Resurgence of Polio - unanswered socio-economic issues

Reading the news about the so called resurgence of Polio has raised many questions. The questions are not only about the scientific / technical issues. I have no doubt that the medical fraternity will have the required the skills to mange the scientific and technical part of the problem but what seems impossible to overcome is parochial mindset of the powers that be, who seem to be hell bent on extracting political mileage out of this essentially apolitical issue.

The other issue which comes to my mind is the huge socio-economic gap between the living conditions of the so called middle class people and the masses. And please bear in mind the basic contributory factor in the transmission of Polio Virus is poor sanitation. [Polio is transmitted primarily through the ingestion of material contaminated with the virus found in stool (poop). Not washing hands after using the bathroom and drinking contaminated water are common culprits in the transmission of the disease.] Whatever little I have known and seen about the abysmal conditions of slums in Mumbai, I do not subscribe to the view that sanitary conditions can be worse than this, even in the most backward villages of U.P and Bihar. Who knows, the outbreak of polio in Uttar Pradesh could be because of the poor sanitary conditions in Mumbai Slums than the other way round. The best recourse would be to concentrate on the eradication of Polio and keep the blame game at bay, at-least for the time being.

The resurgence of Polio in Mumbai, at-least until now, appears to be limited to the slums but it may not take long when it decides to become socially and economically upwardly mobile. It is needless to mention that the whole lot of household workers (maids, cooks, servants, drivers etc.) employed by the so called upper and upper middle class households reside in slums; in such cases, the transmission of infectious diseases may not respect any economic or social barrier.

The health ministry mandarins must look towards the resurgence of Polio in an apolitical manner and then, and only then they will be able to set the rudder in the right direction. As far as improvement in the sanitation levels of the masses living in the slums is considered, now that the Slum Rehabiliation Exercise in the present form has proven itself to be a dud, a different approach with emphasis on social empowerment is required. With social empowerment, willingness for knowledge assimilation may take place and then things may improve. In this context, my contention is that in place of providing the infrastructure and then giving instructions for its use and maintaenance, it could be a better option to prepare the teeming masses for being receptive towards knowledge and then empower them to have a decisive authority in designing the needed infrastructure for better living conditions.

The current approach is towards the eradication of Polio by way of hundred percent inoculation of the target population. This can only be termed as one-dimensional approach and can never be effective beyond a point. A better way would be to supplement this immunization approach with improvement of the sanitation level and for that the society has to prepare itself.

Public memory is dangerously short otherwise an apt example is the management of Plague epidemic at Surat. Let us hope, we are able to draw some lessons.

P.S. It seems that some kind of herbal cure is also available but due diligence from the authorities for bringing it into the market is wanting. Let us hope that this episode of resurgence of polio spurs the authorities to try and usher in an effective cure.