Gorakhpur tragedy | SabrangIndia News Related to Human Rights Fri, 27 Sep 2019 07:01:23 +0000 en-US hourly 1 https://wordpress.org/?v=6.2.2 https://sabrangindia.in/wp-content/uploads/2023/06/Favicon_0.png Gorakhpur tragedy | SabrangIndia 32 32 Vindicated! Govt probe absolves Kafeel Khan of False Charges: BRD College Deaths, Gorakhpur https://sabrangindia.in/vindicated-govt-probe-absolves-kafeel-khan-false-charges-brd-college-deaths-gorakhpur/ Fri, 27 Sep 2019 07:01:23 +0000 http://localhost/sabrangv4/2019/09/27/vindicated-govt-probe-absolves-kafeel-khan-false-charges-brd-college-deaths-gorakhpur/ Two years after the incident, department report finds him not guilty After spending nine months in jail but fighting it out, a departmental inquiry has absolved pediatrician Dr. Kafeel Khan of the charges of medical negligence, corruption and dereliction of duty on the day more than 60 children died due to shortage of oxygen at […]

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Two years after the incident, department report finds him not guilty

kafeel Khan

After spending nine months in jail but fighting it out, a departmental inquiry has absolved pediatrician Dr. Kafeel Khan of the charges of medical negligence, corruption and dereliction of duty on the day more than 60 children died due to shortage of oxygen at the BRD Medical College in August 2017.

In a press release he said, “After 2 years, this enquiry report, (commissioned by the state govt itself) has accepted that there is no evidence of medical negligence on my part. It states unequivocally that I was nowhere involved with oxygen supply/tender/maintenance/payment or order.

The report has also accepted that there was a shortage of liquid oxygen for 54 hours in BRD Medical College on 10 ,11,12th of August 2017 and I had arranged jumbo oxygen cylinders to save dying kids.”

Decrying the Government, he said, “To hide Government failure I was made scapegoat and imprisoned for nine months.”


(Source – Times of India)

The report, handed over to him on Thursday by the BRD officials, has come in two years after Khan was suspended from the hospital and spent nine months in jail for the charges he has now been acquitted.

Out on bail, he continues to be suspended from the hospital. He has demanded a CBI probe into the tragedy.

Surprisingly, though investigating office Himashu Kumar, Principal Secretary (Stamp & Registration Department) had submitted the probe report regarding the deaths to the Medical Education Department on April 18, 2019, the Uttar Pradesh government had not taken any action on it, nor did it make it public.

Dr. Khan has blamed the State government for keeping him in the dark about being absolved of the allegations made against him for around five months.

The Positive Shift
In wake of the incident, Dr. Khan had run from pillar to post trying to prove his innocence. Since his suspension, his remuneration was withdrawn proving to be an additional hurdle in the already challenging time.

On May 10, 2019 in an immense wave of relief, a division bench of Hon’ble Supreme Court of India comprising Justice Sanjay Kishan Kaul and Justice Indira Banerjee ordered the enquiry regarding suspension of Dr. Kafeel Khan to be concluded timely and further directed the Yogi Adityanath government in Uttar Pradesh to pay all subsistence allowances payable to Dr. Kafeel Khan pending his suspension.

The dues, amounting to approximately Rs. 16 lakhs were cleared to be paid to him by the Principal of the BRD Medical College, Gorakhpur on March 17, 2018.

This move proved to be a tectonic shift in Dr. Khan’s arduous journey, where the reality of his innocence and the tardiness of the authorities was slowly coming to the fore.

Exclusive with Sabrangindia
Today, in an exclusive video sent to Sabrang India, Dr. Kafeel has shared happiness that he and his family are feeling after his acquittal. Though he is relieved about his acquittal and that he no longer bears the tag of a ‘murderer’, he calls for the government and the police to conduct a strict probe into the makings of the BRD Medical tragedy and put the real culprits behind bars.

The Video may be watched here.

The 15 –page report handed over to him just recently, states that Kafeel was not guilty of medical negligence on his part and made all the efforts to control the situation on the nights of August 10-11, 2017, when for 54 hours, the hospital was dealing with oxygen shortage.

The report also noted that Khan was involved in private practice till 2016, but not after that.

According to the report, Kafeel was not the nodal medical officer in charge of the encephalitis ward at the hospital and that the documents contesting the same provided by the Department were “inadequate and inconsistent”.

It clarifies that Khan had informed his seniors of the oxygen shortage, providing the inquiry officer with call details of the same and also presenting proof of providing seven oxygen cylinders in his personal capacity, on the night of the tragedy. The report also mentions that Khan and his team managed to procure 500 oxygen cylinders in those 54 hours on their own merit.

“While the government has not been able to pin down the actual culprit yet, I have been made the scapegoat. The report was not sent to me in all these months. Now, the Medical Education Department has asked me to come forth to present my case on the private practice issue, which is not even related to the tragedy,” he said.

“The government should tender an apology, provide victims with compensation and get the incident probed by the CBI,” he added.

In Conversation with Sabrang India
On June 26, 2018, in an extensive interview with Sabrang India, Dr. Khan recounted the events of the nights of the tragic 48 hours of August 2017.

In his interview, he accused the mainstream media of making allegations against him without even checking the ground reality. He cleared his stance on how apathy of the government related to the death of the children, the deaths in the other departments (trauma center, maternity department, etc.) of the hospital on the same night.

He demanded a probe by the five committees of the government into the deaths that took place in the other departments as well due to the shortage of oxygen in the central tank.

Speaking to the Press, he said, “Those parents who lost their infants are still waiting for the justice.I demand that government should apologize and give compensation to the victim families.”

He accused the government of not only harassing him, but also his whole family, as a means of torture and intimidation.

Dr. Khan also spoke about the pathetic conditions in the prison he was kept in, apart from being intimidated by the officials there.

He also said that he would be willing to work if his suspension would be revoked. He wished to start an encephalitis center for kids suffering from such a fatal disease.
 

