Eight ALS ambulances deployed to transport AES patients in Bihar: Union Health Minister Harsh Vardhan

Source: zeenews.india.com

Union Health Minister Harsh Vardhan on Thursday said that eight additional Advanced Life Support (ALS) ambulances have been deployed to transport Acute Encephalitis Syndrome (AES) patients in the affected districts of Bihar. He added that the government officials have also started house-to-house active case finding campaign in order to check the outbreak of deadly viral disease. “8 additional Advanced Life Support (ALS) ambulances deployed to transport AES (Acute Encephalitis Syndrome)/JE (Japanese Encephalitis) patients in the affected districts. House to house active case finding campaign started,” Harsh Vardhan was quoted as saying by ANI.

It is to be noted that the AES has claimed the lives of over 140 children in Bihar, with over 100 children losing their lives at Sri Krishna Medical College & Hospital (SKMCH) in Muzaffarpur alone. The Union Health Minister said that a team of experts from Indian Council of Medical Research has been deployed at SKMCH hospital in order to make the virology lab operational as soon as possible. Harsh Vardhan noted that multi-disciplinary team deployed earlier in Muzaffarpur is reviewing all the case records of AES patients, who were admitted and treated since the outbreak of deadly disease this year.

“ICMR team of experts has been deployed at SKMCH hospital, Muzaffarpur for making the virology lab operational at the earliest. Multi-disciplinary team deployed earlier is reviewing all the case records of AES patients, admitted and treated in 2019,” said Harsh Vardhan.

It may be recalled that Bihar Chief Minister Nitish Kumar on Tuesday visited SKMCH and gave directions to convert the government-run hospital into a 2500-bed facility. Kumar also issued orders saying 1500 new beds for the hospital should be arranged immediately and a ‘dharmshala’ should be build for the relatives and families of the those who are admitted in SKMCH.

Earlier on Thursday, RJD leader Misa Bharti said that no leader from her party will attend the dinner called by Prime Minister today because of deaths of children in Muzaffarpur due to AES. Misa said that medicines and equipment can be bought from the money which the government is going to spent in organising this dinner for parliamentarians.

Encephalitis is a viral disease, which causes mild flu-like symptoms such as high fever, convulsions and headaches and has been claiming lives in the district for the past few weeks.

AES outbreak puts focus on ailing healthcare infrastructure in Bihar

Source: livemint.com

NEW DELHI: The rising death toll of children suffering from acute encephalitis syndrome (AES) in Bihar’s Muzaffarpur district not only points to a health crisis, but also the crippling healthcare infrastructure in the state.

According to the latest data available with the ministry of health and family welfare, about 79.5% of the 1,719 villages in Muzaffarpur district do not have a public healthcare facility. There are only 630 public healthcare facilities in Muzaffarpur, the data reveals.

“What can easily be managed at a primary health centre level, is reaching Muzaffarpur at a critical stage causing deaths. Since there is no primary health infrastructure nearby and no health experts to tell these families the preventive measures, the problem arises,” said a senior health ministry official, requesting anonymity.

Experts also said that in view of the children’s deaths and the number of new cases being reported every day, the district level infrastructure is about to collapse.

“Encephalitis cases have always been witnessed in areas which are economically disadvantaged and have rudimentary health infrastructure at the primary care level. Health infrastructure is a major issue given the high mortality in Bihar. The easy solution to this disease is balanced diet in each meal,” the official said.

“Even if children show early signs, regular glucose consumption can solve the problem. The early warning signals that should be provided to villagers also seem to be absent,” he added.

The official said malnutrition, compounded by heat and humidity, unusually high this year, is the major cause for the high death toll.

According to the census of 2011, Bihar is the third most populous state in India, with around 40% of its population below the poverty line. The major health and demographic indicators of the state, such as infant mortality rate, maternal mortality ratio, and total fertility rate, are substantially higher than the all-India average, and reflect the poor health status of the people. The state has a shortage of 1,210 sub-centres, 131 primary health centres (PHCs), and 389 community health centres (CHCs).

So far, 167 children have died in Bihar, with Muzaffarpur recording 117 deaths. Other districts include Vaishali (19), Motihari (12), Begusarai (8), Samastipur (8), and one each in Arrah, Sheohar and Purnia.

“Blame it on the scarcity of health facilities or unawareness among masses, patients from almost all the villages in Muzaffarpur are coming to us in critical stages, which is increasing the death toll. Private hospitals are unable to handle the pressure,” said Sunil Shahi, medical superintendent, Sri Krishna Medical College, Muzaffarpur, which is handling a majority of the cases.

Interestingly, Muzaffarpur city is part of the centre’s smart cities’ list. According to a recent report by the Smart Cities Mission of Housing and Urban affairs, the doctor-patient ratio at Muzaffarpur is as low as 80:100,000 patients. The report said there are four large hospitals in the city, 46 nursing homes and 175 medicine shops. The city provides some access to healthcare for its residents, but healthcare facilities are “overburdened and far from many residents”.

