Shameful deaths: India’s health system stands exposed

| Updated on January 08, 2020

A staggering number of children have died in different parts of the country. This is reflective of the appalling state of public hospitals in India as also the vulnerability to disease of the impoverished population

A complete lack of policy and social empathy can alone explain the staggering number of children and infants who die in different parts of the country, every year, from entirely preventable diseases — if not sheer hunger, camouflaged as malnourishment. In Muzaffarpur, Bihar, 150 children died in June last year of the endemic Acute Encephalitis Syndrome (AES). Now, another spate of shocking casualties have been reported at different government hospitals in Rajasthan and Gujarat this winter. At JK Lon Hospital in Kota, 105 infants died in December alone. In neighbouring Gujarat, 111 infants died in Rajkot Civil Hospital and 85 deaths were recorded in Ahmedabad Civil Hospital, also in December. If Rajasthan is a backward State in terms of economic indicators, Gujarat certainly isn’t. The divergence in Gujarat between its economic and social indicators (as indeed for India as a whole) points to the problems with India’s model of development, where the State has persistently under-invested in the social sector. As for the prevalence of hunger amidst a stockpile of foodgrains, the government needs to do some explaining. Community medicine research has established the role of nutrition in keeping even vector-borne diseases like malaria at bay.

Meanwhile, politicians of the day continue to brazen it out. Rajasthan Chief Minister Ashok Gehlot stressed that his government had done better than his predecessor Vasundhara Raje because, as compared to 1,300-1,400 overall deaths in the previous years, the number this year stood at 900. He characterised the criticism he faced from the BJP as “frustration owing to anti-Citizenship (Amendment) Act protests”. In Gujarat, Chief Minister Vijay Rupani chose to walk away when asked about the casualties. No official investigation seems to have been ordered in Gujarat. In Rajasthan, the report of a government panel reveals that a majority of infants died due to hypothermia. The ICU did not have warmers to maintain the infant body temperature at its ideal of 36.5 degrees Celsius. Of the total 28 nebulisers, 22 were dysfunctional, there were no para monitors or oxymeters that are routinely required to monitor oxygen levels, there was no oxygen pipeline, and the ICU had not been fumigated for months.

These revelations are reflective of both the appalling state of public hospitals in India and the vulnerability to disease of the impoverished population. In the range of 1.2-1.4 per cent of GDP over the past decade, public financing of health accounts for less than a third of overall, mostly out of pocket, health expenditure. As a result, life expectancy at birth in India is lower than in Nepal and Bangladesh. The infant mortality rate is higher than that of Bangladesh. Full immunisation rate of children is 62 per cent while many countries in Sub-Saharan Africa have rates higher than 90 per cent. The urgency of a substantial increase in public financing of health care, besides health system reforms, cannot be greater.

Published on January 07, 2020

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