www.praja.org 1 WHITE PAPER Report on the Sensitive Disease cases registered in the Municipal Dispensaries and working of the Elected Representatives in the Public Health Committee (April 2008 to March 2010)
Praja Foundation, a Mumbai based NGO released a white paper on the city’s health issues. The report focuses on the sensitive disease cases registered in the Municipal Dispensaries and the working of the Elected Representatives in the Public Health Committee from April 2008 to March 2010 in all 24 wards across Mumbai.
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1. www.praja.org WHITE PAPER Report on the Sensitive Disease
cases registered in the Municipal Dispensaries and working of the
Elected Representatives in the Public Health Committee (April 2008
to March 2010) 1
2. www.praja.org Table of Content Sr. No. Title Page No. I
Foreword 4 II Number of sensitive disease registered in Mumbai
across the wards 5 A) April 2008 to March 2009 5 B) April 2009 to
March 2010 8 C) Top five sensitive diseases during April 2008 March
2010 11 III Trends of top five sensitive diseases registered across
Mumbai 12 A) Malaria 12 B) Diarrhoea 13 C) Hypertension 14 D)
Tuberculosis 15 E) Diabetes 16 IV Number of questions asked by
Councillors on Health issues in top five 17 wards of highest cases
registered V Public Health Committee: Role and Working 19 TABLE 1
Ranking of wards according number cases of Sensitive Diseases 5
registered during April 2008 to March 2009 2 Ranking of wards
according number cases of Sensitive Diseases 8 registered during
April 2009 to March 2010 3 Public Health Committee Overview for
April 2008 to March 2010 19 Map 1 Ranking of wards according number
cases of Sensitive Diseases 7 registered during April 2008 to March
2009 2 Ranking of wards according number cases of Sensitive
Diseases 10 registered during April 2009 to March 2010 2
3. www.praja.org GRAPH 1 Top five sensitive diseases during
April 2008 March 2010 11 2 Quarter wise registered cases of Malaria
12 3 Quarter wise registered cases of Diarrhoea 13 4 Quarter wise
registered cases of Hypertension 14 5 Quarter wise registered cases
of Tuberculosis 15 6 Quarter wise registered cases of Diabetes 16 7
Question asked on health issues in all committee meetings (April
2008 17 March 2009) 8 Question asked on health in all committee
meetings (April 2009 18 March 2010) 9 Meetings attended by Health
Committee Members during the April 20 2008 March 2009 10 Details of
Health Committee meetings attended by Councillors during 21 the
April 2008 March 2009 11 Meetings attended by Health Committee
Members during the April 22 2009 March 2010 12 Details of Health
Committee meetings attended by Councillors during 23 the April 2009
March 2010 13 Number of questions asked by Councillors in Health
Committee 24 meeting during April 2008 to March 2009 14 Number of
questions asked by Councillors in Health Committee 25 meeting
during April 2009 to March 2010 15 Issues raised/Questions asked by
Councillors in Health Committee 26 meeting during April 2008 to
March 2009 16 Issues raised/Questions asked by Councillors in
Health Committee 27 meeting during April 2009 to March 2010 3
4. www.praja.org I. Foreword Malaria is in the news. As it
should! According to World Health Organisation (WHO), In many parts
of the world, the parasites have developed resistance to a number
of malaria medicines. As we have been observing, the malarial
parasite seems to have mutated: the symptoms of the disease are
changing; the efficacy of medicines has also become suspect. The
malaria outbreak that has caused 23 deaths in Mumbai since June may
have become a political blame game, but it raises several intrinsic
issues as well. We at Praja.org have done a systemic study of
healthcare across all the civic wards of Mumbai. We studied the
data for 11 sensitive diseases - Diarrhoea, Hyper Tension, Malaria,
Tuberculosis, Diabetes, Typhoid, Hepatitis A, Hepatitis B, Dengue,
Cholera and HIV as sensitive diseases The results are startling,
and inferences shocking. Clearly, it urges loudly upon all of us
citizens, elected representatives and civic administration to take
note of the trends. In 2008-2009, K East Andheri East reported the
maximum incidences of sensitive diseases. A year later, Andheri
