LET THEM DIE

The Kyasanur Forest Disease is locally known as ‘Monkey Fever’ and it has claimed seven lives so far. One of these is that of 35-year-old Kullan, a Tribal living in Cheeyembam 73 Colony in Wayanad. In the first week of January, after he contracted a fever and developed a headache, his condition began to steadily deteriorate. From the Primary Health Centre at Pulpally, he was sent to the taluk hospital at Mananthavady and then to the Medical College in Kozhikode. On 14 February, his third day there, Kullan died. No one in his family understands why. “The doctor told us that he had bleeding in his brain and thus passed away,” says Suresh, his brother-in-law. A blood sample was taken only after they reached the Medical College, say his family members. Like others of the Kattunaykkar tribe, Kullan also used to go to the forest to collect firewood and honey. That is when he is suspected to have contracted the virus.

According to the latest figures put out by the District Medical Officer (DMO), 124 suspected cases of Monkey Fever have so far been reported in the tribal belt of Wayanad district. As many as 48 have tested positive. But unlike the saturation media coverage of the recent avian flu scare in the state, this outbreak passes silently. In December 2014, about 150,000 ducks were culled in Alappuzha to guard against avian flu, and farmers got their compensation without delay. Though not a single human being contracted the disease, the state was on high alert.

This time, it’s different, and this may be because 112 of the 124 people suspected of suffering Monkey Fever are Tribals—as were five of the seven who succumbed to the disease. As many as 45 of the 48 blood samples that tested positive are of Tribals. Around 13 tribal colonies in Wayanad, located in the border forest belts between Kerala and Karnataka, have been affected this year. Cheeyembam 73 Colony, which has a population of 320 families, is the worst hit. Four have died, and many are yet to recover even after medication.

Monkey Fever need not be fatal. A patient can survive through timely medical intervention and proper healthcare. But that is a privilege beyond the means of most Tribals. Those among them who have fallen ill don’t know how they got the disease, and have no clue how to keep their children and other family members safe. They are given Odomos, a common mosquito repellant, to apply on exposed body parts and warned not to visit forests for the time being. This is not advice they can heed, since most of them earn whatever little they do as forest foragers.

Kuttan and Radha have not yet entirely recovered when we meet them at the temporary medical camp in an aanganwadi building in Cheeyembam Colony. It has been more than a month since they contracted the disease. Kuttan is a Kattunaykkar, the most deprived of Wayanad’s tribes, whose survival depends on gathering firewood and honey. “They are more exposed to the forest than other tribal communities. Hence, the danger of transmission of the disease is high,” says K Rajan, an auto driver and active member of the Aam Aadmi Party In Wayanad who has been doing social work among Tribals.

Kuttan does not know how long he can survive without going to work. “I am having muscle pain in my legs and arms,” he says, “I am not fit to do anything.” He was admitted twice to the nearby taluk hospital over the last two months. His blood sample was taken in February and the disease confirmed by the end of the month. Radha too tested positive and was in the hospital for a week. She still has fever and is under medication.

On 26 February, 85-year-old Machi lost her life to the disease. She was admitted to a hospital on 17 February and discharged after two days. On 21 February, she was re-admitted and passed away in five days. Her daughter Bommi does not know what Monkey Fever is. She does not even know how old her mother is.

“This is a case of sheer negligence,” says Rajan, “There are many who got discharged without the fever being completely cured.”

Most affected people in the area have been admitted twice or thrice. We meet Raju, a wildlife watcher, at the government hospital at Kenichira. He first went to the government hospital at Pulpally and was discharged after six days, once the fever came down. Within a week, it had returned and he went to a private hospital and stayed there for eight days before being discharged. “He again fell ill and we came here yesterday,” says Leela, Raju’s wife. They have spent Rs 2,000, a fortune for a Tribal family.

Several Tribals are wildlife watchers who work for daily wages. They are all in danger of contracting Monkey Fever. Babu, a resident of Sultan Bathery, is a wildlife watcher but not a Tribal. Infected with the virus in the first week of January, he was the first individual to test positive for Monkey Fever. Babu has spent over a month across three hospitals, and on 15 March, the day we meet him, he still has muscle pain and weakness. Two years ago, he had got a permanent job as a wildlife watcher with the forest department, but says he has not received his salary since January. Kerala’s ministers of Health and Tribal Welfare and the local MLA have visited him and he was assured of financial aid that didn’t materialise.

This strange disease was first reported in 1957 among monkeys of the Kysanur forest in Shimoga, Karnataka. Since then, it has had the nickname Monkey Fever. A species of ticks that is rampant in the forests of Kerala, Karnataka and Tamil Nadu, is believed to carry the virus, and monkeys have been dying of it over the decades. These ticks can transmit the virus to humans just as easily as monkeys, the only consolation being that no case of human-to-human transmission has been reported (it’s thought to be impossible). “Avoiding tick bites is the best thing to do to prevent the transmission of the disease,” says Dr E Bijoy, the district programme manager of National Rural Health Mission in Wayanad.

There exists a vaccine against Monkey Fever, but it has not been introduced in the tribal areas of Wayanad despite a couple of cases being reported in 2012. Health authorities here claim that vaccination is not a viable option. “The course of vaccination is six months, which means that the person will not get its benefit in the immediate future. Besides, it cannot be given to those who have liver diseases. Most Tribal people are addicted to liquor, which makes vaccination difficult,” says Dr V Sasidharan, district medical officer of Wayanad.

Health workers cite a different reason for why Tribals are not being safeguarded by the vaccine. “Most of them are scared of injections. They are not willing,” says a health promoter at a Primary Health Centre.

Kunjan, a 48-year-old from Konimoola tribal colony at Kuppadi, is one of the latest fatalties of the fever. A wildlife watcher working in the Kurichyad forest range, he passed away on 10 March. He was the sole member of his family with a steady income.

Sulekha, an ASHA worker, also died after a week-long battle with the disease. Saleekha, her younger sister, says that government hospital doctors diagnosed Sulekha with a urinary tract infection and prescribed medicines for that. “The medication was not very helpful. She had high fever again and was admitted to a private hospital in the locality, from where she was immediately referred to the Medical College at Kozhikode on 24 February. Her blood pressure and blood count were consistently low,” says Saleekha. The test result confirming Monkey Fever came ten days after she died.

The authorities have no convincing reason to explain why the ASHA health worker received such shoddy medical attention. Sulekha’s family have got no compensation, though the declared figure is Rs 2 lakh for the family of the deceased and Rs 10,000 for anyone testing positive. “We face technical difficulties since it is March, the end of the financial year. The compensation will soon be given,” says Manoj, secretary to PK Jayalakshmi, Kerala’s minister for Tribal Welfare, when asked about tardy payouts. The minister himself was not available for a response.

After the current outbreak, the administration has finally decided to go in for a serious vaccination drive. According to the DMO, around 500 people—including doctors and the staffers of tribal and health department—have been vaccinated. But there is no specific treatment for Monkey Fever, apart from the usual medicines prescribed for viral fever in general.

The local MLA, IC Balakrishnan of the Congress, says that Tribals should be held responsible for not taking care of their health. “They are lazy and unwilling to consume medicines,” he says, “They are reluctant to take the nutritious food supplied through local institutions. That is the reason for the rising death toll among Tribals.”

ASHA health workershealth authoritiesKerala forestKyasanur Forest DiseaseMonkey FeverWayanad tribes