Ladakh (Leh), May 5
Persistent
lack of health facilities in Ladakh has made the life of its inhabitants not
just tough, but impossible. As if the peculiar geo-physical conditions of the
plateau were not enough to challenge survival, the rising incidence of rheumatic
heart disease and negligible treatment available for the same here has worsened
the situation for Ladakhis.
Let alone Ladakh, even Jammu and Srinagar does not
offer convincing tertiary level care which is the only solution for those
suffering from rheumatic heart diseases. This leaves Ladakhis with the only
alternative of travelling to Chandigarh or Delhi to seek replacement of valves,
each of which costs Rs 92,000. Not to ignore the cost of travelling, which a
poor villager can hardly imagine to bear.
In the name of medical facilities,
Leh has only one district hospital against a population of 1.17 lakh spread
across 65,000 sq km. Called Sonam Norboo Memorial Hospital, it does not have
CT-scan or MRI facilities, for which people have to travel to Srinagar or Jammu.
Remote villages in Khaltsi and Nyoma areas have no medical stores at all. When
contacted, the district authorities listed many institutions — one sub-district
hospital, 14 primary health centres and 122 medical aid centres. It is another
matter that these have not been able to prevent rheumatic heart diseases in
Ladakh.
More than 130 cases of rheumatic heart diseases with valvular legion
(damaged valves) have been diagnosed in Ladakh over the recent past. The
disease, which can turn fatal in case valves are not replaced, occurs
predominantly among children aged 5 to 15 years. The infection begins as a
routine throat infection caused by Streptococcus bacteria.
Due to lack of
awareness in villages, the infection is taken casually, paving way for acute
rheumatic fever which manifests in the form of swelling in joints and severe
pain. Over the years the infection bites into the heart, though the joints
recover. At this stage, the heart valves stand damaged, leaving the patient with
the last option of valve replacement.
While there has been talk of setting up
AIIMS-level hospitals in Jammu and Srinagar, Ladakh does not even have a medical
college, despite its phenomenally difficult position. Local doctors have been
advocating the need to make Leh district hospital part of the teaching hospital
of Kashmir Medical College so that Ladakhis get their share of medical
attention. The idea has not yet cut ice with the authorities here.
Meanwhile,
Dr Norboo, a physician involved in preventing rheumatic heart diseases in Ladakh,
admitted to the grim scenario. Citing economic implications of the disease as a
major deterrent in its treatment, Dr Norboo said: “Those suffering from an
advanced infection have little hope of life. But we are trying to prevent the
disease among children. In Ladakh one infected child passes the infection to
others at home. To avoid cold, Ladakhis normally confine themselves to the
kitchen. Cross infection thus becomes highly probable.”
Dr Norboo has been
using the international sledge-hammer method to prevent the disease among
children. The process involves diagnostic criteria for strep-throat infection.
If tested positive, prevention requires injection of Benzathine Penicillin
Long-Acting-6 Intra-Muscular for children aged 5 to 12 years and Benzathine
Penicillin Long-Acting 12 injection for children aged 12 years and above.
