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Medical system in rural Uttar Pradesh is ‘Ram Bharose’: Allahabad HC

Tue, 18 May 2021 10:45:36 +0000

Image Courtesy:newsable.asianetnews.com

The Allahabad High Court Bench of Justices Siddhartha Varma and Ajit Kumar has observed that the entire medical system in the state of Uttar Pradesh pertaining to the smaller cities and villages can only be taken to be like a famous Hindi saying ‘Ram Bharose’ (at the mercy of God).

In the suo motu matter on Covid management, the court took note of the fact that a dead body of one of the patients, Santosh Kumar, who had collapsed in the bathroom and died, was disposed of as an unidentified body in Meerut. The Bench had earlier sought a response on this matter as Santosh was reported to be missing from the hospital.

As soon as the court discovered what had actually happened, it held that it came out to be a case of “high degree carelessness” on the part of the doctors who were on night duty at the time. The Bench remarked, “A patient is admitted to the hospital in an absolute care of doctors and paramedical staff and if the doctors and para medical staff adopt such casual approach and show carelessness in the performance of their duty, then it is a case of serious misconduct because it is something like playing with the lives of innocent people.”

It directed the State Government to take stern action against those responsible, and also compensate the dependents who have suffered the irreparable loss because of such carelessness.

Crumbling infrastructure

The court took a dim view of Bijnor district and its inadequate healthcare system. It said, “In district Bijnor the urban population as per 2011 census is shown to be 9,25,312. We have no doubt in observing that it must have gone up 25% more by 2021, but to our utter surprise there is no level-3 hospital in district Bijnor. The three Government Hospitals have only 150 beds, whereas, the total number of BIPAP machines is 5 and High Flow Nasal Cannula is only 2.”

On the other hand, the rural population in the Tehsils is around 27,55,000 as per the 2011 census and might have also increased by 25 percent now. The court calculated that there are only 10 Community Health Centres, with one health centre taking the load of 3 lakh people with just 30 beds.

“..Meaning thereby, one CHC can cater the need of health care to only 0.01% of the population and there is no BIPAP machine or High Flow Nasal Cannula available. Only 17 oxygen concentrators are available with 250 oxygen cylinders against 300 beds. There is no description as to what is the capacity of oxygen cylinders and whether in CHC there are trained hands to operate these oxygen cylinders and concentrators,” said the court.

The Division Bench also noted that these facilities have not been ramped up since the first wave and the situation has not improved at all in terms of health care. “These facts therefore, are quite opposed to the Government’s claim,” held the court.

On the issue of testing, the District Magistrate, Bijnor informed the court that testing for Covid was being done both by RT-PCR and Antigen kit in a 60:40 ratio. To this, the court responded, “In the population of 32 lakhs, if the testing is done of only 1200 persons and that too in 60:40 ratio then the situation is not happy. The manner in which the pandemic has hit the rural areas of the State, the district administration is required to have a robust way of conducting tests.”

Overall, the court said that “in these few months we have realized that in the manner it stands today, it is very delicate, fragile and debilitated.”

Vaccination in UP

The court took stock of the vaccination drive in the state and commented that the people of this state have faced the pandemic for over three months and are under serious threat of its third wave, which makes two things very clear:

“-We need to vaccinate each and every individual in the country; and

-We need to have an excellent medical infrastructure.”

Further, the court recorded in its order, “We have been informed that a global tender has been invited by the Uttar Pradesh Government. In addition to what the Government is doing, the viability of the following may also be checked.”

In addition to this, the court suggested following aspects for the government’s consideration:

1. The vaccines may be first vigorously tested and only thereafter may be given out for use by the public. For this, various incentives may be announced.

2. Big medical companies which are working in the country may not have their own vaccines but they may take the formula from just any of the vaccine manufacturers in the world and start producing the vaccine. In this way, they would help the country to meet the shortage of vaccines which it is facing today.

