Kerala’s battles on the health front

Our Correspondent

The Kerala Model in Health is known the world over for the high life expectancy rate of its population, highly improved access to healthcare, and low infant mortality and birth rates. Nearly 10,000 government and private medical institutions crisscross the state to form the backbone of its health infrastructure. An evenly distributed primary health centres and their sub-centres cater mainly to the rural population.

The National Health Mission has found that the first twelve best primary health centres of India are in Kerala, while three of them have got the National Quality Assurance Standard (NQAS) Certification. Adding another golden feather in its cap, Kerala has topped Niti Ayog’s health index for the fourth year in a row this year, in recognition of its superior health system in both public and private sectors.

Kerala achieved this scale of progress as compared to other states in India with consistent efforts by various sections of society, backed by the succeeding state governments irrespective of political colour. The Kerala model is marked by a rare combination of Marxist and Missionary work in parallel streams.

No wonder then that the state has been able to tackle the Covid-19 pandemic and other threatening epidemics like Nipah, Zika, and Black Fungus in recent times. The state also successfully prevented any major outbreak of H1N1, Dengue, Hepatitis, Chikungunya in recent monsoons, further consolidating its position on the health front. Local bodies, too, have played a key role in making the state a place to live comfortably and lead a healthy life, and for tourists to visit fearlessly and bask in its natural beauty.

Kerala stopping Nipah in its tracks in 2018 and 2019 were stories that attracted worldwide attention. The virus claimed 17 lives in the first phase in 2018, but was quickly restricted to Kozhikode and Malappuram districts. Kerala reined in the dreaded virus later in 2019 after an outbreak in Ernakulam district with no further casualties. This was at a time when 150 children had died of encephalitis in Bihar state.

Nipah had claimed over a hundred lives when it reared its head for the first time in the Malaysian village of Sungai Nipah (hence the name) in 1998. Nipah has no known cure or vaccine. It

gets to humans via fruits infected by Nipah-carrying bats. The 24-year-old person infected with the Nipah virus in Ernakulam in 2019 was brought under isolation and extended medical care in a private hospital while being monitored by a high-level team. Nearly 300 people who might have come into contact with him in 24 hours were brought under observation by different teams and it became another remarkable health victory. The efficient planning and quality healthcare system meant the deadly viral infection was erased out with no damage to any sector, including tourism. Later, the Institute of Human Virology (IHV), Baltimore, in the United States, honoured Kerala Chief Minister Pinarayi Vijayan for effectively containing the spread of Nipah virus outbreak in Kerala. The bulk of the praise came in the way of then State Health Minister KK Shailaja, popularly known as Shailaja Teacher, for coordinating the efforts to contain the virus.

The next major challenge came when Covid-19 was spotted in the state, also for the first time in the country, in January 2020, in university students returning from Wuhan in China. Kerala’s remarkable resilience in the first phase leading up to May 2020 also came in for praise from across the world. UAE’s leading daily Gulf News observed that the three-tier health system of Kerala with primary health centres at the lowest level and medical college hospitals at the top level helped it to imaginatively tackle the crisis. It also patted the excellent pool of Kerala’s homegrown medical professionals.

The Washington Post noted that “the state, where communists have held power for over 30 years in several different governments since the 1950s, has invested heavily in public education and universal health care.”

UK’s vastly respected BBC News said: “Experts say, what really mattered, in the end, was Kerala's robust public health system, and a culture of thriving grassroots democracy with power devolving effectively to the village councils.”

A US tourist went to the extent of approaching the Kerala High Court with the plea that he be not sent across to his home country till the pandemic is over. The 74-year-old Terry John, who is a theatre director and writer, was all praise for the way Kerala tackled the crisis. Bulgarian football coach Dimitar Pantev who was home quarantined in Palakkad district’s Pattambi, scribbled on Facebook that it truly blessed him to be Kerala at the time of Covid-19 outbreak. No wonder then that the United Nations honoured Shailaja Teacher for her leadership role in flattening the curve with effective contact tracing while successfully maintaining low mortality rates.

Though the second Covid-19 wave from the middle of 2021 gave some anxious moments to the state after the Assembly elections, with cases peaking, the steady vaccination programme conducted through the involvement of even Asha workers and local bodies helped it to survive the scare. A large section gained

herd immunity during the period and health workers and doctors in the state, both in the private and public sectors, toiled hard to battle the way forward. Tourism and other industries too began to open up and educational institutions started functioning. And when everything seemed to return to normal, Omicron came like a bolt from the blue by the end of 2021. But in December and early January, Kerala presented a picture different from the rest of the country with limited cases, steady vaccination and people conforming to Covid protocols. The resilience of the people, their awareness, herd immunity and adherence to hygiene and protocols and the robust health infrastructure give Kerala an edge in the battle and make it a safe place to live and travel.

Kerala has performed in remarkable ways not only in these battles but also in fighting the Zika Virus, the Black Fungus, H1N1, Dengue, Hepatitis, and Chikungunya in recent times. The Black Fungus reared its head during the Covid-19 spread, killing half a dozen people, but was soon wiped out. This was against the national death toll of over 4000 people at the hands of the disease. The Zika virus broke out last July amid the fight against Covid-19, with State Capital Thiruvananthapuram being the epicentre. At least 13 health workers in the city were tested positive for the virus apart from a pregnant woman in the first phase. Over 70 cases were reported from the state, but by August middle, the situation was brought under control, with zero prevalence after screening over nine lakh people.

The highest number of dengue cases (21,993) and deaths (165) was reported in 2017 and ever since it was on the decline. The deaths were just five in 2020, while the total number of cases was 4399. Similar was the case with H1N1, Hepatitis and Chikungunya. “We had a three-point agenda: government hospitals should be patient-friendly, high-tech, and out-ofpocket expenditure must reduce,” says Shailaja Teacher about the strategy since she took over. “Primary healthcare units are very important, especially in rural areas. They now have testing labs and are able to catch early signs of different diseases. Medical college hospitals have new equipment and good infrastructure. Our focus definitely strengthened the system to battle the crises. We’ve tried to create a feeling of ‘We’, as a team in this battle. It keeps the morale up of each healthcare warrior,” adds Shailaja Teacher.

The state is today hale and healthy with lush green environs after a prolonged spell of southwest and northeast monsoons in months leading up to last December. It beckons every visitor to its lap with unparalleled warmth and new world-class infrastructure like the Kochi Metro.