MEDICAL AND PUBLIC HEALTH SERVICES

COMMON DISEASES

Endemic diseases like malaria and tuberculosis as also respiratory diseases, dysentery and leprosy and epidemic diseases like small-pox, cholera, fever, etc., are noted to exist in the district. There are special units for the control of diseases like malaria, tuberculosis and smallpox. The public health department offers help to the local bodies in the task of controlling the epidemic diseases through such agencies as the primary health centres, health assistants. Sanitary Inspectors and sanitary squads.

Malaria: Malaria is an endemic disease and was widely prevalent in the district. An intensive campaign against malaria was launched in the district during the period of First Five-Year Plan under the National Malaria Eradication Programme. Under this scheme each house in every taluka of the district was sprayed twice with DDT every year. These operations were continued during the Second Plan period also. Till 1955 the entire district received two rounds of spraying but since 1956 Akola taluka with a population of 96,074 was protected by two rounds and the rest of the district by one round only. The total quantity of DDT 75 per cent wettable powder consumed was 77,094 lb. and of DDT (Technical) 1,450 lb. excluding that used in Ahmadnagar borough municipality under this programme.

In 1956-57, 62 villages in the district were visited wherein 5,923 children were examined, out of whom 25 were found to be positive cases. In the year 1957, population protected under the National Malaria Control Programme unit in 3 rounds was 13,30,000. Of this, the number of persons protected within the Ahmadnagar municipal limits was 80,873. Indoor residual spraying operations were also conducted. In Ahmadnagar district 2,18,503 houses were sprayed and the percentage of unsprayed houses was 21.1. The total population thus protected was 3,63,309 from Shrigonda, Pathardi, Karjat and Akola talukas. The rest of the population in the other talukas of the district. i.e., 10,47,564 was protected by only one round. In 1957-58, 92 villages in Ahmadnagar district were visited wherein 8,991 children were examined, out of whom 152 were found to be positive cases.

In the year 1961-62 an additional third round of spraying was given to 48 villages in Parner taluka covering a population of 62,853, and twenty villages of Sangamner taluka covering a population of 2,495. During the same year 43,885 and 62,030 fever cases were detected in Parner and Sangamner units, respectively, of which 41,382 and 60,627, respectively received presumptive treatment.

In the year 1962-63 the Malaria control unit at Ahmadnagar covered a population of 11,60,085 in (1) Ahmadnagar, (2) Jamkhed, (3) Karjat, (4) Nevasa, (5) Parner, (6) Pathardi, (7) Rahuri, (8) Shevgaon, (9) Shrigonda and (10) Shrirampur talukas whereas the remaining three talukas were covered by the Sangamner unit.

The Ahmadnagar unit started functioning in 1953 when DDT spraying was taken up and continued upto 1963. The seheme of surveillance was taken up in 1960. A team of experts from the World Health Organisation visited this district and recommended that the DDT spraying was no longer necessary. As such it was discontinued. subsequently.

Table No. 7 gives details of spraying undertaken during 1962 and 1963.

TABLE No. 7—D. D. T. SPRAYING UNDERTAKEN BY AHMADNAGAR UNIT

N.A.=Not available.

The following statement shows the number of malaria patients treated in public dispensaries in the district from the year 1949 to 1957: —

In 1961. the number of out-door and in-door patients treated was 2,075 and 23, respectively as against 87 and 85 in the year 1965. In 1926. Ahmadnagar town recorded the highest death-rate of 2.71 per 1,000 of the population. In 1934, the number of deaths due to malaria was 2,034 in the whole of Ahmadnagar district while in 1956 the rural areas of Ahmadnagar district reported 1,297 deaths due to malaria. From 1961 to 1965 no death was recorded from this disease.

Small-pox : Small-pox is another scourge that takes a heavy toll of human life. In 1945, 844 deaths were reported from fifteen villages from the district. In urban areas among the towns high death-rate at 1.45 was recorded in Pathardi and 0.74 in rural areas of the district in the same year. The small-pox was also severe in the years 1958 and 1959 when the number of deaths recorded was 640 and 337, respectively. Karjat, Shrigonda, Ahmadnagar, Sangamner, Kopargaon and Nevasa talukas were affected in 1958 and Parner. Pathardi. Shevgaon. Nevasa and Ahmadnagar in 1959.