The Comptroller and Auditor General (CAG) of India 2018 report said improved healthcare facilities could not be provided because of project delays. “Completion of 75 CHCs was delayed by one to 33 months. Further, 11 CHCs was incomplete even after the delay of one to 36 months, due to non-availability of dispute-free land and slow execution of work. Consequently, there was a delay in the completion of 86 CHCs, which delayed the intended objective of providing improved healthcare facilities.”

Ground Zero | Bihar AES deaths: A hundred deaths, and no answers

Source:- thehindu.com

Cases of acute encephalitis syndrome have seen a spike in Muzaffarpur this year, already claiming more than a hundred lives. Jacob Koshy reports on the appalling state of health care in Bihar, even as the debate on what is causing the deaths rages on

For three days, Bihari Mahato and Shyam Babu Saha’s families have shared a hospital bed. The two daily-wage labourers, who have had to give up work for three days, haven’t exchanged a word, though they have much in common. Both have a boy and a girl each. And their children are battling for life.

Sundar, Mahato’s three-and-a-half-year-old son, is naked, emaciated, delirious and has a distended stomach. Himanshi, six months old and in a striped shirt and shorts, looks bigger and healthier than Sundar. She sleeps longer — fitfully, her mother Vimla says. Both families are from different districts of Bihar. Mahato is from Muzaffarpur and Saha is from Sitamarhi district. Their children were suddenly taken ill. When the children were convulsing and feverish, they were rushed to the Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur. The doctors noted that their blood sugar had dropped precipitously.

Both children are being given dextrose saline (a sugar solution often administered intravenously), but their parents are nervous. “The fever has subsided but it keeps returning,” says Saha. “The doctors aren’t paying us much attention.” But that’s a quibble given that many other ailing children are sprawled out on mattresses on the floor. Amidst peeling plaster, strewn banana peels, stomping doctors, nurses, journalists and television crew, the children’s ward at SKMCH is symptomatic of the confusion and panic that has gripped Muzaffarpur since early June.

The floor above the general ward is home to the Intensive Care Units (ICUs). Each of the five ICUs has eight beds. Not one of the beds has fewer than three children hooked to bleeping monitors and intravenous lines. Unusually for an ICU, there’s little restriction on non-hospital staff shuttling in and out, but unlike the squalid paediatric wards below, there are no patients sprawled on the floor. The floor is clean, the air-conditioners work, the nurses are extra vigilant, and yet here’s where death lurks around the corner.

Season of trouble

There is a protocol for doctors. As soon as children are wheeled in, they are monitored for fever, convulsions and signs of confusion or loss of consciousness. “What I’ve seen is that several children are brought too late. Unfortunately we lose them,” says J.P. Mandal, a resident doctor at SKMCH. Between June 1 and 17, 312 children were admitted to the hospital under the umbrella diagnosis of acute encephalitis syndrome (AES). According to the Bihar health department, 85 died. The bulk of the dead, 48, were children aged three to seven. Twenty-nine children were less than three years of age. As of June 21, 104 of the 424 children admitted since January 1 had died. Encephalitis, which refers to an inflammation in the brain due to a viral or bacterial attack, causes fever and almost never a drop in blood sugar. In the current epidemic, as well as in previous ones in Muzaffarpur, the doctors have marked cases of and deaths by hypoglycaemia (drop in blood sugar), which is unusual.

While Bihar loses hundreds of children to AES every year, there were sharp spikes in 2012 and 2014, when 395 and 372 children, respectively, lost their lives. Through the years, AES cases have been reported from several districts in Bihar: Gaya, Patna, Aurangabad, Saran, East Champaran, Sitamarhi and Vaishali. Government figures show that the peak years of 2012 and 2014 saw Muzaffarpur account for 35-40% of hospital admissions. While this year’s incidences and deaths are fewer in comparison, the season of trouble is far from over. The outbreak in 2012 took place between May and November. In 2014, it was from May to July. There’s no saying how long the current outbreak will last. A common refrain among district administration officials and some doctors is that the yearly outbreak ceases in intensity soon after the monsoon rains begin in Bihar. Why is that? Nobody ventures an explanation.

Sanjay Kumar, the State’s top civil servant in charge of health, says he cannot quite put a finger on a “single, determining factor” that is responsible for 2019 turning out to be a bad year. It could be the ongoing heatwave — several parts of Patna, Gaya and even Muzaffarpur have recorded temperatures in excess of 4-5°C over what’s normal for this time of the year. At least 80 people have succumbed to the heatwave. “The added heat and humidity could have made young children particularly susceptible to dehydration,” he reckons. “It could also be an infectious disease. It could also be because of children eating litchis.”

Kumar says all the children who are admitted belong to the lowest socio-economic rung; there are no instances of infection in cities or even semi-urban localities. He emphasises that the government had been prepared this year too, like in the past, for the outbreak. It stocked up and supplied oral rehydration solution, ensured that medicine and equipment were provided at medical colleges and district health centres, and conducted public awareness campaigns about the imminent outbreak. However, he admits that the district’s key referral hospital, SKMCH, wasn’t equipped to deal with the deluge of patients. “This year will be a turning point. The bed capacity will be increased to 1,500 and we will have a virology lab [to better investigate vitals of patients and determine disease causes].”

