By Dr. Dinesh
You have done Community Medicine from All India Institute of Medical Sciences, New Delhi, and a trained Epidemiologist and a WHO trained Health Cluster Coordinator (HCC) in responding to public health emergencies. Since you are an expert in community medicine, public health and clinical epidemiology and have coordinated health emergencies in several countries. What is your advice during this COVID-19 pandemic?
That on 30thJanuary 2020, WHO Director General has declared COVID-19 as Public Health Emergency of International Concern (PHEIC), and WHO is advising its Member States to aggressively detect, test, isolate, and quarantine every case, and trace every contact. Therefore, testing is the key. Yes, the Ministry of Health & Family Welfare, Government of India do have a guideline ‘Whom to Test’. We have to strictly follow our Hon’ble Prime Ministers instructions on ongoing complete lockdown so that we maintain Social Distancing and avoid mass gathering. In addition, follow basic preventive measures against the COVID-19 such as wash your hands frequently, avoid touching eyes, nose and mouth, practice respiratory hygiene etc. The lockdown is allowing us time to prepare for the public health intervention to contain COVID-19. I must acknowledge and thank the A&N Administration for doing excellent job in terms of initial COVID-19 response, and I remember the first advisory that was circulated by the COVID-19 Nodal Officer, Directorate of Health Services, A&N Administration on 10th March 2019, which coincided with Holi festival, to avoid mass gathering. However, I can see that there are several challenges that the A&N Administration is currently facing in terms of ongoing contact tracing, hospital emergency preparedness, information education communication including community awareness etc. about the COVID-19, as there are still COVID-19 positive cases, with no mortality which is a good sign. Yes, the 12th, 13th, 14th, 15th and today the 16th COVID-19 positive cases are matter of concerns. I am confident that the Directorate Health Services, A&N Administration is taking necessary steps in addressing these challenges. I would strongly recommend to look at WHO’s new guidance and try to fulfil six conditions before ending COVID-19 lockdown on 3rd May 2020.
You are the son of the soil, born and brought up in Andaman & Nicobar Islands?
I belong A&N Islands and have worked as a Medical Officer & Senior Medical officer with Directorate of Health Services, A&N Administration from 1986 to 1996 and served in various parts of A & N Islands including in Dugong Creek, with Onge, and provided health service delivery. I did serve as member of the A&N Administration’s Andaman Adim Janjati Vikas Samiti (AAJVS) contact team for Jarawas and Sentinelese from 1989 to 1991. I was one of the 13-member contact team lead by Mr SA Awaradi, the then Director, AAJVS and Tribal Welfare, A&N Administration made first contact with Sentinelese in North sentinel Islands, on 4th January 1991.
Why did you resign from Directorate of Health Service of A & N Islands?
I resigned in 1996 for personal reasons, mainly in gaining International Public Health experience. I guess, I am the only medical doctor who did return the bond-value, meant for higher studies in mainland, to the A&N Administration.
Can you brief me about some international assignments?
Since 1996, I have worked with several international Non-Government Organizations & United Nations Agencies including World Health Organization, United Nation’s specialized health agency for more than 13 years, in more than 40 countries in WHO’s South East Asia, Western Pacific, Eastern Mediterranean & African region. I have served in different capacity as Coordinator, Manager, Technical Adviser, and provided strategic guidance and technical assistance on health, nutrition & sexual reproductive health including HIV/AIDS, environmental health including Water, Sanitation & Hygiene, climate change affecting human health, livelihood programme, specially the Ministry of Health to address health needs of the internally displaced persons (IDP’s), refugees, returnees and local communities.
When was the last assignment with WHO?
My last assignment was in late 2019 with WHO Mozambique as Health Cluster Coordinator. Actually, I was deployed twice by WHO’s Head Quarter in Geneva to join international response to flash flooding due to Cyclone Idai and Cyclone Kenneth. I have coordinated the health cluster in collaboration with various health cluster partners i.e. national and international NGOs, UN agencies, supported the Ministry of Health in delivering six Health Cluster Core functions including health service delivery to the people affected by flooding.
