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Death
in the Cradle
The state health minister of
CPI(M)-ruled (Communist Party of India-Marxist) West Bengal says there is
"nothing unusual" about 14 children dying within two days in a state-run
hospital. The opposition
parties express 'concern' by protesting with loudspeakers blaring in the
hospital zone. Pigs and cows roam in the hospital compound. Four to five
infants share a single oxygen cylinder, at the same time!
Scenes from a drama of the absurd? Or a satire on the current state of
affairs? Whatsoever it may seem, this is exactly what happened in the
first few days of September in Kolkata's B C Roy Memorial Hospital for
Children, the only referral pediatric hospital in West Bengal.
Ironically, the hospital is named after the legendary doctor, Bidhan
Chandra Roy, who also became the first chief minister of the state after
Independence. After widespread media focus on the appalling events, many
needy patients were turned away on the plea of "inadequacy" of
infrastructure. According to the hospital register, 955 deaths occurred
between the 1st of January 2002, and the 31st of August 2002. In August
alone, there were 140 deaths.
The B C Roy Hospital tragedy inevitably draws attention to the other city
hospitals, like the oldest and well-known Calcutta Medical College and
Hospital. The superintendent here admitted that at the Shishu Niwas
(Children's Home) and Eden hospital (the maternity wing) 16 infants died
between September 1 and 6. In addition, there were 10 still births. The 85
beds - with double the number of patients - need a minimum of 20 oxygen
cylinders, but only 10 were available. Mothers and children share the
hospital beds routinely.
At the Nil Ratan Sarkar Hospital, another well-known hospital, cats roam
around freely in the pediatric ward.
If this is the state of the city hospitals, one can well imagine the
situation in rural areas. In fact, the overcrowding of patients also
reflects a breakdown of healthcare facilities in a state that has been
under Left rule for two decades and where 'people's power' is said to be
the guiding principle.
Patients at B C Roy Hospital are mostly from the slums and rural areas. A
hospital staff member complains that patients come for minor problems that
can be taken care of by the primary health centre (PHC) in their village.
However, the complaint is only another pointer to the poor health
infrastructure in the state: at any given time, the PHCs do not have
doctors, or medicines. Doctors - on occasions when they can be located -
openly enquire about the patient's political party allegiance, say
harassed patients. Many people in the 24 Parganas district say they would
rather go to the homoeopath than to the PHC.
The death of infants because of infections at childbirth has reached
alarming proportions in West Bengal as a whole. According to the status
paper of the family welfare wing of the state health department, 44 per
cent mothers deliver their babies without trained help, or outside the
government healthcare infrastructure. Women in labor are often carried in
open cycle-vans over uneven roads to a distant block hospital; the use of
unsterilized instruments and subsequent infections are common.
In West Bengal, about 65 per cent neo-natal deaths (deaths of babies
one-month-old or less) occur due to unsafe delivery; the infant mortality
rate (IMR) is 51 per 1,000. In the face of such grim reality, state
officials are quick to point out that this figure is far below the
national average - 68 per 1,000. In its report of 2000-2001, the
Comptroller and Auditor General (CAG) of India rapped the West Bengal
government for its inadequacy in preventing and controlling disease.
At another level, some experts put the blame on the people - the lack of
education and information makes parents in rural areas wait, and wait, or
go to a quack. Only when things take a turn for the worse do they go to
the PHC, the block hospital and then to the city hospital - and by then,
precious time has been lost.
Facts show that half the neo-natal deaths occur in the first week which,
UNICEF officials say, points to malnutrition of the mother. Incidentally,
UNICEF plans to begin its integrated Management of Childhood Illnesses
Program in the state shortly.
At the B C Roy hospital meanwhile, there is a scurry of activity to make
amends for the abysmally inadequate facilities. One can only hope that the
tragedy serves as a wake-up call, and that long-term monitoring is
introduced to ensure accountability.
Although the Calcutta High Court has admitted a public interest litigation
connected with the death of the infants, no one knows when the deeper
malaise - the state's poor health infrastructure - will receive adequate
attention.
– Ranjita Biswas
September 22, 2002
By arrangement with
Womens Feature Service
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