Debating the litchi link

Arun Shah, a paediatrician and private practitioner who has been working in the city since 1984, insists that the spike in AES cases and in fatalities is a result of malnourished children suffering brain damage after eating litchis, particularly unripe or overripe ones. In a 2014 paper, Shah and virologist T. Jacob John had argued that the children in Shah’s clinic in Muzaffarpur were found to have extremely low blood sugar levels and signs of brain damage. While viral or bacterial infections that cause encephalitis (an inflammation of brain cells due to an infection) were well known in Muzaffarpur and neighbouring districts, many of them were taking sick and dying due to encephalopathy (brain damage, in this case, due to an environmental toxin). In 2016, a detailed investigation, published in The Lancet Global Health by the National Centre for Disease Control, India, and the U.S. Centers for Disease Control and Prevention, found “confirmation” that litchis contained a chemical called methylene cyclopropyl glycine (MCPG). These are naturally occurring toxins that cause hypoglycaemia and metabolic derangement in children.

When a child is malnourished, her body, having exhausted its reserves of glucose from the digestive tract and the liver, typically turns to fatty acids in biochemical desperation to supply blood sugar to the brain. MCPG, the theory goes, thwarts this mechanism. This can send the brain into hypoglycaemic shock triggering convulsions and, if unaddressed, even death. “But please don’t blame litchis,” stresses Shah. “It is the pride of Muzaffarpur.”

At a press conference two years ago, to underline that the litchi fruit was only a triggering factor and sickened only malnourished children, Shah and John ate a bowlful of the fruit in front of television cameras to emphasise that it was malnutrition, and not the fruit, that was the dominant cause of the disease. Shah is unambiguous that the children are suffering because the government didn’t do enough. The recently concluded Lok Sabha election distracted the government from adequately preparing for the outbreak, he says. In 2016, he was part of a government-constituted committee that prescribed guidelines: Children shouldn’t be allowed to skip their evening meal, they should avoid stepping out in the heat, and local public healthcare centres must stock up on anti-convulsion drugs as well as dextrose. These were adhered to in 2017 and 2018. And that’s why there were relatively fewer reports of AES, he argues.

While encephalitis outbreaks in Uttar Pradesh’s Gorakhpur were due to other causes, and children from Muzaffarpur and neighbouring districts have battled viruses such as the Japanese encephalitis virus, the large-scale litchi cultivation in Muzaffarpur, which contributes about 40% of the State’s litchi production, “can’t be ignored as a triggering factor,” he points out.

At SKMCH, several parents of the ailing children are categorical that their children did not eat litchis. The authors of The Lancet study found that two-thirds of children who were sick had eaten litchis. “We work in the fields and there are litchi orchards aplenty where we live,” says Indal Paswan, whose two-and-a-half-year-old son is prostrate on a hospital bed. “But this boy isn’t capable of plucking fruit on his own. We do feed him some fruit as well as other food but we don’t starve him.”

Mandal is insistent that there is a virus or some biological agent that is responsible for the recurrent outbreaks. He scoffs at suggestions of the litchi’s complicity. Children who were brought to the hospital were “poor but not classically malnourished,” he says. If malnutrition and litchi consumption were the causes, then there ought to have been a fairly constant number of deaths every year. This has not been observed, he says. “A peak and an ebb in cases and deaths is what we see. And that’s more typical of a biological agent.”

That no virus or bacteria has been isolated yet in Muzaffarpur is because the hospital lacks adequate facilities to collect tissue and blood samples from patients and preserve them adequately for examination. “I’m confident that at some point this will be found and there will be no mystery,” Mandal says. The focus of treatment, he adds, is to ensure that convulsions are brought under control and blood sugar levels are restored.

What Shah and Mandal do agree on is that the vast majority of deaths could have been prevented if the children had made it to a hospital on time. The most important medicines were easily available, and most of the primary health care centres were well stocked and equipped to deal with AES cases.

No time to grieve

Yet, four-year-old Mohammed Jahid lost his life. Until he fell sick, Jahid had spent his days playing with his older siblings and cousins in the village of Bishnupur Chand, Musahari. His home was a single room thatched hut that did not have a toilet. His and his cousins’ houses lay at the edge of an orchard that had several rows of tall, stout litchi trees. In June, there were only a few fruits that clung to the trees. Most had been plucked and carted away for sale by the owner of the orchard who lives in Patna. “He didn’t show any signs of illness. He had a fever for two days,” recounts Jahid’s aunt, Asha Khatoon. “We took him to a private doctor nearby.” One night, Jahid became delirious, and his father Mohammed Idris rushed to get an autorickshaw to take him to a hospital. He didn’t find one immediately as the roads had been dug up. When they made it to SKMCH, Jahid was immediately taken to the ICU, but he didn’t survive beyond three hours. A day after burying Jahid, Idris was away to find work as a daily-wage labourer. There were still two boys, two girls and a wife to feed.

Bihar B.Ed 2019 CET Spot Counselling result declared

Source:- scroll.in

The Spot counselling result was initially scheduled to be declared on June 20th but was later changed to June 21st.

