Indian Express
09 August 2010
By Swatee kher
Mumbai,India

The mosquito sting has the country’s commercial capital thronging hospitals this monsoon season, with the number of deaths due to malaria recording a high and hospitals spilling over with patients. The civic body – responsible for tackling monsoon–related diseases – has been forced to rope in private practitioners and private laboratories. Alarmed with the figures being reported out of Mumbai, the Centre had sent a team of health experts who have submitted a detailed report.

As per data recorded with the Directorate of National Vector Borne Disease Control Programme, there has been a 55 per cent increase in the number of positive cases and 15 per cent increase in the falcifarum variety in Mumbai in comparison to the cases reported between April 2009 and June 2010. There have been 31 deaths due to malaria so far this year.

In 2009, the BMC had reported a 10 per cent rise in cases with the civic body identifying 134 new high risk areas in the city along the construction sites of Metro rail. Civic officials and health experts in Mumbai have blamed the increased construction activity for the spurt in malaria cases. Not only are these construction sites ideal breeding ground for the female anopheles mosquito, labourers from malaria endemic states like Chhattisgarh, who work at these sites, are also being blamed for spreading the disease.

The 2,500–odd construction sites here give abundant scope for fresh water collection after rains through water stored in tanks, layer of water on the surface of cement used for ‘curing’ the concrete and puddles of water in and around the place of construction. Three lakh migrant workers at these construction sites are also being blamed for the spread of malaria. The logic being that they carry the plasmodium parasite responsible for malaria.

As per the BMC, 58 per cent of Mumbai’s 19,500 malaria cases recorded since June 1 are concentrated in seven civic wards. About 33 per cent of the cases this monsoon were recorded in Sewri, Mahalaxmi, Byculla, Chembur and Ghatkopar, while 25 per cent of the cases were recorded in Reay Road, Mahim Causeway, Dharavi, airport, Santacruz and Vikhroli. These areas have a high number of construction sites that have stagnant water, the rising number of slum–dwellers and presence of dilapidated mills. About 83 per cent of those who tested positive for malaria comprise construction workers and slum–dwellers.

"The Central team is of the view that major construction activity and monsoons are the reasons for high incidences of malaria," said Dr R K Srivastava, Director General of health services (DGHS).

The Central team was also adverse to the idea of the builders being entrusted with the work of vector control. "In other states vector control is done by the government and not by the builders. This is one of the reasons for the high level of mosquito breeding seen in Mumbai," added another official.

Dr A C Dhariwal, Director of the National Vector Borne Diseases Control Programme, said the Central team had found that several construction sites and abandoned buildings (textile mills) were breeding grounds for mosquitoes. "Delhi, Chennai and Kolkata have reported malaria cases, but the figure is the highest in Mumbai. The number of deaths due to malaria is also the highest in Mumbai. The local civic body has identified certain wards where maximum cases are being reported," said Dr Dhariwal.

Adding to the government’s woes, even the milder variety of plasmodium vivax has reported complications in some instances prompting civic body and doctors to take a closer look at the treatment of the disease. "According to the WHO guidelines, chloroquine should still be the first drug for uncomplicated malaria. If a patient reports four–five days of fever, it is advisable to avoid risks and start multi–drug treatment," said Dr Sanjay Oak, the BMC’s Director For Medical Education and Research. Civic officials have drawn support from private hospitals to tackle the "spurt" in malaria cases as its own hospitals are overflowing with patients.

The health concern has been converted into a political controversy with the Shiv Sena and MNS blaming "migrants" for the spread of malaria. NCP’s Mumbai president Narendra Verma, on the other hand, has said it’s the Shiv Sena–run BMC that should be blamed.