“For that matter, one cannot understand as to why the Government of ours which is a welfare state is not trying to manufacture the vaccine itself on a large scale”, the court observed.

3. Such people who might like to buy the vaccines for the have nots, may be allowed to do so and may also be given certain benefits under the Income Tax Act. In the global tenders, the Government after getting the reasonable prices may negotiate with the world manufacturers and try to buy as many vaccines as can be bought from wherever the vaccines are available.

4. Big business houses who take various advantages under the taxation laws by donating to various religious organisations may be asked to divert their funds to vaccines.

Directions issued

The Court directed the appointment of Nodal Officers by the District Judges of districts Bijnor, Bahraich, Barabanki, Shrawasti, Jaunpur, Mainpuri, Mau, Aligarh, Etah, Etawah, Firozabad and Deoria to submit reports of their respective districts about Covid management.

For the development of the medical infrastructure, the Centre and State governments have been asked to report on the current facilities in the State. Both governments have been also instructed to

-increase oxygen facility in all nursing homes

-increase ICU beds in all nursing homes at 40 percent

-of the designated 40 per cent; 25 percent should have ventilators, 25 percent should have High Flow Nasal Cannula and 50 per cent of the 40 per cent reserved beds should have bipap machines.

-construct an oxygen production plant in hospitals that have more than 30 beds

-villages and small urban areas should be given all kinds of pathology facilities and treatments should be made available in Community Health Centres which are at par to the treatment given by Level-2 hospitals in bigger cities.

The matter will be taken up on May 22.

The order may be read here:

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Karnataka Prisons: HC seeks State’s response to overcrowding, medical facilities

Fri, 16 Apr 2021 12:44:51 +0000

Image Courtesy:livelaw.in

On a plea pertaining to the present prison conditions in the state, the Karnataka High Court has sought the State’s response on the issues of overcrowding, hygiene and medical facilities, reported Bar & Bench.

Chief Justice Abhay Shreeniwas Oka has pointed out that the data from Central Prison, Bengaluru has shown that one toilet is available for 9.41 prisoners whereas, according to the prison manual, one toilet should be limited to only 6 prisoners.

The standard reportedly prescribed by the model prison manual lays down the provision of one common bathroom for 10 prisoners but in many jails in the state, one bathroom is used by approximately 15 prisoners. The court, according to a Bar & Bench report, has also directed the government to respond about the general cleanliness in all prisons.

On the issue of overcrowding, the court has said, “The State government must point out whether there are any standard norms regarding the size of the cells for various categories of prisons. If there is perpetual issue of overcrowding in the Central prison of Bengaluru, State to place on record whether there are any proposals pending for constructing additional premises for the Central Jail.”

B&B has also reported that the court has inquired about provision of nutritious food inside jails and whether there is any quality control on the food prepared. “State should explain whether opinion of experts has been taken for finalising the categories of food items provided to the prisoners and quantity also”, directed the court.

The High Court Bench has also taken cognisance of vacant positions of the medical staff and has directed the government to fill up these posts as an immediate measure. It has also ordered the State to consider whether some of the staff members attached to the hospital can be transferred to prisons in the state. The matter will be next heard on June 4.

Noting the seriousness of prison conditions, recently the Apex Court has asked the Tihar Jail (Delhi) authorities to file an affidavit in a matter related to three death row convicts who were found to be in an intoxicated condition inside their cell and were allegedly beaten up by the police officers, reported SabrangIndia.

In addition to the alleged police excesses, the court has also asked Tihar to disclose information about CCTV cameras, budgetary allocations made for it, information about circumstances, materials, such as tobacco pouches or any other contraband/such things that find their way inside the jail premises and what kind of preventive and other measures are being taken by the jail authorities.

