CHIKUNGUNYA OR WHAT?

As Chikungunya rages, turns fatal and makes a mockery of health and hygiene in India's Capital, MEENAKSHI RAO delves into the disease from a patient's point of view

It was in the early 2000s that I first heard of the term Chikungunya. It had broken out in and around the Gorakhpur-Ballia-Basti belt of east Uttar Pradesh. Ah, I thought then. So here comes another one of those unknown epidemics from a region which has gained notoriety for large-scale populace ailments over the years.

Though scores of people were hit back then, the blazing epidemic hardly ever made it to page one in any national English dailies, after an initial mention.

In school, which was relatively nearer to this ailing area than Delhi, being in Lucknow, I had often learnt the name of epidemics from this chronic belt. Meningitis, I remember, was one such dreadful outbreak. Hordes, mostly children, died before the news died. Then there was Filaria, that Elephant Foot disease. It all used to happen down there in the remote part of UP.

In a child’s mind back then, it was something that struck people of another world, nothing to do with us, much like Yellow Fever that happened far, far away in remote China, along that Geography textbook river called the Yangstze.

Back in real time, it was just another weekend of mall-crawling when I suddenly felt this striking pain in my knees and back — a never-before kind of pain which I put down to the stress of walking and standing for long hours in the mall which, I presumed, would vanish after a long, hot bath and a good night’s sleep.

Morning came, and with it, the longest period of disease that I’ve ever been in the grip of in my entire life. It’s been over two months and I am like an old woman struck by something that closely resembles crippling arthritis. No fever (it went down in the two initial days), no cold, no throat infection. Only crippling, devastating, unexplained — and if I must point out — money-draining pain with no succour.

With the pain, began the trail of doctors, hospitals, ghar ke nuskha and what not — but only to more misery, more pain.

Within a day, my knees were gone. I was being carried to the toilet and the family started thinking “wheelchair”. A rash of doctors, medicines and misery later, nothing worked. Only thing I felt lucky about was that I was alive while 16 others had died in the Capital to the same disease.

DOCTOR 1 (Consultation Rs  700 plus tests): The first doctor I went to, a trusted physician, looked at me and said straightaway: “This looks like Chikungunya. The pain will take some time to go away”. His gentle, concerned tone didn’t give away the horror I was in for. He prescribed a CBC (Complete Blood Profile) and on my pleading, gave me some painkillers which would not plummet my platelet count.

All was well with my CBC but the pain was unbearable and the 102-plus fever had vanished in a matter of two days. I returned to Dr ML Rastogi who was by then so deluged with “chikungunya-like” patients that he was spending around 20 hours a day in hospital and still was unable to tackle the load.

By day four, and many tears down the drain, I was struck with something more than just “chikungunya like symptoms,” considering that my serology test for this ailment was negative. I had inflammation of nerves knee down. This basically meant that besides the knees and the wrists and the fingers and the shoulders, every nerve point in my lower legs was so painful that I was unable to even wear clothes.

DOCTOR 2 (Consultation Rs  1,200 plus more tests): As the paracetamol-pancid-becosule-lots-of-fluids rigmarole continued, I changed doctors, went to a bigger hospital, a bigger doctor — of Internal Meds. He barely even let me explain. “It’s chikungunya, continue with paracetamol, four times a day,” he told me curtly. As I protested, trying to draw his attention to the excruciating pain, he told me to do another, more advanced chikungunya test. “Here’s the report,” I said. “Not this one, this one doesn’t really catch the disease. Do an RT-PCR test (the sure shot test for chikungunya) and whatsapp the report to me immediately,” he said, before calling in the next patient.

He also suggested a doppler of the lower limb, considering I was diabetic and he thought it was best to rule out any blockage of blood circulation. A week later, there was no relief. In the second visit, he gave me a steroid painkiller injection and said one wouldn’t kill me even if I was diabetic. I got myself injected, the pain stayed.

THE TESTS: As I was to discover, the initial test called the chikungunya serology test cost Rs  900 at Dr Lal PathLabs. However, what the doctor did not tell me was that it needs to be done at least 4-5 days after the fever strikes and only then it shows results. So Rs  900 went down the drain and the pain only increased.

The more advanced test, which was ordered on me just a week after the tribulations started, is actually effective 15 to 20 days after the disease sets in. Now, RT-PCR was not available anywhere in Delhi at that time, except for Dr Dang’s Pathology. Even Max Hospital, where I got tested, I later discovered outsourced it to Dang’s. The test cost me Rs  4,000 and the doppler of the legs another Rs  3,500.

Both were negative! On whatsapp the doctor, meanwhile, said one line: “Meds unchanged, continue with paracetamol.”

(The Delhi Government took over a month to cap the price of the chikungunya serology test at Rs  600, like they did for dengue last year. Thousands paid out of their bones literally for these tests in this month. Even now the Rs  600 cap is for only serology and not the extremely expensive PCR test. Dr Lal Pathlabs is now doing the PCR for Rs  1,500!)

