Not in the pink of health
Poor administration is at the core of the infant deaths in Srinagar. Sanchita Sharma writes.
In India, 12.5 lakh babies die within a year of being born - which is one in every four infant deaths in the world - making the country's infant mortality rate of 47/1,000 live births a lot worse than neighbouring Nepal, Sri Lanka and Bangladesh. Childbirth complications, pneumonia and diarrhoeal infections cause two in three infant deaths under the age of one year.
Almost all are avoidable. Most happen because parents cannot or do not take their sick baby to a health centre or a doctor for the necessary treatment.
What's shameful is when parents lose their baby not to a disease or complication but to incompetence or the apathy of the staff at a hospital or health centre. And apathy is a charge that keeps cropping up at government centres, with Srinagar's GB Pant hospital being the latest to join the ignominious rank of incompetence.
Infant deaths in West Bengal's Malda Medical College and Hospital made headlines countrywide three times last year, but very little has been said in the national media about the 366 babies who have died at the Srinagar hospital this year. Perhaps one reason is that infant deaths at the Valley's only paediatric super-speciality hospital have always been shockingly high. In 2011, 895 babies died there, which makes the continuing death rate unacceptable.
The average deaths per day at the hospital is almost the same for 2011 and 2012 - 2.5 and 2.6, respectively.
Doctors at the hospital and Omar Abdullah's government have been quick to cite poor infrastructure as the cause, but the deaths have more to do with mismanagement and incompetence in providing care than a shortage of medical staff and equipment, the enquiry report being presented to the government shows.
That the state government doesn't care is obvious from the fact that death and disease data from all the hospitals falling under the state's Department of Education, which governs the GB Pant Hospital, are sent to the ministry, the Government Medical College principal and the commissioner secretary every quarter each year.
The opposition People's Democratic Party (PDP) has called it a genocide and is gunning for Omar over the issue, accusing his government's "persistent preoccupation with political survival, lack of vision and strategy, lack of accountability and corruption, and mismatch between demand and supply" as being collectively responsible for this preventable tragedy.
Union health minister Ghulam Nabi Azad, on a whirlwind visit to Srinagar on Sunday, also squarely put the blame on the state government. "When I was chief minister (2005-08), I earmarked 50 kannals (7 acres) near Hajj House for a 350-bed children's hospital. Two years ago as Union health minister, I released Rs. 65 crore for it," said Azad. "Construction of the hospital is a state subject and the government should have come up with the hospital by now."
Incidentally, the state medical education ministry is headed by RS Chib, a leader from the Congress, which is the ruling National Conference's coalition partner in the state.
Omar Abdullah, on his part, reacted by replacing the hospital's medical superintendent and ordering an enquiry. He has also asked his health department to initiate the process of formulation of a Detailed Project Report (DPR) for the construction of a new 200-bed paediatric hospital at Dewan Bagh in Srinagar.
The problem, however, is much deeper. Enquiry officer Dr Showkat Zargar, who has been commissioned to prepare a report on the deaths, has put the blame on poor hospital administration and bad sanitation. The report, based on extensive interviews with at least 30 doctors posted in the hospital, has surprisingly, ruled out the shortage of life-support equipment such as ventilators and missing infrastructure as a cause for the deaths. Jammu's paediatric hospital, for example, manages better with just two ventilators. The report recommends administrative shortfalls be met to avoid similar tragedies in future.
Vigilance enquiries into the nexus of senior doctors at GB Pant hospital with pharmaceutical companies and allegations that senior doctors depute junior doctors to run the hospital while they run private clinics are not uncommon. What's needed is better accountability, and this is where the government can learn from the private sector. The learning has to happen very quickly, for lives are at stake here.
