by P.K Taneja,
IAS
Principal
Secretary and Commissioner
Department of
Health
Sickle Cell Anemia Control Program of Gujarat state was
honored by “Prime Minister Award for Excellence in Public Administration” by
Department of Administrative Reforms and PublicGrievances, Government of India
Introduction
Sickle Cell Anemia (also known as Sickle Cell Disorder or
Sickle Cell Disease) is a genetic disorder, where the blood cells contain
abnormal sickle-shaped hemoglobin cells called sickle hemoglobin (HbS) which
cause blockage of the blood vessels leading to severe health complications.
The highest frequency of occurrence of the Sickle Cell
Disease is in tropical regions, particularly Sub-Saharan Africa, India and the
Middle-East. In India, the prevalence of Sickle Cell Anemia is highly common in
the tribal belt of the central and southern parts.
The public health implications of Sickle Cell Anemia are
significant leading to poor quality of life, lower life expectancy and higher
rates of infant mortality.
Sickle Cell Anemia in Gujarat
Gujarat is one of the few States in India which have
incorporated the Sickle Cell Anemia Control Programme in their existing health
services. Initially this program was started in five districts of South Gujarat
viz. Surat, Tapi, Navsari, Valsad and Dang on a PPP mode with the help of an
NGO named Valsad Raktadan Kendra. In 2008, the activities under this program
were replicated in the rest of the tribal districts viz. Bharuch, Narmada,
Vadodara, Panchmahal, Dahod, Sabarkantha and Banaskantha aided by the Indian
Red Cross Society, Ahmedabad. Thus, the entire tribal belt of eastern Gujarat
was covered from Ambaji to Dang.
Sickle Cell Disease does not have a cure as of now;
therefore any strategy to deal with the disease should focus on prevention,
early diagnosis. The Sickle Cell Anemia Control Programme does just that. Its
focus is early diagnosis, treatment and counseling. So far more than 30 lakh
tribal people have been screened for Sickle Cell Anemia.
Gujarat Sickle Cell Anemia Control Society:
In the year, 2011 Gujarat Sickle Cell Anemia Control Society
was formed to integrate the various activities among different departments of
Government and various NGOs for better implementation of the program. The
society was formed with a goal to stop all Sickle Cell Disease child births and
deaths due to the Sickle Cell Disease, by 2020.
Sickle Cell Anemia Screening
The screening under this program covers the all age group
from newborns to aged people. The main target group for screening comprises of
the antenatal and newborns. As this disease is genetic in nature and there is
no cure for this disease, prevention is the only way to keep it away. For this,
marriages between Sicklers and non-carriers or two Sicklers have to be
prevented. Therefore, the Government of Gujarat has adopted a policy of
screening adolescents. So the sickle cell gene can be diagnosed before
marriage.
All Antenatal mothers in the tribal areas are screened for
Sickle Cell Anemia at “Mamta Divas”- a special immunization day in the villages
of Gujarat.The unique feature of the sickle cell anemia screening program is
that it covers the whole life cycle.
Counseling
Counseling is the key objective of this program. All the
Sickle Cell Traits and Sickle Cell Disease patients are counseled regularly by
trained counselors. Family counseling is done at door steps. All the
adolescents are counseled on marraige and pregnancy. All the tribals are given
color coded cards according to their Sickle Cell Status, which help them to
take a decision during marriage.
Treatment
All the patients are given Tab. Folic Acid regularly and
Analgesics. Antibiotics and Anti malarial tablets are given as and when
required. Arrangements have been made for the supply of free blood and blood
products to all these patients as and when required in emergency through
Regional Blood Centers and First referral Units.
As Pneumonia is the major cause of death in Sickle Cell
Disease, especially in children under 5, all the Sickle Cell Disease patients
are given Pneumococcal vaccine.
The Govt. of Gujarat has signed an MOU with GIOSTAR, an USA
based company for creating stem cell treatment facilities at the Govt. Medical
College, Surat. Stem cell transplantation will bring a hope of survival for all
Sickle cell disease patients in Gujarat.
Situation after the formation of the Society
The Society has decided to complete the screening of the
remaining tribal population in the next three years. To complete this task
within the set time frame with the help of different NGOs; district wise screening
work has been outsourced among interested, qualified and competent agencies. In
the first six months, more than 11 lakh persons were screened; which is much
more than previous years.