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A year after the Gorakhpur tragedy, TCN investigation into BRD College shows all is well as long as you don’t dig too deep https://sabrangindia.in/year-after-gorakhpur-tragedy-tcn-investigation-brd-college-shows-all-well-long-you-dont-dig/ Mon, 13 Aug 2018 05:45:59 +0000 http://localhost/sabrangv4/2018/08/13/year-after-gorakhpur-tragedy-tcn-investigation-brd-college-shows-all-well-long-you-dont-dig/ Last year, BRD College in Gorakhpur shot to worldwide notoriety after dozens of children died due to a critical failure of oxygen. What followed was one of the most intense media investigations into the hospital, its staff and its officials. No wonder then, that one of the first things that the administration did was to […]

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Last year, BRD College in Gorakhpur shot to worldwide notoriety after dozens of children died due to a critical failure of oxygen. What followed was one of the most intense media investigations into the hospital, its staff and its officials. No wonder then, that one of the first things that the administration did was to shut its doors to the media and hide behind press releases, counter-narratives and the usual bureaucratic procedures. A year on, however, it has emerged that factors which caused the deaths are far from solved and even now, the hospital is indulging in hiding its gaps instead of addressing them. Siddhant Mohan spent many days in and around BRD Medical college, speaking with patients, families, doctors and other staff to find out what is going on in the hospital a year after the deaths. In a two-part investigation, he exposes the good, the bad and the unchanged aspects of the hospital. Here is Part One of the investigation.


AES patient at epidemic ward of BRD medical college (Photo – Siddhant Mohan/TwoCircles.net)

When the train stops at Gorakhpur railway station, one can smell the city which saw one of the most surprising political changes of this year. Vendors, rickshaw pullers, autorickshaw drivers and every other person talks about ruling Bharatiya Janata Party losing the Loksabha by-poll in Gorakhpur— a seat which Yogi Adityanath held for decades—to Samajwadi Party.

But another subject they do not forget to talk about is the Baba Raghav Das Medical College or more popularly known as “BRD Medical College”. Pradeep Saini, a 34-year-old rickshaw driver, said, “Even if Baba (Yogi Adityanath) lost the election this year, he has made sure that everything is good at (BRD) Medical College. He goes there in his every visit to Gorakhpur to make sure that what happened in August 2017 is not repeated,” while taking me to my place of stay at Gorakhpur.

It was a disaster at Medical College on the night of August 10 and 11 in 2017. A critical shortage of the liquid oxygen at the Medical College led to the death of 36 children in the Neonatal Intensive Care Unit and Paediatric Intensive Care Unit of Nehru Hospital associated with BRD Medical College. The lesser reported death number is of adults. Around the same critical shortage period, about 18 adults lost their lives, more likely due to a shortage of oxygen, in the Medicine ward of the hospital. If sources at the medical college are to be believed, the Medical College as well hospital most likely manipulated and hid the number of deaths that occurred that night in the Emergency Ward of the hospital.

Following the incident, three separate investigating committees were constituted under various powers, and surprisingly, all refuted the claim that the shortage of oxygen had anything to do with the deaths. Committees went a step further claiming that there was no particular shortage of oxygen which could be termed “critical”. But committees held Pushpa Sales, the firm responsible for supplying oxygen, and store manager responsible for deaths and both were put behind the bars along with several doctors of the medical college. Siddharth Nath Singh, a BJP leader and health minister in the state, showed his apathy for human values by dismissing the deaths, saying, “Children usually die in August.”


Baba Raghavdas Medical College (Photo – Siddhant Mohan/TwoCircles.net)

So one must wonder that things would have been improved or changed at BRD Medical College—at personal as well as administrative level—to minimise the damage to human lives. To witness the same, we conducted an investigation across several days including interviews with various officers, doctors, sources, and journalists, and on a broader scale, we could possibly infer that things at BRD Medical College as well as associated Nehru Hospital is standing behind a black curtain to regulate and censor the incidents as well as practices going inside the premises.
From January 2018 to July 2018, about 89 children suffering from encephalitis lost their lives out of total 278 admitted. Until the end of June, 1,049 children had lost their lives collectively, and by the end of July, this number reached about 1200.

Until the oxygen shortage controversy in August last year, the Medical College used to give out death numbers to media, the municipal department as a public record. But it soon stopped doing so. So for media, the verbal quotes from the sources at the medical college are the only possible way to get into the College’s system.


Entrance of BRD Medical College and Hospital (Photo – Siddhant Mohan/TwoCircles.net)

Soon I entered the Medical College on a rainy morning, I saw a freshly made road in the premises—which was still emitting the heat of the fresh tar—and the walls painted with the saffron colour. Taking a left turn from the entrance, I entered into Nehru Hospital, which showed the high dependency of nearby districts and villages over a single hospital. The plan was to completely understand the admission, checkup and discharge procedure at BRD medical college, especially of paediatrics department, to witness the loopholes. I could see one enquiry counter right from the entrance, but there was no one inside. When no one showed up for about 15 minutes of waiting—during busy working hours at a government hospital—few people sitting by it told me that they had rarely seen anyone there. During random conversations with people, people around said that they were there from Kushinagar, Maharajganj, Deoria, Ballia, Mau, Siddharthnagar districts of Uttar Pradesh, as well as from Siwan and Bettiah district of Bihar, revealing the high dependency of individuals on BRD Medical College.


Enquiry counter at BRD Medical College (Photo – Siddhant Mohan/ TwoCircles.net)

Ramesh Kumar Agrahari, a 42-year-old resident of Mau, came with his wife at the medical college after her repeated complaints of back and stomach pain. His wife, Phulmati, was sleeping alongside him wearing a yellow coloured saree. Agrahari said, “I got her examined at the district hospital in Mau, but she did not go any better. From Mau, we can either go to Banaras (Varanasi) or come to Gorakhpur for better treatment, but treatment, as well as stay cost, is high in Banaras, so we decided to come to Gorakhpur.”

Not only Agrahari, many counted the same point of cheaper facilities at Gorakhpur than Varanasi or Lucknow as the reason behind them choosing this as the treatment centre. Many told that there were not enough facilities and staff at the government hospitals in their district, which is why they chose Gorakhpur.

Pramila Devi, a 68-year-old housewife from Deoria district, came to the hospital with her 13-year-old grandson to have him examined for continuous fever. Devi was sitting by the same enquiry counter, while her husband had the sleeping grandson in the lap. When I touched the forearm of his grandson, I noticed he had an extremely high fever. Devi told me, “At first it was just a fever, but now whenever fever comes, he nearly faints.”

From the entrance of the medical college from the main road until the ward entrance, banners have been put asking people with encephalitis patients to go directly into ward number 12 or Epidemic Ward, as if most of them are aware of their patient is suffering from one. Devi said that a couple of the attendants told her to take the grandson directly into the ward number 12 but she did not know where it is, and also she does not have the idea if he is suffering from encephalitis. This was the reason she was sitting by the enquiry counter, while her son—also the father of the sick child—went to clear the confusion about admission and examination.

