Bhopal: With the lockdown in place and health workers across India occupied with the treatment of COVID-19 patients, the process of immunisation of children has been hit hard, especially in areas that have been categorised as red zones or districts.
A young lawyer and health activist from Indore is worried for his three-year-old son as he could not find a government or private institution for routine vaccination despite making the best efforts.
The lawyer, Abhijit Pandey, has no idea if this might have an impact on his son health. There are thousands of anxious parents like him who are clueless about how harmful a delay in immunisation could be for their little ones amid the spread of COVID-19 pandemic.
Government-aided reproductive and child health and immunisation services have been severely impacted in districts like Indore where a large number of coronavirus cases have been reported. So far, the commercial capital of Madhya Pradesh has seen 1,545 cases and 74 deaths.
With almost the entire healthcare staff including physicians, accredited social health activists (ASHA) and auxiliary nurse midwives (ANMs), engaged in coronavirus-related duty in Indore, the government institutions which take care of community health are almost defunct.
After the administration closed down private clinics in the city fearing mass infection at these crowded health centres, the problem has compounded as there are no places where pregnant women and infants can be offered their immunisation doses.
Besides, private medical practitioners are apprehensive after the two local doctors –Shatrughan Panjwani and Om Prakash Chauhan – who had contracted the disease died during treatment.
Meanwhile, Pandey has written to Chief Minister Shivraj Singh Chouhan and Health Minister Narottam Mishra seeking resumption of immunisation services in the state.
He said when he contacted the Chief Medical health Officer of Indore, Dr Pravin Jadia, the latter said that immunisation has been temporarily banned and there was no plan to resume the same in the near future.
The crisis is near similar in the state capital of Bhopal, another COVID-19 hotspot.
Arun Sharma, a resident of Piplani in the city, said he had to struggle to locate a government or private facility where his a month-and-half-old son could be immunised.
When Sharma finally reached Khushilal Sharma Ayurvedic Hospital, the staff there told him to visit a few days later saying the child was suffering from jaundice.
A resident of Hoshangabad Road in Bhopal, Nitin Vishwakarma, faced a similar crisis while looking for a facility to immunise his one-and-a-half-year-old son.
“I prefer private clinics for immunisation but most of them are avoiding OPDs and immunisation services amid the coronavirus scare,” said Vishwakarma.
Several other citizens had similar complains as they found government community health centres and dispensaries closed and most of private doctors only offering telephonic advice.
“Nursing homes are mostly offering emergency services that are being taken care of by on-duty doctors and nurses,” a senior pharmaceutical company executive said.
Dr Anup Hajela, president of Bhopal Private Nursing Homes’ Association, however, said most of the services are underway at private institutions.
Refuting claims of OPD services remaining shut, Dr Hajela said that telephonic advices, patients can visit clinics/nursing homes for health issues.
“Personal protective equipment (PPE) kits are required only in critically affected areas,” he told News18 when asked about availability of the same.
Private practitioners are slowly starting immunisation services, though in a limited manner.
Dr Vinod Jain from Anushree Hospital said that though routine immunisation is important, it is a blessing in disguise that children are away from infections due to the lockdown.
The doctor, however, added that vaccinations must not be avoided beyond one-and-a-half month, adding his hospital has started limited immunisation services.
“If possible immunise babies now as after the lockdown is lifted there could be a rush at clinics and children with immunisation could be prone to infections,” he added.
Dr HR Pippal from Pranjal Hospital in the state capital said that delay in immunisation has minimal impacts on children, adding that some some vaccines are offered in series which are crucial at regular intervals. “We have started immunisation at regular intervals at our clinic,” he said.
State Immunisation Officer Santosh Shukla said that institutional immunisation is banned in red zones as per Centre’s directives, while the same is underway in green and orange zones.
He said the authorities are considering offering vaccines to private hospitals, if required, but only they commit to administer it free of cost.
When asked how much risk the delay in immunisation could pose to a child, Shukla said a slight delay would not be harmful, adding a number of other countries are keeping a gap of two-four months due to the health emergency.
"If all the vaccines which are mandatory in first year for kids are administered within one year, it is okay," he said.
Meanwhile, pregnant women are having their own set of troubles amid the pandemic.
Ishita Singh (name changed), a resident of Mandideep in Raisen, had initially avoided visiting a doctor after conceiving recently. However, when she contacted a noted gynaecologist in Bhopal, the physician kept avoiding an appointment.
On Saturday, when Singh had some bleeding in the uterus, she approached the doctor without appointment and was informed about a miscarriage.
For E-1 Arera Colony resident Priyanka Mishra (name changed), getting a doctor’s appointment was easy but she could not find a functional pathology where she could get her tests done as prescribed by the doctor.
She finally got help from a pathology clinic owned by an acquaintance who collected samples from her home after she completed three months’ pregnancy a few days ago.
Deputy Director (ASHA) at National Health Mission (NHM) in MP Dr Shailesh Sakalle said that he has no idea about immunisation status in MP. He said ASHA workers are only entrusted with the responsibility of coordinating with pregnant women for ensuring government healthcare benefits.
However, various central government guidelines, including a letter from Vandana Gurnani, Additional Secretary and Mission Director of NHM (dated April 20), have specified that among other things, ASHA workers are responsible for keeping a data of pregnant women and immunisations.
Indore’s Assistant CMHO Indore Dr Madhav Hassani told News18 that there were issues with immunisation due to the intensity of the COVID-19 outbreak in the city. He said fresh guidelines have been received and institutional immunisation would commence in Indore from Tuesday.
Confusion prevailed as later Indore CMHO Dr Pravin Jadia told reporters that vaccination required at the time of delivery is being offered, but general immunisation has not started in the city as it could lead to crowding that might affect social distancing norms. He added that a gap of a couple of months in immunisation would not harm children.