East was trumped by 4 other wards with far less population! In
2009-2010, Kurla (W) reported the highest cases of sensitive
diseases followed by Parel, Prabhadevi, Andheri (E) and Mazgaon
areas. In fact, these five wards seem to be consistent in reporting
highest cases of sensitive diseases. Have we tried to find out the
intrinsic causes behind this trend? Should we not think of
long-term prevention measures? The data in the following pages
reveal a trend. Statistics do not lie; they warn us of a malaise
that can very well turn into an epidemic, if not tackled quickly on
almost a war-footing! Do you realise that of all the sensitive
diseases reported in the city of Mumbai, the maximum complaints
throughout the year across all civic dispensaries is that of
diarrhoea! While the privileged population of the city has access
to bottled water and filtering systems, many of the economically
challenged population has no recourse but to consume potable water
supplied by the BMC. They are the ones who are also likely to visit
civic dispensaries! It is indeed a crying shame that in this day
and age, potable water supplied by the civic administration leads
to diarrhoea? Diarrhoea is a water-borne disease. Clearly the
quality of water is suspect! The civic administration definitely
needs to clean up its act and its water! Why is it that we are
constantly fire-fighting? Why do we always try to shut the door
after the horses have fled? Why can we not be proactive? Why should
we not take preventive measures so that disasters are avoided in
the first place? In fact, our elected representatives too need to
start asking pertinent questions. Each year, we have 36 councillors
on the Public Health Committee of the BMC. In two years (2008-2010)
a total of 28 health committee meetings were held. A total of 63
questions were asked in these meetings, maximum of them related to
staff behaviour. Not a single question was raised about improving
or enhancing health environment in the wards. Do our elected
representatives even know what are the pertinent issues plaguing
their wards? Our aim at Praja.org aims is to arm our elected
representatives and citizens with pertinent information that can be
a great motivator for the civic administration. We seek the support
of the media in spreading the word for the benefit of our entire
city. Nitai Mehta Managing Trustee 4
5. www.praja.org II. Number of sensitive disease registered in
Mumbai across the wards A. April 2008 to March 2009 Ward Number of
cases registered K/E 10,496 G/S 9,682 F/S 9,314 E 7,874 L 6,866 F/N
6,208 K/W 5,369 G/N 4,992 H/W 4,787 M/W 4,680 H/E 4,535 R/S 4,343 A
4,245 R/C 4,139 N 3,820 S 3,583 D 3,033 P/N 2,798 M/E 2,753 B 2,261
C 2,068 T 1,846 R/N 1,226 P/S 1,043 Table 1: Ranking of wards
according number cases of Sensitive Diseases registered during
April 2008 to March 2009 5
6. www.praja.org Inference: The data is collected from 158
dispensaries of Mumbai from April 2008 to March 2009. The above
table presents number of registered cases of sensitive diseases.
Sensitive diseases consist of Diarrhoea, Hyper Tension, Malaria,
Tuberculosis, Diabetes, Typhoid, Hepatitis A, Hepatitis B, Dengue
and Cholera. The above table shows that K East ward has highest
registered cases (10,496) and P South has least cases (1,043)
registered for sensitive diseases in the year April 2008 to March
2009. There are other four wards like G South, F South, E, and L
ward which comes under top five wards for highest number of
registered cases for sensitive diseases. 6
7. www.praja.org 10,496 cases 6,866 cases 9,682 cases 9,314
cases 7,874 cases Map 1 : Ranking of wards according number cases
of Sensitive Diseases registered during April 2008 to March 2009
7
8. www.praja.org B. April 2009 to March 2010 Ward Number of
cases registered L 14,593 F/S 13,373 G/S 12,703 K/E 12,223 E 10,724
F/N 10,254 N 7,690 H/E 7,403 D 6,507 G/N 6,433 S 6,098 M/W 6,076
K/W 5,487 R/S 5,182 H/W 4,980 M/E 4,728 A 3,966 R/C 3,949 P/N 3,472
B 3,295 T 2,694 C 2,587 P/S 1,812 R/N 1,376 Table 2: Ranking of
wards according number cases of Sensitive Diseases registered
during April 2009 to March 2010 8
9. www.praja.org Inference: The data is collected from 158
dispensaries of Mumbai from April 2009 to March 2010. The above
table presents number of registered cases of sensitive diseases.