Located after several tries, I found a way to NICU and PICU of the hospital, where most of the deaths have occurred last year due to the scarcity of oxygen and are still happening. The passage to connect these intensive care units with the hospital’s main lobbies was supported by public toilets alongside. I could see human excreta as well as discarded sanitary pads/cloths soaking up in the rainwater out in the open just few meters from NICU and PICU.


Passage to NICU/PICU at BRD Medical College (Photo – Siddhant Mohan/ TwoCircles.net)

At my first try, I could not go into NICU and PICU. There was an unusually high number of security guards at the gate of these ICUs. Patient attendants standing outside of the gate told me that such guards came up after August deaths in 2017. Rekha (32) said, “My second son is admitted to PICU. He is getting better so I tried to click his picture to send it to my sister. Soon I pulled out my mobile phone, the staff started scolding me that why I was clicking pictures,” while smiling. “Why would anyone want to click the photograph his / her son? Should there be any specific reason for that?”

Ward number 12 or Epidemic Ward was filled with nurses and doctors who became kind of hostile when they noticed me taking several rounds of the ward and looking into their files. Later, Mahima Mittal, the head of the paediatrics department, and Ganesh Kumar, the principal and dean at BRD Medical College, allowed me—after hours of pursuance—to take rounds and pictures of the concerned wards and units which have been showing the highest number of deaths since past several years. To take control, a couple of resident doctors were assigned to take me to these units and to tell me things I was not interested in.


Way to Epidemic Ward of BRD Medical College (Photo – Siddhant Mohan/TwoCircles.net)

First I was taken to the newly made ward number 11 of 76 beds which was not even started yet. I was told that this ward could reduce the load at the paediatrics unit of medical college but the ward had not started yet. By the time this copy was filed, the ward was still being prepared for regular purposes, however, it was already inaugurated by the authorities as one could easily notice the ribbons and decorative items. “It is just new. We are hoping that more children will come in this,” said the resident who was accompanying me. “Where are the children now, if they are supposed to be here?” I asked. To this, the resident replied, “They are being treated, of course, but we have more facilities here. Things have changed since August 2017.” Obvious question came up “So there were no such facilities here earlier to August 2017?”, the resident hesitatingly smiled, did not say anything and took me to the ICUs.

At the entrance of PICU, I was asked to wear a shoe cover—a necessary practice in intensive care units—but it was a different scene inside. As it looked clean and ‘protocol-following’ unit, it was filled with the attendees and none of them were wearing any shoe cover or protective masks, even when several of the admitted children were put on a ventilator, a vulnerable condition to get infections.

On the bed sheet of a severely malnourished child, who was just taken out of the ventilator, I could see stains of blood and wound exudates. And worse, it was not just a single case in the PICU. One could notice blood stains, excreta stains, spots made by exudates—risking infections—on several beds where patients did not have any wounds or any cause that could lead to such bed sheets. One attendant came to me and said, “Actually, these beds were like this even before our child came up. We asked to get them changed, but we fear that if we pursue more, they will not take care of our child.”


Malnourished child in PICU at BRD Medical College, Bed showing blood stains from a different patienet (Photo – Siddhant Mohan/TwoCircles.net)

One staff at PICU anonymously, told, “Critical care code is not so much in practice here. If checked, patients could be dying because of the infections coming in from the dirty mattresses and beds, who knows.” Despite an occupancy of about 40 patients, I could notice only four staff nurses and ward boys. When raised it with the resident—who was kind of “following” me to my every talk—he said it is indeed less for a such a big hospital. He even went to say, “We have beds, what we lack is trained medical staff,” reiterating the same crisis which Principal Ganesh Kumar told me back in April this year.


Gyanti with her encephalitis affected daughter Kajol (Photo – Siddhant Mohan/TwoCircles.net)

I met seven-year-old Kajol and her mother Gyanti from nearby Rakhat village of Chauri Chaura in the newly-made paediatric ward. Kajol, a patient of encephalitis—or Acute Encephalitis Syndrome (AES)— was discharged from PICU just three days back. Gyanti, who was worried because her daughter was still in a COMA and was being fed through a pipe, revealed that she had to buy several medicines from outside of the hospital, contrary to the claims of authorities that AES patients are being provided medicines inside the hospital free of cost. Gyanti’s claim disturbed the resident doctor, who has been accompanying me, and he fired over her, “Which medicines did you have to buy from outside? You must be getting all from inside,” and he turned towards me, “She does not know exactly, or maybe she is confused.” While the doctor was trying to make me aware of the fact, Gyanti pulled out all the medicines from a bag and showed me exactly the same ones which she had to buy from outside.


Gyanti showing the medicines some of which she has to buy from outside of medical college (Photo – Siddhant Mohan/TwoCircles.net)

Surprisingly, she had to buy Piracetam syrup—a routine drug which is given to AES patients to improve brain function—from outside of the medical college. Gyanti said, “When my daughter was in ICU, there were few more medicines which I had to buy from the medical stores.”
It was not a single case in the same “newly established ward”. Many of the patients I met complained that they had to buy many drugs from outside. According to the rules, district hospitals and state-run medical colleges have to maintain a good stock of medicines, but at BRD medical college, such rules have been put aside.

The resident doctor accompanying me tried to take control of whatever I found in these wards. He said, “Some medicines they get to buy from outside, but they get many from here.” When I pressed that attendees are buying neurotropic drugs, a routine and essential ones, from the shops, the doctor said, “It is not that a big deal.”

In the same section of the medical college, there was NICU as well, which recorded the highest number of deaths in August 2017. On the horrifying night of August 10 and 11 last year, parents whose children were kept in NICU were called and were given resuscitator—a device to manually pump oxygen in the lungs—to keep their neonates breathing. Evidence showed that at least four to five kids were put on one neonatal warmer, which is to be used for a single baby.

The resident accompanying me took me to the same level in the building where NICU was located but told me, “You cannot go in. Even doctors are not allowed to go in there.” I asked, “Not even doctors? Really?” He did not say anything. Even after several tries, I could not get into neonatal ICU, however, it revealed minutes after why one was not allowed to go into one. Another doctor, who saw me taking rounds of the ward, came to me when I was alone and said, “If you are searching again for oxygen scarcity, yet again, let me assure you that it is not the case this time. But condition inside NICU has not changed since August.”


