In one sense, Peter Piot, a former World Health Organization (WHO) official and one of the discoverers of the Ebola virus, was right. He had expressed concerns about the deadly disease spreading to India. There are nearly 45,000 Indian nationals living in West Africa. The man whom India has quarantined after traces of the virus were detected in his semen happens to be an Indian working in Liberia which along with Sierra Leone and Guinea is the West African country most affected. The 26-year-old man arrived at the Delhi airport on Nov. 10. Leaving nothing to chance, India has stepped up its Ebola vigil. The screening protocol that helped detect the case has now been set up in 24 airports and nine seaports across the country. Thermal scanners are being used in 18 major airports to detect any traces of fever, usually the first symptom of the disease, in passengers. Around 30 hospitals across the country are being equipped to treat patients in isolation. Authorities say there is no shortage of drugs. A round-the-clock helpline has been opened to respond to people's queries on Ebola. The Airports Authority of India has instructed airports across the country as early as last August to set up screening facilities at arrival terminals. It is possible that the detection of the virus in the young Ebola victim was the result of “extra caution” shown by the government, as Health Minister J. P. Nadda claimed. But media reports and initial assessment suggest that guidelines to screen passengers arriving from countries struck by Ebola might not have been followed in all airports. Complicating the situation is the fact that quarantine facilities at airports other than those at Delhi and Mumbai leave much to be desired. are not many laboratories equipped to screen samples for Ebola. Existing ones need to be strengthened for faster screening. Around 22,000 passengers have been screened in different airports. Only 55 were found to be high-risk. In the southern state of Tamil Nadu, 17 people are under home surveillance. Unlike in America, where there was overreaction and all sorts of frenzied questions about the way the disease spreads, Indians, according to media reports, are not showing any sign of panic. But complacency, out of ignorance or overconfidence, can prove as dangerous as panic. Whatever the reason, domestic flyers are not being screened in India. Even if they are, there are so many other ways in which an infected patient can slip through. India is a country where thousands travel daily in trains or buses and gather in shopping malls and public places. Though flight patterns predict that India has a low risk of importing a case of Ebola, the virus could land via a third country. We should also remember that India's sanitation record is one of the world's worst. The lack of toilets in West Africa was highlighted by the United Nations as a possible cause of the spread of the highly contagious hemorrhage disease. But the country with the largest number of public defecators happens to be India, which has 600 million. Even Vietnam and Bangladesh have virtually stamped out the practice entirely by 2012. Prime Minister Narendra Modi is aware of the problem and has said building toilets is a priority over temples. His government had set the goal of ending defecating in the open by 2019. This is in the long run. In the short run there is an urgent need to strengthen national capacity for early detection of the virus, prompt management and rapid containment. Unfortunately, government health services are overburdened, and many in rural areas have to struggle to get access to even basic health services. Overcrowded public hospitals can turn into disease-spreading centers. Three months after the Health Ministry first issued advisories to state governments and started screenings for Ebola at airports, private hospitals and laboratories are still to get advisories on protocol for suspected cases. No infectious disease can be controlled unless people are informed and taught to protect themselves. Authorities must provide accurate and relevant information to the public including measures to reduce the risk of exposure. They should know simple preventive measures including hand hygiene. Most important, the government should know India is a country where diseases deadlier than Ebola have for long enjoyed a free run. In 2013 alone there were 61 million cases of malaria and 116,000 deaths in India — a number that dwarfs the total number of Ebola infections and fatalities worldwide.
