Nanded deaths only tip of the iceberg: Experts warn of crisis in health system

Between September 30 and October 1 — in a 24-hour period — 24 deaths were reported at the GMC hospital, Nanded. Of these 11 were newborns. Dr Shukla, who is also the national co-convenor of Jan Swasthya Abhiyaan along with other activists from Jan Arogya Abhiyaan (Maharashtra), has called for a special session of the state legislative assembly on the looming health crisis.

Towards that end the JAA will commence a state level Arogya Hakk Parishad (Health Rights Conference) on October 27 at Nanded. “The excess deaths in Nanded are symptoms of a larger, state-wide public health crisis in Maharashtra. Urgent actions are now required, including conducting a participatory public audit of the incident in GMC Nanded, convening a special session of the Maharashtra Assembly on public health, doubling the state’s health budget, establishing a state level health humanpower policy, immediately adopting a state level transparent and effective medicine procurement system, majorly improving staffing and expanding infrastructure at GMC Nanded, strengthening specialist and basic healthcare services in the public health system in rural and urban areas of the district,” Dr Shukla and activists with JAA said at a press conference held on Friday.

“These tragic deaths must serve as a wake-up call for the politicians as well as people of Maharashtra, prompting total overhaul of health policy and increased political commitment to public health,” Dr Shukla said while presenting the findings of their fact finding team. “There are five key causes as to why the deaths occurred at Nanded. First there is a very high influx of patients in GMC Nanded due to a lack of specialized care at lower levels, inadequate referral systems, and insufficient neonatal and pediatric care facilities,” Dr Shukla explained.

According to Shailaja Aralkar who was part of the team that visited Nanded, GMC Hospital Nanded treatment capacities and staffing are also overwhelmed, due to shortages in essential resources, including nurses, doctors, and medications, and suboptimal infrastructure in both the neonatal and pediatric intensive care units (NICU and PICU).

“The hospital’s overwhelming focus on patient care leaves limited space for quality medical education, as residents are overburdened with clinical responsibilities, affecting their training. Involvement of some faculty in private practice further strains the hospital’s capacity.”

Dr Kishore Khilare from JAA also added that health insurance schemes Ayushman Bharat – PMJAY and MJPJAY, promoted as game-changers in providing hospitalization care, have been totally ineffective in addressing critical healthcare gaps.”

Vinod Shende who was also part of the team said that certain short-term factors also worsened the existing capacity-patient load mismatch at GMC Nanded in late September 2023. These factors include a rise in patients and average daily deaths in August and September 2023 due to seasonal illnesses, the declaration of free public healthcare services leading to recent increase in utilisation, and a long holiday weekend from September 29 to October 2, which led to lower functionality of private and peripheral public hospitals, further increasing the flow of patients to GMC.
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