Sensitive diseases consist of Diarrhoea, Hyper Tension, Malaria,
Tuberculosis, Diabetes, Typhoid, Hepatitis A, Hepatitis B, Dengue,
Cholera and HIV. The above table shows that L ward has highest
registered cases (14,593) and R North has least cases (1,376)
registered for sensitive diseases in the year April 2009 to March
2010. There are other four wards like F South, G South, K East and
E which comes under top five wards for highest number of registered
cases for sensitive diseases. 9
10. www.praja.org 12,223 cases 14,593 cases 12,703 cases 13,373
cases 10,724 cases Map 2: Ranking of wards according number cases
of Sensitive Diseases registered during April 2009 to March 2010
10
11. www.praja.org C. Top five sensitive diseases during April
2008 March 2010 Graph 1: Top five sensitive diseases during April
2008 March 2010 120000 100000 80000 60000 40000 20000 0 Hypertens
Tuberculo Malaria Diarrhoea Diabetes ion sis Year 2008-09 10004
72548 16648 10154 2593 Year 2009-10 19867 104377 19198 10096 3263
Inference: The above data represents the top five sensitive
diseases recorded in 158 Municipal Dispensaries across all the 24
wards of Mumbai during April 2008 to March 2010. The above graph
shows that in both the years i.e. April 2008 to March 2009 (72,548
cases) and April 2009 to March 2010 (104,377 cases) the highest
number of cases were recorded in Diarrhoea. 11
12. www.praja.org III. Trends of top five sensitive diseases
registered across Mumbai A. Malaria Graph 2: Quarter wise
registered cases of Malaria Malaria Jan10 to Mar10 3306 Jan09 to
Mar09 1778 Oct09 to Dec09 6244 Oct08 to Dec08 2082 July09 to Sep09
7937 July08 to Sep08 4287 April09 to Jun09 2380 April08 to Jun08
1857 0 1000 2000 3000 4000 5000 6000 7000 8000 9000 Inference: The
above data presents quarter wise distribution of register cases for
Malaria. Comparison is between quarters of two year data on Malaria
from April 2008 to March 2010. The above graph shows highest number
of 7,937 cases of Malaria registered in July 2009 to September 2009
and the previous year in July 2008 to September 2008 cases
registered were 4,287. Similarly in October 2009 to December 2009
has second highest 6,244 registered cases for Malaria and the
previous year cases registered were 2,082 in October 2008 to
December 2008. 12
13. www.praja.org B. Diarrhoea Graph 3: Quarter wise registered
cases of Diarrhoea Diarrhoea 24307 Jan10 to Mar10 16727 Jan09 to
Mar09 26650 Oct09 to Dec09 16940 Oct08 to Dec08 34731 July09 to
Sep09 23321 July08 to Sep08 18689 April09 to Jun09 15560 April08 to
Jun08 0 5000 10000 15000 20000 25000 30000 35000 40000 Inference:
The above data presents quarter wise distribution of register cases
for Diarrhoea. Comparison is between quarters of two year data on
Diarrhoea from April 2008 to March 2010. The above graph shows
