Elephant(iasis) in the room

Capstone Health Shahpur State Taluk

Even though the patients suffer from Elephantiasis, they refuse to consult the doctors, by choice.

Shlok Arya

Swelled legs, heavy steps and no rest–this is the life of many Shahapur residents suffering from elephantiasis.

Situated in the north of Karnataka, Shahapur taluk suffers from elephantiasis, but most of the patients, however, refrain from undertaking the treatment.

Caused by parasitic nematodes belonging to Filarioidea family, elephantiasis is a condition, caused by mosquitoes, where the arms and legs of the patient swell up, sometimes including sex organs also.

According to the National Vector Borne Disease Control Program (NVBDCP) annual report 2018-19, Brugia malayi, Wuchereria bancrofti and Brugia timori parasites cause Lymphatic Filariasis. Wuchereria bancrofti one of the parasites is mainly found in India and has contributed to 99.4% of the disease in the country.

The Shahapur taluk Health Office data shows that there were 525 registered cases of Elephantiasis. Gogi, a village in Shahapur, has 25 new cases out of which six cases are of children making it the severely hit residential area with elephantiasis. Contaminated water because of inactive nuclear plant is the mosquito breeding ground in the village, affecting the people living nearby.

India plays an active role in the Mass Drug Administration (MDA) program, an International effort to eradicate elephantiasis. Under the program, the government provides DEC, Albandazol and Ivormatrin tablets for free to the public. In Karnataka, the MDA program has been existing for the last 15 years and yet the cases of elephantiasis has not decreased.

Inayat Pasha: elephantiasis leg

The gradual uprising in the cases is directly proportional to the people refusing treatment and medication provided under the MDA program for many reasons. Vamala a patient said, “I don’t take the medicine because I have thyroid. If I feel any pain only then I consult the doctor.” Just like Vamala, there are many other patients who suffer from other health issues which stops them from taking the medicines for elephantiasis.

The doctor at the Shahapur government hospital regularly visit the villages for night blood smear test. This test allows the doctor to keep a record on the number of the new and existing cases. Lack of co-operation between the doctor and patients is one of the reasons in failure of controlling the filariasis cases.

Dr VM Patil said, “We are conducting the MDA program and since the last 15 years we are approaching people, but they reject the medicines. Even though we are going for a house to house visit and encouraging them to take the medicine according to the age, still they are not able to consume the drugs.”

Due to the lack of cure, the doctors are more dependent on taking preventive measures, but as people refrain from any kind of medical assistance, there is little the doctor can do to curb the disease. Dr Susanta Kumar Ghosh said, “There is some local issue and for that, you need to have a community engagement program. There is a severe lack of community engagement. According to me, doctors should take feedback from the patient after giving them the medicine to know how it affects them and how they are reacting to the program.”

Elephantiasis is a pandemic issue. According to the National Vector Borne Disease Control Programme 2018, there were 12,98,233 Lymphatic Filariasis cases in which Bihar and Jharkhand had 25 per cent and 12 per cent respectively. According to the WHO (World Health Organisation), in 2018, 893 million people in 49 countries were living in areas that required preventive chemotherapy to stop the spreading of Infection.

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