Nalanda Open University has released the Bihar B.Ed. 2019 CET Spot Counselling result today, June 21st, at 6.00 pm. Candidates who have registered to participate in the Spot Counselling can check the official website, biharcetbed.com, to see if they have been allocated a seat.

Nalanda Open University had conducted the registration process and choice filling for the spot counselling from June 18th to June 20th. The spot counselling choice filling was scheduled from June 18th to June 19th but a day’s extension was given for that, and thus the spot counselling result was also delayed by a day.

For Spot Round Counselling, candidates can checklist of vacant seats at various colleges in this link. Rules around spot counselling can be accessed in this link. The Spot Counselling result can be accessed in this direct link.

Bihar B.Ed CET examination and counselling process is being conducted by Nalanda University. Nalanda University conducted the CET for admissions to B.Ed programme offered for regular students in various colleges and universities in the state of Bihar. The exam was conducted on March 10th and now the results was declared on March 20th, 2019.

There are around 350 colleges who will be conducting admissions for their programmes through this entrance exam. The list of colleges can be accessed in this link.

Will Nitish Kumar go down as the ‘Kushasan Babu’ of Bihar?

Source:- nationalheraldindia.com

He was hailed as ‘Sushasan Babu’ or a good administrator not too long ago. But nothing seems to be working for him as lawlessness and a rush of deaths of children in Muzaffarpur expose his govt

Nitish Kumar is one of the greatest hoaxes going around in Indian politics. He turns ‘secular’ when it suits him. The very next day you might find him sleeping with the BJP without batting an eyelid. He even does not mind stabbing a political partner in the back if it suits him to survive in power. He did it with Laloo Prasad Yadav twice and even ditched Narendra Modi once. He is a survivor whose politics revolves around surviving in power.

When it suited Nitish to take on Laloo Prasad, he marketed himself as Susashan babu or a good administrator. Bihar was then sick and tired of the Laloo-Rabri misrule. It was a period when kidnappings and pot-holed roads of Bihar were making national headlines. The upper-caste establishment, both in Patna as well as Delhi, too, wanted to get rid of Laloo Prasad who had turned too big for his boots for the system.

Fodder scam came handy for the system to replace Laloo. Yet someone was needed to fill Laloo’s vacuum. Nitish was ready to play ball with anti-Laloo forces. But he needed a label to market himself that he did with media-support which sold him as Susashan babu. Nitish who had lambasted BJP for the Babri mosque demolition both inside and outside the Parliament jumped to form an alliance with saffron forces in Bihar to come to power in 2005. Ambitious Nitish was now Bihar chief minister taking on Laloo Prasad who was his one-time close friend as well as political comrade in arms.

It suited both the establishment and the media to project Nitish as an excellent administrator, rather as Bihari messaiah, who put Bihar back onto rails after Laloo’s mayhem in the state. Nitish, to be fair to him, did manage to improve Bihar roads. He also succeeded in putting down kidnappings that had instilled a sense of insecurity among Biharis during Laloo and Rabri Devi’s rule. Nitish Kumar was now hailed as the Susasan Babu not only in Patna but Delhi as well.

Nitish had smooth sailing both in Bihar and outside. He was happy with his alliance with the BJP in Bihar. But politics took a major shift with the rise of Narendra Modi in national politics in 2014. Modi took the country by storm and came to power with a comfortable majority to form the government in Delhi. It was the period when the Congress and its allies were down in the dumps. The Anna Hazare movement had destroyed the ‘secular’ camp’s credibility across the country.

Nitish now sensed a vacuum hitting the anti-Modi secular camp. He now started distancing himself from Modi and the BJP. Ambitious Nitish even started projecting himself as the ‘secular’ national alternative to Modi. He was now rubbing shoulders with the likes of Rahul Gandhi and Sita Ram Yechuri in Delhi while he had already tied up with one-time ‘corrupt’ Laloo to continue in power in Bihar.

But Modi being a much smarter political player than the likes of Nitish Kumar, the Prime Minister forced him to surrender to the BJP in Bihar and finally acknowledge Modi as a tall national leader. Of course, he ditched Laloo Yadav again. There was nothing strange about it as it comes naturally to him to ditch partners when they are down in the dump.

Political opportunism however comes with an expiry date. Because, as the saying goes, you can fool some people for some time but not all the people all the time. Nitish was neither a good administrator nor a principled politician ever. Look how the Bihar administration has crumbled with just one wave of Encephalitis that has turned Muzaffarpur into a killing field for poor children who are dying like rats.

Now even the media reports suggest that Muzaffarpur hospitals are a shame on modern health services. This breakdown of health services has not taken place overnight. It was all there when media marketed Nitish as Susahan Babu.

The only difference is that now Nitish has already served his utility of taking on Laloo and destroy him. Nitish neither has any vision to be a mass leader like Laloo Prasad Yadav nor does he seem to have much administrative skill.

He is essentially a rank opportunist who survives by switching sides whenever it suits him. But all shades of opportunists ultimately hit the dead end sooner or later. Nitish Kumar’s dead end seems to be nigh. Unfortunately, he may go down as Kusashan Babu rather than Sushasan Babu of Bihar

Abdullah Khan, author of ‘Patna Blues’, on his long struggle to become a writer


omeone had once asked Abdullah Khan, the author of Patna Blues, which team he rooted for during an India-Pakistan cricket match. The thoughtless query is par for the course for most Muslims in the country. “I was born in a Muslim family, so I’m Muslim; I was born in India, so I am Indian. The two don’t have to be contradictory: I am both Muslim and Indian,” Khan remembers answering.