highest number of 34,731 cases of Diarrhoea registered in July 2009
to September 2009 and the previous year in July 2008 to September
2008 cases registered were 23,321. Similarly in October 2009 to
December 2009 has second highest 26,650 registered cases for
Diarrhoea and the previous year cases registered were 16,940 in
October 2008 to December 2008. 13
14. www.praja.org C. Hypertension Graph 4: Quarter wise
registered cases of Hypertension Hypertension 4938 0 ar1 oM 0t n1
4415 Ja 9 ar0 oM 9t n0 5099 Ja 09 ec toD t09 4169 Oc 08 ec toD t08
5309 Oc p09 o Se 9t ly0 4412 Ju 08 p o Se 8t ly0 3852 Ju 09 un oJ
9t ril0 3652 Ap 08 un oJ 8t ril0 0 1000 2000 3000 4000 5000 6000 Ap
Inference: The above data presents quarter wise distribution of
register cases for Hypertension. Comparison is between quarters of
two year data on Hypertension from April 2008 to March 2010. The
above graph shows highest number of 5,309 cases of Hypertension
registered in July 2009 to September 2009 and the previous year in
July 2008 to September 2008 cases registered were 4,412. Similarly
in October 2009 to December 2009 has second highest 5,099
registered cases for Hypertension and the previous year cases
registered were 4,169 in October 2008 to December 2008. 14
15. www.praja.org D. Tuberculosis Graph 5: Quarter wise
registered cases of Tuberculosis Tuberculosis 2926 0 ar1 oM 0t n1
2223 Ja 9 ar0 oM 9t n0 2504 Ja 09 ec toD t09 2430 Oc 08 ec toD t08
2414 Oc p09 o Se 9t ly0 2578 Ju 08 p o Se 8t ly0 2252 Ju 09 un oJ
9t ril0 2923 Ap 08 un oJ 8t ril0 0 500 1000 1500 2000 2500 3000
3500 Ap Inference: The above data presents quarter wise
distribution of register cases for Tuberculosis. Comparison is
between quarters of two year data on Tuberculosis from April 2008
to March 2010. The above graph shows highest number of 2,926 cases
of Tuberculosis registered in January 2010 to March 2010 and the
previous year in January 2009 to March 2009 cases registered were
2,223. Similarly in April 2008 to June 2008 has second highest
2,923 registered cases for Tuberculosis and the next year cases
registered were 2,252 in April 2009 to June 2009. 15
16. www.praja.org E. Diabetes Graph 6: Quarter wise registered
cases of Diabetes Diabetes 1028 Jan10 to Mar10 773 Jan09 to Mar09
843 Oct09 to Dec09 576 Oct08 to Dec08 789 July09 to Sep09 759
July08 to Sep08 603 April09 to Jun09 485 April08 to Jun08 0 200 400
600 800 1000 1200 Inference: The above data presents quarter wise
distribution of register cases for Diabetes. Comparison is between
quarters of two year data on Diabetes from April 2008 to March
2010. The above graph shows highest number of 1,028 cases of
Diabetes registered in January 2010 to March 2010 and the previous
year in January 2009 to March 2009 cases registered were 773.