Anyway, by this time, I was screaming in pain and of course screaming in pocket too. Rs  10k had been spent with no relief.

DOCTOR 3 (Consultation fee Rs  700, no tests only expensive meds): By the time I reached the third doctor, very highly recommended by a former colleague whose chikungunya she had apparently cured, I had a stressed tummy on top of the pain and the immobility. Relatively young, this doctor told me that the PCR test had been wrongly timed so may not have caught the strain and I needed to do it again after 10 days! She said, a diagnosis was important because if it was not chukungunya which the earlier one indicated, it had to be something more serious.

However, all she did was put me on the next generation painkillers, a set of two four times a day plus an antacid to protect my stomach, which incidentally was already reeling. These had to be taken for 10 days.

Struck with stomach unease and nausea, I discontinued these medicines after five days. When I called her to say the pain had not moved out an inch, she told me categorically she could not do much as “I have prescribed the maximum dosage of painkillers.”

I never went back to her. Imagine, a helpless, clueless doctor!

It was only later that I found out that she was not at fault alone. Actually, the entire medical community in Delhi is clueless about what the disease actually is. Some say it is a mutated virus from the chikungunya family. Some call it viral rheumatism in which the joints are giving way. Alarmingly, research on this strain is nil till now and so there is no specific medicine like Tamiflu or a vaccine to deal with the ailment. One does not know if the institute of vector-borne diseases has even started to study this new strain.

DOCTOR 4 (Consultation fee Rs  700, Rs  200 per weekly dose, alternative medicine): It was over a month and two hospitalisations for pain later that I turned to homoeopathy, mostly moulded by whatsapp videos and messages about the efficacy of ayurveda and homoeopathy as opposed to only the painkillers in allopathy.

The ayurveda guy at a reputed centre ruled out any massage treatment in such intense pain but gave a rheumatism ointment to apply on the areas of pain. Though that hasn’t worked on the knees, it does give a 10-minute release of pain in the wrists. So, have used up at least five bottles of this till now.

Even as the allopaths cry foul of homoeopathy, this was the only medicine that has helped me. “It will take a week and reduce the pain by 50 per cent,” Dr Khaled Qasmi promised at his basement clinic in Nizamuddin. It has and I am, for now, sold out on homoeopathy even though dear friends in the allopathy medicine are direly warning me against stealthy steroids in those sugar pills which I eagerly wait to have and do not delay even by a second.

Steroids, as you would know, mess up the body for normal patients and are poison for diabetics like me. But Dr Qasmi and his father Dr Mohammad Qasim, the senior homoeopath, laugh off the allegation, saying this has been an age-old, never-proved charge borne out of the pharma lobby-propelled bias towards alternative medicine worldwide. I believe him but almost fall in my chair as he tells me what is it that I am having. Apparently, it’s a highly processed medicine made out of pus that is infected with the same virus. It helps the body to develop immunity to the virus and heal. Such is the pain that I don’t mind the processed pus at all. “Like homoeopathy, allopathy does not look for a clinical diagnosis and only medicates you with painkillers which often stress the kidneys and the patients,” Dr Mohammad opines.

It’s been two weeks with the homoeopaths but the pain though receded has not gone. 

On the whole, till now, I have spent around Rs  30k on doctors and their medicines.

So much for living in Delhi, the capital of beautiful India. As it turns out, Delhi is the biggest urban slum of India ridden with all the urban ills that you can count.

As I closely watched from my bed, sometimes at home and mostly in hospital (who would have thought of hospitalisation on account of pain?), it took the newspapers over a month to report the epidemic in its full strength and the political administrators much longer. And even when they did, it was all about the disgusting, needless, futile and tedious spat between Arvind Kejriwal’s Government in Delhi and the BJP at the Centre through their man Lt Governor Najib Jung. When it was not the spat, then it was about one or the other of Kejriwal’s Ministers falling by the wayside due to his libido for sex or money.

For Delhi to be in the influence of vector-borne triple whammy — chikungunya, dengue and malaria — is a shame on India’s global emergence, a blot on its effort to emerge from the “Third World” tag it has been vigorously trying to shake. The bins are overflowing and the garbage continues to remain littered well into the roads with no one really taking care of the waste as the mosquitoes are getting their best-ever breeding ground they could have expected. The much touted Swachch Bharat Abhiyan looks like a mockery and it is time the Government spent more time on actually cleaning up the streets of Delhi than spending money on striking and engaging toilet ads on TV.

The healthcare budget of our nation is only one-fourth of the Defence budget and the population so big that a lakh deaths here and there don’t really matter to the Government. This complete negation of qualitative human existence needs to be urgently reversed. About time the Government respected human life and stopped treating health as an NGO concern.

Even a humidity prone, less prosperous island nation like Sri Lanka has managed to blink on the malaria free map of the world. Not India though. 

Source: Sunday Pioneer, 18 September, 2016