The district of Jodhpur is located in the western part of Rajasthan. It stretches between 26° 0’ and 27° 37’ north latitude and 72° 55’ and 73° 52’ east longitude. The district is bounded on the north by Bikaner and Jaisalmer districts, on the south by the districts of Pali and Barmer, on the east by the districts of Pali and Nagaur and on the west by Jaisalmer district. The total area of the district is 22,850 sq. kms.

The district resembles in shape an irregular rectangle studded with a few small hillocks. Large parts of the district fall under the category of Indian Thar desert. It is an arid region where sand dunes are commonly visible. Luni river rises near Pushkar in Ajmer district and flows through Nagaur and Pali districts. It enters Jodhpur district near village Jhak in Bilara tehsil and ends in the form of an artificial lake known as “Jaswant Sagar”. Total length of the river in the district is 122 kms.

Balsamand located in the north of the Jodhpur city, Kailana tank and Ummed Sagar are notable water reservoirs. There are two natural water springs in the district namely the Beri Ganga and Banganga. Besides, some of the important tanks are Soorpura and Golejor bundhs, Jaswant Sagar and Birai tanks which are maintained by the Irrigation Department.

Total population of the district according to 1991 census was 2.1 million comprising of 1.1 million males and 1.0 million females. Rural population of the district was 1.4 million and urban population was 0.7 million. The Scheduled Castes and Scheduled Tribes population was 0.3 million (14.3%) and 0.06 million (2.8%) respectively.

Table 1. Profile of Jodhpur district at a glance

Out of the total population of 2.1 million about 65% of the population lives in the rural area. The population density per square kilometer is low (93) as compared to that of entire Rajasthan (128). The Decennial growth rate for 1981-91 was higher in urban area (28.8%) as compared to rural area (26.9%). Hindi and Rajasthani are the main languages spoken in the district. Hinduism is the main religion (1.9 million) followed by Islam (0.2 million). Amenities available in the villages as per 1991 census are shown in table 2.

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

The district at present comprises of six tehsils and nine Community Development Blocks. It has four towns and 863 villages (860 inhabited villages and three uninhabited villages).

Table 3. Administrative units in Jodhpur district

The district is well connected by road, rail and air. It has a national highway as well as state highways. There are 3,940 kms road in the district. The district is connected by metre gauge line of Northern Railways. There are in all, 36 railway stations in the district. Jodhpur city has a Railway Divisional Office. District Headquarter, Jodhpur is connected by air services (both private and Government) with Jaipur, Delhi, Udaipur and Mumbai.

Important crops in order of production in the district are wheat, bajra, gram, rapeseed and mustard, Kharif pulses, sesame and barley. Out of the net irrigated area of 56,041 hectares, most of the area (90.8%) was irrigated by wells and tube-wells.

Out of the total livestock population 21.7% were cattle, 41.5% sheep and 30.8% goats. Of the total poultry in the district 99.6% were fowls. There were 15 veterinary hospitals, four dispensaries, eight artificial insemination centers, and two mobile units.

The largest industrial unit in the district is Northern Railway Workshop. Other factories in the district mainly concern various types of edible oils, cotton textiles, spinning, weaving and finishing of other textiles, synthetic fibre rayons, nylons etc. There were 428 small-scale industries registered wit the Industries Department. In addition to the traditional manufacturers of tie-and-dye saris, embroidered shoes, plastic industries are also present. In the rural areas of the district, the most important industries are skin hide-black-smithy, oil crushing, limestone etc.

Among the articles exported out of the district are building stone, plastic goods, shoes, brass utensils, saris, chilies, dyed cloths, wooden toys, lime stones and handicrafts. The articles imported in the district are consumption goods, medicines, petrol, diesel, machinery, iron and steel, timber, kerosene, edible oils, and general merchandise goods etc.

The district besides having one university had three non-professional educational colleges, 11 professional colleges, 104 higher secondary and secondary schools, 231 middle schools, 824 primary schools and one professional school.

