Asha Kiran deaths: Lack of hygiene, drinking water, staff crunch flagged 8 times over a year by CMO, Delhi HC told

Here’s what the documents highlight:

-March 23, 2023: Dr Bharti flagged injury cases among female inmates. “It has been noticed that injury cases from the female wing are reported frequently in the last few days. These types of incidents show that the care of residents is compromised which needs to be improved… appropriate action may be taken in the interest of the residents at earliest.”

-May 8, 2023: Dr Bharti raised concerns over the “neglect” in caregiving to a male tuberculosis patient. The patient, she said, was admitted to the medical care unit for nearly two months after complaining of bedsores. While he was then shifted back after “complete healing”, he again developed bedsores in 10 days. The relapse, she pointed out, “shows the quality of care provided to him during the stay in Male Cottage 2,” where he was shifted after the healing from the first bout.

“The matter of non-availability of caregiving staff in Male Cottage 2 (designated cottage for male TB patients) has been repeatedly brought to your knowledge… but only short-term measures are being taken… due to which the residents’ care is compromising and health is deteriorating,” she noted.

-July 19: Dr Bharti, flagging the lack of improvement in the condition of residents and cases of gastroenteritis, TB, and low albumin levels, wrote, “It has been noticed that proper hygiene, sanitation, and monitoring by welfare officer as well as superintendents is not being adhered to as per norms. The Administrator has been apprised of the said situation many times but if the same conditions remain unchanged it may worsen the situation further.”

Moreover, since March, Dr Bharti highlighted, 15 new cases of TB among male inmates, and two new TB cases among female residents were detected. “The MCU (medical care unit) has been advising to take proper care of residents in terms of their general hygiene, food, physical activities, and proper look after of residents for their well being and to protect them from such infections. Despite the instructions, the male residents were not been taken care of properly and that is evident from the notable surge in TB cases among male residents in comparison to female residents,” she noted.

Recommending comprehensive medical examination of all residents at the shelter home, Dr Bharti also pointed out that a lot of residents were found with low body mass index, “which indicates lack of proper food and nutrients.” “There is a need for proper monitoring of food distribution among residents and supervision while serving meals to residents,” it was suggested, while underlining the need for immediate action to “prevent further escalation.”

The CMO in charge undertook a round of inspection in the male dormitories on July 6 and she then communicated her observations — “personal hygiene of residents was very poor”; “residents were not properly dressed and groomed… general care was grossly compromised”; “welfare officer was not available for supervision and monitoring of food”; “dormitory was stinking badly”; “no proper cleanliness in toilet and bathrooms… filth, urine, stool was lying all around toilets and residents were barefoot using the toilet facility which makes all dormitory unhygienic”; “entrance of two dormitories was full of filth as the drain was overflowing due to logging of sewage”.
On July 15, Dr Bharti constituted a dedicated medical team to visit and inspect the premises and submit a report with recommendations or other steps required to improve the situation.

Here’s what the report submitted on July 18 recorded: a defunct RO system, tap water provided for consumption, “superintendents/ administrator failing to resolve such adverse conditions like basic need of adequate potable drinking water”, “every second or third resident facing malnutrition condition, skin infection, lice, many have bedsores”, “no proper ventilation, low-quality desert coolers”.

On July 18, Dr Bharti again flagged an outbreak of acute gastroenteritis with four cases reported among residents and an inspection revealed that “residents in many areas were drinking tanked water.”

Within four days, Dr Bharti then raised an alarm and sought reinforcements while writing to the Social Welfare Department that the acute gastroenteritis outbreak since July 16 had resulted in eight fatalities at Asha Kiran.

In another communication to the Social Welfare Department’s director on July 22, she said — as per the documents — that superintendents were made aware of the situation from time to time, but the recommendations “were not complied with or half-heartedly implemented.”