Last December, an infectious disease hospital in Delhi exhausted its supply of medication for diphtheria. In the months that followed, it failed to replenish it. Multiple deaths ensued.
Diphtheria is an infectious disease caused by the bacterium Corynebacterium diphtheriae. Symptoms – onset of which typically occur two to seven days after infection – include fever, swollen glands in the neck, breathing difficulties, sore throat, cough, and a thick grey membrane coating the tonsils and throat. The virus is spread through the air or direct contact, person to person.
India is one of the leading carriers of diphtheria worldwide. In 2016, it witnessed 3,380 cases of the disease, resulting in 177 deaths. While the Universal Immunisation Programme (UIP) includes diphtheria vaccination, coverage varies between states and is just eighty percent at the national level. This lays the groundwork for outbreaks of the disease to occur in various parts of the country.
“India is one of the leading carriers of diphtheria worldwide”
With this in mind, it potentially constitutes a case of gross medical negligence that – for a period of almost a year – the Maharishi Valmiki Infectious Disease Hospital at Kingsway Camp in New Delhi did not stock a single dose of the anti-diphtheria serum (ADS) used in treatment of the disease.
The shocking revelation emerged in the wake of an inquest into the large number of diphtheria deaths at the hospital. 169 patients were admitted to the hospital with the disease in September, of whom 21 died. An additional two sufferers succumbed in early October.
North Delhi mayor Adesh Gupta has accused hospital authorities of “callousness”. The hospital superintendent has since been suspended after it emerged that he delayed his response to the notification by ADS manufacturer, the Central Research Institute (CRI), that it would not be able to supply ADS for a period of a year whilst its lab was undergoing renovations.
“It potentially constitutes a case of gross medical negligence that – for a period of almost a year – the Maharishi Valmiki Infectious Disease Hospital…did not stock a single dose of the anti-diphtheria serum (ADS) used in treatment of the disease.
The CRI informed the superintendent that ADS could be supplied from raw materials with the express consent of the Directorate General of Health Services (DGHS). The superintendent “took a considerable time” to seek this permission. He also waited until August to seek quotations from private firms for the potential supply of ADS. The panel overseeing the inquest said such a step ought to have been taken “in March or April”.
The case appears to be one of procrastination that, in multiple cases, has proved lethal. The preventable deaths due to the ostensible failure of hospital authorities to adequately provide for patients’ needs can be seen to have echoes of last year’s Gorakhpur tragedy, where the failure of a government hospital in Uttar Pradesh to guarantee supplies of medical oxygen saw the deaths of scores of newborns suffering Japanese encephalitis. One can only hope, then, that the diphtheria tragedy in Delhi will not witness a repeat in future and that authorities will take the appropriate precautions to ensure patients of all diseases, including diphtheria, can avail the treatment they need.