There are a large number of government hospitals, dispensaries, Primary Health Centres and sub-centres in Jodhpur district. These health facilities are staffed with medical and para-medical personnel including laboratory technicians. The details of the government health facilities along with their numbers are given in table 4.

Table 4. Health infrastructure and manpower in Jodhpur district

There are ten government hospitals with total bed strength of 2,207 beds. There are many private hospitals and nursing homes in addition to the Railways hospital. The details of government hospitals along with their bed strength are shown in table 5.

Table 5. Beds in Government Hospitals of Jodhpur

National Surveillance Programme for Communicable Diseases

Jodhpur district in Rajasthan was included as a pilot district in 1999. The District Rapid Response Team was trained by the State Nodal Officer at Jaipur and consists of the following members (table 6):

Table 6. Composition of Jodhpur District RRT

Note: Post of Microbiologist of lying vacant. Also, no statistician is the member of the RRT.

Laboratory support

The laboratory is situated at Sir Ram Nathji Tak satellite Hospital (SNT satellite Hospital), Mandore, Jodhpur. This laboratory will provide support to NSPCD activity at Jodhpur district. The in-charge of the laboratory was Dr. B. N. Purohit who is a physician by training. Three trained laboratory technicians assist him. It was informed that a qualified pathologist is due to join shortly.

The laboratory is the part of the SNT satellite Hospital. It has six rooms with bench space. The laboratory has facilities of electricity, running water and Liquefied Petroleum Gas along with a standby generator. Entire laboratory is air-conditioned. It works six days a week from 8 AM to 2 PM. Currently, only Mycobacteriology and Parasitology tests are being done. There is a plan to upgrade the laboratory in terms of qualified manpower and necessary equipments so that bacteriology, virology, and mycology tests also become available. The reports were reviewed before signing. Unusual findings were discussed wit the user on phone. Reports were shared with the District Epidemiology Cell.

There were no written protocols (Standard Operating Procedures) for the technical staff. The laboratory records were maintained manually. Clinical specimens could be referred to a higher level of laboratory through special messenger. It was estimated that about 30-40 percent of clinical specimens were being referred to outside laboratory mainly on account of absence of bacteriological test facilities. The investigation forms were duly filled so that it was possible to identify the specimen source, date and time of collection.

No quality control programme was 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 that was performing the test. Common method of waste disposal was by pre-treating with a disinfectant and then washing. Sometimes autoclaving was also employed for waste disposal. Functioning of electrical and mechanical equipments was not routinely monitored and the maintenance records were properly kept. Sputum for AFB, blood for MP smear and water for chlorination test were being performed. There was a plan to start tests of stool for V. cholera, and blood for HIV and hepatitis B.

Disease outbreak

During the month of May and June 1999, an outbreak of measles occurred in Jodhpur district wherein 135 cases were reported, No deaths were reported during this period. The outbreak was not investigated. In year 2000, during the months of May and June, an outbreak of diarrhea was reported. In this outbreak more than one thousand persons were affected. However, no details regarding time, place and person distribution of cases is available since this outbreak was not investigated. Similarly, this year i.e. in 2001, a rising trend in reported cases of jaundice were observed. No intervention had been instituted.

Lessons learnt

• Good record of cases was maintained at the SNT Satellite Hospital, Jodhpur. However, this data was not plotted and no analysis at the local level took place. As a result, though outbreaks were present in the last three years, no interventions were instituted. It may be due to the fact that the district was included in NSPCD only in 1999. It is suggested that the data may be stored in electronic medium and RRT members regularly review it and take appropriate actions.
• Review of records showed that the monthly reporting from the district to NICD is regular. The District Nodal Officer may be encouraged to continue this good work.
• There is a great potential that SNT Satellite Hospital laboratory may develop into full-fledged laboratory. Management may be encouraged to realize the full potential of the laboratory.
• Absence of standard case definition is a handicap at the hospital. The same may be supplied to them so that data reporting from various units becomes uniform.
• Overall, all the members were committed to further improve and strengthen the programme. This is an encouraging sign and a follow up visit after a period of about six months would help assessing the progress.