NICU at BRD Medical College (Photo – Siddhant Mohan/ TwoCircles.net)

The doctor requested anonymity and said, “They rarely allow anyone in there. Because the practices are not up to the code of treatment. We still keep four-five neonates on bed warmers.” For the confirmation of what happened last year at BRD’s NICU, I showed the doctor the photographs provided by my sources. There were pictures of parents using resuscitator and warmers full of babies, several of whom were already dead. The doctor said, “Yes. Warmers still get full like this. Babies still die. But oxygen is not the reason.”

I was into much-debated Epidemic ward (12) where encephalitis patients could go directly. There was a separate OPD setup inside the ward, and thanks to the newly made paediatric ward discussed above, the ward had a lesser number of patients.


Satya Devi with her encephalitis affected daughter Reena (Photo- Siddhant Mohan/TwoCircles.net)

I met Satya Devi of Karjahan village of Ramnagar, whose 16-year-old daughter Reena was admitted in the hospital on July 6 following the symptoms related to AES. While Satya Devi was talking to me, she was also holding her unconscious daughter by tilting her body to the left side. She said, “She has been given food from the nose pipe. I have to tilt her to let the food settle.” Prior to BRD Medical College, she took Reena to a CHC in her locality, but she could not be treated there. She immediately took her to BRD Medical College for treatment, where Reena was kept in PICU for several days, and shifted to the wards just a week ago. Devi told me, “In my locality, back at the village, several people have lost their sons and daughters here at the medical college. One has died in August 2017 due to lack of oxygen, but I had to get my daughter treated, otherwise she would have died anyway,” while discussing the necessity to come here.

In the ward, some beds were lying vacant, giving a kind of a relief to the patients as well as doctors. In the same ward, I managed to count six patients suffering from AES as well as five patients of meningitis.  Several patients were suffering from malnutrition, followed by developmental delay, and the third largest number of the patients were of sepsis, commonly known as blood infection.

For the obvious reasons, another doctor was again put by my side for the ward visit.

This time I raised the question with the doctor accompanying that why was there was an unusually high number of meningitis cases, “this is the season,” he replied.

However, it was not the case that meningitis patients were increasing at BRD Medical College unless authorities were not trying to minimise the encephalitis cases by labelling them as meningitis. One paediatric doctor, requesting anonymity, confirm this rumour to me. Catching me alone in the hospital corridor, he told me, “You were asking about meningitis, no? The thing is that indeed meningitis cases happen in this season, but for the medical college, encephalitis is always the bigger problem. There are around one or two cases of meningitis.”

He further said, “But the pressure from the government is immense. The college has to achieve lesser encephalitis death, so the instruction has been passed on to report few encephalitis cases as meningitis, so at least authorities would stop pinging every time.”

When I talked with the senior resident accompanying me, he said, “Actually, AES is like an umbrella and meningitis comes under it.” I asked, “So, why are you not labelling it as AES just like you are doing with other encephalitis patients?” He did not say anything.

In the second and final part, we look at how the administration is both trying to fight the menace as well as cover up any possible investigation into it’s affairs. As we find out, they are failing ok both these fronts.

Courtesy: Two Circles
 

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BRD hospital records 433 child deaths in a month. Should Kerala still follow UP? https://sabrangindia.in/brd-hospital-records-433-child-deaths-month-should-kerala-still-follow/ Sat, 07 Oct 2017 06:11:27 +0000 http://localhost/sabrangv4/2017/10/07/brd-hospital-records-433-child-deaths-month-should-kerala-still-follow/ Data shows that the Northern Indian state stands nowhere in front of the healthcare system in the South Indian state. Uttar Pradesh Chief Minister Yogi Adityanath claims that the Kerala should learn from his government how to run infirmaries, but the data shows that the Northern Indian state stands nowhere in front of the healthcare […]

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Data shows that the Northern Indian state stands nowhere in front of the healthcare system in the South Indian state.

Uttar Pradesh Chief Minister Yogi Adityanath claims that the Kerala should learn from his government how to run infirmaries, but the data shows that the Northern Indian state stands nowhere in front of the healthcare system in the South Indian state.
 

Image Courtesy: IndiaSpend
 

According to the data provided by Baba Raghav Das (BRD) Medical College and Hospital in UP’s Gorakhpur district, a total of 433 children – highest in the past four years – died in September this year.

BRD had been in the spotlight for the past few months following the deaths of nearly 60 children because of lack of oxygen supply between 7 and 11 August.

The horror returned to BRD once again in less than three weeks with 42 children dying in 48 hours from August 30.

After the tragedy hit headlines, the government swung into action and suspended their staff, including doctors, for alleged dereliction of duty and corruption. Cases were filed against them and they were sent behind bars.

With an aim to improve the medical care, 20 new doctors were appointed at the BRD Medical College’s paediatrics department. But no improvement was observed. Against 372 deaths of children in September last year, 433 newborns died in the same month this year.

A maximum number of deaths were reported from the BRD’s Neonatal Intensive Care Unit (NICU) – an intensive care unit designed for premature and ill newborn babies – where 247 breathed their last in the previous month.

In addition, 186 children died of encephalitis and other diseases in Pediatric Intensive Care Unit (PICU).

The number of deaths that took place so far in BRD Medical College is highest in the past four years. In 2014, this number stood at 302 and it went up to 378 in 2015. The year 2016 recorded a marginal decline by registering 372 death of children.

In fact, comparing UP and Kerala may not be such a great idea for the Bharatiya Janata Party (BJP). If one compares the data obtained from National Family Health Survey (2015-16) and National Vector Borne Disease Control Programme (until August 20, 2017), there is no-contest between UP and Kerala. 

Gorakhpur

Dengue

Chikungunya

Courtesy: Newsclick
 

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India Is Failing Its Infants Long Before They Arrive At Hospital https://sabrangindia.in/india-failing-its-infants-long-they-arrive-hospital/ Mon, 25 Sep 2017 06:39:14 +0000 http://localhost/sabrangv4/2017/09/25/india-failing-its-infants-long-they-arrive-hospital/ Jamshedpur/Ranchi: Soon after the death of 70 infants in a tertiary care hospital in Gorakhpur, Uttar Pradesh (UP), made the headlines last month, similar stories began to pour in from across the country. Ninety children were reported to have died in two months in Rajasthan’s Banswara district hospital; in the month of August alone, 55 […]

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Jamshedpur/Ranchi: Soon after the death of 70 infants in a tertiary care hospital in Gorakhpur, Uttar Pradesh (UP), made the headlines last month, similar stories began to pour in from across the country. Ninety children were reported to have died in two months in Rajasthan’s Banswara district hospital; in the month of August alone, 55 children had died in Maharashtra’s Nashik Civil Hospital and 49 in UP’s Farrukhabad District Hospital.