This is one of the many instances where the author and banker had been made to realise his status as a minority. I meet Khan at an al fresco café a few metres away from an Axis Bank branch in Mumbai where he works in the compliance department. We discuss his debut novel, Patna Blues, published last year, that had taken two laborious decades to finish. It’s the tale of Arif Khan, a young Bihari Muslim who dares to desire a Hindu woman. Running through this love story are strands of caste, discrimination and nationalism. Born in Pandari, a village near Motihari in Bihar, the author studied in an Urdu-medium school before encountering English at the age of seven. But he was so bewitched by the language that he took it upon himself to write a novel in English. Excerpts from an interview:

When did you first encounter stories?

I was always hungry for stories. If an aunt would visit, the first thing I would ask is if she knew any stories. If they didn’t have anything ready, they’d make something up with Sheikh Chilli, a fictional character who was a mischief-maker. When I was seven or eight, my father gifted me a Hindi Bal Bharti. I thought it was a text for the next academic year, but then he explained it was a book of stories.

What sparked the desire to become a writer?

I was helping my brother with an English assignment and I came across an excerpt from George Orwell’s Animal Farm. I started thinking that since such a great writer was born in my home town, I must follow in his footsteps. I must have been 21 then: I felt a great urge to be a writer.

How did Patna Blues happen?

It was the day Arundhati Roy’s The God of Small Things won the Booker Prize in 1997. The same day, I purchased a fancy spiral-bound notebook and a fountain pen. The first chapter was mostly inspired by Amit Chaudhuri’s writing style (chuckles). I was able to finish five to six chapters quickly. I got it typed for ₹25 per page and sent it to Mary Mount, an editor at Picador, by registered post, for ₹90. She wrote back saying, “You have fire in your writing, but it’s not ready for publication and you should work hard.”

Why did Patna Blues take so long to reach the bookshelves?

I stopped writing after getting a job in Bank of Baroda. After my wedding in 2002, my wife was dusting the house one day and she found my [manuscript] and the newspaper cuttings of old articles. And she almost blackmailed me to continue. I used to write long-hand with pen and paper and she would type it out. I then wrote to literary agent and author Noah Lukeman, who wrote back and told me about Joseph Conrad who didn’t know English till the age of 20. Lukeman said only those people are published who work hard and persevere. It was 2005 and I kept rewriting the first few chapters — I rewrote it 200 times. I would finish writing, then I would read something by a big writer and feel low. In 2009, I finished the first draft of the book. I sent it to [literary agent] Kanishka Gupta. The feedback I got was devastating. Finally, I signed a contract with Juggernaut in 2016. The book was published in September 2018.

There’s now news of Patna Blues being adapted into a web series…

A big Bollywood director called to tell me that he loved the book and wanted to make a web series for an international streaming platform. It’s in the works. The contract is such that I can’t talk about the details of the project — it’s under consideration.

You’ve also written for television and the big screen. How did that happen?

I’ve always been interested in films and I’ve also tried to get into acting — tried to become a hero when I was in college. In 2015-16, a well-known author posted on Facebook about a Channel V project, which was planning to adapt classics for Indian television — Shakespeare, Charles Dickens, Jane Austen, etc. Mine was called Rehaan meets Jamila based on Romeo and Juliet. They liked three stories, one of which was mine. I started staying in touch with producers and directors. In a stroke of bad luck, the channel head left and the project was scrapped. Now, people get in touch with me. Earlier, I used to chase them.

What have you worked on so far?

I wrote a project for Shashanka Ghosh (director of Veere Di Wedding); I’ve worked on a spy thriller for Ekta Kapoor, but nothing worked out in the end. I wrote the story for the movie Viraam (2017), which my brother, Ziaullah Khan, directed. It was released in 400 to 500 theatres, but didn’t do very well.

What are you currently working on?

Right now, I’m working on a web series about an American ex-commando who’s half-Scottish and half-Indian. He falls in love with a Bihari journalist when she lands up in Goa. There are two-three other projects that are under consideration. And I’m working on my next book, Aslam, Orwell and a Porn Star. It’s about a man who was born in the same room as George Orwell in Motihari. But people are already objecting to the title.


I’m not really sure. There have been so many films made on courtesans, they’re human beings. I’m writing about their human side. I’m not writing pornography (laughs). It’s the truth of life, and they exist.

Historical treasures of India in Bihar: Bodh Gaya, Nalanda, Pawapuri

Source:- connectedtoindia.com

The Mahabodhi Temple Complex or Bodh Gaya, in India’s Bihar state – which is also known as the place where Gautam Buddha attained enlightenment – is probably one of the top 100 places in the world to visit before you die.

For Buddhists, Bodh Gaya is one of the four main pilgrimage sites related to the life of Gautama Buddha. The three other sites are Kushinagar, Sarnath (both in Uttar Pradesh state), and Lumbini (in Nepal).

