Sunday, July 8, 2007

KVM demands : Appoint District Epidemiologists in Punjab - An letter to CM Punjab


Capt. Amarinder Singh
Hon’ble Chief Minister of Punjab,
Punjab Civil Secretariat,

Subject: District Epidemiologists in Punjab

Respected Sir,

Your good self is very much aware of Environmental- health crisis of Punjab and we also appreciate initiatives you had taken in this regard.

Sir, the environmental- health crisis needs constant surveillance and a mechanism for regular information and data collection. For this, a District Epidemiologist has to be posted at Civil Surgeons’ Office every district headquarters.

The district epidemiologist is responsible for collecting information and primary data, making arrangements for monitoring, coordinating with hospitals to keep vigil on occurrence of any communicable or non-communicable disease. Maintaining list of notifiable diseases and sending information to State Epidemiologist.

Chief Minister Sir, according to our information no body is posted in any of district in Malwa belt where environmental-health crisis has become acute and it is epidemic like situation.
The district epidemiologist /CMO office does not seem to have the current list of Notifiable diseases wherein he can receive mandatory notification of certain diseases from the periphery. The monthly/periodical report of morbidity/mortality generated by him to the state HQ mainly includes number of patients of various diseases admitted in Government hospitals. Sir, the cancer and other patients related to the present environmental crisis in the Malwa belt largely get OPD treatment/admitted in other than Government health facilities, hence may not be getting registered in government facilities, giving rise to incomplete picture of the pattern of diseases. Had there been such a provision, the Epidemiologist would have readily discerned the unusual clustering of cancer cases/ rise in prevalence of neural tube defects in children / occurrence of other pesticide-toxicity related disease in the Malwa belt districts.

There is no cancer registry, nor is there any provision to notify occurrence of cancer to the district epidemiologist from private health facilities or OPD treatment. Then how health department is working on the mitigation of environmental health crisis without baseline date and primary information?

What mechanism has been adopted by health department for surveillance of communicable and non-communicable diseases?
If Chief Medical Officers does not have any list of Notifiable diseases then what information and depending on which situation is gathered? Then how they are monitoring the state of health in their respective districts?
Sir, Punjab being a progressive and "the Best" state in the country, a more professional and responsive health system is expected under you able leadership and especially as Health is a state subject.
Sir, We requests you please look into this urgent matter and make sure the posting of district epidemiologists in Punjab especially in Malwas’ cotton belt and make an efficient arrangement of regular monitoring and surveillance system to check the devastating environmental-health crisis in Malwa belt.

In fact we are of view that a citizens committee on epidemiological surveillance can be formed under District Epidemiologists to ensure community participation in mitigation and crisis management process.

Hope that Punjab Government will take our submission in a constructive perspective and mention the civil society initiatives in its plans.

Thanking You

Yours truly,

(Umendra Dutt)
Executive Director
Kheti Virasat Mission

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