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Gujarat's swine flu puzzle

It was October 29, 2009 evening, around 5.00 pm. I had just reached my office in Gandhinagar after my routine round of Sachivalaya. A journalist-colleague, representing a vernacular daily, came down to me and told me that Gujarat chief minister Narendra Modi, back from Russia, was suffering from swine flu. As a newsperson, I didn’t believe what he said, yet I tried to frantically find out whether this was true, but all in vain. Then sitting in the same building, Akhbar Bhavan, this journalist told me frankly, he had filed a story about this to his paper, but it was not being carried as his bosses in Ahmedabad found the information “humbug”. Hence, in retaliation he had decided to pass on the “exclusive” information, to which he alone was privy, to me and others. 
Thanks to this journalist, several newspapers quietly pushed out a news item about Modi suffering from swine flu as some sort of rumour with a punch-line (not uncommon) that there was no confirmation from official sources.Next day, all congratulated this journalist. At a media conference in the ministerial complex of Gandhinagar, at the community hall opposite Modi’s residence, top doctors from Ahmedabad, who were treating Modi, announced that the CM had “early symptoms” of swine flu, his condition was “under control” and was “normalizing”. About the same time when the media conference was on, I received 14 missed calls from a senior Civil Hospital physician, whom I knew well. I had put my mobile phone on the silent mode. I rang him up. He asked me straight: “I was frantically searching you, Rajiv. Do you have any idea who leaked this information about Modi having swine flu?” I replied I had no knowledge, wanting to know why he was asking this. “I phoned you up yesterday to confirm if Modi was suffering from the disease, but you didn't pick up”, I complained.
I tried exchanging a few pleasantries, but I found he terribly disturbed. I didn’t understand what was wrong. Later, a senior bureaucrat told me that Modi suspected not just this physician, who often undertakes routine check-up for Modi and his ministers, but also others for passing on the information about swine flu. Modi, even in bed, was bitterly castigating babus and physicians left and right for the leak. One of the physicians was quoted as saying that he had never witnessed this kind of “odd behaviour” from any politician before. The bureaucrat said, a frantic search was being made, under the able guidance of the chief minister’s office, on how the information about Modi having swine flu was leaked, though everything was kept in the wraps. After all, the leak had taken place despite the fact that Modi’s identity wasn’t revealed even in the sample sent for checking. The sample carried the name "Ramesh"!
I recall this incident, even as it is becoming increasingly clear that, with about 150 deaths this year, Gujarat tops in negligence towards swine flu, and things have gone so far that the Gujarat High Court had to come down heavily on the state government, wondering why it has not declare the disease "an epidemic". Terming the state government's report on steps being taken to handle the disease as "eyewash", the High Court suggested that health care was in bad shape in Gujarat: "Instructions do not work. There are no qualified doctors in your community health centres. Even for X-ray, patients have to go outside". Indeed, there was a time when top Gujarat officials close to Modi would gleefully declare the state was “ideal” for medical tourism. Even memorandums of understanding were signed for this at Vibrant Gujarat business summits, a biennial event. But no one remembers them now.
Soon after Modi suffered from swine flu in 2009, the state babudom went into action. Quarantine wards in government hospitals were activated. As Gandninagar Sachivalaya was also found to be in the grip of the disease, with some officials, including the then state health secretary Ravi Saxena, having tested positive, a routine checkup was announced for all those who suffered from even mild cold. Many officials were quarantined. Things remained active over the next one year or so. Every passenger getting down from an international flight at the Ahmedabad airport was asked to fill up a declaration that she or he wasn’t under the grip of the disease. If running nose was detected, checkup was done at the airport itself. Someone close to me, who came from the US, recalled how it was all very odd. “There was so much of rush. The paper work took so much of time. As if they are going to overcome swine flu with this piece of paper”, was the comment on coming out of the airport three hours after the plane landed. At the Gujarat University grounds, where a state-sponsored exhibition was on, special gadgets were put up at gates, which would, one of the organizers told me, “detect” if you had any symptoms of swine flu!
I don’t know how reliable these gadgets were, but one thing is by now amply clear: Over the last two years, nobody seemed to take swine flu seriously. There was no action plan, and nobody remembered it. In fact, there appears to be little awareness among those at the top in Gujarat that public health should not be taken lightly. Modi-style propaganda through hired PR agencies, on one hand, and suspicion towards anyone who disagrees, on the other, rules top government circles. Negligence towards health has reached a point where the view has gone strong that the best policy would be to hand over public health to private institutions. A senior bureaucrat quoted Rajesh Kishore, who heads the health department, to say that there is “no option but to privatize health in order to improve it”! In fact, the Gujarat’s government tall claims on social sector are in sharp contrast to ground reality.
I was scanning through state budget documents, and this is what I found: The Gujarat government’s proposed expenditure for the health sector as ratio to the total allocation in 2013-14 has come. It was 4.6 per cent in 2012-13, and for 2013-14 it will be 3.9 per cent. As for education, it was 16.1 per cent in 2011-12, went down to 13.4 per cent in 2012-13, and for 2013-14 it is 13.9 per cent. Reserve Bank of India document, “State of Finances: A Study of Budgets of 2012-13”, reveals that Gujarat’s social sector expenditure as ratio to total expenditure has been receding. It was 37.6 per cent in 2012-13, as against 39.9 per cent in 2010-11 and 38.6 per cent in 2011-12. In fact, Gujarat’s social sector expenditure as aggregate of the total in 2012-13 was less than the national average, 40 per cent, and worse than 14 out of 17 major states, including Chhattisgarh (49.3 per cent), Jharkahand (45.4 per cent), Rajasthan (43.8 per cent), Bihar (43 per cent) and Maharashtra (42.5 per cent).
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https://timesofindia.indiatimes.com/blogs/true-lies/gujarat-s-swine-flu-puzzle/

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