After the death of her father two months ago due to a stroke, 17-year-old Maddela Padma bravely stepped into the role of breadwinner, working as a daily wage labourer to support her mother and five younger siblings in Sarada Colony, a densely populated slum in Guntur city of Andhra Pradesh. On February 10, the teenager developed sudden health complications. “For two days she had terrible motions and vomiting,” says Katamma Maddela, Padma’s mother, who thought her daughter would feel better eventually. Herself bedridden for the past two months after a spinal surgery, Katamma could not do much to help her daughter. On February 10 in the morning, her condition deteriorated. “We shifted her to the Government General Hospital (GGH) with the help of our neighbours,” she recalls. Within hours, Padma died.
With Padma’s passing, Katamma, who is in her 40s, finds herself at the intersection of grief and uncertainty. After her husband’s death, her daughter took on two jobs: cutting the stalks of dried red chillies before they went to the mill to be pounded, and a cleaning job in the Railways, working for a third-party service provider. She now faces the daunting challenge of earning just for her family to survive. Two of her younger daughters are still in school, studying in Class 1 and 5, while the other three — another girl and two sons, all below 15 years — have dropped out of the education system. The ₹5 lakh ex-gratia that she received from the government following Padma’s death will tide her over for a while.
Between February 10 and 13, as many as 120 people from different parts of the city, including Sarada Colony, were admitted at GGH-Guntur. Hospital superintendent Y. Kiran Kumar says eight were in critical. As the number of patients mounted, the hospital dedicated an ICU and a ward for them. “Since the incident happened over the weekend, some of the doctors were not available and the existing staff provided treatment to them,” says Kiran Kumar.
He does wish that Padma had been brought in earlier though: “We may have been able to save her life,” he says, adding that an autopsy report would confirm the reasons for her death.
Acknowledging that the situation could deteriorate, the administration set up emergency health camps. Scores of people — officials did not disclose the exact number — received treatment here and at health centres and private hospitals. All treatment was government-funded.
Struck by illness
Like most slums, the one in Sarada Colony, inhabited by about 1,500 people, is characterised by congested houses, narrow roads, and a poor sewage and garbage disposal system. Outside Katamma’s ₹2,000-per-month rented dwelling, the residents collect municipal water from a tap above a drain. They have set up a plastic drum by the roadside, using an extension pipe to collect water.
Shaikh Nasar Vali, a resident of Mallikharjuna Pet in the city, says that his 73-year-old grandmother was admitted to GGH-Guntur around 3 a.m. of February 12 following vomiting and diarrhoea. She has been receiving intravenous drips since. Other members of his family were also showing similar symptoms, he says. “Several others from my colony have also been admitted to hospital,” he says of the area that badly needs a sanitation upgrade. “But the doctors are not responding adequately to the situation,” he says, alleging that doctors and nurses were not giving relatives enough information about the illness.
Lying on the adjacent bed, Shaikh Mahaboob Johny, a 48-year-old resident of Srinagar Colony in Guntur, says he was admitted to the hospital on February 10. “It started with loose motions and then I began vomiting. I had a sleepless night and got hospitalised the very next morning,” he adds. Johny shares that his son Amid, 25, also got sick but managed with medicines at home.
While a majority of people, including those affected and doctors, believe water contamination triggered the health crisis, authorities of Guntur Municipal Corporation, the district administration, and experts at GGH are yet to confirm the reason for the sudden outbreak.
Government in action
Municipal Commissioner Keerthi Chekuri says despite the cause being unknown, the civic body has initiated the process of collecting water and food samples for laboratory testing. “We are also conducting house-to-house surveys to identify affected people, and are setting up health camps on a war footing,” she says. Preventive steps like creating hygiene awareness is also being carried out by ward volunteers.
Stating that they were waiting for the lab reports to reach a conclusion, Minister for Health, Medical and Family Welfare Vidadala Rajini also maintains that the focus is currently on preventive and control measures across the city and not just at suspected hotspots. The maximum number of cases were reported from three pockets: Sarada Colony, IPD colony, and Sangadi Gunta. Velangini Nagar, Srinagar, Vasantharaya Puram and Ponnur Road also saw cases.
An expert committee has been constituted to look into the possible causes, she says. “Stool, urine, and blood samples of those affected will help analyse the disease and reasons for the health crisis,” she asserts. The government has deployed several health and ward secretariat staff in addition to municipal employees to conduct a family member health survey across all places in the city that saw incidents, the Minister adds.
M.T. Krishna Babu, Special Chief Secretary to the Health, Medical & Family Welfare department, on Monday said that since the outbreak was spread across the city, it was difficult for field staff to isolate a reason for the spread of symptoms.
Lathkar Shrikesh Balajirao, commissioner and director of the municipal administration, has instructed civic body officials to clean all drainage canals, repair water supply pipelines, and remove pipelines adjacent to drainage canals, during his field visit on Tuesday.
Guntur district collector M. Venugopal Reddy says the government has been supplying water to affected areas through tankers, along with creating awareness about boiling water before consumption.
What microbiologists say
Some doctors suspect a cholera outbreak that is caused by contaminated water or food, with diarrhoea and vomiting being the main symptoms. The scientific way to investigate this is to get the stool sample examined under the microscope. If traces of Vibrio cholera bacterium are found, it can be broadly diagnosed as cholera, says former Additional Director of Medical Education and former principal of Andhra Medical College, Dr. P.V. Sudhakar.
Microscopic examination takes a day, but sometimes, stool culture is necessary, as there may be sub-species, especially when there is a mass outbreak. This process takes about three to five days, says Director of Visakha Institute of Medical Sciences, K. Rambabu. He says there is no need to panic, because with medicines, it can be treated in three to four days.
The vital aspect is to maintain electrolyte balance. “On one hand, we must ensure that the toxins are drained out of the body, and on the other, we inject electrolytes to maintain homeostasis,” says Dr. Sudhakar. Personal hygiene is key — hands should be kept clean to avoid spread of germs, say doctors.
