Overcrowding, exaggerated doctor-patient ratio and other factors contribute to a higher death percentage, writes Gajanan Khergamker
It’s only when a catastrophe affects huge numbers that people get up and take notice. So, when earlier this year, 107 babies died in state-run hospitals within just one month in Kolkata, the nation was left shell-shocked. The Left was swift to blame the crib deaths on medical negligence in the state-run hospitals claiming that healthcare in Kolkata had deteriorated since the Trinamool Congress had come to power.
The Mamata Banerjee government, on its part, defended the party saying that it wasn’t medical negligence that was responsible for the crib deaths but the fact that the babies “were severely underweight.” Truth being, 107 babies breathed their last at Malda Medical College and Hospital in January, while nine died in Murshidabad and 48 in B C Roy during December without the state doing anything about it.
In an exasperatingly inhumane gesture, minister of state for health Chandrima Bhattacharya at the same time went ballistic with her attempts to exonerate the West Bengal government of the guilt by saying “the state had witnessed a three per cent drop in child mortality,” since the Mamata government had assumed office. It only worsened the situation at a time when, just everyone knew, it was a blatant lie!
That was then and only recently, news of a whopping number of neonatal deaths occurred at Srinagar’s G.B Pant Children’s Hospital in a shocking repeat. Reportedly, more than 400 children died in the hospital since the beginning of this year.
Jammu and Kashmir Minister for Medical Education R S Chib’s ordering a high-level inquiry into the causes of deaths didn’t dilute the fact that 895 infant deaths occurred in the same hospital last year. Apparently, there were a series of problems the hospital faced. Plagued with an infrastructural crunch, more infant patients than they could handle and more, a disaster was waiting to happen.
The dearth in ventilators, shortage in medical supplies and life-saving drugs or an equipment crisis is caused by governmental apathy and stark negligence towards patients, it is felt.
A Right to Information application brought the issue to light in Mumbai, particularly with regard to infant deaths ‘due to hospital infections.’ The information revealed that in the BMC-run KEM Hospital, where more than 7,000 deliveries occur annually, a whopping over 11 per cent of neonatal deaths in ICU in the last two years were caused by nosocomial or hospital-acquired, infections (HAIs).
In the paediatric age-group overall, 19 per cent of deaths were due to HAIs. The top five causes of infant deaths include hospital acquired infections, the authorities concede.
Filed by Delhi-based activist Rahul Verma of Uday Foundation, 68 of the 586 neonates (a newborn child) who died in the neonatal ICU (NICU) in 2009 and 2010 died of HAIs. In the paediatric ICU (PICU), 205 of the 1,099 children who died during the same period died of HAIs. Verma maintained, "Nosocomial infection at KEM Hospital seems a matter of concern when compared to public hospitals in Delhi, where infection rates are much lower."
In New Delhi's Chacha Nehru Bal Chikitsalaya, affiliated to the Maulana Azad Medical College, HAIs were responsible for 1.78 per cent of 3,085 NICU and PICU deaths between 2009 and 2011. The National Neonatal Perinatal Database (NNPD) 2002-2003 had pegged the incidence of neonatal sepsis (a blood infection that occurs infants younger than 90 days old) in India at 30 per 1,000 live births. The incidence of death was three per cent among babies delivered at the same centre and 39.7 per cent among babies referred to from other centres.
Overcrowding, exaggerated doctor-patient ratio and several other factors contribute to a higher death percentage, feel experts. The hospital's NICU treats over 3,000 newborns annually and has 10-11 per cent HAI deaths. Lack of antenatal care largely contributes to the deaths. In the absence of laws on hospital infections in India and there being very little data available with regard to hospitals in the private sector, it’s difficult to compute and compare the incidence.
There’s a whole sea of changes in practice and perception that overdue, A lot of hospital authorities are reserved about sharing data and, in view the lack of legislation on the issue, it’s impossible to get them to divulge details.
Hospital Acquired Infections range from those acquired at the surgical site to urinary tract infection; extent of sanitisation and hygiene exercised by the medical and para-medical faculty, the extent to which the use of invasive techniques is cut down to minimal use and more.
PIL filed to probe infant deaths, upgrade healthcare facilities
A Public Interest Litigation was filed by two social and child rights activists Dr Rouf Mohi-ud-Din Malik of Banakoot, Bandipora and Tanveer Hussain Khan of Gopalpora Mattan Anantnag through Advocate Syed Faisal Qadri in High Court of Jammu and Kashmir.
The litigation also sought the upgradation of healthcare facilities in the hospitals across the State.
The PIL expressed grave concern over the infant deaths in G B Pant Hospital. “Being conscious citizens of the State, respectable members of the society and social activist, we are joining hands to project the recent deaths of infants as a social issue of grave concern before the Court,” litigants Rouf and Tanveer submitted .
The petitioners added that during last few months more than 350 infant have died in G B Pant Hospital. “According to newspaper reports, about 35 infant deaths have taken place in the hospital in a fortnight, indicating an average of 2 deaths per day.”
“If such reports are to be believed, then situation seems to be alarming and requires a thorough probe and investigation. We believe that all such deaths have taken place due to negligence of doctors and improper and inadequate infrastructure facilities in the hospital.”
“It is thus clear that negligence of doctors in protecting the precious lives of the new born babies is not only violative of constitutional guarantees, directive principles of State policy but is also against the international covenants as well”.
Through the PIL, the petitioners prayed the court direct the government to hold an inquiry into the recent deaths of infants in G B Pant Hospital.
“An inquiry team headed by a high level official should submit the report before this Court within one month.
The court should also direct government to compensate the victim families, if the inquiry committee finds it appropriate. The court should ensure that no more infant deaths take place on account of lack of infrastructural facilities or negligence of doctors or para-medical staff or otherwise in the hospitals”.
They also prayed the High Court direct government through its Commissioner/Secretary Health and Medical Education and Medical Superintendent G.B Pant Hospital to improve infrastructural facilities in the hospitals across the State especially in G B Pant Hospital.
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