Fractured/Earth

Reportage on a planet without equitable or sustainable development.

Lessons from Bihar’s 2016 dengue outbreak : Migration, poverty, garbage are spreading new diseases

In 2016, dengue hammered Krah. As many as 100 people living in this densely-packed, predominantly Muslim ghetto of about 1,000 families near Biharsharif contracted the disease, say residents. The scale of the outbreak was unprecedented. As Mohammad Ilyas, a young tailor who works and lives in Krah, said: “We never had such an outbreak earlier.”

The disease itself is a newcomer to the region. Krah and surrounding areas have been battered by many diseases. But many of the old diseases are in decline now, according to Dr Lakshmi Chaudhary who runs a clinic in adjacent Silao. “There were only two-three cases of jaundice last year,” he said. “Hepatitis B is even lower. We now almost never see cases of diarrhoea.”

Here, people now suffer from other ailments. There is more cancer, dengue and chikungunya, said Chaudhary.

This is the story across Bihar. Doctors, epidemiologists and people living across the state say that in the last ten years the state’s disease burden has seen three large changes. First, some infectious diseases like kala azar, measles, diphtheria, pertussis and polio that used to wreak havoc earlier are far less common now. Second, people are falling to new diseases like drug-resistant tuberculosis, dengue, chikungunya, Japanese encephalitis and arsenic poisoning. Third, some of the old infectious diseases – hepatitis A and E, malaria, pneumococcal meningitis and typhoid – are claiming more patients than before.

This, as the article says, is very different from the epidemiological transitions in other states. And gets into the reasons why. Part two, out tomorrow, will look at the state’s response to these causal factors.

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m rajshekhar

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I am an Indian journalist with interests in energy, environment, climate and India’s ongoing slide into right-wing authoritarianism. My book, Despite the State, an examination of pervasive state failure and democratic decay in India, was published by Westland Publications, India, in January 2021. My work has won the Bala Kailasam Memorial Award; the Ramnath Goenka Excellence in Journalism Award; and five Shriram Awards for Excellence in Financial Journalism. Write to me at despitethestate@protonmail.com.

Reviews

“…une plongée dans les failles béantes de la démocratie indienne, un compte rendu implacable du dysfonctionnement des Etats fédérés, minés par la corruption, le clientélisme, le culte de la personnalité des élus et le capitalisme de connivence. (…a dive into the gaping holes in Indian democracy, a relentless account of the dysfunction of the federated states, undermined by corruption, clientelism, the cult of the personality of elected officials and crony capitalism).” Le Monde

“…a critical enquiry into why representative government in India is flagging.” Biblio

“…strives for an understanding of the factors that enable governments and political parties to function in a way that is seemingly hostile to the interests of the very public they have been elected to serve, a gross anomaly in an electoral democracy.” Scroll.in

“M. Rajshekhar’s deeply researched book… holds a mirror to Indian democracy, and finds several cracks.” The Hindu

“…excels at connecting the local to the national.” Open

“…refreshingly new writing on the play between India’s dysfunctional democracy and its development challenges…” Seminar

“A patient mapping and thorough analysis of the Indian system’s horrific flaws…” Business Standard (Image here)

“33 മാസം, 6 സംസ്ഥാനങ്ങൾ, 120 റിപ്പോർട്ടുകൾ: ജനാധിപത്യം തേടി മഹത്തായ ഇന്ത്യൻ യാത്ര… (33 months, 6 states, 120 reports: Great Indian journey in search of democracy…)” Malayala Manorama

“Hindustan ki maujooda siyasi wa maaashi soorat e hal.” QindeelOnline

“What emerges is the image of a state that is extractive, dominant, casteist and clientelist.” Tribune

“…reporting at its best. The picture that emerges is of a democracy that has been hijacked by vested interests, interested only in power and pelf.” Moneycontrol.com

Book lists

“Ten best non-fiction books of the year“, The Hindu.

“Twenty-One Notable Books From 2021“, The Wire.

“What has South Asia been reading: 2021 edition“, Himal Southasian

Interviews

“Journalism is a social enterprise…,” Booksfirst.in.

“Democratic decay at state level: Journalist M Rajshekhar on book ‘Despite the State’,” The News Minute.

“Covid-19 en Inde : “des décès de masse” dont un “État obscurantiste est responsable,” Asialyst.

Allusions/Mentions

“JP to BJP: The Unanswered Questions“.
Mahtab Alam’s review of “JP to BJP: Bihar After Lalu and Nitish”.

“Urban History of Atmospheric Modernity in Colonial India“. Mohammad Sajjad’s review of “Dust and Smoke: Air Pollution and Colonial Urbanism, India, c1860-c1940”.

“Westland closure: Titles that are selling fast and a few personal recommendations,” by Chetana Divya Vasudev, Moneycontrol. (Because this happened too. In February, a year after DtS was released, Amazon decided to shutter Westland, which published the book. The announcement saw folks rushing to buy copies of Westland books before stocks run out.)

“Time to change tack on counterinsurgency” by TK Arun, The Federal.

“All Things Policy: The Challenges of Governing States” by Suman Joshi and Sarthak Pradhan, Takshashila Institute (podcast).

“The Future of Entertainment“, Kaveree Bamzai in Open.

“On What India’s Watching“, Prathyush Parasuraman on Substack.

“The puppeteers around us“, Karthik Venkatesh in Deccan Herald.

“Will TN election manifestos continue ‘populist’ welfare schemes?“, Anna Isaac for The News Minute.

“Why wages-for-housework won’t help women“, V Geetha in Indian Express.

“The poor state of the Indian state“, Arun Maira in The Hindu.

Book discussions

26 December, 2021: Rangashankara, Bangalore, a discussion with Dhanya Rajendran.

16 November: Rachna Books, Gangtok, a discussion with Pema Wangchuk.

29 August: Books In The Time of Chaos, with Ujwal Kumar.

21 May: Hyderabad Lit Fest with Kaveree Bamzai and Aniruddha Bahal.

28 March: Paalam Books, Salem, Tamil Nadu.

19 March: The News Minute, “Citizens, the State, and the idea of India“

6 March: Pen@Prithvi, with Suhit Kelkar

20 February: A discussion between scholars Usha Ramanathan, Tridip Suhrud, MS Sriram and me to formally launch Despite the State.

6 February: DogEars Bookshop, Margoa.

5 February: The Polis Project, Dispatches with Suchitra Vijayan.

30 January: Founding Fuel, “Systems Thinking, State Capacity and Grassroots Development“.

25 January: Miranda House Literary Society