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#Kerala had anticipated #Nipah's return, so they examined all encephalitis deaths in the last year. It even led to identifying some other rare diseases: a patient in Malappuram was found to have the rare West Nile virus. There could've been no under-diagnosis, only over-diagnosis
An anecdote we didn't use—Kerala's Rajeev walked into central health secretary's office in Delhi few days after the West Nile case. "Rajeev tell me," she asked, "isn't Malappuram in Kerala?" “Yes,” he said. "If it is Kerala, we don't have to bother. You guys will take care of it"
Some more anecdotes we couldn't use (limits of print real estate): After the 23-year old first Nipah patient was admitted, it is instructive how the state drew up a contact list of more than 300 people who happened to be in contact with him in the past few weeks...
At 23, Sreedevi didn't expect him to have told everything about his life to the family. So what you do? They found out his close buddies from phone contacts, social media profiles and so on. Diff people then spoke to them in turns to retrace his life in the last few weeks...
By the end, they knew the hotels where the patient had food, the autos he travelled in, the (multiple) affairs of his friends, and even a favourite hangout place the family hardly knew.
An auto story needs a special mention. Mistakenly, they were told by the family that the patient travelled from point A to point B one day in a car. He had in reality travelled in an auto. It came up during the probe. Now, how do you find a nondescript auto driver among hundreds?
That's where one needs to salute the extraordinary work of ordinary people in Kerala, like it happened in the floods. The state's ground-level health workers, political party workers, community groups, among others, got together for finding this one auto driver.
When I interviewed Rajan Khobragade, Kerala's health sec, he said: "The difference between other places and here is that here the community involvement is very strong. Because of the panchayati raj institutions and their leadership, the community comes to the forefront."
The fight back against Nipah was also led by several working women. Shylaja led from the front, others who assisted her from top to bottom were also women. Many said that Shylaja's occasional speeches to the team boosted their confidence and morale.
During the first Nipah crisis, Shylaja told the Kozhikode team: if it was a landslide or earthquake, we could seek help from fire and rescue or even the masses to mitigate the damage. But in this case, only the medical community can shoulder the crisis and chart out a rescue plan
A person who was in attendance had this to say about it: there is a warmth in the way she talks, we listened like kids listening to their fav school teacher talking.
The Nipah also came with significant costs in terms of disposables like gloves, protective equipments— they will be used only for abt six hours. And it was met from the state budget (Kerala’s budget for drugs is about Rs 380 cr, acc to Rajeev). Will a central aid cover this cost?
Last time, however, private parties also chipped in with their money and resources. For example, the Abu Dhabi-based VPS Healthcare group that runs Lakeshore hospital in Kochi flew in hospital disposables to Kozhikode.
Rajeev Sadanandan deserves due credit for a lot: Last time, the state wanted to get th drug Ribavirin used in Malaysia for Nipah. The biggest producers of it in India was a company in Hyderabad. When contacted, they told Rajeev that it is out of stock.
Rajeev woke up the stockist for the company at midnight, send trucks to the godown, collected it and in the next day morning flight it reached Kozhikode.
Similarly, he also had a crucial role in bringing the monoclonal antibody to Kerala. It was developed by the United States military and was stored in Australia (because that is the only developed country which got hit by the rare Hendra virus).
Last time, Rajeev called up a friend who is a prof in a US med clg, also a uniformed medical officer, and via mutual friends they finally managed to stock the thing in Kottayam med clg. This time, a container took it from there to Kochi within two hours after Nipah was confirmed.
There's also smthg unique in Kerala about how journalists talk to people, crucial in a democracy than what politicians talk to people. Manorama was churning out stories after stories about how to face this, what to do etc. Hope overrode the tension. Kudos @KtonyjoseMM nd others
There are others who engaged in panic mongering too. But they were reigned in by the editors immediately. I saw a WhatsApp msg from an editor of a news channel to his team, can't devolve details. But trust me, you don't want to get that from your boss.
“It has always been like this,” said Rajeev in an intvw. “Now it will be difficult for you to imagine. In the 90s, we started working on sex workers using government money to tackle HIV. That would have been sensational now...(conti)
But we talked to the media and they took us in confidence. Later, people who were involved in it, like Nalini Jameela became heroes in Kerala (Jameela dropped sex work and became an author, activist and social worker)."
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