Kasaragod: Twenty-eight months after the then health minister K K Shailaja inaugurated a catheterisation or cath lab in Kasaragod's district hospital, the government is yet to create a post of cardiologist there.

Neither has the government kept its word to activist Daya Bai in October 2022 to conduct special medical camps by March this year to identify endosulfan victims.

The last time the government conducted such a camp was six years ago in 2017. That camp was conducted after endosulfan victims and activists organised a series of protests. 

Scores of children born with physical and intellectual disabilities are denied free-of-cost specialty care, pension, and compensation given to endosulfan victims. 

The government had also ignored its promise made in January 2019 to review the cases of 1,031 suspected endosulfan patients who were shortlisted in the 2017 special medical camp but not recognised as endosulfan victims.

Now, the mothers of these suspected victims have formed a collective -- Endosulfan 1031 Protest Committee -- to hit the streets to press for their demand. 

"Our only demand to the government is to include the 1,031 patients in the list of endosulfan victims," said the collective's convenor P Shyni.

Endosulfan 1031 conducted a token protest meet on June 30 and is planning to take out a protest march to the Kasaragod collectorate on August 8. Before that, they met Minister for Social Justice R Bindu, Minister for Health Veena George, and Leader of Opposition V D Satheesan and submitted their petitions.

Satheesan has taken up their cause and written to Chief Minister Pinarayi Vijayan to initiate steps to include the 1,031 patients in the list of endosulfan victims.

From the mid 1970s to 2011, the state government-owned  Plantation Corporation of Kerala (PCK) aerially sprayed endosulfan on its cashewnut plantations in 11 grama panchayats to protect the crop from tea mosquito bugs.

Up to 2017, the government had identified 6,727 persons with physical and intellectual disabilities as victims of the aerial spraying of pesticide.

The long wait for care

After the 2017 special medical camps, specialist doctors short-listed 1,905 patients as probable endosulfan victims. 

But after social screening by the health department, the government identified only 363 patients as endosulfan victims. 

The Endosulfan Peeditha Janakeeya Munnani, an NGO fighting for the rights of endosulfan victims, organised a hunger strike of mothers in front of the Secretariat in January 2019 demanding that the remaining 1,542 patients should also be included in the list of beneficiaries.

The hunger strike was called off after the government agreed to recognise the patients below 18 years as endosulfan victims, without further examination.

The government kept its word and included 511 patients below 18 years in the list of endosulfan victims.

But in the same meeting attended by the chief minister, the government also agreed to review the case files of adults and take a call. "The government never initiated steps to review their cases," said Shyni.

Satheesan wrote to Pinarayi Vijayan now saying the inaction on the part of the government had led to the denial of justice and benefits to the remaining 1,031 patients. 

Promises to break protests

In October 2022, the government made four promises to end the 18-day hunger strike of 82-year-old activist Daya Bai.

Ministers Veena and Bindu gave signed statements to Daya Bai that the government would conduct special medical camps to identify endosulfan victims in five months.

Eight months on, parents of children born with disabilities in the past six years are still waiting for the medical camps.

The two ministers also assured Daya Bai that the government would set up daycare centres for children with disabilities in every grama panchayats in Kasaragod, and set up a Neurology Department in the District Hospital in one year. 

The government has three more months to miss the deadline. But it is yet to create a post of cardiologist in the cath lab inaugurated in February 2021.

Cath lab, a 'working arrangement'

The state government set up a   catheterisation or cath lab with an initial investment of Rs 9 crore in the District Hospital in Kanhangad in February 2021. At the inauguration of the cath lab, minister Shylaja said a cardiologist would be appointed at the lab in 10 days.

In October 2022, 20 months after the inauguration, the Directorate of Health Service sent a general medicine consultant posted in Perumbavoor Taluk Hospital to run the cath lab in the Kasaragod District Hospital. The department called it a 'working arrangement'.

The general medical consultant was sent because his post-graduation was in cardiology.

Ten days ago, the doctor was transferred to Ernakulam General Hospital and he left. 

Cath labs, headed by cardiologists, are examination rooms where cardiovascular diseases are diagnosed and procedures such as angiogram, angioplasty, and implantation of pacemakers are performed. 

Kanhangad's cath lab has another cardiologist, a junior pulmonology consultant, said the health official. "Her PG was also in cardiology and so she is posted there on working arrangement," he said.

The two doctors used to conduct outpatient consultations on Tuesdays and Wednesdays, for around 40 patients each day. The procedures were done on Thursdays, Fridays, and Saturdays. 

In around 250 days, the two doctors conducted around 200 procedures such as angiogram and angioplasty in the cath lab, said the health official.

They also used to attend to casualty patients needing cardiovascular interventions.

The doctor transferred to Ernakulam General Hospital can return only if the minister and the superintendent of the hospital agree to another round of "working arrangement."

But that is not a long-term solution, he said. 

Considering Kasaragod district does not have a cardiology department in government hospitals, the cath lab in the district hospital should function round the clock. "For that, the government should create at least three posts of cardiologists and 12 posts of nurses," the official said.

As of now, the hospital management committee has appointed 10 nurses on a temporary basis at the cath lab, and paid by the district panchayat.