Mumbai: Last week, a report in MiD DAY spoke of the ongoing dissension between the municipal corporation and some NGOs over the number of reported dengue cases in the city, with the latter pointing out that figures released by the BMC fall far short of accurate ('Is dengue really on the decline in Mumbai?' December 7).
Turns out the NGOs aren't the only ones who feel that the civic body is trying to manipulate figures to mislead the masses.
A doctor who is a member of the Maharashtra Malarial Death Review Committee has added credence to their claims, admitting that he and his colleagues have been facing constant pressure from officials of BMC and the State Health Department to avoid mentioning dengue as the primary cause of death while they review cases.
MiD DAY report on December 7
The Malarial Death Review Committee consists of several doctors and experts appointed by the state health department and the BMC. Its primary responsibility is to review the cause of death of a malaria or dengue patient and then declare the primary cause of death.
The doctor who requested anonymity, said, "We at the committee are asked to review the actual cause of death of malaria and dengue patients. Though the death certificate issued to a victim may already mention the cause of his death - both primary, such as dengue, and morbid, such as the organ failure stemming from dengue - a case can come to our committee if the BMC or the state health department feels that there is need for reviewing."
Asked if BMC's statistics regarding dengue deaths were accurate, he said emphatically, "One word answer to this question is 'NO'. The actual numbers are much higher than the declared ones. Being in the committee, I know very well how many people die due to dengue."
The doctor explained that when an individual is suffering from dengue, his platelet count falls well below normal, causing his condition to become critical. This in turn leads to complications in the functioning of organs - lungs, liver, kidney, to mention just a few. He said, "So even if the patient dies due to the failure of any organ, we can never forget that the primary cause is dengue. How then can the BMC claim that the cause of death is organ failure and not dengue?"
Asked if it was possible for the numbers to be manipulated, he confirmed, "The number of dengue deaths is being manipulated. The BMC and the state health department are trying to give the impression that they have been successful in controlling dengue cases at the ward level and across the state. Hence, they refuse to accept the number of dengue deaths, even if dengue is mentioned as the cause of death on the death certificates of the victims."
He claimed that though the committee members do not wish to manipulate the cause of death in the certificates, pressure from the upper echelons of the BMC and the state health department forces them to do so. He said that the BMC and state officials force the committee to mention the morbid ailments that a victim suffers owing to dengue as the primary cause of death.
The NGOs had pointed out that the civic agency does not bother to collect data from private hospitals and dispensaries, as a result of which the number of victims and casualties is reassuringly small in their statistics. An NGO had alleged that the even their statistics on dengue cases till March this year are much higher than the figures portrayed by the BMC till December this year. The doctor confirmed that the civic body does not take cases reported in private hospitals while drawing up its figures.
He added that the numbers provided by the NGO are also incorrect, and in reality the figures are much higher.
The other side
Additional Municipal Commissioner Manisha Mhaiskar said, "The figures released by the NGO on dengue occurrences and dengue deaths is incorrect. The data provided by the NGO is merely based on the death certificate records. However, doctors who aren't even qualified with MBBS degrees provide most of these death certificates. Hence the BMC does not take such cases into account."
Asked about the revelations made by the doctor, she said, "There is a committee similar to the Maharashtra Malarial Death Review Committee that reviews dengue deaths. However, it is only in very unusual cases that the committee is asked to review the actual cause of the victim's death.
The committee consists of doctors appointed by MCGM, the state and few other experts. The allegations are incorrect as there is no pressure from our side to manipulate the cause of death. During the review, a panel of expert doctors is involved in a discussion based on the medical records of the victim. The decision made is based on unanimous consent. If a decision is not made at the end, the discussion continues for a longer time."