The shocking incident that left over 60 children dead in Uttar Pradesh’s Gorakhpur due to an alleged lack of oxygen was still making headlines every now and then. To stretch the shock further, a similar incident has now come up in Uttar Pradesh’s Farrukhabad where 49 children have died within the span of a month, again due to an alleged lack of oxygen. The situation in this case however has been much more grave. Only one doctor had been available since years to attend the 10-15 or even 20 new-born babies that are born every day.
The hospital in question this time is the Ram Manohar Lohia (Mahila) Hospital in Farrukhabad. According to the reports, 49 deaths have been recorded between July 21 and August 30; 30 deaths at the Special New Born Care Unit (SNBC) and 19 during delivery. Oxygen to the patients was supplied through cylinders and the hospital lacked a proper oxygen supply system completely. Even after constant complaints by the City Magistrate, J K Jain, the administration did not bother to investigate the issue. However, the City Magistrate kept used his position perfectly and exposed the ugly scenario of the hospital. As of now, the CMO and CMS along with a few more unnamed doctors are being probed by the police.
The real picture however is much more grave and heart wrenching. It is not about a few tens or hundreds of deaths but about at least 50,000 deaths in the past 4 decades. The major cause has been a disease called Encephalitis, in which the patient goes to a coma and dies soon after. Encephalitis has haunted 38 districts of Eastern Uttar Pradesh majorly. Vaccination drives and many more campaigns were conducted but still the situation remains blue. Was it always like this? Did no government made an effort to fight off this issue? Let us just know what the recent governments have done and why they’ve failed so miserably.
This is what the Pre-2014 governments (UPA at the centre and SP at the state) did to control the menace of Encephalitis
The government kept making attempts to somehow get hold of the ever so increasing effect of the Japanese Encephalitis (JE). Every year cases of children dying in clusters persisted but the number shot up in the rainy season. A pattern was formed and the government in 2013 allocated a mammoth sum of Rs 4000cr to a plan that was supposed to follow an inter-sectoral approach.
A group of ministers (GoM) stepped up and guided the departments of public health, water and sanitation, urban development, and social justice to work in unison to ensure the outbreak doesn’t slip out of hands. All the attempts, every single one of them failed to even bring down the number of deaths every year. Why? we’ll come to that after we discuss the efforts of the present government.
The present governments (BJP at both centre and state) too have tried out a few schemes to somehow stop this blatant onslaught of Encephalitis
Current Chief minister Yogi Adityanath was at the helm of a vaccination drive in May 2017 that lasted till June 11 and was expected to cover 88 lakh children in the 38 majorly affected districts of Eastern Uttar Pradesh. Add to that, the majorly hyped Swachh Bharat Abhiyan and the stance of CM on fighting off the public health issues prevalent in the state. His plans to ramp up the public health services included 6 new AIIMS-like hospitals and 25 medical colleges in the next 5 years.
Then came the month of August, in which CM Yogi Adityanath happened to inaugurate an additional ICU unit at BRD hospital in his own constituency, Gorakhpur. What followed after that was horrific, which left almost every plan of the government completely shattered and exposed. Just hours after that, the whole world was buzzing with the news of “Children dying due to lack of oxygen supply in an Indian hospital”. The poor governance that left the bills unpaid for around 2 years came under the scanner. All the massive planning and plotting were buried down in the grave of shame. Why? Let’s now clear that up.
There have been two major reasons for the failure of all government plans and schemes against Encephalitis
The neonatal (newborn children) mortality rate of Uttar Pradesh stands at 49 per 1,000 live births. It gets even worse in the affected Eastern half of the state where districts like Shravasti have that number as high as 97 per 1,000 live births. Just to tell you how poor that is, even Sierra Leone, one of Africa’s poorest nations, has a better neonatal mortality rate of 89 per 1,000 live births. Officially, over 25,000 deaths have taken place in Uttar Pradesh due to Encephalitis since 1978. Eventually, Gorakhpur’s BRD Hospital has been witness to 85% of these tragic life endings. It used to serve patients from West Bengal and even Nepal when the Japanese Encephalitis first set foot in India.
The major reason for the failure of government plans has been a misdirected approach
Governments that have tried to encounter the deadly Japanese Encephalitis and Acute Encephalitis Syndrome (AES) have been focusing on vaccinating people against the vector that spreads the disease. Yes, prevention is better than cure but it seems the governments forgot that vaccination is not the only way of prevention. Vaccines are effective only against the Japanese Encephalitis (JE) but controlling the AES through vaccination is not possible as of now.
The only way of prevention is proper hygiene and a clean environment. The former should be maintained by the masses to some extent while the latter should be completely looked after by the government. As of now, neither the masses are aware about what they’re supposed to do nor is the government bothered to do what they should do.
The other cause, failure of primary healthcare system, has got a lot to do with the government
Approximately, had the children who died in Uttar Pradesh taken birth in any other state like say Kerala, 90% of them would have been alive today. Such has been the dismal condition of primary healthcare system in UP. Despite the fact that Encephalitis has killed thousands and thousands of children over the years, BRD in Gorakhpur stands as the solo hospital good enough to counter it. No other hospital is even equipped with the basic necessities. 97,000 villages are served by just over 3600 Primary Healthcare Centres (PHCs). Lack of proper primary healthcare is undoubtedly going to distort the functioning of tertiary healthcare systems as well. This has left the complete healthcare system in a complete mess.
While the government is busy looking after the more urgent issues like lack of oxygen supply, the root cause of this mammoth tragedy has been left unattended. UP holds the distinction of being India’s most populous state and yet it spends a mere Rs 452/capita on health, 70% less than the national average.
If this trend doesn’t change we are least likely to save all those innocent lives lost owing to an ignorant system. The solo doctor attending all those new born babies in Farrukhabad and the doctors working day in day out in Gorakhpur won’t be able to do much. The tears will keep rolling, the souls will keep getting lost, all because of a system that is too busy to step up and take the responsibility.
We just hope that the real issue gets addressed and the government wakes up before all gets lost.