In 2002, Mahabodhi Temple became a UNESCO World Heritage Site and though the complex is well-maintained, the surrounding town is still under developed.

Next to the temple, to its western side, is the holy Bodhi tree, under which the Buddha is said to have meditated and reached enlightenment. In the Pali Canon, the site is called Bodhimanda and the monastery there the Bodhimanda Vihara. The tallest tower is 55 metres in height.

In approximately 250 BCE, about 200 years after Buddha attained enlightenment, Indian Emperor Asoka the Great who was one of the rulers of the Mauryan Empire – one of the world’s largest empires at its time – is said to have visited Bodh Gaya with the intention of establishing a monastery and shrine.

As part of the temple, he built the diamond throne, called the Vajrasana, attempting to mark the exact spot of Buddha’s enlightenment. Asoka is therefore considered the founder of the Mahabodhi Temple.

One of the interesting features of the sprawling complex is the Mucalinda Lake in the centre of which is a sculpture of Buddha seated under the hood of a cobra. It is said that when Buddha was spending his sixth week of enlightenment here, a cobra and other creatures protected him from severe thunderstorms.

Rajgir, the first capital of the kingdom of Magadha, a state that would eventually evolve into the Mauryan Empire, is not far from the temple and also a must visit. Its date of origin is unknown, although ceramics dating to about 1000 BC have been found in the city. This area was one of the favourite places for Gautama Buddha and the well known ‘Atanatiya’ conference was held atop the mountain called Vulture’s Peak.

Known for the Vishwa Shanti Stupa, located at a considerable height, one of the ‘adventurous’ aspects of the place is that you can take a ride in a cable car on a ropeway to ascend and descend. Rajgir is also famous for its hot water springs, locally known as Brahmakund, a sacred place for Hindus. The Vishwa Shanti Stupa, built in 1969, is one of the 80 peace pagodas in the world built to spread the message of peace and non-violence.

An ancient centre of higher learning – the Nalanda University – is also within travelling distance. The university founded by a King Sakraditya flourished between the fifth century CE and 1197 CE, supported by patronage from the Hindu Gupta rulers as well as Buddhist emperors.

An official guide at the place explained that the complex was built with red bricks and its ruins occupy an area of 14 hectares. At its peak, the university attracted scholars and students from as far away as Tibet, China, Greece and Persia and its architectural uniqueness lay in the way the spaces for learning, residence and meditation were clearly demarcated.

The university was ransacked and destroyed by an army under Bakhtiyar Khilji in 1193. The great library of Nalanda University was so vast that it is reported to have burned for six months after the invaders set fire to it.

Opposite the ruins is a museum that houses various items of historical interest unearthed during the excavations and a little way ahead is the Xuan Zang Memorial Hall which has a beautiful tapestry covering two walls that provide an account of the traveller’s sojourn across India and other countries.

Xuan Zang primarily became famous for his 17-year overland journey to India, which is recorded in detail in the classic Chinese text ‘Great Tang Records on the Western Regions’. The place is immaculately maintained though of course the same cannot be said for any of the towns in Bihar where, for one thing, there is no traffic discipline and you are likely to be either mowed down by a truck or be rendered deaf with the drivers’ habit of sounding their horns at a high pitch and for long periods of time.

One of the other interesting sites is Pawapuri, a holy place for the Jain community located about 101 km from Patna, Bihar’s capital city. It is here that Mahavira attained nirvana or ‘moksha’ in around 5th century BCE. Mahavira, according to a temple priest there, was the last of the 24 ‘tirthankaras’ of the Jain faith and it was here that he was cremated.

There was a great rush to collect his ashes, with the result that so much soil was removed from the place of his cremation that a pond was created. Now, an exquisite marble temple in the middle of a lotus pond, the Jal Mandir, stands magnificently on a rectangular island.

What’s causing ‘brain fever’ in Indian state Bihar?

Source:- gulfnews.com

Muzaffarpur, India: The stench of urine, chlorine, vomit and death fill the main hospital in Muzaffarpur, the epicentre of a brain fever outbreak in India that has killed more than 100 children since June 1.

Doctors are not sure what the cause is, but one theory is that the culprit is a toxin found in lychees eaten by children of poor families who go to bed with empty stomachs.

One of the distraught parents crowding the chaotic corridors of the Sri Krishna Medical College and Hospital (SKMCH) is Dilip Sahni, 25, a construction worker and father of three.

He brought his four-and-a-half-year-old daughter Muskan early in the morning, only 24 hours after she fell ill, to SKMCH. There almost 100 other children are being treated, many sharing beds.

“When her mother went in to wake her yesterday at 11 am, she was shocked to see her hands and legs tightened and her teeth sticking together,” Sahni told AFP.

“Her mother started screaming for help, and we rushed her to the Kejriwal hospital. At midnight the hospital doctors told us to take her to SKMCH,” he said.

“Early morning we shifted her here but her condition has been deteriorating,” Sahni said before breaking down.

Not long afterwards came the news that little Muskan had died.

The night before she had eaten bread, she did not have any lychees. It was 10 days ago she had the fruit.