Infant
A low birth weight baby at Sick New Born Care Unit, Kashida, East Singhbhum district, Jharkhand. The death of 70 infants in an Uttar Pradesh hospital was followed by similar stories from across the country. Our investigation shows that efforts to reduce child mortality must start way before a visit to the doctor.

 
Tragic as these deaths were, they were hardly unusual, IndiaSpend found on visiting half a dozen primary, secondary and tertiary healthcare centres in Jharkhand, another state that reported numerous infant deaths. Doctors told IndiaSpend that such seemingly high child death figures were routine for the months of July and August, when infections peak and already overburdened hospitals are unable to cope.
 
From our on-the-ground reporting, the picture that emerged is of a failing healthcare system that stacks the odds against a child’s survival even before she is conceived. Poorly-fed young women are married off too early, remain underweight when pregnant and get little prenatal care and nutrition. Babies are born underweight (less than 2.5 kg) and live in conditions where they are exposed to high risk of infection, getting inadequate nutrition that limits their ability to develop the strength to fight disease. Government-run community and primary health centres are dysfunctional, while tertiary care institutes, both private and government-run, are overburdened and mismanaged.
 
Our investigation shows that efforts to reduce child mortality must start way before a visit to the doctor, and public policy must focus on improving primary health care.
 
Why we chose to report from Jharkhand
 
Carved out from Bihar in 2000, Jharkhand made rapid economic progress from 2005-06 to 2015-16, raising its per capita net domestic income by 36.7%. During this period, women’s literacy improved from 37.1% to 59%, the proportion of institutional deliveries increased from 18.3% to 61.9%, infant mortality rate fell from 69 deaths per 1,000 live births to 44, and under-five mortality fell from 93 per 1,000 to 54, data from the fourth National Family Health Survey (NFHS-4) show.
 
In collaboration with UNICEF, the state launched the Jharkhand Nutrition Mission in 2015 with the aim of eradicating malnutrition by 2025. Part of the plan was to track health indicators during the first 1,000 days of a child’s life.
 
Yet, 45.3% of Jharkhand’s under-five children were stunted, 47.8% underweight and 29% wasted in 2015-16, while 40.3% of its population continued to live under the poverty line (set at Rs 356 per capita a month in villages and Rs 538 per capita in cities).
 
At the same time, IndiaSpend found, Jharkhand failed to utilise the funds allocated for health–only 40% of its approved budget for National Rural Health Mission in 2014-15 was spent, down from 61% in 2013-14, and there continues to be much mismanagement and lack of oversight all along the value chain. In its failure to translate economic growth into all-round prosperity, Jharkhand holds a mirror to much of India.
 
Why tertiary care centres fail to save babies
 
For five decades, the Mahatma Gandhi Memorial (MGM) Medical College in Jamshedpur has served as the tertiary care referral centre for four Jharkhand districts as well as the bordering districts of West Bengal and Odisha.
 
In the month of July 2017, it recorded 52 deaths–40 infants in the neonatal intensive care unit (NICU) and 12 in the paediatric intensive care unit (PICU). “Had the babies died in the districts they were born in, our numbers would not be high. Being a government hospital, we have to admit everyone,” B Bhushan, the medical superintendent of the college, told IndiaSpend.
 
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B Bhushan, medical superintendent, MGM Medical College, Jamshedpur. In July 2017, MGM recorded 52 deaths–40 infants and 12 children. “Had the babies died in the districts they were born in, our numbers would not be high. Being a government hospital, we have to admit everyone,”Bhushan said.
 
The combination of heat and humidity increase the incidence of infections ranging from malaria, dengue and encephalitis to viral and influenza across India during the months of July and August.
 
Experts ask why hospitals such as MGM were not better prepared. “As in other medical emergencies, more doctors and more beds could have been dedicated to treating children during the months of July and August,” Suranjeen Pallipamula, senior programme officer at international health non-profit Jhpiego, told IndiaSpend.
 
Doctors said they frequently handle low birth weight babies (weighing less than 2.5 kg at birth) who are usually born to underweight mothers. When these babies are rushed to overstretched and poorly managed tertiary hospitals–often at critical stages–they rarely survive.
 
Yet, the news of 52 infant deaths in one month had not reduced the number of patients arriving for treatment when IndiaSpend visited the hospital in early September.
 
Everywhere, there were more patients than could be accommodated–about a hundred people were queued up in the central registration wing to consult a doctor in the out-patient unit; in the maternity wing, some mothers with newborns were sleeping outside in the corridor because there were not enough beds; in the NICU (for babies younger than 28 days), there were three infants on one bed.
 
A foul stench pervaded the labour ward which had soiled walls, torn mattresses, leaking bathrooms and filthy toilets. Patients said they had to bring their own bed sheets and buy many medicines with their own money from the market.
 
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The postnatal room in the obstetrics department at the MGM Medical College, Jamshedpur. Patients said they had to bring their own bed sheets and buy many medicines with their own money from the market.
 
The paediatrics unit needed 11 full-time doctors, Bhushan said, but had managed with five since 2010 when two professors had retired, one had died and another was transferred. “There has been no effort to find their replacement, no advertisements have been placed,” one doctor told IndiaSpend, not wishing to be named.
 
Over a decade after the six-bed NICU was set up in 2005, enough nurses and doctors have not been appointed. The NICU often admits 22 to 24 babies—up to three to a bed. “Most doctors are working extremely hard to save lives, but we are over-worked,” the doctor said.
 
“It is not possible to keep the hospital premises clean with this crowd,” Bhushan said, adding, “There is no lack of funds in the hospital, just shortage of staff across departments.” As a government-run hospital, it cannot fill vacancies on its own and must rely on the state government to do so.
 
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The building which houses the paediatric and labour wards at the MGM Medical College, Jamshedpur. “It is not possible to keep the hospital premises clean with this crowd,” MGM’s medical superintendent B Bhushan said, adding, “There is no lack of funds in the hospital, just shortage of staff across departments.”
 
