On Saturday, Jamal Shaikh undertook an arduous 90-km trip from Maharashtra’s Yeola town to the Nashik Civil Hospital, fervently hoping his seven-day-old, prematurely born, underweight son would survive. His wife, who had visited a government-run primary healthcare centre at Yeola for the seven months of her pregnancy, was never told about the complications that would arise, claims Shaikh. “If my wife had been treated properly at the PHC, this day would have never dawned on us,” says the 30-year-old farmer.
While Shaikh says doctors have assured him his baby would pull through, over the past five months, since April, 187 infants admitted to Nashik Civil Hospital’s Sick Newborn Care Unit (SNCU) have not been so lucky. Hospital authorities said a majority of the 187 deaths were of newborns who were brought to the hospital in critical condition from rural areas or municipal hospitals in the district.
“In the month of August, 346 children were admitted to our SNCU. Most of them were in a critical condition and we, being a government hospital, can’t turn them away,” said Nashik District Civil Surgeon Dr Suresh Jagdale.
Officials say the 740-bedded civil hospital, which caters to nearly 60 lakh residents of the district, is severely overburdened. Nashik, a district with a large tribal population, has 106 primary healthcare centres, 592 sub-centres, 26 rural hospitals and one civil hospital. With the heath centres in poor shape, patients usually travel long distances to get to the civil hospital.
Like all the other departments in the hospital, the newborn unit is short of both manpower and equipments.
The SNCU ward, which has 54 beds, has three paediatricians, but no specialised neonatalogist. “The newborn care unit is supposed to have six doctors but only has three. It has no ventilator either,” said Rizwan Shaikh of Star Bahuuddeshiyha Sanstha, which provides counselling and help to poor patients at the hospital.
The nursing staff is stretched too. “The ideal nurse-patient ratio for sick newborns is 1:1. In our case, we have 11 nurses taking care of 54 children. The nurses work in three shifts of eight hours. So at any point, you only have three or four nurses to take care of all 54 children. We need to increase our staff almost three-fold to tend to patients,” said matron-in-charge Malini Deshmukh.
The newborn care unit is also short of incubators. “For the existing load of patients that the unit receives, we need at least 44 incubators. We are making do with 18,” said a doctor working in the unit who spoke on condition of anonymity.
Maharashtra Health Minister Deepak Sawant, who paid a surprise visit to the hospital on Saturday, attributed the pressure on the hospital to the high patient load. “From 28,000 babies in 2011, their number touched nearly 50,000 annually. Nearly 44 per cent of these newborn babies come from 200 to 300 km away. Many of them carry infections, which then gets passed on to others,” he said. The minister said his department would add “five to six incubators” in the next few days and another half a dozen soon after.
Sawant was, however, non-committal on the hospital’s long-standing demand for a ventilator. Under present norms, only hospitals attached to government medical colleges are provided funds for ventilators. There is no government medical college in Nashik.
The minister also stated that the government could not be held responsible for the deaths. “How can we take responsibility for their deaths? These were babies who weighed less than 400-500 gm (when they came here),” Sawant said.
Forty per cent of newborns in the SNCU ward weigh less than 1 kg, another 55 per cent weigh between 1and 2.5 kg and only 5 per cent weigh over 2.5 kg.
“Most of the deaths are due to low birth-weight. The hospital also suffers from over-crowding. Even if we expand our beds, overcrowding will not reduce,” said Dr Satish Pawar, director at the state Directorate of Health Services.