Column : What not to do in tackling swine flu

Aug 10 2009, 22:00 IST
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SummaryI’m not sure who it is I’m misquoting but it’s often said “India can handle famines but not malnutrition”, that is, we respond well to crises but not to the day-to-day to problems that continually plague us.

I’m not sure who it is I’m misquoting but it’s often said “India can handle famines but not malnutrition”, that is, we respond well to crises but not to the day-to-day to problems that continually plague us. The current crisis is the death of one fourteen year old girl from swine flu in Pune. For this we see great mobilisation of public resources and individual precautions in many parts of the country. Whether this degree of concern is warranted or not is beyond my expertise to judge.

I suspect it is not but I certainly wouldn’t want to stand in the way of standard procedures on the part of health ministries for fear of blame if it turned into a full-blown epidemic. But I sure wish that a small fraction of this concern were given to the grinding, day-to-day problems of the health of many Indians, particularly our poorest and most vulnerable.

Compared to about 600 confirmed cases and one death of a (mysterious?) new disease over several months we have tens of thousands of cases and hundreds of deaths every day from diarrhoea and other routine, unglamorous health problems. These diseases are not mysterious at all; they are not news-worthy in the least and are eminently preventable by public and individual action. Why do we not see panic such as that in Naidu hospital in Pune over these problems?

It is a well known result in the study of attitudes toward risk that people wildly overestimate the probability of very rare events. Clearly one out of a billion is pretty rare in comparison to the daily tragedies of deaths that we seem to accept as a part of life. In our reaction to risk we seem to be responding true to form.

We know about and are kept informed hourly about the new problems, we find out about and, briefly, worry about the usual ones with a lag of years. Public reaction may be explicable psychologically and may also explain the politics behind hasty reactions that determine health ‘policy’ but is not a good guide to the economics of health policy. Forget economics: this sort of reaction is not a good guide for any common sense approach to the problem.

In the US there were numerous cases of schools being closed, businesses shut and other aspects of daily life disrupted. These all carry costs to people in the value

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