After facing criticism for dismal health infrastructure in the state of Bihar the central government has informed the Supreme Court that it intends to fund a paediatric intensive care unit (ICU) in Muzaffarpur, the district at the centre of the state’s child death tragedy.
More than 150 children have died in the state following an outbreak of what is believed to be acute encephalitis syndrome (AES), including 142 deaths in Muzaffarpur alone. (It is worth noting that this claim has been disputed in recent days).
The epicentre of the deaths has been the Shri Krishna Medical College and Hospital (SKMCH), a government-run facility where 121 deaths have been reported. The neighbouring Kejiriwal Hospital reported 21 deaths.
Stating in June that “the deaths of children cannot go on”, the Supreme Court directed the Centre and the Bihar state government to provide details of policies responding to the crisis. It also exhorted the latter to provide a report on “medical facilities, nutrition, sanitation and hygiene conditions” in Bihar hospitals. The Centre, in its response, said it has been helping the state government to contain the outbreak and that five virology labs have been established in the state so far. As well as the ICU, which will be housed by the SKMCH, the Centre intends to fund smaller, ten-bed facilities in other districts.
The crisis has highlighted the issues plaguing public health infrastructure in Bihar. The state suffers from a shortage of doctors, with just one physician for every 17,685 people – worse than the national average of one doctor for every 11,082 people. Facilities, as well as manpower, are in short supply: there is a shortage of 1,210 sub-centres, 131 primary health centres (PHCs), and 389 community health centres (CHCs) – symptomatic of a primary healthcare system in tatters.
The announcement of a paediatric ICU is undoubtedly a boon for Muzaffarpur, but it cannot be denied that wider improvements are needed for Bihar’s public health system to become fit for purpose. The child deaths have occurred every year since at least 1995, always coinciding with the lychee season. Yet despite the consistency of the phenomenon, the public health system is consistently overwhelmed when the deaths occur.
As one official who belonged to a team that visited the SKMCH noted, “the medical system not in [place] increased the number of deaths. They didn’t even have drip set and glucometer in place. And despite the huge public outrage, the government did little to make the necessary types of equipment available in surplus quantity despite the Health Minister visiting the hospital.
The official went on to conclude that “the primary healthcare system is in shambles in Bihar. The government had been in denial first but [is] now being forced to accept. It’s high time that the Prime Minister, Health Minister and Bihar’s Chief Minister probe into the recurring Muzaffarpur deaths. They need to provide the basic infrastructure to the rural doctors.”