Similarly in October 2009 to December 2009 has second highest 843
registered cases for Diabetes and the next year cases registered
were 576 in October 2008 to December 2008. 16
17. www.praja.org IV. Number of questions asked by Councillors
on Health issues in top five wards of highest cases registered
Graph 7: Question asked on health issues in all committee meetings
(April 2008 -March 2009) 12 10 10 8 6 4 4 3 3 2 0 0 K east G south
F south E L Number of questions 3 4 0 3 10 asked Inference: The
above data presents number of health related question asked by
councillors in all committee meetings in top five wards having
highest number of registered cases for sensitive diseases from
April 2008 to March 2009. The above graph shows councillors from K
East ward have asked only three questions while councillors from F
South have not asked any questions in any of the committee meetings
on health in the Year April 2008 to March 2009. 17
18. www.praja.org Graph 8: Question asked on health in all
committee meetings (April 2009 March 2010) 8 7 7 7 6 5 4 3 2 1 1 1
0 0 L F south G south K east E Number of questions 7 1 7 1 0 asked
Inference: The above data presents number of health related
question asked by councillors in all committee meetings in top five
wards having highest number of registered cases for sensitive
diseases from April 2009 to March 2010. The above graph shows
councillors from F South and K East wards have asked only one
question while councillors from E ward have not asked any question
in any of the committee meetings on health in the Year April 2009
to March 2010. 18
19. www.praja.org V. Public Health Committee: Role and Working
Table 3: Public Health Committee Overview for April 2008 to March
2010 Year Number of Number of Number of Questions Meetings
Councillors Asked April 2008-March 16 36 33 2009 April 2009-March
12 36 30 2010 Inference: 1. In the Health Committee meetings for
the year 2008-09 only 33 questions were asked by 36 members in 16
meetings. Approximately two questions by all councillor per
meeting. 2. In the Health Committee meetings for the year 2009-10
only 30 questions were asked by 36 members in 12 meetings. Around
three questions by all councillors per meeting. Public Health
Committee: The Corporation under Section 38A (1) of the M.M.C. Act,
appoint the Public Health Committee out of their own body
consisting of 36 members in their meeting after general election
and delegate any of their power and duties to such Committee and
also define the sphere of business of Committee so appointed and
direct that all matters and questions included in any such sphere
shall be submitted to the Corporation with such Committees
recommendation. Sphere of Business: "Sphere of Business of Special
Committees defined by the Corporation vide Corporation Resolution
No.46, dated 11th May 1999 in exercise of the powers vested in them
by Sub-Section (1) of Section 38A of the Mumbai Municipal
Corporation Act, 1888, as amended up to date. All questions
relating to the King Edward VII Memorial Hospital and the Seth
Gordhandas Sunderdas Medical College, Kasturba Hospital for
infectious diseases, Medical Relief in the Municipal outdoor
dispensaries, Medical and Nursing assistance to the poor in their
homes Venereal Diseases Dispensaries, Anti Tuberculosis League and
any Medical Institution to which monetary assistance is given by
the Corporation. Health Department (including Street Cleaning,
Conservancy, etc.) with the exception of questions pertaining to
the Mechanical Branch so far as they fall within the province of
the Works Committee. At present, there are 36 members in the Public
Health Committee. 19
20. www.praja.org Graph 9: Meetings attended by Health
Committee Members during the April 2008 - March 2009 18 16 17 14 12
13 Number of Meetings 10 8 6 4 5 2 1 0 Under 5 6 to 10 11 to 15 16
and Above Number of Councillors 5 13 17 1 Number of Councillors
Inference: During the year 2008-09, Sixteen Health Committee
meetings were conducted. In that Five Councillors attended five or
less than five meetings, Thirteen Councillors attended six to ten
meetings, Seventeen Councillors attended eleven to fifteen meetings
and only one councillor attended all the sixteen meetings. 20
