Delhi Superbug? Bah! Humbug!

Shhh, don’t tell anyone, but the superbug is here. Well, yes, it could kill you. But you know, life is so uncertain — don’t fret over these new-fangled firang studies. They just do it to discredit us. Jealousy, that’s what it is. Just because their patients come over to get complicated operations done in our super-specialty hospitals

, these firangs are getting all het up. Envy, just envy.
First they said that there was this unbeatable bacteria in our hospitals — and patients who had come over for medical procedures had gone back with the superbug. A wicked gene here made ordinary bugs invincible and bred antibiotic-resistant bacteria that could kill millions. They said the superbug had popped up in Britain, the US, Canada, Australia and Sweden. So what did they do? Promptly named this international scumbug after us! The NDM-1 (New Delhi metallo-beta-lactamase 1) they called it. Just to put an end to our medical tourism industry. Of course, our government did the honourable thing — it threw its weight behind the private medical industry and joined voices with it to deny the very existence of the bug in our hospitals. For effect, it then cried foul about the nasty name, NDM-1. It was an attempt to stigmatise India, we hollered in righteous indignation.
And now, further digging by the jealous guys in London shows that the superbug-spawning NDM-1 gene is in our everyday environment — and not limited to hospitals. Apparently it was found in 51 out of 171 samples taken from water pools in Delhi and two out of 50 tap water samples. The NDM-1 gene was found in 11 types of bacteria, including those that cause dysentery and cholera. Which means that most antibiotics would have no effect on our most common and deadly waterborne diseases. Perhaps, if we had access to more specialised — and far more expensive — antibiotics, we could be saved. But who knows for how long before those too are rendered impotent?
Of course we took instant, decisive, multi-pronged action. First, the customary denial. We denied the presence of the superbug in our environment. Delhi’s water was very safe and absolutely fit for drinking, the sarkar said. The customary sarkari attack on make-believe legal grounds followed. It was illegal to take water samples out of the country, we thundered. (No, it was not, but no harm in trying.) Then the customary mud-slinging. The findings published in the Lancet Infectious Diseases Journal were baseless, unscientific and wrong. It was a shameless attempt to malign us.
It’s another matter that we know that the Lancet report is true. And that the fearsome superbug has settled cosily in our environment, has contaminated the water we drink and lives in our guts. An antibiotic policy must be put in place, we demanded in hushed voices. Don’t worry, it’s all a lie, recited the government. But here, take some chlorine tablets anyway and feel safe.
Sure, antibiotic-resistant bacteria are a huge threat — they could throw us back to the pre-antibiotic era of cholera and dysentery pandemics, for example. Grudgingly, the government is cooking up a policy to check indiscriminate use of antibiotics that gradually makes bugs stronger and the whole population more vulnerable. A recent WHO (World Health Organisation) study has claimed that 53 per cent of Indians take antibiotics without a doctor’s prescription. But the matter doesn’t end with antibiotics-resistant superbugs. We already have drug-resistant tuberculosis, remember? The real issue is our denial. It speaks of the deeper, far more fearsome disease that is killing us all — the rotten state of public health in India.
Government apathy, unethical medical practitioners and political indifference has made public health in India an utter shame. We worry about individual patients — what happens when I get Delhi belly and no antibiotics work? We ignore the cesspool that we live in. Millions die every year for lack of proper health practices, social awareness and medical facilities. Sanitation and safe drinking water are among the basics of governance. If we had that, we wouldn’t have to lie about the NDM-1 not being present in our water.
To keep us happy and to keep the private tills ringing, the medical fraternity and the government, strangely, have shot the messengers. They have clamped down on Indian medical researchers who had collaborated in the Lancet study. And have claimed that this is an attempt to discredit our state-of-the-art medical facilities and an evil plot to destroy medical tourism. The government, while rushing to protect the private medical fraternity, is doing nothing to address the main issue — that the bulk of the Indian population has no access to adequate healthcare.
Public health services — which include responsible, free or affordable medical facilities for the general population and measures to reduce exposure to disease through sanitation and vector control — are seriously lacking in our country that boasts of commendable economic growth. We have been talking of healthcare for all since before Independence. It is still not in place. And the budget for health is still at just over one per cent of the gross domestic product (GDP), among the lowest in the world. As government healthcare remains abysmal, especially in rural areas, the private sector caters to about 70 per cent of health needs. And since less than 20 per cent of the population has health insurance, most middle class and poorer Indians cannot afford good treatment, or are driven to debt when they attempt it. Besides, unless you have connections, even if you sell your kidney to treat your child you have no guarantee of reliable treatment.
We need comprehensive, quality healthcare for all, irrespective of one’s ability to pay. For healthcare needs to be seen in the context of civil rights and entitlements. We see it as a favour from doctors and government. State of the art medical services for a few is good, but only when the rest of the population has access to basic healthcare. We have no reason to preen about how we have the best medical services for a handful of rich, but nothing for the majority of Indians.
Experts have made a strong case for universal, quality public healthcare and demanded that at least three per cent of our GDP be devoted to health. Our economic growth could easily fund this. If we intend to achieve health for all by 2020, as the government plans, we should stop denying the obvious.
Actually, the real superbug is not in our water or in our guts. The soul destroying evil superbug is lodged in our brain. And it makes us push most of our own people towards preventable death.

Antara Dev Sen is editor of The Little Magazine