No lessons learnt from last year's tragedy

Saurabh Sharma

One would have thought a tragedy of the proportions that unfolded at Gorakhpur’s Baba Raghav Das (BRD) Medical College last year would have led to corrective action in the course of a year.

As many as 60 infants had died at the UP hospital in a matter of days allegedly due to disruption in oxygen supply over unpaid bills to the supplier. Most deaths were reported from the neonatal and encephalitis wards.

After the hue and cry the incident caused, it is shocking to witness the state of the hospital today. Sample this:

The Yogi Adityanath-led government has started the second part of Dastak immunisation programme to curb the dreaded encephalitis, but the death rate due to the disease in the hospital’s ward this year is at least six per cent more than it was in 2017.

The college’s paediatrics department, which witnesses the maximum number of deaths between June and October each year, is still in a sorry condition.  

The BRD institute is the only medical college in a radius of 130 km in the district and serves a population of over two crore people in eastern UP, which includes Deoria, Sant Kabir Nagar, Basti, Maharajganj, Kushinagar and some districts of Bihar too.

‘The hospital is ready for any kind of situation’

Heading the college’s encephalitis and paediatrics wards, Dr Mahima Mittal has been unsuccessfully struggling to curb the mortality rate due to acute encephalitis syndrome (AES).

She seems to take heart from the fact that the hospital has received fewer patients this year than the previous years.

"The inflow of patients this year has been very less in comparison to last year or the last few years. This is because the government has done a lot of work on community and primary health centres. The other reason behind less number of patients could be late rainfall,” she said, insisting that “the hospital is ready for any kind of situation”.

Fewer cases - but more deaths

According to the records accessed by this reporter from the CMO Gorakhpur and the hospital itself, 80 children have died in its encephalitis ward from June to July this year, out of a total cases of 245 that came to the hospital.

Comparing with data from earlier, the mortality rate in 2016 was 25.80% while in 2017 it was 26.98%. This year it is 32.65%. 

While the state government has frequently boasted about its healthcare efforts on social media, not much appears to have been done on the ground to save the children dying from the vector-borne disease, mainly in the Terai area bordering Nepal - except for the launch of the Dastak campaign.

Social activist and local journalist Manoj Kumar Singh pointed out that there are many problems with BRD Medical College and other such institutes and they cannot be solved in a day.

"There is a lack of doctors. There are also not enough hospitals in the region and besides that, there is little health awareness. Quacks are plenty but they are like the last nail in the coffin. The government this year launched the Dastak vaccination programme in two parts in a bid to stop the deaths, but it will take time to show results," he said.

Shortage of doctors is a problem throughout UP. As per a government report, the state has only one doctor for every 19,000 people. 

Singh also alleged that the Yogi government is more interested in trying to hide the number of deaths instead of improving facilities at the medical college in Gorakhpur - a constituency that was long under the stranglehold of CM Adityanath. 

‘There is everything in our hospital’

Like Dr Mittal, Dr Ganesh Prasad, principal of BRD Medical College, expressed confidence about adequate measures having been taken to curb infant deaths due to encephalitis and was very sure of bringing down the numbers further this year.

"Everyone needs to understand that the only way to reduce deaths is prevention but people do not work towards that. Illiteracy and poverty are the biggest causes,” he said.

He went on to blame the public for the healthcare crisis. “Despite the government laying emphasis on toilets, people still go out to defecate. They do not use mosquito nets and drink water without boiling it. We doctors can only provide quality treatment and tell them how to live, but people do not follow these protocols,” the doctor added.

He said the hospital has more than 300 beds “ready to serve the kids” suffering from encephalitis and “two new wards ready for inauguration and we will use them if needed”.

“No doctor wants any patient to die but we get the patients only when their condition has deteriorated to a level when everything is out of control. Yet, the doctors put in their best efforts to save the child,” Dr Prasad said, emphasising that “there is everything in our hospital”.

Last year’s report by data journalism portal IndiaSpend highlighted how Uttar Pradesh's per capita expenditure on health, at a mere Rs 452, is 70% of India's national average.

Dr Abhay Shukla, a public health policy expert and a programme coordinator at Support for Advocacy and Training to Health Initiatives, had also sounded the alert on the dismal state of medical facilities in UP.

"The proposed budget for 2016-17 demanded Rs 30.4 crore for healthcare, of which only Rs 10.19 crore were approved by the Centre. In 2017-18, the demand was cut to Rs 20.01 crore but the Centre managed to further slash it to Rs 5.78 crore – barely 29% of the proposed amount," he had told Firstpost.