Largely impressed with the orderliness of the Mela and the lack of any major disease outbreak there, the team of international health experts comprising mainly medical doctors from Harvard University in Massachusetts, USA, stationed at the Kumbh Mela to record diseases among pilgrims have given a positive verdict so far.
There were a few warnings though. ‘The systems are indeed streamlined. But while there are parts that worked, some didn’t,’ said Dr Satchit Balsari, who led the team of 25-odd doctors from Harvard University’s FXB Center for Health and Human Rights to Allahabad. It was found that even though ambulances were in place, their pathways were blocked. The largest cause for respiratory illnesses among the 15,000-odd patients who had visited the various hospitals so far was the smoke from choolahs.
According to a few members from the Harvard team Kumbh could be better managed if some ‘minor’ issues were ironed out. Team member Dr Michael Vortmann said, ‘Pilgrims use cow dung or firewood to light a fire, resulting in over 23% of patients seeking medication for a cough,’ said. Powerful painkillers were among the main medicines given out to these patients.
‘I was glad to locate an advanced life-support ambulance nearby, but the paramedics didn’t have the key to the oxygen tank,’ said Dr Dhruv Kazi, a cardiologist from San Francisco General Hospital who found a senior citizen collapsing right next to him. It took them 40 minutes to reach a health centre that was less than 5 km away because the crowds were unwilling to make way for the ambulance, he added.
The team with the support of the National Disaster Management Authority and the Allahabad Medical College was at the Mela to map patterns of diseases, water distribution, sanitation and disaster management plans. The Maha Kumbh had a massive turnout of thirty million devotees on the ‘big bath day’ of Mauni Amavasya on February 10. A research paper highlighting public health concerns during mass gatherings and migrations will be published by the university.
The team was the astonished at the degree of organization. ‘The electrical grid, wide boulevards, street lights, water supply, sanitation, crowd control, security, sector hospitals and a central referral hospital would be impressive anywhere. But the fact that this is all temporary and will be gone by the end of March makes it an absolutely astounding organizational feat,’ said the doctors.
With a goal to prove that it is not difficult to gather data in resource-scarce settings, the research team used a few iPads to map 15,000 patients who visited the various hospitals. Dr Kazi said, ‘If we can do it, the government can certainly do it. Our surveillance tool should help with early detection of impending epidemics in the future.’
The data made a few significant observations like, hospitals near the bathing ghats being more crowded than others. ‘Each hospital had the same staff strength despite the disproportionate number of patients. Our data shows that there can be better resource allocation,’ said Dr Balsari. ‘Also, most patients who visited the hospitals did not have acute problems. This means that interns and junior doctors could also be used so that senior physicians can spend more time with the acute cases,’ he added.