– Dilip Sahni, father of Muskan

She was very likely just the latest victim in a health crisis blamed on Acute Encephalitis Syndrome (AES) in the dirt-poor, baking hot eastern state of Bihar.

The onset is lightning fast, its young victims quickly developing a high fever, seizures, and vomiting. All often, if treatment is not swift, leading to death.

A total of 128 have died so far.

“Obviously it is tough to make ends meet and raise three children. But I try my best. She was a healthy and playful child,” Sahni had said when he had brought his daughter in.

“The night before she had eaten bread, she did not have any lychees. It was 10 days ago she had the fruit,” he said.

‘Dying with worry’

As the hospital guards scream at parents not to crowd the wards, Raju Kumar, 35, a father of five, has just admitted his two-and-half-year-old son to the intensive care unit.

“I am dying with worry. So many dead bodies of little children I have seen standing here. I am just praying my son is saved somehow,” Kumar, a shopkeeper, told AFP.

“He fell unconscious suddenly the day before yesterday. We rushed him here immediately,” he says, holding his four-month-old baby in his arms.

Another being admitted is Krimta Kumari, a girl around nine years old sat on her father’s lap in a yellow T-shirt, visibly flushed with fever and unable to keep her eyes open or speak properly.

Just then, there is a power cut, leaving mothers in colourful saris and gold nose studs to try and cool their sick children in the sweltering hospital with hand-held fans.

Bihar, home to almost 100 million people, has also been hit by a heatwave, with temperatures of 45 degrees Celsius (113 Fahrenheit) killing 184 people this summer – including 78 since Saturday.

Not only is Bihar poor, its healthcare system is in a dire state. For every 100,000 people there are fewer than two health workers, compared to the average for India of around nine, according to the Hindustan Times daily.

“We as doctors are trying our best to save the lives of as many children as possible,” said Srikant Prasad Bharti, an overworked junior paediatric doctor at the SKMCH.

“No one talks about how many sleepless nights we have been spending to look after the sick kids. No one is talking about the children who have been cured. It is easy to blame hospitals and doctors,” he complained.

This is not the first outbreak of AES in Bihar. But fatalities – until this year – had fallen sharply since 2014, when 355 children died. There were just 33 deaths last year, the Hindustan Times reported.

“This is happening because the children come from very poor socio-economic backgrounds. The parents couldn’t care less whether their children have taken their meals or not,” Bharti says.

“The children wander around in heat and eat rotten or unripe lychee and go to bed on empty stomachs. This leads to a sudden drop in blood sugar levels and leads to seizures and convulsions.”

Frequently asked questions

What is encephalitis?

Encephalitis is an inflammation of the brain, caused by any one of a number of viruses.

Early symptoms can be similar to those of flu, with patients suffering from high temperatures or headaches. But symptoms can worsen within hours, and can include serious complications like seizures, paralysis and coma.

In Bihar, children were typically taken to hospital with fevers.

How could lychees cause sickness?

Researchers who conduced a study of 390 children who fell sick in 2014 in Muzaffarpur said that lychees contained hypoglycin A, an amino acid that can disrupt metabolism, lowering blood sugar levels. That can trigger hypoglycaemia, and in extreme cases, death.

The study by India’s National Centre for Disease Control and the US Centers for Disease Control and Prevention, added that when the brain lacks glucose, it turns to other sources of energy, which are rapidly depleted, eventually pushing people into coma.

“The synergistic combination of (lychee) consumption, a missed evening meal, and other potential factors such as poor nutritional status, eating a greater number of litchis, and as yet unidentified genetic differences might be needed to produce this illness,” the researchers said in their study, which was published in the Lancet in 2017.

Retired virologist T. Jacob John also raised the possibility that encephalitis cases in Muzaffarpur could be associated with lychees in a 2014 study published by Indian science journal Current Science. Muzaffarpur is a major hub for growing lychees, which ripen at this time of year.

EXCLUSIVE: Will put heart, soul into fighting Bihar encephalitis outbreak, says Health Minister Harsh Vardhan


In an exclusive interview with Rajdeep Sardesai, Union Health Minister Harsh Vardhan admitted that a lot needs to be done to combat the encephalitis outbreak in Bihar. He, however, assured that he is personally monitoring the situation in the state even as the death toll from encephalitis deaths reached 128 in Muzaffarpur.

As the death toll in the encephalitis outbreak in Bihar continues to rise, Union health minister Harsh Vardhan admitted that many improvements need to be made to India’s health system.

In an exclusive interview with Rajdeep Sardesai, Harsh Vardhan said, “There is certainly a need for a lot of improvement in the health system of the country. In the past five years, we have been trying to do our best to systematically strengthen the system in the country but I think there is a lot to be done.”

The death toll due to Acute Encephalitis Syndrome (AES) rose to 128 in Bihar’s Muzaffarpur district on Wednesday. Amid growing criticism over governmental inaction, Health Minister Harsh Vardhan had issued directions for immediately sending a high-level team to Muzaffarpur to set up a state-of-the-art multi-disciplinary research centre in the wake of these deaths.

Harsh Vardhan also said five virological labs will be set up in different districts in the state. The districts can be decided in consultation with the state government and can be funded through the National Health Mission (NHM), he said.