The hospital receives water twice a day, when the overhead tank is filled, but often there is no water to sterilise equipment and even wash hands.
 
The situation was similar at the Rajendra Institute of Medical Sciences (RIMS) in Ranchi, where 660 children’s deaths were reported this year.
 
The hospital’s superintendent was sacked when the news broke; his replacement, Vivek Kashyap, denied medical negligence. “It is important to know how many patients were admitted in the hospital when we talk about the deaths,” he said, making the point that the deaths were proportionally few. Previously, hospital director B L Sherwal had claimed a 84% success rate–4,195 of the 4,855 children admitted were cured and discharged.
 
The autonomous institute is much larger than MGM Hospital and has a capacity of 1,500 beds and 33 departments spread over a sprawling campus. Yet, it gets more patients than it can handle.
 
“The paediatric unit has 100 beds but we have 143 patients admitted,” a doctor in the paediatrics unit told IndiaSpend. “We need more beds, more doctors.” He said most patients arrive at the hospital long after the golden hour–the first hour after a medical emergency–because they have to travel from far-off rural areas. “If primary health centres and community health centres worked, we wouldn’t see these many patients,” another doctor complained. They did not wish to be named.
 
Where public primary health care fails
 
The sub-centre in Palasbani village in East Singhbhum district, of which Jamshedpur is a part, is housed in a new, two-storeyed building with a neat hand-pump at the front. On the day IndiaSpend visited, it was locked–as usual, the villagers said. “Why did they build the sub-centre?” one villager said. “Earlier our children played in the grounds there, now it is just wasted space.”
 
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The sub-centre in Palasbani village in East Singhbhum district was locked–as usual, the villagers said. “Why did they build the sub-centre?” one villager said. “Earlier our children played in the grounds there, now it is just wasted space.”
 
In India’s primary healthcare ecosystem, a sub-centre is the first point of contact for a community and typically caters to 2,500-3,000 people. Government guidelines say each sub-centre should have one Auxiliary Nurse Midwife (ANM) and one health worker, preferably male. A doctor is supposed to visit the sub-centre at least once a month.
 
Although the Palasbani sub-centre is assigned a full-time ANM and an Accredited Social Health Activist (ASHA or community health worker, locally called a sahiya), they visit only once a month, the villagers say.
 
Most members of the 12 hamlets this sub-centre caters to are subsistence farmers and labourers. With the sub-centre nearly non-functional, the villagers travel to the Dumaria Community Health Centre (CHC), Suresh Naik, a local teacher, told IndiaSpend.
 
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Recalling a 2013 incident in which a pregnant 22-year-old had died–she had had to be taken to the Dumaria CHC and then to MGM Hospital due to complications–Mini Murmu, a young mother, said sahiyas should come at least weekly to check on pregnant women.
 

Staff Shortage In Jharkhand’s Primary Healthcare System
Type of health worker Shortfall (In %)
2016 2015
Health worker (female)/ANM at SC Excess Excess
Health worker (female)/ANM at SCs and PHCs Excess Excess
Health worker (male) at SC 89.8 89.8
Health assistant (female)/ LHV at PHCs 96.9 90.6
Health assistant (male) at PHC 98.8 87.5
Doctors at PHCs 26.9 0
Total specialists at CHCS (Obs&Gyn, General Surgeon, Physician, Pediatrician) 92.1 92.1
Nursing staff at PHCs and CHCs 8.9 35

Source: Rural Health Statistics 2016
Note: SC: Sub-Centre; ANM: Auxiliary Nurse Midwife; LHV: Lady Health Worker; PHC: Primary Health Centre; CHC: Community Health Centre
 
On paper, in 2016, there were surplus ANMs or female health workers in Jharkhand–7,632 were posted at sub-centres (SCs) and primary health centres (PHCs) as against the 4,280 required, as per rural health statistics.  
 
In contrast, East Singhbhum civil surgeon Kala Chand Munda told IndiaSpend, the district needs 141 doctors but has 61. Two-thirds of the 243 sub-centres in the district do not have facilities to deliver babies, so that 86 sub-centres with facilities to deliver babies serve a population of 2.3 million–one sub-centre for 26,744 people.
 
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A locked sub-centre at Laldih village, East Singhbhum district, Jharkhand. A sub-centre is the first point of contact in India’s healthcare ecosystem and typically caters to 2,500-3,000 people. Each sub-centre should have one Auxiliary Nurse Midwife and one health worker. A doctor is supposed to visit the sub-centre at least once a month.
 
At the PHC in Musabani town in the same district, IndiaSpend found two pharmacists and no doctors, although doctors are supposed to be on duty every day. “Doctors come twice a week,” one of them said, adding that although this PHC has been upgraded to a CHC, it has five doctors against the sanctioned seven posts. “Doctors often need to go for meetings and use the ambulance for transport,” he said.
 
In the newborn unit in the CHC in Kashida town in the same district, three of the 12 warmers are not working. Seven nurses are assigned but there are no doctors in sight. “Doctor comes once a day for a round,” the only nurse present told IndiaSpend. She said they admit 3-5 patients each day, mostly for fever, jaundice, low birth weight and  birth asphyxia. “We do what we can but it is difficult to manage without a full-time doctor and a paediatrician,” she said, adding that they refer patients to MGM Medical College, Jamshedpur, in case of complications.
 
At the bigger sub-divisional hospital in Ghatshila in the same district which started functioning in July this year, the building is clean and well-ventilated. When IndiaSpend visited, the outpatient department was working but most other departments were closed. “We have three doctors but only one is permanent, the rest are on contract,” head clerk Saryam Mormu told IndiaSpend. There are four additional doctors but they are posted in other PHCs. Only the labour ward, malnutrition treatment centre and postmortem facility are functional. The newborn unit at Kashida is to be moved here when work is complete, Mormu said.
 
This hospital’s malnutrition treatment centre is one of two in East Singhbhum district that treat children with severe acute malnutrition. The 15-bed centre has seven nurses and two supporting staff. Admitted children are given a nutritious diet and discharged once they gain 15% of their body weight. “Most mothers get married early and do not give enough complementary food after six months other than breast milk,” Rinku Mukherjee, a nurse with 10 years of experience, told IndiaSpend. She said poverty and illiteracy give rise to high malnutrition in the region, but the centre ensures compliance with the treatment protocol by giving mothers Rs 100 a day for their own nutrition while the child is admitted and Rs 150 per visit thereafter to encourage them to follow up.
 
