Methanol Deaths: Understanding that health care is interdisciplinary

This week in health, we read about Kallakurichi hooch tragedy, NEET imbroglio, Sickle Cell Disease, and more.

Updated - June 26, 2024 02:30 pm IST

Published - June 25, 2024 03:39 pm IST

(In the weekly Health Matters newsletter, Ramya Kannan writes about getting to good health, and staying thereYou can subscribe here to get the newsletter in your inbox.)

There are scandals, and scams, and all kinds of misdoings that we report on regularly. This week though, we have the mother of them all, a tragedy, and as these things usually go, it’s scarcely only health-related. There are social, economic, cultural and political aspects to why the Kallakurichi hooch tragedy was allowed to happen, and take with it, at last count, 59 lives. 

One of the worst-such hooch tragedies in recent times in Tamil Nadu and possibly even the country, Kallakurichi marks that occasion when every thing that can go wrong with a system, does go wrong. In a bunch of villages in northern Tamil Nadu, last week, at least 59 people died of consuming local arrack laced with methanol, and over a 100 others have been admitted to hospital with classic symptoms of methanol poisoning. A post facto analysis at ground zero by The Hindu’s S. Prasad lists out the sequence of events that led to the Kallakurichi hooch tragedy, fermented with methanol and apathy. This is also a classic proof of the pudding that health does not exist in a vaccum, that good health is the function of multiple agencies, or looking out for the social and economic indicators in society, preventing criminal activity, if necessary, and ensuring that behaviour change communication is effective. That bootleggers were brewing away and selling their moonshine close to the local police station and behind the courts, in full view of, as it were, the law, and that it went unchecked months on end is all the makings of a horror story. 

The specially-appointed Prohibition Enforcement Wing of the police, to handle such illegal brewing, either failed thoroughly or were complicit in the crime, by accepting bribes and turning to look the other way. With the prices of the alcohol at the State-run TASMAC shops raised recently, that put the legally packaged alcohol above the budgets of a number of daily labourers. Sold as packets for less than half of what is available at the TASMAC shops, the illegal moonshine soon became the favourite. Additionally, the role of the district collector and police in denying that the deaths were due to methanol poisoning, while other evidence definitely pointed towards it were criminal, as emboldened by this, other villagers went ahead and drank the bootlegged alcohol,which unfathomably, was still available. 

Methyl alcohol is a potent poison - it can lead to blindness, liver failure and death when ingested by humans. Some State laws ban or control the distribution of methanol for any other than industrial purposes, but apparently wiley bootleggers live outside of the law. It is time to pull up an explainer by Vasudevan Mukunth, from earlier, on what methanol poisoning is and how it can be treated. Kallakurichi should be a watershed moment for Tamil Nadu yes, but also the rest of the nation, the rural parts of which are no strangers to methanol in moonshine. For it to be forgotten would be nothing short of a crime. 

The NEET imbroglio, meanwhile, is far from over. After charges of paper leaks, and awarding of grace marks, and mismanagement at the examination centres, and a swathe of protests across the country, the government conveyed its decision to the Supreme Court that it would conduct a re-test for over 1500 students who had received grace marks. Less than half of those students took the retest, and meanwhile, Krishnadas Rajagopal reported from the apex court that the judges said any negligence in the conduct of NEET should be dealt with thoroughly. The DMK Rajya Sabha MP urged Centre to order CBI probe, take action against concerned officials in this case, echoing the sentiments of the students, and professors. While the boss of the National Testing Agency that conducts NEET was removed, the NEET PG exam was postponed, introducing a further element of confusion among those waiting for the PG specialisation seats too. Maitri Porecha reported that a member of the committee constituted to overhaul the operations of the NTA opined that it was impossible for any one organisation to conduct online tests for 23 lakh students (the number of UG students writing NEET. A CBI probe has also been ordered to investigate the charges, writes Ashna Butani. While the courts and the government tussle over this, students feel victimised, and hope for a solution that will be fair and reasonable, free from bias.

There have been fascinating developments around sickle cell disease of late. Let’s begin with the good news: Abhinay Lakshman reports that India is getting close to developing gene therapy for sickle cell disease. Speaking at a recent meeting, officials of the government said they were expecting to hear “good news” by January 2025 on the laboratory tests that are being run. M. Srinivas, Director of the All India Institute of Medical Sciences, said researchers were working to develop a gene therapy using CRISPR-Cas9, a gene-editing tool. “We want, in the next six months to one year, to be able to go forward with using this method for treating SCD — making India one of the first countries to do so,” he added.

