Dengue and Negligence. Sheer negligence!

Ye to isko macchar ki tarah masal kar rakh dega!That was one of the analogies used during childhood when we used to watch W.W.E. matches and there would be a comparatively small fighter facing a giant. The mosquito was considered a very weak creature. But slowly and slowly it has acquired the strength of a monster. Keeping with the times, it has updated its ammunition.  These days whenever a mosquito bites me, it worries me that i might get dengue, chikanguniya or malaria, the former being the page three celebrity these days. These facts called for an investigation.

Statistics regarding the number of people affected by dengue vary. According to the National Vector Borne Disease Control Programme , till October 2nd this year , 51731 cases of dengue have been reported while these have been 93 instances of death while last year 220 people died because of the disease. It mentions that till 2nd October 2016, there have been four deaths due to dengue in Delhi   whereas a Press Trust of India report on NDTV states that till 29th of September this year, 21 people have fallen prey to the disease. However, this might be due to the fact that patients from other states travel to Delhi for treatment. Another news article on NDTV, states the number of deaths in Lucknow, to be a staggering 148 till October 1st , 2016.  Other parts of the country have not been spared from the menace either.  Odisha (6963 cases), West Bengal(6933), Kerala (5988), Karnataka (4556) and Maharashtra (4033) are the worst affected states(see here). Don't gasp, take this. According to a study by the government's National Institute of Health and Family Welfare(N.I.H.F.W.), New Delhi, India could have had ''an annual average of 5,778,406 clinically diagnosed dengue cases, or 282 times the reported number per year" between 2006-2012. The study reported that the "National Vector Borne Disease Control Programme captures only 0.35 percent of the annual number of clinically diagnosed dengue cases in India".(see here)

The National Capital Territory of Delhi, being the centre of media and political attention and tussle, was the focus of debates and legal actions over the issue . The state of affairs has come to such a pass that the Delhi High Court had to direct both the Centre as well as the State Government not to deny treatment to  Dengue or Chikunguniya patients. The attitude of the authorities has even irked the Supreme Court, who has asked the incumbents to perform their duties in this regard, thinking of the interests of the people of  Delhi. Sadly, other parts of the country haven't got their due media attention, which is basically confined to the mega and the metropolitan cities, and we know that in the absence of media limelight, any action , be it an opening ceremony of a store or mere submission of a memorandum hardly takes place, let alone steps for prevention and control of an epidemic for which almost every politician and party of the country would want to hog the limelight as a milestone achievement.

The World Health Organisation(W.H.O.) says that, the main methods for prevention or control of the transmission of the dengue virus is to combat vector borne mosquitoes through :

1. preventing mosquitoes from accessing egg-laying habitats by environmental management and modification; 
2. disposing of solid waste properly and removing artificial man-made habitats;covering, emptying and cleaning of domestic water storage containers on a weekly basis; 
3. applying appropriate insecticides to water storage outdoor containers; 
4. using of personal household protection such as window screens, long-sleeved clothes, insecticide treated materials, coils and vaporizers;  
5. improving community participation and mobilization for sustained vector control; 
6. applying insecticides as space spraying during outbreaks as one of the emergency vector-control measures;  
7. active monitoring and surveillance of vectors should be carried out to determine effectiveness of control interventions.

These methods/strategies for combating the menace of dengue call for participation of both, the Government as well as the public. But i would limit my discussion from the perspective of Government action because it has the power to ensure compliance or punish in the case of disobedience.

The methods stated by the WHO, mainly include prevention of breeding grounds for mosquitoes, proper disposal of solid waste management and spraying of insecticides/fogging. These are functions to be performed by the local administration basically through their municipal bodies which in turn are monitored by the higher ups in the executive and the elected representatives siting in various ministries. The question here arises that if a disease is taking away lives year after year and certain arrangements are to be made beforehand to prevent its spread but no concrete steps are taken, instead sheer negligence on the part of the authorities turns it into an epidemic, then who is responsible for the loss of lives? If for the loss of life of one person, an accused is tried and if convicted, is send to jail, then why for the loss of thousands for lives , many of which could have been saved, the authorities involved are able to continue as if nothing has happened?

Accepted that its a tough task to administer, that there are bound to be failures even with the best of efforts, and if punished for not being able to administer well, people would not want to join such services or leadership roles. But the flip side of the coin is that nobody can be allowed to be left unaccountable. It is not the case when the executive or the legislature has tried and failed in its efforts, it is the case when there is a blatant disregard for the lives of the common citizens, when the common man is left to deal with the problem or to die and when efforts are made only for namesake , for political paparazzi or for political mudslinging.

All this is not something extralegal idea. Among our laws, Section 304A of the Indian Penal Code is of relevance here. It states the following :

"Whoever causes the death of any person  by doing any rash or negligent act not amounting to culpable homicide, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or both."

The essential requirements to the section are that there must be death of the person in question, the accused must have caused such death, that such act of the accused was rash or negligent and that it did not amount to culpable homicide.

Negligence, as defined in the section, is a breach of duty imposed by law. It may be civil or criminal negligence  depending upon the nature and gravity of negligence. Criminal negligence is gross and culpable, neglect, or failure to exercise reasonable and proper care and precaution to  guard against injury, either to the public generally, or to an individual in particular, which, having regard to all the circumstances out of which the charge has arisen, it was the duty of the person to have adopted.( Text Book on the Indian Penal Code by K. D. Gaur , Fourth Edition, pg. 499-500)

 If steps would have been taken for preventing mosquitoes from accessing egg-laying habitats, if there would have been proper solid waste management, if fogging would have taken place frequently and at appropriate times, if common public would have been fined for not performing their role in this regard, deaths on such a large scale might not have taken place. Spread of dengue, year after year, when it could be contained, is a failure to exercise reasonable and proper care and precaution to  guard against injury to the public generally and to every affected individual in particular. The large scale deaths, recurring every year, qualify it as a criminal negligence.

By vicarious liability, which means that the master is responsible for the acts of his servant, if the higher ups in executive or legislature, who have the power and the responsibility to monitor the performance of such acts and also to direct, if needed, the action to be taken by the sub-ordinates, have instead stopped them from performing their duties, by overt acts or otherwise, for one reason or the other such as for political gains etc, they should also be held responsible for the deaths and tried under the ambit of section 304 A of the I.P.C.. 

Until and unless, those wielding power and responsibility to take care of others are held accountable for non-performance of the duties concerned and are punished in the cases of sheer negligence, it will be very difficult to make them perform and till then the common man on the street will continue to suffer unabated!