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Rinku Mukherjee, a nurse with 10 years of experience, weighing a child at the malnutrition treatment centre in Ghatshila sub divisional hospital, East Singhbhum district, Jharkhand. “Most mothers get married early and do not give enough complementary food after six months other than breast milk,” Mukherjee said.
 
How families neglect young mothers and infants
 
Jharkhand could do with more such malnutrition treatment centres, because women’s poor health lies at the bottom of the state’s poor child health indicators.
 
Take the case of two-month-old Shravani Gop, who died in MGM Hospital on July 12, 2017. Her 32-year-old mother Sushma Gop lives in the Lal Tal area of Jamshedpur, which lacks electricity, piped water and sewage facilities. The Gop family lives in a single rented room shared with three other families, with whom they also share a hand pump.
 
Sushma’s husband Bablu Gop is a daily-wager and the sole earning member of the family, who brings home about Rs 4,500 per month. His wife from a previous marriage had died of jaundice, leaving behind a daughter, Shalu, who is 10 and bedridden due to a neural-cerebral disorder.
 
Sushma got pregnant soon after she married Bablu last year. Her pregnancy diet consisted of doodh-roti (milk and unleavened bread) and chawal-saag (rice and vegetables), she said, adding that she often felt dizzy and weak, which are signs of anaemia. She was hospitalised thrice and given blood transfusions.
 
Sushma had a normal delivery in May, but could not express milk, so baby Shravani was fed formula milk. One day, when two months old, Shravani vomited all the milk she had been fed and seemed to have difficulty breathing.
 
The family rushed her to MGM Medical College on July 11. The next day, they were told Shravani had died. They are not sure what caused the death. The medical records show Shravani weighed 1.8 kg at two months (normal weight at birth is above 2.5 kg in India), which made her a very low birth weight (VLBW) baby. She was diagnosed with septicaemia, a condition in which infection enters the bloodstream and causes sepsis, a life-threatening condition when chemicals released by the immune system into the bloodstream to fight an infection instead cause inflammation throughout the body.
 
Twenty percent of all deaths in VLBW babies are due to sepsis, and babies with sepsis are three times more likely to die than those without.
 
Sushma’s pregnancy, due to her severe anaemia, should have been flagged as high-risk by the ANM at the sub-centre where Sushma registered herself. Instead, Sushma says, she never saw a doctor at the sub-centre during her entire pregnancy. “I went to the sub-centre but the day the doctor was supposed to come, he never did and we were turned back,” she told IndiaSpend. “All I got was sui [a tetanus toxoid injection] and some sattu [ground Bengal gram powder] from the anganwadi didi [child care centre worker].”
 
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Sushma Gop with her husband Bablu and step-daughter Shalu at Lal Tal, Jamshedpur. Sushma’s two-month-old daughter Shravani died at the MGM Medical College in July 2017. Sushma’s pregnancy, due to her severe anaemia, should have been flagged as high-risk at the sub-centre where she registered herself. Instead, Sushma says, she never saw a doctor at the sub-centre during her entire pregnancy.
 
Government guidelines say a pregnant woman must receive at least four antenatal check-ups examining her blood pressure, weight and haemoglobin levels; she is also supposed to receive iron and folic acid supplements. Sushma’s antenatal card was at her mother’s place, so it was difficult to ascertain the amount of antenatal care she received.
 
IndiaSpend checked the antenatal care cards of three other mothers whose children were admitted in the NICUs at MGM Medical College, Jamshedpur, and Rajendra Institute of Medical Sciences, Ranchi.
 
All three women had weighed less than 45 kg at six months of pregnancy and were anaemic (with haemoglobin levels lower than 11 gram per decilitre), and their babies had weighed between 1.2 and 1.85 kg at birth.
 
These women are not outliers–in 2015-16, 62.6% of pregnant women in Jharkhand were anaemic, worse than the high national average of 50.3%; and 31.5% of women in the state were underweight, compared with a national average of 22.9% , according to the latest National Family Health Survey (NFHS-4).
 
In comparison, 23.8% of men in Jharkhand were underweight (the national average for men is 20.2%), pointing to a widespread disregard for women’s nutrition and health.
 
Malnutrition is a multi-faceted problem without easy fixes. “It is linked with issues of food security, sanitation, education and empowerment of women, with poverty and deep-rooted cultural practices like early marriage and not breast-feeding children,” Rajan Sankar, programme director for nutrition at Tata Trusts.
 
Source: National Family Health Survey, 2015-16: Jharkhand & India factsheets
Note: BMI: Body Mass Index
 
Further, 38% of women aged 20-24 years had married before the legal age of 18 years, as against the national average of 26.8%.
 
Effectively, four among every 10 women in Jharkhand were married before attaining 18 years of age, three out of 10 were underweight, and six out of 10 mothers were anaemic in 2015-16. Underage, undernourished and anaemic mothers are more likely to give birth prematurely, have complications during delivery and give birth to low-weight babies, all of which increases the risk of death for both mother and child.
 
In addition, these women are less likely to get the minimum four antenatal care visits, consume iron-folic tablets during pregnancy and give institutional births. It is no surprise that Jharkhand has among the worst infant mortality rates in India–44 per 1,000 live births.
 
Yet funds are under-utilised
 
While IndiaSpend found widespread under-capacity in most healthcare facilities it visited in Jharkhand, a budget brief by the non-profit Centre for Policy Research shows the state had not utilised 60% of its approved budget for the National Rural Health Mission in 2014-15. In 2013-14, it had not utilised 30% of its allocation.
 
The entire state’s health department has been drawing its salary from NHM funds, Gurjeet Singh, social audit coordinator with the Government of Jharkhand, told IndiaSpend. He said funds are released in spurts when big tragedies occur.
 
There is an urgent need to bring back community-led monitoring of primary healthcare through platforms like Rogi Kalyan Samiti (RKS, or Patient Welfare Committee) introduced under NRHM in 2005, Singh said. Most RKSs in states have not been very active in holding monthly meetings and putting forth their requests, but the few that have have ensured better quality care at the community level.
 
Investing in primary health works
 
In contrast to Jharkhand, Tamil Nadu has achieved among the best child health indicators in the country, mostly by improving health infrastructure and healthcare management.
 
Since the 1980s, the state has deployed thousands of multipurpose workers as village health nurses to serve population clusters larger than 5,000 people. It has built more health sub-centres and PHCs, and has started round-the-clock services to cater to emergency obstetric cases. It has also adopted a universal immunisation programme since 1985.
 
