Since the beginning of the year over 175 children had died due to Chamki Bukhaar or Acute Encephalitis Syndrome in Bihar. In an interview to BusinessLine, the State’s Health Minister Mangal Pandey throws light on the investigation into these deaths and efforts being taken to strengthen the healthcare infrastructure. He also elaborates on why the State is consistently ranked lowest in the NITI Aayog’s State health index graph. Excerpts:

Bihar has been ranked lowest in the NITI Aayog State health index for the second consecutive year. What do you have to say about it?

NITI Aayog had released its first report last year based on projections from the numbers of 2015-16. At that time, Tej Pratap Yadav was the health minister. I do not want to comment on what happened or did not happen during Yadav’s time.

The leadership at that time was weak, so the graph is low.

Even the second report of 2017-18 shows that things are not looking up. We have a total fertility rate of 3.2 (which means on an average each mother has three children, whereas national average hovers at two) and our maternal mortality ratio is 165 (which means 165 mothers die per thousand live births) during delivery. Our infant mortality rate is 38 per one thousand population, slightly higher than the national average of 33.

What are you doing to upgrade the healthcare infrastructure in the State?

We are studying sites to build medical colleges in Purnia, Chhapra and Madhyapara. We are tendering for establishment of medical colleges in Samastipur, Jhanjharpar, Sitapur, Vaishali, Jamui, Buxar, Siwan and Bhojpur.

There is an acute shortage of healthcare staff. Bihar’s health systems are working on half the staff they ideally should get. What are you doing about it?

We are in the process of recruiting doctors and paramedics. Close to 6,000 Auxiliary Nurse Midwives (ANMs) will soon be in the system. We have posted advertisements for recruiting 9,130 A-plus grade nurses; up to 2,425 specialist doctors; 4,110 medical officers; and 552 dentists. This may take six to nine months.

The death of 175 children, and three times more being affected by Acute Encephalitis Syndrome has shocked the country. A case has been filed against you and the Union Health Minister Harshvardhan in this regard. Your comment.

As you must be aware, the Supreme Court has dismissed the petition against me and the Union Minister of Health after receiving our replies. People think that I as a health minister will have answers to the causes of a mysterious illness, questions of which reputed institutes like the US’ Centre for Disease Control and Prevention (CDC), the National Institute of Virology (NIV), Pune, and the Indian Institute of Medical Council and Research (ICMR) are still grappling with.

In 2014, we sent blood and cerebrospinal fluid samples of these cases to CDC and till date they have not pinpointed a cause. They could find no disease-causing agent in the samples.

But we do know that 22-30 per cent (which is one in three affected) children die of the disease. A report from the central team is also awaited in the case.

Sri Krishna Medical College and Hospital (SKMCH) where majority of the AES deaths happened is crumbling. In 2014, a ward was proposed to be set up for children which never went through. Why is the current hospital block in such a dismal state with lack of drainage outlets?

Lets not talk about the past. We have committed to making operational a 100-bed Paediatric Intensive Care Unit (PICU) and a research centre with an investment of ₹65 crore within a year. The tendering process has been initiated.

A 900-bed hospital is coming up in the campus which we are aiming to make operational by December 30.

The new building will have appropriate drainage systems.

There have been many grievances about the tendering process. Tenders are awarded to contractors who quote as low as 30 paise per square meter a day for cleaning SKMCH, but end up doing a shoddy job. What is the solution?

See, our hands are tied. We are bound to award the tender to the lowest bidder, if we do not follow the rules, then our names will be splashed all across the media raising many questions.

I understand the issues of unhygienic conditions in SKMCH, but tenders will only go to the lowest bidder.

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