A good measure of success has been achieved in the eradication of this disease. National Small-pox Eradication Programme was introduced in the district as a part of the Third Five-Year Plan with a plan provision of Rs. 1.89 lakhs. Since 1st November 1963 the scheme was handed over to the Zilla Parishad. The staff of this scheme consists of a Special Medical Officer, twenty Inspectors and 87 vaccinators.

In the 1st consolidation phase, 2,71,547 primary and 15,07,525 re-vaccinations were carried out accounting nearly for 97 per cent of the total population. From the year 1968 a decision was taken to protect children in the age-group of 1-15 years. Accordingly 2,23,159 primary and 5,27,833 re-vaccinations in the above age-group were performed in 1968 and 1969 respectively.

The following statement shows the attacks and deaths due to smallpox in the district during the period from 1967 to 1970:—

Tuberculosis: The B.C.G. vaccination work was started in the old Bombay State from 1954 to fight the dreaded disease. B.C.G. Immunisation and T. B. Control was transferred to the Public Health Department in 1955. The scheme is now functioning under a full-time Assistant Director of Public Health. There are also some private teams working in the district which are financed by the concerned municipality and other private institutions. The staff of such private teams usually consists of one medical officer, one nurse and one technician. Under the mass B.C.G. vaccination scheme initiated in Ahmadnagar district in 1954, apart from the preventive measures undertaken the Government also takes curative measures There is a T. B. sanatorium for T. B. patients at Aranagaon near Ahmadnagar. which accommodates 110 patients.

During 1957, the Government team working under the B.C.G. Vaccination Scheme tested 3,04,678 persons, out of whom 1,39,784 were found to be positives, 1,05,247 negatives and 59,647 absent, as against 15,710 persons tested by the private teams, of whom 6,917 were found to be positives, 7,567 negatives and 1,226 absent.

The following statement shows the review of the B.C.G. vaccination in the district in the years 1956, 1961 and 1964:—

* B.C.G. vaccination done in second round by Government.

Table No. 8 shows the review of B.C.G. vaccination done in the second round by Government teams in various talukas of the Ahmadnagar district during the year 1961.

TABLE No. 8—B. C. G. VACCINATION IN AHMADNAGAR DISTRICT IN 1961

Following statement shows the number of out-door and in-door patients treated and number of deaths due to tuberculosis in the district since 1946:—

Cholera : Cholera is another epidemic disease which takes a heavy toll of human life. The conditions in some of the districts of the Presidency including Ahmadnagar, which were called cholera nests favoured the out-break and spread of cholera. Scanty and unprotected water-supply and failure of rain generally helped the spread of the epidemic. Only intensive measures helped to keep the cholera out-break under control. A feature of great importance in connection with the cholera out-break in Ahmadnagar district was that in almost every infected village especially in Kopargaon taluka, the cases occurred in temporary camps erected for the purpose of cutting down sugarcane or making sugar and gur. Cholera also made its appearance in the district at the time of the Kartiki fair at Pandharpur. In the cholera epidemic of 1935 the severity of the epidemic was very much felt in the district. There were 1,768 attacks and 812 deaths from thirteen registration circles and 179 villages. The incidence was highest in the month of September. Shevgaon rural circle returned the highest number of cases and deaths, viz., 467 and 215, respectively. Among town circles. Sangamner town had the highest incidence with 46 attacks and 32 deaths. The year 1940 also showed a substantial fall in the cholera mortality.

In the year 1945 Kopargaon, Shevgaon, Nevasa, Rahuri and Jamkhed talukas were greatly affected by cholera. There were 4,205 cases and 2,798 deaths in 137 villages involving sixteen registration circles. The death-rate in rural areas in the district was 2.46 and 5.15 in urban areas, viz., Kopargaon town.

The statistical details pertaining to cholera epidemic from the year 1959 to 1968 are given in the statement below:—

Leprosy: The scheme of leprosy control is worked through the Zilla Parishad.

The following statement shows the number of lepers pet 1,00,000 persons for the Census years from 1891 in the district:—

In 1961 the incidence of leprosy was 6.12 per thousand in the district. In the years 1945, 1951 and 1961 the deaths recorded due to the disease were 127, 50 and 73, respectively. In 1963-64 there were about 1,000 cases under treatment and ten survey, education and treatment units were functioning for propaganda and treatment work. A leprosy control unit has been established at each primary health centre. In addition, the leprosy technicians give regular treatment to individual leprosy cases. There is one leprosy control unit at Jamkhed covering 55 villages and a population of 59,397. In 1960, 16,409 persons were examined.

Besides this there is one voluntary colony for lepers at Savedi providing a bed-capacity of 100.

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