“Tamil Nadu has also been able to concentrate on many of the health ‘basics’ that have been so neglected in much of India,” Amartya Sen and Jean Dreze wrote in their 2013 book India and Its Contradictions.
 
Tamil Nadu is also the first state to develop a public health cadre which separates the role of the doctor and that of the administrator/manager. In addition, a medical services corporation was formed to regulate procurement, distribution and rational use of generic medicines.
 
Further, it enacted a Public Health Act, the only one of its kind in India, that assigns responsibility and sets standards for water quality and food hygiene, and mandates monitoring.
 

 

Tamil Nadu Health Indicators Vis-a-vis Jharkhand, India
Source: National Family Health Survey, 2015-16: Jharkhand, Tamil Nadu & India factsheets
Note: IMR: Infant Mortality Rate, U5MR: Under five mortality rate
 
Jharkhand, like all Indian states, could benefit from following the Tamil Nadu model. But for that, health has to be a public policy priority.
 
Solutions Box
 
(Yadavar is a principal correspondent with IndiaSpend.)

Courtesy: India Spend
 

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It’s Oxygen Interruption that Caused Children to Die, says FIR even as CM is in Denial: Gorakhpur https://sabrangindia.in/its-oxygen-interruption-caused-children-die-says-fir-even-cm-denial-gorakhpur/ Fri, 01 Sep 2017 06:12:56 +0000 http://localhost/sabrangv4/2017/09/01/its-oxygen-interruption-caused-children-die-says-fir-even-cm-denial-gorakhpur/ The report in a way concludes that the deaths did not occur only due to interruption of the oxygen supply, but also due to administrative lapses. Newsclick Image by Nitesh Kumar   The Yogi Adityanath-led government in Uttar Pradesh on August 12 said that oxygen supply to Gorakhpur’s Baba Raghav Das (BRD) Medical College and […]

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The report in a way concludes that the deaths did not occur only due to interruption of the oxygen supply, but also due to administrative lapses.
Gorakhpur
Newsclick Image by Nitesh Kumar
 

The Yogi Adityanath-led government in Uttar Pradesh on August 12 said that oxygen supply to Gorakhpur’s Baba Raghav Das (BRD) Medical College and Hospital was disrupted on the intervening night of August 10-11. But maintained that it did not cause death of children. It seems as if the left hand does not know what the right hand is doing.

The FIR – which is in possession of NewsClick – lodged against nine persons (mostly doctors and staff) at Hazratganj police station in Lucknow on August 23 has charged most of them with “dereliction of duty”, “lapses in the hospital” and “corruption” that led to the “interruption in supply of oxygen, causing tragic deaths of 30 children” on the fateful night.

But an action report – a copy of which is available with NewsClick – by the Chief Minister’s Office has not revealed the actual reasons of the death. The report in a way concludes that the deaths did not occur mainly due to interruption of the oxygen supply, but administrative lapses.

Interestingly, the CMO report has extensively quoted a chief secretary-headed enquiry committee report but preferred to keep mum on exact reasons cited by it for such a large number of loss of precious lives.

The CMO has just highlighted the actions recommended by the probe panel, that comprised of Chief Secretary Rajiv Kumar, Secretary (Health) Alok Kumar, Secretary Finance Department Mukesh Mittal and Medical Superintendent (SGPGI) Dr Hem Chand. It has not gone into the details of the findings of the committee on the exact reasons for the deaths.

The then principal of BRD Medical College RK Mishra, his wife Poornima Shukla, Oxygen in charge and HoD (anesthesia) and Dr Satish have been booked under various sections of the Indian Penal Code – 409, 308, 120 (b) and 420, for their “irresponsible behaviour” in the disruption of oxygen supply to the hospital. Relevant sections of the Prevention of Corruption Act and the Indian Medical Council Act were also invoked.

“Dr Mishra and Dr Satish left headquarters without any information, thereby failed to address the emergency situation,” said the FIR.

A homoeopathic medical officer, Poonam Shukla has been accused of interference in the hospital administration and of seeking a commission in the purchase of surgical equipment.

Dr Kafeel Khan, the nodal officer of 100-bed acute encephalitis syndrome (AES) ward, has been charged with the “criminal prosecution” for “defying procurement norms” and “wrongfully arranging the oxygen cylinders from his wife’s nursing home and bringing wrong facts before the media”.

He has also been charged for “hiding facts in his affidavit on the procurement of medicines and chemicals filed before the chief medical officer, Gorakhpur, and the CAG that conducted special audit”.

A Grim Reminder

Out of 1,256 deaths of children that the government-run BRD Medical College has witnessed this year, August alone has witnessed the deaths of 296 children, especially in the encephalitis, the infant and the children’s wards, said PK Singh, principal of the college. This was the maximum number of deaths recorded in a month so far.

“Of the many children coming to us in an extremely critical condition, some survive for barely an hour,” said Singh in a PTI report.

The hospital saw 152 deaths of infants in January, 122 in February, 159 in March, 123 in April, 139 in May, 137 in June, 128 in July and 296 till August 29.

Courtesy: Newsclick.in
 

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Gorakhpur Tragedy: BRD Principal & 3 Others Found Guilty, Clean Chit to Dr Kafeel Khan https://sabrangindia.in/gorakhpur-tragedy-brd-principal-3-others-found-guilty-clean-chit-dr-kafeel-khan/ Fri, 18 Aug 2017 08:54:23 +0000 http://localhost/sabrangv4/2017/08/18/gorakhpur-tragedy-brd-principal-3-others-found-guilty-clean-chit-dr-kafeel-khan/ The probing committee found out only lack of coordination between Dr Kafeel and his team. After the tragic death of 30 children at BRD Medical College hit the headlines on August 11 2017, Gorakhpur District Magistrate Rajeev Rautela formed an investigating committee comprising of 5 members. The team, which submitted its report to the DM […]

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The probing committee found out only lack of coordination between Dr Kafeel and his team.

After the tragic death of 30 children at BRD Medical College hit the headlines on August 11 2017, Gorakhpur District Magistrate Rajeev Rautela formed an investigating committee comprising of 5 members. The team, which submitted its report to the DM who finally submitted it to the state government, has named the  principal of the college to the clerical staff as prima facie accused. The probing committee found out only lack of coordination between Dr Kafeel and his team.

Courtesy: Newsclick.in

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