Have you worked in anything related to communicable diseases?
I have worked on WHO’s several Areas of Work to support member states on Disaster risk management for health including emergency preparedness and response, health sector contingency planning; communicable diseases & epidemiology including outbreak investigations, established integrated Disease Surveillance Response System including rapid response team; and implemented pandemic Influenza preparedness framework.
Have you coordinated any public health emergencies?
As WHO HCC, coordinated the Bangkok-Based international response to Cyclone Nargis in 2008, flash flood response in Solomon Islands in 2014, draught response in Timor-Leste in 2016, and health cluster in Sudan from 2017 to 2019 for the ongoing emergencies including public health emergencies due to acute watery diarrhea; and recently during flash flood response in Mozambique. Any sudden or slow-onset disasters are usually followed by public health emergencies unless necessary preventive measures are undertaken. In addition, supported the MoH in public health emergency preparedness for Ebola Virus Disease.
Do you have any teaching experience in Medical Colleges?
As a Junior Resident during MD days in AIIMS New Delhi, one has to learn, and teach as well to undergraduate MBBS student, and other paramedical staffs. During international assignments I have been engaged in capacity building/training of health care professionals including doctors, nurses. Yes, with WHO, I have been invited to deliver guest lectures on various topics in several medical universities in Thailand. I did serve as an external advisor for Master of Public Health and PhD students in Mahidol University, Bangkok in Thailand and their scientific work was published in international journals.
Since you have decided to stay back at Andamans, and planning to serve as an Independent Public Health Consultant, what advice would you like to give to the people of A & N Islands during this COVID-19 pandemic
We must strictly adhere to time-to-time guidance disseminated by the A&N Administration. I take this opportunity to reiterate that all of us must strictly follow our Hon’ble Prime Ministers instructions on the ongoing complete lockdown so that we maintain Social Distancing. Please stay home and stay safe
Which all countries have you worked, just out of curiosity I am asking?
I have worked in international environment in more than 40 countries during past 24 years. I have lived and worked in 15 countries, and I began with Libya, Laos, Mongolia, China, Tanzania, Sierra Leone, Indonesia, Thailand, South Sudan, Nepal, Philippines, Solomon Islands, Timor-Leste, Sudan and recently in Mozambique.
Oh that is great, have you done any international short course which can give expertise in this field specially epidemiology?
I have done several short courses such as Principles of Epidemiology organized by International Clinical Epidemiology Unit in AIIMS New Delhi, WHO short course on communicable disease in humanitarian emergencies in Geneva, and recently WHO Health Cluster Coordination Training in France.
The last question, what if the A & N Administration calls you for expert advice on epidemiologic view on COVID-19 if the situation arises since you have handled much cases abroad, will you provide valuable service on contract basis if the situation arises?
Why not, I will be very happy and honored to accept the offer to join the team of the A&N Administration to support the ongoing COVID-19 response through engaging various partners including the Directorate of Health Services, Regional Medical Research Centre, Andaman & Nicobar Islands Institute of Medical Sciences, and the National Health Mission in A&N Islands and civil society organization and sharing some of the international experience. Yes, I have already expressed my interest to the A&N Administration. At this point of time, it is extremely important that our hospitals are fully prepared to manage COVID-19 cases, not only in Port Blair but also hospitals in other islands including ambulance services to transport suspected COVID-19 cases. There is an urgent need for capacity building/refreshers training on contact tracing, surveillance data analysis, case management and patient transportation, risk communication, specimen collection and transport, disinfection and hazardous waste management. We have to make sure that our staffs are trained in Covid-19 dead body management also (god forbid it doesn’t happen and all patients recovers completely), the Ministry of Health & Family Welfare already released guidelines for the Covid-19 dead body management.
Thank you, it was a pleasure talking to you Dr. Mallik.
