ORISSA MATTERS Exposed a Malady that reached a Remedy, thanks to Prasad Harichandan and the new Health Minister

Subhas Chandra Pattanayak

ORISSA MATTERS had exposed a malady in Orissa’s health care sector, which, thanks to Opposition Chief Whip Prasad Harichandan and a number of alert MLAs and a considerate minister-in-charge has reached a remedy on September 1.

While investigating into how far welfare verdicts are being honored by the Government, ORISSA MATTERS had stumbled upon a milestone judgment delivered by the Orissa High Court a year ago on 28 July 2011 in the matter of compensation claimed by the father of a small kid of 17 months, infected with AIDS because of transfusion of unsafe blood supplied to him by a government blood bank in course of his operation.

In response to the case, the blood bank as well as the State Government had claimed that “safe blood”, determined to be so by screening in ELISA method, was supplied to the kid.

But the kid’s advocate Mrs. Sujata Jena had put up a tremendous argument. She had established that ELISA method was not efficient beyond doubt to detect HIV in its “window period” which comprise about three months from the day of infection.

If blood is drawn from a HIV infected person within the first three months of infection, the virus may escape detection through ELISA screening and may appear to be “safe” even though HIV positive. This had happened to the kid, Jena had argued.

Accepting her well researched argument, the High Court had come to the conclusion that the disaster could not have befallen the kid had the blood given to him on an operation table could have been screened through the “latest technology” called Nucleic Acid Testing (NAT) in Polymer Chain Reaction (PCR) method.

And, thus determining, the High Court had awarded a compensation of Rs. 3,00,000/- to the child including cost of his further treatment to be borne by the State, and had issued a mandamus that “the Government must ensure that in all Blood Banks, the PCR method is available to identify the virus of HIV during window period”.

But as is its wont, the government run by Naveen Patnaik did not welcome the mandamus.

Therefore, despite a bureaucratically constituted committee comprising eminent serologists and Professors of microbiology in all the Government Medical Colleges of Orissa having “unanimously” resolved on 25 Feb.2012 that the NAT PCR technology, being “the latest and foremost technology available in India”, “need to be introduced for screening of the blood units to reduce the gray zone period of Transfusion Transmissible Infections like HIV-I, HIV-II, Hepatitis-B and HCV”, the political Government ignored the same.

We exposed this malady in these pages on 8 July 2012 as it came to our attention while investigating into non-implementation of welfare verdicts.

It was a cue for other newspapers in Orissa to stress on the necessity of blood screening in NAT PCR method.

But to our shock, the Government wanted another committee to undo the 25th February “unanimous” recommendation of the committee aforesaid.

The new committee, wherefrom the experts of the previous committee were kept out, rejected the recommendation for NAT PCR method and resolved on 24 July 2012 to challenge the High Court order dated 28 July 2011 through a review petition.

Harichandan turned it turtle

As we again exposed this mischief, it attracted the attention of Sri Harichandan, the well erudite Opposition stalwart. With the Assembly in session, he headed an adjournment notice that came up for discussion on September 1. Government got the jolt.

In initiating the debate, Sri Harichandan completely razed down the 24 July decision of the Government in Health department that had tried to justify non-implementation of the High Court order for adoption of NAT PCR method for blood screening.

He cited National Blood Policy and many other referral documents including the 1996 Supreme Court verdict in Common Cause case to demolish the government stance reflected in July 24 resolution and castigated the government for the contempt shown to the High Court order and for discernible lack of concern for human life as is seen in its reluctance to equip blood banks with the latest technology to ensure that the bloods collected and supplied by them do not carry latent viruses of HIV-I, HIV-II, or other Transfusion Transmissible Infections like Hepatitis-B and HCV as happens in the “window period”.

If HIV and other killer viruses continue to spread from the blood supplied by blood banks, patients would fear to take blood transfusion and all the blood banks will collapse, causing thereby serious dislocation in health care in the State, he warned. Though the Red Cross is tagged to Blood Banks, it cannot bear the cost of NAT and hence the State must provide necessary fund for adoption of the method, he said.

Besides the fire his speech usually emits, he was so much his persuasive best in this matter of immense public importance, that, despite the 24 July resolution to challenge the High Court verdict, the Minister of Health announced that the Government will adopt the NAT technology to obtain safe blood for transfusion.

Stop all avoidable luxurious spending by ministers and bureaucrats and give primacy to blood screening by NAT PCR method instead of avoiding it under the plea of financial constraints, said Pratap Sarangi. Dr. Prafulla Majhi supported the demand for adoption of NAT technology in place of ELISA even as Dr. Nrusingh Sahu cited the cost factor in support of continuance of ELISA method. Dr. Ramesh Chandra Chyau Pattanayak and Alekh Jena contributed their input to the debate.

In reply to the debate, Minister of Health Dr. Damodar Raut pointed out that the departmental reluctance to adopt NAT PCR method was driven by, cost factor besides, lack of direction in NACO and NBTC guidelines.

But, he confessed, howsoever marginal be the failure in detection of HIV through ELISA, it is most unfortunate that a kid of only 17 months was infected by AIDS, which is being attributed to unsafe blood transfusion.

He announced to introduce blood screening through NAT method in the four most busy blood banks in the State, to begin with.

So bureaucratic bungling may no more stymie the latest technology and NAT should soon be in use in the blood banks operating in each of the three Medical Colleges and the Capital Hospital, Bhubaneswar.

For us in ORISSA MATTERS, it was a day of victory, as the malady we had exposed got remedied.