Ajmer district is located in the center of Rajasthan state between 25° 38’ and 26°58’ north latitudes and 73° 54’ and 75° 22’ east longitudes. It is bounded on the north by Nagaur district, on the south by Bhilwara district, on the east by Jaipur and Tonk districts and on the west by Pali district.

The district is triangular in shape. Total area of the district is 8481 sq. kms. It is generally a level plain interspersed with low hills that run in the northwesterly direction. The range of hills between Ajmer and Nasirabad marks the dividing watershed of the continent of India. The rain, which falls on the southern Nassirabad side, finds its way through the Chambal river into the Bay of Bengal; that which falls on the other side is discharged by the Loni river into the Gulf of Kutch. The district is endowed with a large number of non-metallic minerals e.g. asbestos, beryl emerald, feldspar, garnet, mica, and vermiculite. Around 4.17% of total area is covered under forest.

Total population of the district according to 1991 census was 1.7 million, comprising of 0.9 million males and 0.8 million females. Rural population in the district was 1.0 million and urban population was 0.7 millions. The scheduled caste and scheduled tribe population of the district as per 1991 census was 0.3 million (18%) and 0.04 millions (2.4%) respectively. The decennial growth rate of population between 1981 and 1991 was 19.63%, which was slightly less than that of the state of Rajasthan (28.07%). Hindi, Rajasthani, Urdu, and Sindhi are the main languages spoken in the district. 

Table 1. Profile of Ajmer district at a glance

The district at present comprises of six tehsils and eight Community Development Blocks. It has eight towns and 1001 villages (985 inhabited and 16 uninhabited villages). The district has efficient communications and is connected by rail and road to most important centers of the country. Among the educational institutions functioning in the district there were 870 primary schools, 220 middle schools, 130 higher secondary schools, 11 general education colleges in addition to 16 professional education colleges and five professional schools. Amenities available in the villages are shown in table 2.

Table 2. Villages having one or more amenities in the district (1991 census)

All the important places in the district are connected by road. National highway number 8 (between Delhi and Mumbai) passes through the district. Total length of roads in the district is 1,676 Kilometers. There is a Tourist Bungalow, a Dak Bungalow, and a Circuit House at Ajmer city and a Tourist Bungalow at Pushkar town. These Bungalow are maintained by the State government. The Public Works Department also maintains Dak Bungalow at Beawar, Kekri, Kishangarh and Sarwar.

The major Kharif crops are bajra, jowar, pulses, maize and groundnut. Main Rabi crops are wheat, barley, gram and oilseeds. Cotton is an important cash crop that is grown in the district.

Cattle, buffaloes, sheep and goats constitute main livestock population of the district. Donkeys and mules, horses and ponies, camels, and pigs are also reared in the district in small numbers. There are 16 veterinary hospitals, 12 veterinary dispensaries, seven sheep extension centers, three sheep artificial insemination centers and a mobile veterinary unit in the district.

Large-scale workshops and industries have been set up by the Indian Railways. Other industries in the district are concerned with cotton ginning, cleaning, spinning and weaving, oil mills, wool industry and stone crushing and dressing. The main small scale and cottage industries of the district are manufacturing of “Bidi”, “Gota” shoes, toy making, dyeing and printing, pottery, lac bangle making, carpentry, black smithy, and gold-smithy etc. Most of the wool cleaning factories are concentrated at Beawar because it is an important market for the wool trade. The district abounds in mineral wealth and more minerals including radioactive ones are being discovered.

The articles that are exported out of the district consists of food-grains, raw cotton, wool, mica, feldspar, and quartz while the import includes grain and pulses, sugar, jaggery, salt, and oil seeds.

Table 3. Administrative units in Ajmer district

Table 4. Health infrastructure and manpower in Ajmer

Table 5. Beds in Government Hospitals of Ajmer

National Surveillance Programme for communicable Diseases

Ajmer district in Rajasthan was included as a pilot district in 1998. The district Rapid Response Team was trained by the State Nodal Officer at Jaipur and consists of the following member (table 6):

Table 6.Composition of Ajmer District RRT

Note: Currently, there is no statistician in the RRT

Laboratory support

The laboratory situated at Amrit Kaur district hospital, Beawar, has been identified as laboratory supporting the NSPCD at Ajmer. The in-charge of the laboratory was Dr. P. R. Agarwal who has post-graduate qualification in pathology. Four trained laboratory technicians helped the doctor in carrying out the tests. The laboratory had eight rooms and a hall. Three of the rooms were air-conditioned. Electricity and running water supply was available. There was no provision for liquefied petroleum gas. The laboratory works in two shifts (morning and evening) for six days a week. No written protocols (Standard Operating Procedures) were available for the technical staff. The investigation forms had incomplete clinical details and it was not possible to trace the patients based on the information provided on the form. The laboratory records were maintained manually.  There was no system whereby clinical specimens could be refereed to a higher level of laboratory. No quality control procedures and programmes were in operation. Laboratory technicians were using apron and latex gloves as safety precaution. However, the use of gloves was inconsistent and depended on the decision of the technician performing the test. Liquid waste was mostly disposed of by draining it into the municipal drain. Sometimes formalin was used to disinfect the liquid waste before discharging it into the drain. Solid waste was disposed either by burial without any pre-treatment or by burning it with the help of Kerosene oil. The laboratory in-charge felt that the main impediment in efficient functioning of the laboratory was administrative structure. Sometimes there were problems in getting the appropriate test kits in a timely manner. No bacteriological, virological, Mycobacterial, or parasitological tests were performed at the laboratory. Widal test was done for the patients. Currently the laboratory undertakes VDRL, HbsAg and HIV testing for the blood bank. These tests would shortly become available for the patients as well. The laboratory was performing approximately 100 tests each of HIV and HbsAg, and 160 VDRL tests every month. The laboratory also performed few pathological  (mainly hematological) and biochemical tests for the hospital patients.

Disease outbreak

During April-May 2001, outbreak of measles occurred in Ajmer wherein 207 children were affected and seven deaths were reported. The 15 affected villages were scattered over the district. Children up to the 16 years were affected. The overall measles immunization coverage rates were low among the affected villages. The control measure adopted was to give measles immunization to all children between nine months and ten years old that were residing in the affected villages irrespective of their previous immunization status.

No active surveillance was conducted and no epidemiological investigation was carried out. No serological confirmation of the diagnosis was attempted in any of the cases.

Lessons learnt

• The monthly reporting of cases and deaths due to communicable diseases have been highly irregular. No report has been received from Ajmer since September 2000. The reports for the months of May, June, and July have not been received. The importance of regular reporting to the National institute of Communicable Diseases was stressed during the meeting with the District Nodal Officer.
• The district had not received the standard case definitions. No local adaptation of standard case definition was available. Therefore case reporting was liable to subjective interpretation. The comparison of data over different time periods, geographical areas, and population groups was difficult to make in the absence of uniform case definition. It was agreed the standard case definition prepared by NICD would be supplied to the District Nodal Officer. The same could be simplified and adapted in local language to be used by paramedical staff.
• Adequate laboratory space was available, and the hospital administration indicated that more space could be made available if so required. Though the microscope is available, none of the four laboratory technicians have been specifically trained for microbiology. It appeared that the laboratory was under-utilized. Other health institutions in the district could be encouraged to use this facility more intensely. At the same time, it would be appropriate if the range of services currently available at the laboratory is enlarged by providing additional resource and training in-puts.