Union Health Minister Dr Harsh Vardhan is taking cognisance of a tragedy in a hospital in the Rajasthan city of Kota, with more than 100 children dying in the span of a single month in a single hospital.
The Union Minister has written to Rajasthan Chief Minister Ashok Gehlot, concerning the government-run JK Lon Hospital where 103 children have lost their lives in just a month as of the time of writing.
The news from Kota has sparked significant outrage and prompted the convention of an investigative committee, comprising additional principal of Sawai Mansingh Hospital Dr Amarjeet Mehta and paediatrician Dr Rambabu Sharma. The report of the investigative committee, delivered on December 30th, did not find any wrongdoing on the part of doctors and other practitioners at the hospital. But it did find a plethora of issues likely to have triggered the crisis.
“The children have not died because of a single factor,” the committee reported. “The extreme cold weather is also perhaps an added reason for the sudden spike in deaths as extreme weather affects neonatals adversely, especially those who are low birth weight.” A probe into the deaths was also ordered by the Rajasthan State Commission for Protection of Child Rights.
JK Lon: A hospital in crisis?
However, numerous causes for concern have been raised. An initial inspection conducted on December 27th by Health Secretary Vaibhav Galeria at the direction of Gehlot uncovered oxygen shortages, hygiene issues on wards, and a dearth of multiple vital pieces of medical equipment. “There are not enough doctors in the hospital,” noted department head at the JK Lon Hospital Dr Amrit Lal Bairwa.
Deficient medical equipment is also an issue at the Kota hospital. “Thirteen out of nineteen ventilators, 81 of 111 infusion pumps, 44 of 71 warmers, 32 of 38 oxymeters, and 22 of 28 nebulisers…were not in working condition,” reported The Times of India.
Such deficiencies mean that “the hospital is working at 150 percent of its capacity,” according to the review by the government-appointed panel. “The number of beds is less than the flow of patients. Similar is the situation at the ICUs [intensive care units] as well. There is a need to increase the number of beds.”
The National Commission for Protection of Child Rights visited the hospital at the end of December, releasing damning findings. “It is evident that there was no glass in windows panes, gates were broken and as a result the admitted children were suffering with extreme weather [conditions],” said the Commission’s chairperson Priyank Kanoongo, referring to the hospital’s maintenance as being in the “worst condition.” It was even found that “pigs were…roaming inside the campus of the hospital.”
Despite the difficulties confronting the hospital, Bairwa said that the number of deaths at the hospital were declining, even against the backdrop of an uptick in admissions. “In the year 2014, a total of 15,719 patients were admitted, out of which 1,198 died, 17,569 were admitted in 2015, while 1,260 died. In 2016, as many as, 17,892 were admitted and 1,193 died. In 2017, a total of 17,216 patients were admitted and 1,027 died, against 16,436 admitted in 2018, and 1,005 deaths. This year the number is 940.” (Other sources posit the death toll for 2019 to be between 900 and 963.
Irrespective of circumstances behind the tragedy, the deaths in Kota have sparked political controversy. The Congress-led state government in Rajasthan has pointed to the fact that the number of deaths under their leadership are fewer compared to the period when the BJP governed the state. However, Gehlot has been criticised for his language concerning the tragedy.
“This year there have been the lowest number of deaths compared with the last six years,” Gehlot said. “[Though] the death of a child is unfortunate…in the past years, there have been 1,300-1,500 deaths every year…every day some deaths occur in every hospital in the country. There is nothing new in this.”
These remarks were castigated by BJP officials. “‘Children are dying, there is nothing new in this.’ The head of the state [were] very hurt to hear this statement,” said Gehlot’s predecessor as Chief Minister, Vasundhara Raje. “This statement is like rubbing salt on the wounds of those mothers who have lost their children in JK Lon Hospital due to government negligence.”
“Even after these deaths, the attitude of the government is insensitive, inhuman,” said Satish Poonia, the BJP president in Rajasthan. Poonia further commented “it is regrettable that the state health minister did not even visit the hospital. The chief minister is known for being sensitive. A delegation of BJP MPs had met the families who lost their children. They were in deep anguish. If the government is not sensitive then it is worrisome.”Gehlot, for his part, has spoken out against politicising the issue. “The government is sensitive to the death of sick infants in JK Lon Hospital in Kota,” he said. “There should [be] no politics over the issue. Infant mortality at this hospital is steadily decreasing. We will try to reduce it further. It is our top priority that mothers and children remain in good health.” However, the Chief Minister himself has been accused of and criticised for “playing politics” over the issue.
“Nothing can be more hazardous to the democracy than, when leaders or rulers in power approach immoral means to defend its delinquency! Well the Congress party in India has been a super suitable specimen of such wrongdoings,” wrote News Bharati. “While the number of infant deaths in the state of Rajasthan are unfortunately jumping up, Chief Minister Ashok Gehlot, playing a political gimmick, blatantly noted that the alarming statistic was in fact an improvement over what the previous BJP government had recorded at the same hospital.”
Politics aside, the tragedy requires a cohesive response. “I have written a letter to Rajasthan Chief Minister Ashok Gehlot requesting him to look into the matter,” said Union Health Minister Dr Harsh Vardhan. “We have assured all kind of support from our side…I believe that all people concerned, including the state government, hospital administration, doctors should get into the depth of the matter and if they need any sort of help, including the financial assistance, they should ask for it so that there is no lack of facility.”
Gehlot expressed willingness to collaborate with the Centre on the matter. “An expert team of the Centre is welcome to further improve health services,” he said. “We are ready for the improvement of medical services in the state with their consultation and cooperation. Rajasthan without any disease is our priority.” He further invited Vardhan to visit the hospital in Kota himself.
Gorakhpur, Muzaffarpur, Kota
What the Kota tragedy does make clear is that the inadequacies in India’s public health system are continuing to manifest themselves in disasters of this nature. As put in an editorial published in The Times of India, the Kota tragedy “must put us to shame…the situation exposes an absolute lack of accountability…the lack of action until the deaths gripped national headlines points to nonexistent oversight mechanisms.no government functionary has condescended to explain the criminal failure to replace so many pieces of faulty medical equipment. A political blame game has begun but as usual it will lead nowhere.”
India has been ravaged by a plethora of tragedies involving the deaths of numerous children in recent years, from the outbreak of acute encephalitis syndrome in the Muzaffarpur district of Bihar last year which killed more than 140 children to the Gorakhpur tragedy of 2017, where more than 325 children – many of them being treated for encephalitis – died in the space of a month due to medical oxygen shortages.
In all these instances, from Muzaffarpur to Gorakhpur to Kota, the shambolic state of the country’s public health infrastructure was put in the spotlight, inviting mistrust of the public health system and condemnation of inadequate funding, poorly maintained or non-existent infrastructure, and defective equipment whose working order can mean the difference between life and death.
Rectifying the issues at the heart of India’s health system will not be achieved overnight. But as the Kota tragedy at present – and the tragedies of Muzaffarpur, Gorakhphur, and more in the past – reminds us, it must be done.