The death of 18 children in 36 hours at the BC Roy Hospital in Kolkata, an ‘apex’ referral hospital for children, is shocking beyond belief. It proves yet again that India’s public health infrastructure has not only collapsed but has also lost the capacity to learn from past tragedies. In 2002, 18 babies, and in 2006, 22 died in the span of two and three days at the same hospital. But no one thought that lives are precious enough to learn anything from those man-made deaths. Though West Bengal chief minister Mamata Banerjee has ordered a probe (blaming the previous Left Front government), fixing the calamitous situation is going to need something much more drastic. Bengal has the dubious record of being one of the states with the highest infant mortality rate. Ms Banerjee will also have to look into other pressing issues such as filling up vacant posts of doctors and nurses, employing specialists and setting up specialised units in the state’s hospitals. Along with seeing to the need for basic training meted out to medical staff in government hospitals — training that must include a professionalism that incorporates the very basic trait of caring.
Every year, 40,000 children die in Bengal. The daily mortality figure is 140 (1-6 years). Bengal, however, is not the only state facing such a condition of criminal neglect. In Rajasthan recently, scores of women died because of contaminated intravenous fluids. It is pertinent to note that in the Kolkata incident, most of the children could have been saved if basic facilities were in place and basic procedures were undertaken. In India, nearly 60,000 women die every year during pregnancy and childbirth and around 1.7 million (under-5) children perish due to the lack of basic infrastructure and medicine. So much for the rising economic power called India. The initial reaction to such deaths is: blame the doctors and the support staff. While there have been many cases of negligence on the part of the doctors and the support staff — exacerbated by their indifference towards people coming from the lower strata of society — the health professionals are also handicapped by the sheer number of patients and variety of diseases they have to handle every day with limited resources. Referral hospitals like BC Roy Hospital are forced to handle so many cases only because the hospitals at the district level and public health centres at block levels are not equipped to solve even the very basic problems.
It is imperative to increase the budgets for health services in states and to simplify spending and disbursal mechanisms. Only infusion of funds, however, won’t improve matters. What is also required, perhaps in much stronger doses, is structural changes that allows the allocated money to spent much more effectively and in a timely fashion.