Has India Really Been Rendered Free of Polio? - Part I
According to the famous Scientific Advisor Sam Pitroda, the battle which ex-prime minister Rajiv Gandhi started to eradicate Polio, took 25 years to get completed (Reference DainikJagranHaldwani Dated 26.03.2014). In January 2014, the eradication of Polio from India featured as the main news in almost all the national dailies. Then nobody among them had the inkling that the Polio virus or Polio paralysis that had been eradicated from the country, had its percentage merely 0.1 to 2 percent (see page 554 Text Book of Microbiology By Surinder Singh Jaypee Publication). About the rest i.e. non-viral polio was never mentioned in detail at any time or any place by any medical scientist or researcher (except the writer of this article). Dr.Shri Gopal Kabra however briefly described this in his “From A Doctor’s Diary” column titled as “One Injection And A Matter Of One Life.” (Amar Ujala Dated 22.5.2011 issue). Similarly Dr. M. Walia of Dr. Ram ManoharLohia Hospital, New Delhi in the “Understanding Polio” column featuring his interview conducted by Aditi Tandon (in The Tribune 25 October 2011 issue), favoured not administering injection to small children for polio eradication if they happen to suffer from fever at that time. This maybe be due to all kinds of paralysis whether resulting from a virus, administering medicine into the hip(s) muscles through a needle, injury related, resulting from a fall or due to certain diseases of the brain; the cause of all these has been surmised as polio virus and right from the beginning, the focus has been only on the eradication of this virus. World Health Organization too with the help of different health agencies made efforts to eradicate the virus and these are continuing even today.
Polio or poliomyelitis is an enterovirus. Like many other viruses, it has its own way of operating. Polio actually means gray. This word has been taken from the gray matter of the nervous system. Till now it has been believed that polio virus is found in the stool of a patient afflicted with polio. Whenever the virus gets an opportunity, it travels from the mouth and reaches the stomach mostly in the small aged children (less than 5 years). Then through the intestines, it circulates through the blood and reaches the brain. Here it gets settled in the anterior motor horn cells of the spinal cord and damages them. From anterior motor horn cells, axons originate and control the functions of voluntary muscles (contraction and relaxation) of the hands, legs and some other parts of the human body. The nerve cells after being damaged by the virus, lose their control on the voluntary muscles. As a result the muscles get paralyzed. This is also called acute flaccid paralysis. Generally people refer to this as polio. Due to inactivity of the flaccid muscles, after some time these muscles slowly get emaciated and become small in size. This leads to thinning of the affected organs (which is mostly the hand(s) and leg(s)). In spite of this, all the sensations except motor functions remain intact in the affected organs.
In this matter, the most surprising thing is that till date none of the virologist or pathologist has mentioned anywhere how virus actually damages motor nerves in his/her article/research paper appearing in the newspapers, journals or books. This means that the pathogenesis and pathology involved in the polio affliction has not been rightly described ever since. Whatever we get to read in this context is merely based on conjecture.
During any month of 2013, I was ordained by my present institution Chandola Homoeopathic Medical College and Hospital to participate in a meeting called by the District Collector of the district Udham Singh Nagar, Rudrapur regarding the successful management of Pulse Polio Program. In this meeting, representatives of all the colleges and schools of the district along with the employees and officials of health and medical department also took part. The data related to polio infection in the whole world collected by Dr. M Khanna, Surveillance Health Officer of World Health Organization, Kumaon Region of Uttarakhand State was shown in the form of a documentary on the screen. After that Dr.PankajPandey the District Magistrate who was the chairman of the meeting, gave the necessary instructions for the successful management of the Pulse Polio Program. The writer after obtaining permission of the chairman then brought the people’s attention to the news item dated 12 February 2013 titled “Two Year Old With Polio Symptoms” published in the Hindustan, a hindi language newspaper. It mentioned that in the past year 2012, 137 acute flaccid paralysis cases were found and none of them was positive for polio virus. The moment this writer brought the chairman’s attention to this particular news item, the concerned official replied that this news erroneously got leaked to the press. This surprised me a lot and like the famous English saying “The cat came out of the bag” revealed the truth about polio eradication in India to all. Meanwhile the meeting was called off. After that Dr.Khanna took me to his office which was located within the same premises at some distance. There we had a detailed discussion on polio. On the subject of polio eradication with the help of my long experience and deep study of 40 years, I wrote two articles; one in English titled “Polio or Traumatic Paralysis Eradication by 2000 A.D. (Now 2010 A.D.)” and the other one in Hindi titled “AkhirKabTak” (meaning Till When) which I gave to Dr.Khanna for reading. He just had a quick look at them and kept their photocopies with him.
