Uttar Pradesh: Ritual of announcements fails to check deaths
The death of over 30 children in 48 hours last week shows that the BRD Medical College hospital still lacks basic infrastructure despite announcements that the central and state governments have made from time to time about providing better facilities.Updated: Aug 18, 2017 16:13 IST
Announcement of projects and schemes has become a ritual for successive governments even as children have kept falling prey to Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES) in Gorakhpur and the adjoining districts for four decades.
The death of over 30 children in 48 hours last week shows that the BRD Medical College hospital still lacks basic infrastructure despite announcements that the central and state governments have made from time to time about providing better facilities.
Adding to the list, union health minister JP Nadda on Sunday declared that central government had sanctioned Rs 85 crore for establishment of the National Virology Research Centre in Gorakhpur.
In 2004, the then Union health minister Anbumani Ramadoss visited Gorakhpur and announced establishment of a research centre and a separate block for treatment of encephalitis patients. The research centre is yet to see the light of the day.
When the Bahujan Samaj Party (BSP) was voted to power in 2007, the then chief minister Mayawati announced the BRD Medical College would be upgraded to a centre of excellence for treatment of encephalitis patients. But the project failed to take off.
The then union health minister Ghulam Nabi Azad visited Gorakhpur in 2011 and announced establishment of a super-specialty hospital, rehabilitation centre and para medical staff training centre in the district. The project remained limited to paper.
After the SP formed the government in 2012, the then chief minister Akhilesh Yadav visited Gorakhpur in October and announced establishment of a 500-bed hospital for the encephalitis patients. Though five years have gone by, construction of the hospital is yet to be completed.
Dr KP Kushwaha, former principal of BRD Medical College, told HT,“In 1978, a report by the Indian Council for Medical Research said the mysterious virus that was killing children in Gorakhpur and its adjoining districts was Japanese Encephalitis (JE). But it took the central and state governments over two decades to realise that hundreds of children were dying due to lack of proper health facilities.”
In 2004, the then chief minister Mulayam Singh Yadav released Rs 93 lakh for establishment of oxygen pipeline in wards and purchase of ventilators at BRD Medical College. In 2005, the central government decided to launch a vaccination drive in districts infested with JE virus. But no concrete measures were taken to improve facilities for patients, he said.
Kushwaha said the Allahabad high court in 2006 directed the state government to increase the number of beds for encephalitis patients in wards, set up intensive care units, a rehabilitation centre and research centre.
In 2007, the state government set up two wards. In 2009 a unit of National Institute of Virology (NIV), Pune was set up in BRD Medical College to conduct research on patients.
In 2011, the high court again directed the state government to set up an expert committee and improve facilities for encephalitis patients. The state government released Rs 11 crore for upgradation of 100 bed encephalitis wards, he said.
Kushwaha called for establishment of a separate authority for the treatment of the encephalitis as was the case in Thailand, Taiwan and Singapore that have successfully controlled the outbreak of the disease.
Rather than working in an ad-hoc manner, the state government should set up sustainable infrastructure for the working of the authority, he said.
A fact-finding team of the National Commission for Protection of Child Rights (NCPCR) visited the districts of east Uttar Pradesh in November 2011 to find out what measures had been taken by the state government to protect children from JE and AES. The NCPCR expressed dissatisfaction over action taken by the state government to deal with and prevent the JE/AES cases. It had directed the state government to prepare a long-term plan to protect the vulnerable children and take appropriate measures to curb the disease.
In 2015, experts of the US- based Center for Disease Control and Prevention (CDC) visited Gorakhpur and expressed concern over continuing deaths due to acute encephalitis syndrome (AES) in east UP and failure of the health department to identify the reasons for the illness.
In its report submitted to the health department, the CDC observed that despite its efforts, the department failed to put a stop to the deaths.
The members of CDC observed that BRD Medical College, Gorakhpur was overburdened with a continuous flow of patients. To check the rush, the CDC urged the health department to classify patients according to the severity of illness and send them to OPD, general ward, AES ward and ICU accordingly.
Expressing concern over understaffing in BRD Medical College, the CDC recommended planned deputation of medical and nursing staff. The ancillary staff should be trained to perform dedicated respiratory care to support ventilator management, it said. The CDC suggested greater involvement of adult neurology and intensive care specialists of the BRD Medical College in management of patients.
The recommendations of NCPCR and the CDC are yet to be implemented.