21. www.praja.org Graph 10: Details of Health Committee
meetings attended by Councillors during the April 2008- March 2009
Jayanthi Siroya 16 12 Nitin Salagre 16 10 Pravin Shah 16 9 Sujata
Waghm are 3 16 Geeta Yadav 16 7 Ajanta Yadav 16 14 Anahita Mehta 16
14 Kisan Mistry 16 13 Ashw ini Mate 16 13 Names of Health Committee
members Ram narayan Barot 16 12 Abdul Aziz Barudgar 4 16 Prakash
Phaterperkar 16 13 Yashodhar Fanse 16 13 Anuradha Pednekar 16 12
Manohar Panchal 16 5 (Mahesh) Krishna Parkar 10 16 Sangeeta Patil 6
16 Supriya Paw ar 16 12 Kokila Parm ar 16 14 Rajul Patel 16 12
Shantaram Naik 5 4 Sandhya Doshi (Sakre) 15 16 Parshuram Desai 16
14 Madhukar Dalavi 16 10 Anjali Darade 16 5 Kashinath Tharli 16 10
Prakash Chalke 16 10 Baliram Ghag 16 12 Sarika Gracious 16 9
Mangala Gaikw ad 16 9 Rahebar Khan 16 6 Kashinath Karadkar 16 9
Shobha Ashar 16 14 Shazia Azm i Aslam 16 8 Minal Juw atkar 16 11
Shubhada Gudhekar 16 16 0 5 10 15 20 Meetings (* Late Shantaram
Naik) 21
22. www.praja.org Graph 11: Meetings attended by Health
Committee Members during the April 2009- March 2010 30 25 24 20
Number of Meetings 15 11 10 5 1 0 Under 5 6 to 10 11 to 12 Number
of Councillors 11 24 1 Inference: During the year 2009-10, Twelve
Health Committee meetings were conducted. In that Eleven
Councillors attended five or less than five meetings, Twenty-Four
Councillors attended six to ten meetings and only one councillor
attended eleven meetings. 22
24. www.praja.org Graph 13: Number of questions asked by
Councillors in Health Committee meeting during April 2008 to March
2009 25 23 20 15 10 10 5 3 0 Zero Questions asked 1 to 3 Questions
asked 4 to 6 Questions asked Number of Councillors 23 10 3
Inference: During the year 2008-09, the number of questions asked
by Councillors in the Health Committee meetings is as follows.
Three Councillors asked four to six questions, Ten Councillors
asked one to three questions and twenty-three Councillors asked no
questions in the Health Committee meetings. 24
25. www.praja.org Graph 14: Number of questions asked by
Councillors in Health Committee meeting during April 2009 to March
2010 25 21 20 15 13 10 5 2 0 Zero Questions asked 1 to 3 Questions
asked 4 to 6 Questions asked Number of Councillors 21 13 2
Inference: During the year 2009-10, the number of questions asked
by Councillors in the Health Committee meetings is as follows. Two
Councillors asked four to six questions, thirteen Councillors asked
one to three questions and twenty-one Councillors asked no
questions in the Health Committee meetings. 25
26. www.praja.org Graph 15: Issues raised/Questions asked by
Councillors in Health Committee meeting during April 2008 to March
2009 Staff behaviour 4 PHC 1 Quacks 1 MCGM related 1 Health
Education/institute 1 Private health services 2 Policy on Health 2
Pest control 1 Renaming of Crematorium/health inst 2 Medicines 4
License to Food selling 1 Municipal hospitals Infrastructure 4
Equipments 3 Doctors / nurse 4 Cemeteries / related 1 Unauthorized
Construction in hospital compound 1 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5
Inference: During the year 2008-09, a total of 33 questions were
asked in the Public Health Committee. The highest number of
questions were asked on Staff behaviour (Medical/health services
staff), Medicines (availability and other related), Infrastructure
of the dispensaries/hospitals and Doctors/Nurse related issues.
26
27. www.praja.org Graph 16: Issues raised/Questions asked by
Councillors in Health Committee meeting during April 2009 to March
2010 Renaming of Crematorium/health inst 2 Accident 1 Community
Development 1 Pest control 2 Goverment Land / Hospital/Market
Related 1 License 1 Staff behaviour 5 health related 1 Maternity
homes 1 Health infrastructure Related 3 Up gradation Equipments 1
Doctors / nurse 4 Medicines 1 Health Education/institute 1
Mortality rate 1 Policy on Health 4 0 1 2 3 4 5 6 Inference: During
the year 2009-10, a total of 30 questions were asked in the Public
Health Committee. The highest number of questions were asked on
Staff behaviour (Medical/health services staff), Infrastructure of
the dispensaries/hospitals, Doctors/Nurse related issues and
schemes and policy of health (Programs and Campaigns). 27