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Why a protesting nation needs both dedicated doctors & a transparent medico-legal system

Mon, 20 Jan 2020 08:34:47 +0000

The protests against Citizenship Amendment Act (CAA) and National Register of Citizens (NRC) have entered the second month. Groups of women, people from Muslim communities, students from well known universities have all joined these protests at some point or the other and the protests are relentless. In the initial stages of these protests BJP ruled states saw unprecedented police brutality. Every day news would be rife with reports of a new method of police excess. One of these reports was of Mangaluru where not only did the police fired bullets at protestors but also entered Highland Hospital and hit people with batons and tried to bash down doors of intensive care unit. The police even resorted to tear gas shelling.

The protest was taking place at some distance from the hospital and the protestors injured in the police firing were brought to Highland Hospital with bullet injuries. The police arrived at the hospital sometime later, and then went on their rampage. All of this was captured on the hospital’s CCTV cameras, and played widely across news media.

The police had done the same in a confined space of a library of Aligarh Muslim University which was also widely condemned. The use of tear gas in a hospital, where no one was protesting is something that India has not witnessed, not on civilians at least.

The Mangaluru Police seems to have taken inspiration from Hong Kong police who resorted to a similar kind of brutality on its protestors, about a month before the Mangaluru incident. At least the HK police used tear gas outside the hospital where protestors had gathered and the smoke had entered the hospital premises. Mangaluru went a step further and did shelling within the premises.

This incident is only one of the many such shocking incidents of police action where students have been attacked, activists and locals beaten up and detained, medical care denied to those injured, many a times ambulances were also attacked and medical professionals were injured in this fight of masses versus the State.

A source at Highland Hospital confirmed that the police used tear gas in the hospital four times and that patients had to be shifted to the ICU (Intensive care Unit) because of breathing difficulty. The source said on the condition of anonymity, “The way the police handled the situation, it was unacceptable”. The management of the hospital even sent a written complaint to the police to investigate the matter and to conduct proper investigation in this regard. A month has passed since the terrifying incident and yet no inquiry has begun neither has any final report been filed by the police.

The support of the medical community has been commendable in all this mayhem. The Hippocratic oath asks that doctors treat all people to the best of their abilities. The Universal Declaration of Human Rights demands that, even in conflict, people have access to a good standard of health care.

Doctors in Delhi have even gone to site of protests to give medical aid to injured protestors and have demanded the police to allow them to treat the injured detainees. All this is being done while the medical professionals, the support staff put themselves in danger as there have been incidents of ambulances being attacked and vandalised thus injuring the medical staff.

Ambulances have also not been let to pass by rallies in support of the contentious and discriminative law. One such incident took place when BJP’s West Bengal State President, Dilip Ghosh, who is also notorious for making controversial statements and hate speech, refused to let an ambulance on duty to pass through the rally that he was addressing. By contrast, when ambulances wanted to get through thousands of protestors in Delhi, Karnataka, and Kerala, the crowds parted swiftly to let the vehicles through.

The Indian Medical Association (IMA) has also condemned police action in its press statements. These statements say that the violence on doctors and nurses is a “barometer of anarchy”, that hospitals should remain “safe zones”, and that the Indian Government has “no right to deny anyone their right of access” to health care.

The lethal combination of CAA-NRC seeks to ultimately disenfranchise the poor and marginalised and also the Muslim community. Those who are not able to prove their citizenship will be put in detention camps, as is being predicted seeing Assam as a case study. Assam has 6 detention centres where about 970 people have been detained and live a miserable life.

The processes of National Register of Citizens and detention have unsurprisingly led to enormous mental trauma resulting in suicides and deaths. A member of the National Human Rights Commission (NHRC) team who visited those in detention spoke of the “environment of intense, permanent sadness…. It was as though everyone was in mourning”.

The British Medical Journal’s (BMJ) Indian community has appealed the government to “repeal the Citizenship Amendment Act 2019 and stop the nationwide implementation of the National Population Register and National Register of Citizens immediately”; and has also called upon the nation-wide medical fraternity to be alert to the danger of a public health emergency as a consequence of this (NRC) exercise.

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