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Uttar Pradesh: Healthcare in tatters due to staff crunch

In March-April and August-September every year, the number of children dying at government hospital goes up.

lucknow Updated: Sep 01, 2017 15:29 IST
Chandan Kumar
Crowd at the OPD of Bareilly’s Maharana Pratap district hospital --the biggest government hospital in the region.
Crowd at the OPD of Bareilly’s Maharana Pratap district hospital --the biggest government hospital in the region.(HT Photo)

When UP health minister Siddharthnath Singh presented the figures of previous years to claim that the month of August witnessed high number of children’s death, he was not completely wrong.

In March-April and August-September every year, the number of children dying at government hospital goes up.

In Bareilly division comprising Bareilly, Badaun, Pilibhit and Shahjehanpur, the number of deaths in August-September last year crossed 300 which is over three times the average deaths.

In Bareilly alone, more than 70 deaths were reported from different parts of the district.

WHAT AILS BAREILLY DISTRICT HOSPITAL
  • The hospital has 25 doctors against the requirement of 43
  • There is no super-specialist at the hospital
  • The hospital has an acute shortage of pharmacists, technicians, nurses and other support staff.
  • Only 3 of 100 patients return for follow up at the district hospital as compared to 28 in private hospitals.

Most of the patients were brought to the hospital with symptoms similar to encephalitis and died before their ailment could be diagnosed.

The outpatient department of Bareilly’s Maharana Pratap district hospital – the biggest government hospital in the region – receives over 3,000 new patients every day during late monsoon and the onset of summers.

Flu-like symptoms and stomach infections are common in this season.

New patients are inspected by general physicians who suggest medications based on symptoms. Those with mild fever and throat infection are suggested a three-day dose of antipyretic with mild sedative or painkiller (Paracetamol).

These patients, who comprise 70-80% of the people having flu-like symptoms, are termed as “sardi, khansi wale” in local medical parlance.

Read more: Death too frequent a visitor at Gorakhpur’s BRD Medical College

About 10% patients have exaggerated symptoms like high fever and lethargy. They are asked to go for blood test and are given DNS (dextrose neutral solution) with Paracetamol.

The remaining patients with other symptoms are directed to other wards for treatment.

“We admit about 125 patients with exaggerated symptoms. Majority of patients with mild symptoms are returned the same day,” said chief medical superintendent (CMS) of the hospital Dr KC Gupta.

HISTORY

Maharana Pratap district hospital was established as a military hospital in the fag end of 19th century by the British.

It was opened for general public in 1940s and was made district hospital in 1970s. Since then, an operation theatre, an emergency ward, separate female ward and digital X-ray room have been added to the hospital.

More advanced developments were limited to the offices of the chief medical superintendent (CMS) and the chief medical officer (CMO).

PROBLEMS AND ISSUES

Despite the high number of patients it receives, the hospital has 25 doctors against the requirement of 43. None of the doctors are super-specialists.

“We have vacancies of super-specialists in dermatology, cardiology, neurology, nephrology and pathology. Fresh appointments have not been made since years,” CMS Dr KC Gupta said.

The hospital has an acute shortage of pharmacists, technicians, nurses and other support staff.

“Patients visiting the hospital have no other place to go. They are marginal farmers, labourers, homeless and jobless people. The hospital is their last hope but we do not have enough people to help them. We do not have facilities,” Dr Gupta said.

The same holds true for 6 community health centres (CHCs) and 10 primary health centres (PHC) spread across the district.

“We have only two nursing staff at the PHC. We receive around 300 patients every day. Over a dozen of them are serious but we either have to return them or refer them to the district hospital,” said the in-charge of a PHC on condition of anonymity.

“We have informed the authorities about the shortage but nothing has been done to improve the facilities,” he added.

“As advised by the government, we highlight the problems of staff shortage and lack of facilities at the hospital in every report that we submit. We are assured of support but no concrete action is taken,” Dr Gupta lamented.

WHAT AILS ‘SARKARI ILAAZ’

Despite the high number of patients received at the district hospital, it is surprising that only a small percentage continues treatment or returns for follow up.

According to the data of district hospital and two private hospitals collected by HT, only 3 of 100 patients return for follow up at the district hospital as compared to 28 in private hospitals.

Though doctors hold patients responsible for the problem but for the common man, getting treatment at a government hospital is a pain in itself.

“Main to yahan phans gaya hun (I am stuck here). Doctors hardly care about patients. The hospital staff behaves rudely and the wards stink,” said Sudhir Singh, 28, a bank employee who was admitted to the emergency ward after he complained of severe pain in abdomen.

When the X-ray confirmed stones in his kidney, Sudhir visited a private hospital for surgery.

Patients who can afford treatment at private hospital avoid visiting the district hospital.

“I bathe my father, change his diapers and even wash his bed sheets when the hospital staff refuses to change it,” said Pradeep Singh, a marginal farmer whose father is undergoing treatment at the district hospital.

“We don’t have enough money to go to a private hospital. Agar paise hote to bhool ke bhi yahan nahin aate,” he said.

Read more| Gorakhpur’s BRD deaths: Things would have been different if victims were children of VIPs, says distraught father

PRIVATE HOSPITAL THRIVES

If a patient arrives at the OPD of district hospital, it takes four hours to get examined by physicians and get medicines from dispensary.

This is when the doctor arrives in time and pharmacists at the dispensary are not on strike.

The same procedure requires less than an hour at a private nursing home.

Private practice by doctors is another issue that plagues health care. A large number of patients from government hospitals are directed to private nursing homes and hospitals.

Doctors and nurses at the district hospital often advise patients to visit private hospitals. Many government doctors are engaged in private practice at hospitals owned by their family members or themselves.

Laxman Yadav, a milkman, took a loan of Rs 60,000 to pay for appendix operation at a private hospital. The operation involves basic surgery and can be performed in less than 18 minutes.

Yadav has taken up the job of a watchman to repay the loan and works for 20 hours a day. There are many who have to sell their cattle, jewellery and land to pay their medical bills.

There have been instances when health officials came to the rescue of private hospitals. Earlier this year, the leg of an infant had to be amputated due to an infection that occurred after a minor surgery at a private hospital.

The CMO office allegedly delayed investigation into the case.

The city has over 400 registered hospitals and an equal number of diagnostic and ultrasound centres. There are four private medical colleges and a dozen nursing and dental colleges in the city.

The Bareilly chapter of the Indian Medical Association (IMA) has over 700 private doctors as members.