Here I am feeling enormously happy and satisfied to mention that out of these articles, the one written in English that was then titled “How to eradicate non-viral Polio” was prepared by me during the start of 1995. I sent this article to some news bulletins/journals where it got published. I also sent it to World Health Organization (W.H.O.) through email. Two months before the end of 2000 A.D. with a changed title “Polio or Traumatic Paralysis Eradication by 2000 A.D.”, I sent this article to various state governments, journals as well as newspapers. But most of them overlooked it though some did evince keen interest in it. But like a true freedom fighter, I moved ahead unconcerned at the dangers lying in my way. During this time the Polio Eradication Program’s time limit which was again extended for the year 2010 A.D., had also ended. It is said one person cannot take on the high and mighty, but at least he can make efforts towards this. I also did the same.
In view of the changed circumstances, I got this English article translated to Hindi titled “Akhir Kab Tak” (meaning Till When) and then sent it through simple post to the Central Health and Family Welfare Minister, Mr.Ghulam Nabi Azad along with its English version. I did this in January 2011. Though I did not get any acknowledgement from his side about receiving the article, but one main suggestion out of a few mentioned in the article was implemented. Its clear evidence is now not only being seen by me, but also by you as well as others. The suggestion goes like this:-
The Health and Family Welfare Ministry of Indian Government or may be The Director General of Health Services through its government order (G.O.) directly or through the chiefs of state health services, institutions restrained pediatricians from injecting medicine in the gluteal or brachial muscles of a small child and even if it is a must, to inject it in the femoral muscles. In this matter, the directives had not been turned into a government ordinance. Had it been so, it would have got due coverage in the newspapers and every common or important man, government and private medical practitioners would have quickly known about it.
The second thing that got missed here is that in case a physician, nurse or a compounder deliberately administers medicine through needle into the gluteal muscles and the small child gets afflicted with a flaccid paralysis due to this, he would be held guilty and punished for this act. At present, there is no provision of such a punishment in India or may be all over the world which could have served as an effective deterrent. The Central Health and Family Welfare Ministry thought it prudent to forward the photocopies of my sent articles to Central Council for Research in Homoeopathy, New Delhi. From it, I got a letter which on one hand requested me to send data about polio and on the other hand mentioned to me that polio (all kinds of paralysis) is caused by virus alone. To describe this letter in detail here would be like diminishing the worth of this article.
Here in Rudrapur the district headquarters of Udham Singh Nagar Uttarakhand, a private pediatrician got a stool culture done of a 2 year old girl child who was suffering from diarrhoea in the summer months. He had administered medicine to the child through a needle in her femoral muscles. This fact was stated to me by the girl’s father when he brought the child to me as her diarrhoea did not improve. I felt very happy that the suggestion provided by me, was starting to get implemented even though late. I thanked God for granting wisdom to all.
After the year 2013 ended, I called Dr.Khanna to enquire how many cases of acute flaccid paralysis in total, happened in the past year to which he replied 135. This meant that these were just 2 less than 137 cases that happened in 2012. After this, I met Dr.Khanna twice in the district collectorate first time in the context of an AIDS rally and the second time during the Pulse Polio Immunization Program as was held before. But on both these occasions, I did not feel it appropriate to discuss or raise questions on these two matters.
On 20th June 2015, Dr.Khanna while performing his duty came to my college. Though he also used to come during the past years, I did not get an opportunity to interact with him then. This time it was a sheer coincidence that I was on duty in the outpatient department and Dr.Khanna came into the department and got seated on a chair in front of me. Soon we got engaged in a conversation and I sought information from him about the acute flaccid paralysis cases that happened in the Udham Singh District in the year 2014. To this, he replied that total 7 cases have come into light and in all of these cases quack medical practitioners were responsible. I felt elated on hearing his reply. I was so heartened that I also introduced Dr.Khanna to my other fellow physicians as well as the Principal. The interns too felt pleased at this success. According to Dr.Khanna he himself advocates to all physicians, nurses, compounders, private practitioners to administer medicine to small children through injectable needle only when it is absolutely important and that too in the femoral muscles. He said he also wrote to World Health Organization about this success. I also urged him to hold discussions with World Health Organization’s surveillance medical officials of other districts about it. This success provided this writer the energy and inspiration to write this article.
For informing the readers, it would be appropriate to mention here that whichever state of India passed the general order (G.O.) and fully got implemented the Central Health Department’s or chief officials’ directives aimed at its medical institutions, hospitals, primary health centres, etc., sooner or later the number of polio cases whether caused by a virus or the ones associated with a non-virus related paralysis would be reaching there towards zero. I strongly expect this to happen. Otherwise by merely making the small children swallow the polio vaccine drops any number of times, would bring no change in the status of acute flaccid paralysis. The 30th December 2014 Times of India issue that states during the year 2011 Uttar Pradesh’ Pilibhit district alone reported 318 cases of children afflicted with acute flaccid paralysis, 283 cases in 2012, 219 cases in 2013 and 164 cases reported in the first 48 weeks of the year 2014, is a clear evidence of this. These figures themselves make it clear that whether India has been really ridden free of polio or like earlier it is still trying to become free from it.
(Dr. P.S. Rawat is the Professor of Chandola Homoeopathic Medical College and Hospital, Rudrapur, Udham Singh Nagar, Uttarakhand, India. He can reached at Email: email@example.com)
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