Amidst pandemic, Hepatitis outbreak in children of Pulwama village

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On the night of 15 November, Riyaz Ahmad Mir’s eight-year-old son, Momin Riyaz, woke up with severe abdominal pain and began to profusely vomit. Alarmed at this, Riyaz drove his son to the district hospital in Pulwama town, some nearly twenty kilometers from their village, Agri Check. 

After a medical examination and some tests, the doctors at the hospital informed Riyaz that Momin was suffering from Hepatitis A, a highly contagious liver infection that is spread through contaminated food or water or by contact with an infected person. 

Soon after, more children began to exhibit symptoms similar to Momin. Twenty-two children of the village, comprising 450 households, tested positive for the hepatitis virus, some have even been hospitalised for severe symptoms. 

Momin has since begun recovering from the infection but treatment has cost Riyaz, a school teacher in the service of the government, about five thousand rupees. “Most of us [in Agri Check] do not even have our own vehicles to take our children to the hospital,” Riyaz said of the economic status of the village.

According to Javaid, the Block Medical Officer of Agri Check, said that the cause of the infection’s outbreak was determined to be the Bidnai stream, on which the residents of Agri Chak depend for water supply, including for drinking purposes.   

“The doctors told us that we should avoid drinking water [from Bidnai] but how can one survive without it?” asked Riyaz. “We only drink boiled water, everything else is done with dirty water. We wash our clothes and even cook with this water only.”

Multiple challenges

The Bidnai stream is the only source of potable water for the residents of Agri Check is being polluted by a hospital, just three kilometers from the village, said Riyaz. “The stream passes just outside a hospital in Kellar [in Shopian], they throw everything in it,” he said. “The water is full of diapers, sanitary napkins, syringes, empty bottles, wrappers, and disposables.” 

Moreover, Riyaz said, residents living around the stream have constructed toilets, discharging the waste directly into the stream. “Even if someone urinates, that directly gets mixed with our drinking water,” he said, adding that the village receives water twice a day through the network of old and cracked pipelines. “Water gets contaminated because of these cracks as well.”

After repeatedly requesting the Public Health Engineering (PHE) department to take measures to clean Bidnai, local residents of Agri Check took it upon themselves to clean the stream. “They hardly clean it once or twice in a year but it gets contaminated in just 15 days,” rued Riyaz.  

Ramesh Kumar, Chief Medical Officer in Shopian, however, refuted allegations that medical waste was being dumped in the stream. “The bio-medical waste of the hospital goes to Lassipora plant for bio-medical waste management,” he said, instead accusing local residents of dumping waste into the stream. “The water has been contaminated probably because of the overall waste of the village thrown into the stream by the villagers. Hospital is not involved with it.”

‘Tomorrow it can be anyone’

Javaid, the BMO, told The Kashmir Walla that seventeen cases of infection were reported among the children due to contaminated water. The outbreak, however, he said was under control. “While the earlier cases are recovering, the new cases are very less,” he said.

As per Javaid, the water test report was unsatisfactory, indicating that there is some sort of serious contamination in it. “Water has been a problem there, although the PHE Department has been working over it but this time the problem has increased,” he said. “The PHE Department needs to treat the water as soon as possible. Hopefully, there will be no cases left soon.”

However, a few houses away from Riyaz’s residence, nine-year-old Aabiru Jan has also been diagnosed with Hepatitis A. Her father, Mohammad Shameem Dar, a driver by profession has only been able to get her treatment done by taking loans from people. “Since August 5 there has been no work at all. When she fell ill, I didn’t even have money to take her to the hospital,” said Dar.

Aabiru, like other infected children in the village, has not been able to eat anything due to abdominal pain and indigestion. “She even starts vomiting after drinking water,” said Dar, who can’t afford a water purifier or storage tank at his home. “I think 90% of people here don’t have enough facilities,” he said.

As per the research conducted by Kashmiri epidemiologists on the outbreak of Hepatitis A and E in Kashmir, it was found that during the three year period, between 2015 and 2017, twenty-three outbreaks were detected, which affected the districts of Anantnag, Kulgam, and Pulwama in south Kashmir; Budgam, and Ganderbal in central; and Baramulla and Kupwara in the north. A total of 393 cases of hepatitis were reported. 

Ishfaq Hameed, Assistant Executive Engineer at PHE Department said that raw water always has contamination but it was tested, the results were satisfactory and chlorination was done. “I think that the kids who have fallen ill must have drunk the contaminated water directly from the stream,” said Hameed.

Hameed believes that it is the people who throw garbage in the stream, causing further contamination. “If people throw the garbage in the river who will clean it later?” asked Hameed. He added that the holes are created in the pipelines at a distance of every 200-300 metres for removing any sort of airblocks.  

As the contamination of water continues, the people of Agri Check village continue to suffer due to improper filtration facilities. “God has been merciful till now, otherwise we would not have been even alive,” said Dar. “Today it is my child, tomorrow it can be anyone.”

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