In one of the decisions taken during his visit, Vardhan instructed to set up a 100-bed paediatric ICU at SKMCH. Also, in the adjoining districts, 10-bed paediatric ICUs will be set up with support from the Centre, so that such cases can be given better and exclusive treatment and there is no unnecessary load on the facilities available at Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur.

He had made similar suggestions when the Narendra Modi government first came to power in 2014.

When asked about why the Modi government failed to deliver on its 2014 promises, the health minister give a list of work that was in progress. “Let me tell you, super speciality building in the college will be ready by year-end. It will be dedicated to people of Muzaffarpur and those from adjoining districts. I myself visited the site this weekend. As far as the pediatric ICU is concerned, I had suggested there should be exclusive pediatric ICU separate from the main hospital setup but they created ICU within the hospital.”


Harsh Vardhan said his 2014 suggestions were not fully implemented as he was health minister for only four-five months then. The Union minister agreed things need to be improved further, “We need to ensure 100 per cent immunisation of children, we are proactively bringing many children into the net of immunisation but India being a large country we need to go ahead at a fast manner. You have seen the initial impact of Ayushmann Bharat. We have the ambitious plan to build 1.5 lakh health and wellness centres at primary level, out of which 18,000 have been created.”

However, Harsh Vardhan admitted that expenditure on health in India needs to increase. “There is an ambitious plan to increase the health budget to 2.5 per cent (from the current 1.5 per cent) of the total Union budget. Personally, as a doctor, I wish I could get much more,” said Harsh Vardhan.

The spread of encephalitis in Bihar has been attributed to malnutrition. Unripe litchi fruit contains a high concentration of the toxin called MCPG which triggers hypoglycemia if consumed by a child with a malnourished body. Therein lies the answer to the question: why only the poorest of the poor and mostly those living in Muzaffarpur and adjoining districts are suffering from the disease.

Harsh Vardhan said that the Modi government has diagnosed the problems in the system and hopes to eradicate them by 2022. “When we took over in 2014, under the leadership of PM Modi we tried to diagnose each and every problem in the country. A lot has been done and a lot needs to be done and we are very hopeful that in the new India that we are talking about in 2022, you will see a lot of perceptible and measurable changes in the country,” said Harsh Vardhan.

However, the minister was not able to give a clear answer on whether the NDA government in Bihar or CM Nitish Kumar should be held accountable for the encephalitis outbreak. “You have to appreciate that this disease has not been eradicated anywhere in the world. It is endemic to this part of the country. This is not happening only here,” he said.

When questioned on how the UP government had managed to control the encephalitis outbreak in the state but Bihar had failed, Harsh Vardhan said that he was doing his best to improve the situation and was monitoring it closely. “I can only tell you that we are trying to do our best. I have sent one of my joint secretaries there [to Muzaffarpur], have sent all possible help — paediatricians, virologists, epidemiologists. From our side, we have ensured that whatever gap exists is filled. I was only four-five days old in this ministry, but I sent a high-powered team there. Every day I am monitoring things on an hourly basis and the teams are reporting to me directly.”

Finally, when asked if he could give a guarantee that such a grim scenario would not be seen in Bihar next year, Harsh Vardhan said, “I can only give you one guarantee that Dr Harsh Vardhan will personally monitor the implementation of all the suggestions that he gave in 2019. I will do my best and I will put my heart and soul into it.”

Bihar: Death toll in AES outbreak climbs to 163; Muzaffarpur, Vaishali worst-hit districts


The death toll in Acute Encephalitis Syndrome (AES) outbreak in Bihar climbed to 163 lives on Friday, leaving the state in despair. 

Muzaffarpur: The death toll in Acute Encephalitis Syndrome (AES) outbreak in Bihar climbed to 163 lives on Friday, leaving the state in despair. 

Muzaffarpur was the worst-affected district with 126 fatalities. Two more children, admitted to the district’s Sri Krishna Medical College and Hospital (SKMCH) died, earlier on Friday. 

In Vaishali’s Lalganj area, another child lost the battle to the viral disease, taking the death toll to 18. At least nine children with AES symptoms are admitted to the district’s Sadar Hospital and are receiving treatment in the special ward.

Another six children lost their lives in Begusarai district, five in Samastipur, two each in Motihari, Patna and Bettiah and one each in Bhagalpur and Gopalganj.

Taking cognizance of the alarming health situation prevailing in the state, Minister of State for Home Affairs Nityanand Rai announced that all 17 BJP MPs in Bihar will build a Pediatric Intensive Care Unit (PICU) in their districts. He took responsibility to get PICU constructed in Samastipur district. On June 19, the MoS issued Rs 25 lakh from Members of Parliament Local Area Development (MPLAD) fund for the construction of the PICUs. 

On Tuesday, Chief Minister Nitish Kumar visited Muzaffarpur and held a meeting with officials to review the situation, but refused to answer any questions on the health crisis.

The state health department deputed additional medical officers, child specialists and nurses from other districts to Muzaffarpur to help the health officials in the district.

AES is a viral disease which causes mild flu-like symptoms such as high fever, convulsions, and headache