long way to go before we reach the basic healthcare standards that are taken for granted in the developed world. Besides, let’s not forget however laudable Modiji’s “cleanliness” campaign may be, the clinical cleanliness required in an Ebola environment is of a very different order and its disinfection parameters are extremely severe.
But here’s a thought. Instead of treating the Ebola virus as a calamity, let’s look at it as a challenge and as a major educational opportunity. If all of us join hands and forget our totally man-made differences, and spread the message that spitting is deadly, maybe we will come out of this disaster with zero spitting as in Singapore. Secondly, we can also undertake an education campaign to teach our population the connection between Ebola and bodily fluids like spit, urine, excreta. Each denizen of this land could have his/her own check-list that is followed rigorously every single day.
But there is an even greater benefit. Have you noticed how, like AIDS, swine flu, TB, Ebola too is singularly democratic and secular. It strikes all of humanity, Hindus of every shade and caste, Muslims whether they be Shias or Sunnis, Catholics, Protestants, Jains, Buddhists alike.
We have to perforce think of the Ebola fight as priority number one on the “development” agenda unless we want hundreds of thousands of Indians to die. The health minister must not only build state-of-the-art Ebola hospitals with hundreds of beds in each city and the best equipment immediately, but buy ambulances and equip them with the most modern instrumentation. But what is key is meticulous training under the most experienced medical teams like Doctors Without Frontiers.
What we need desperately is an unflinching, handpicked team of Ebola experts in every state if we are to get the better of this awful virus. The head of Ebola campaign, no czar, please, but a hands-on expert, must liaise with researchers across the world and, if we can, involve enlightened pharmaceutical companies to conquer this disease, especially in the context of the deprived poorer peoples of the world.
Kiran Nagarkar is a novelist, playwright, film and drama critic and screenwriter both in Marathi and English. His latest novel is Extras.