A development that would be of tremendous significance to India, given that the prevalence of Sickle cell anemia is high among tribals, B. Madhu Gopal writes. On the occasion of Sickle Cell Disease day, observed on June 19, here’s a news report on prevalence: Sickle Cell Disease: 192 cases, more than 2,000 individuals with traits identified in Karnataka in the last one year

Radhika Peddinti , a practitioner based in the US, insists that the need for the hour is for Sickle cell patients to get better access to modern medication. There have been a lot of developments as far as treating the disease, but the question is one of access of patients to such treatment, particularly given that these people are part of the lower economic strata or disadvantaged communities. Here’s an old explainer on Sickle Cell Disease, pulled up to give you some context. 

R. Sujatha reports on a HelpAge India report that calls for action on senior citizen’s welfare in the country. Elders are ailing, alone and without the means to support themselves, the study found. Yet another instance of how health must be seen as a multidisciplinary unit, involving several other sectors of the government, the community and the voluntary sector. Do hit the link for details of the study.

Leaving it out here, even if as evidence. Jacob Koshy writes that Patent filings credit Bharat Biotech as ‘inventor’ of Covaxin, omit ICMR. Notably, the two jointly worked on Covaxin and the safety and efficacy trials. Recently ICMR discredited a study on the side effects of Covaxin by researchers at the Benares Hindu University, you might remember reading about it here. Turns out, it was an ‘oversight’. Bharat Biotech said it had erred in not crediting ICMR as co-inventor of Covaxin, and promised it was making amends to rectify that.

A couple of weeks ago, we wrote of the immense possibilities of a liquid biopsy making things easier for cancer patients, and here’s an enthusiastic follow up. V Geetanath reports that breast cancer diagnosis could be possible with just a drop of blood. The CSIR-Centre for Cellular and Molecular Biology (CCMB) scientists in association with clinicians of the Regional Cancer Centre (RCC) in Thiruvananthapuram (Kerala) have identified a potentially cost-effective and non-invasive method to detect various kinds of breast cancer from just a drop of blood. How does it work? Cancer cells shed DNA/RNA in the circulating blood called ‘Circulating Nucleic Acids (CNAs) and tumour-specific genetic changes, including DNA, RNA, and proteins, which are detectable in plasma or other body fluids of cancer patients to identify the earlier stages of cancer development. Based on this principle, the identified biomarkers could be made into a liquid biopsy system. 

In the tailpiece, this time, genetics trumps, perhaps yet again. Jenny Graves writes a fascinating tale on the mysterious fate of the Neanderthal Y chromosome. The Homo sapiens genome today contains a little bit of Neanderthal DNA. These genetic traces come from almost every part of the Neanderthal genome – except the Y sex chromosome, which is responsible for making males. So what happened to the Neanderthal Y chromosome? It could have been lost by accident, or because of mating patterns or inferior function. However, the answer may lie in a century-old theory about the health of interspecies hybrids, the story says. Do click on the link to read more. 

Sridhar Sivasubbu and Vinod Scaria also go back in time to talk of how ancient genomes reveal legacies of human sacrifice and mediaeval epidemics. By comparing the ancient remains of Mayans, and the modern genomes from Mexico, the researchers found evidence of positive selection in genes related to immunity, especially those associated with resistance to enteric fever caused by Salmonella enterica Paratyphi C, a pathogen serotype previously identified with the 16th century cocoliztli epidemic in Mexico.

As we do explainers pretty well, here are a few, that give you the context behind what makes news: C. Maya reports on whether H5N1 poses a threat for humans

Zubeda Hamid’s In Focus podcast asks: Is India equipped to deal with the rise in its elderly population? 

R. Prasad explains the controversy behind the Rotavirus vaccine: tortured data analyses raise false safety alarm

If you have a few more moments, do also read:

Karthik Vinod on: Complex PTSD: When trauma persists…

Avian flu confirmed at nine more places in Alappuzha

Kerala to form new guidelines to regulate ‘altruistic’ organ donations

Air pollution caused 8.1 million deaths in 2021 globally, 2.1 million in India: Report

2,000 TB survivors helped out over four lakh patients across India

For many more health stories, head to our health page, and subscribe to the health newsletter, here.

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