The legacy of Gorakhpur: Suspicion of child healthcare

The Gorakhpur tragedy has produced an atmosphere of suspicion across Indian healthcare. A number of other hospitals in several states are now under investigation, with scrutiny over cases similar to Gorakhpur, where numerous children have died in a short space of time. Media speculation is rife over who or what is to blame, with causes ranging from lack of medical oxygen to negligent doctors being suggested.

Official investigations into the situation are helpful in assessing the problems and establishing ways to address them. However, constant media speculation and accusations may  foster mistrust of the whole medical system. It may make parents more reluctant to seek hospital treatment for their children. This could drive up child mortality.

Since Gorakhpur, media reports have been released showing a similar situation in the government-run Raipur hospital in Chhattisgarh. During a half an hour period a drop in oxygen pressure occurred, alleged to be the cause of the deaths of three children who were receiving ventilation. Calls of negligence occurred when local media claimed an official in the oxygen department was asleep during work due to alcohol consumption, leading to the lack of oxygen pressure. The official has since been dismissed for “dereliction of duty” and arrested.

On Monday 21st August, three newborns also died at the Kolar district hospital. Sparking a panic that negligence had also led to the deaths in a similar manner to both Gorakhpur and Raipur, the media were quick to pick up on the matter.

Apparent quotes by relatives of one of the babies paint the situation in a similar light. A relative claimed the hospital had told them “We don’t have enough doctors here. Duty doctors have also gone on leave. Get a doctor to treat your baby,”.

Doctors at the hospital claimed an entirely different situation occurred. Two of the babies had been born severely underweight, which means that  the child has less chance of surviving. The third baby to die was born with a congenital anomaly that had impaired brain development. For these babies, it may be the case that no amount of medical treatment would have prevented their deaths.

Later evidence suggested two babies, at the time of death, had sepsis. This condition can occur due to unsanitary conditions during delivery, such as unclean handling (failure to wash hands or use sterile gloves), or an unsanitised labour room. This indicates that some level of negligence — at the very least negligence of hygiene — was occurring at the hospital.

Stories such as this are becoming common. At the Davanagere Taluk Hospital, another three children died within a day. Two of the deaths were twins, whom doctors claimed had died before the birth occurred. Family members dispute this claim by the doctors, alleging that the doctors had made this claim after the deaths had occurred as an excuse for negligence.

India’s child mortality rate was 48 per 1000 as of 2015. This is slightly above the world average of 42.5. This value will not be uniform across the country and is expected to be far higher in rural or poorer areas due to lack of access to healthcare.

When child mortality occurs, negligence may have contributed.To break down the levels of public trust in India’s healthcare system by hastily reporting every instance of child mortality as the consequence of neglect may have severe negative consequences in the future as some parents may opt to avoid the use of medical treatment for their children. This could lead to India’s child mortality rising, after years of consistent reduction.