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Harvard doctors give Kumbh health facilities thumbs up

Author: Malathy Iyer, TNN
Publication: The Times of India
Date: February 16, 2013
URL: http://timesofindia.indiatimes.com/india/Harvard-doctors-give-Kumbh-health-facilities-thumbs-up/articleshow/18521955.cms

The first verdict from the international health experts at the Kumbh Mela to record diseases among pilgrims has been positive.

 The team comprising mainly medical doctors from Harvard University in Massachusetts, USA, is "largely impressed" with the orderliness of the Mela and the lack of any major disease outbreak.

 However, the caveats follow. "The systems are indeed streamlined. But while there are parts that worked, some didn't," said Dr Satchit Balsari, who led the team of 25-odd doctors from Harvard University's FXB Center for Health and Human Rights to Allahabad.

 The team found that even though ambulances were in place, their paths were blocked.

 Smoke from choolahs was the largest cause for respiratory illnesses among the 15,000-odd patients who had visited the various hospitals so far. "Pilgrims use cow dung or firewood to light a fire, resulting in over 23% of patients seeking medication for a cough," said team member Dr Michael Vortmann.

 In a reflection of modern India's pill-popping habits, powerful analgesics or painkillers were among the main medicines doled out to these patients. A few members from the Harvard team, who travelled to Mumbai for their return flight, said that the Kumbh could be better managed if such "minor" issues were ironed out.

 The team cited other instances where better management was called for. Dr Dhruv Kazi, a Vile Parle-born cardiologist from San Francisco General Hospital, found a senior citizen collapsing right next to him.

 "I was glad to locate an advanced life-support ambulance nearby, but the paramedics didn't have the key to the oxygen tank," he said. Moreover, the crowds were unwilling to make way for the ambulance. "It took us 40 minutes to reach a health centre that was less than 5km away," he added.

 The main objective of the Harvard team, which had the support of the National Disaster Management Authority and the Allahabad Medical College, was to map patterns of diseases, water distribution, sanitation and disaster management plans.

 The university plans to publish a research paper highlighting public health concerns during mass gatherings and migrations. The Mahakumbh with its massive turnout—thirty million devotees arrived on the "big bath day" of Mauni Amavasya on February 10—made it an ideal study spot.

 The first reaction of the team was the amazement at the degree of organization. "The electrical grid, wide boulevards, street lights, water supply, sanitation, crowd control, security, sector hospitals and a central referral hospital would be impressive anywhere—but the fact that this is all temporary and will be gone by the end of March—makes it an absolutely astounding organizational feat," said the doctors.

 The team's goal was to prove that it is not difficult to gather data in resource-scarce settings. Using a handful of I-pads, the doctors have so far mapped 15,000 patients who visited the various hospitals. "If we can do it, the government can certainly do it. Our surveillance tool should help with early detection of impending epidemics in the future," said Dr Kazi.

 The data of 15,000 patients already has some telling points. For instance, some hospitals near the bathing ghats were more crowded than others.

"Each hospital had the same staff strength despite the disproportionate number of patients. Our data shows that there can be better resource allocation," said Dr Balsari. "Also, most patients who visited the hospitals did not have acute problems. This means that interns and junior doctors could also be used so that senior physicians can spend more time with the acute cases."
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