Something is rotten in the Brihanmumbai Municipal Corporation’s state of data collection. While the corporation’s official data for the year 2013 showed 1,393 residents of the metropolis died of tuberculosis (TB), statistics collated by a Right to Information (RTI) query revealed the figure to be much higher.

According to the RTI response, the BMC registered 7,127 deaths due to malaria in 2013. The figures come from death certificates issued by the corporation, reports the Praja Foundation, the NGO watchdog which filed the RTI.

The discrepancy was huge even in case of malaria deaths: 30 in Mumbai, according to BMC’s officially-released data versus 199, as found through the RTI route.

The statistics are part of Praja Foundation’s latest report on the ‘State of health in Mumbai’.

The corporation has, meanwhile, refuted the NGO’s findings.

The report says 195 people died of malaria and 108 dengue deaths were reported in the 2013-14 financial year. It says 1.2 lakh residents suffered from diarrhea, with 255 cases turning fatal; seven died of cholera, and 10 due to typhoid.

According to the NGO’s finding, RTI data collected from the BMC and other government dispensaries and hospitals, including state hospitals, reveal that the rate of malaria cases continues to remain high. With 46,606 deaths in the past six years, including 7,075 TB deaths in 2013-14, a total of 7,650 “avoidable deaths” took place in that period. 

The report says, “Mumbai may soon become the Tuberculosis death capital of the world. Despite world class medical expertise, state-of-the-art medical facilities, both public and private, the city does not seem to have the leadership to control the disease.”

Milind Mhaske, the project director at Praja Foundation, says, “The statistical objective of RBD (registration of births and deaths Act, or RBD Act-1969) is to provide a source of demographic data for socio-economic planning, development of health systems and population control.”

Mangesh Pednekar, director, Healis Sekhsaria Institute of Public Health, says there is no dearth of data, and the authorities should study them to address the situation. “In Maharashtra, reports are received at the state office of deputy chief registrar of birth and death in Pune on the 10th of every month. The entire data has been coded and computerised since September 2004 and currently maintained according to ICD (international cause of death)- 10 standards,” Pednekar says. “This data is the most authentic source for epidemiology studies, which can improve or suggest corrective actions on public health policies.

“Based on information gathered through this source, studies can be done on challenges patients face in accessing the healthcare system (both public and private). It can help improve the delivery of healthcare services and ultimately reduce unnecessary deaths from curable diseases.”

Nitai Mehta, founder-director, Praja Foundation says his NGO, along with Healis (Sekhsaria Institute For Public Health) and Centre for Global Health Research (Canada), plans to initiate such a study on TB. The organisations, he says, have urged the government to “share relevant information so that both public and private institutes can undertake similar studies on devising local strategies to suit Mumbai residents’ health needs.”

Callous representatives

Meanwhile, the Praja Foundation report also says that two of 32 MLAs from Mumbai (barring four ministers) did not raise a single health-related question in any assembly session in 2013. Two other legislators asked one question each on health.

In the public health committee, of 34 elected municipal councillors, eight who have been committee members for two years (2012-14) have not raised a single question in the committee. Of 227 councillors, 121 did not ask a single question on health in 2013-14 financial year, according to the report.

“Were the elected municipal councillors not responsible – both at the municipal and the state level – to let governance slip into a coma while the state of health of Mumbaikars is becoming worse?” asked Mhaske.

Public health surveillance – or the health information system – needs to be immediately augmented to regularly collect data from private and public health facilities, the report says.

“Health should be available for research on an open e-platform where raw data sets are made available. Elected representatives should become more engaged in the debates on public health policies, proposed legislations such as clinical establishment Act, health surveillance reports etc., and focus should be on strengthening primary health care ensuring quality health service to the poorest of the poor,” Mehta said.