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Monday, June 21, 2021

Boost paediatric infra for 3rd wave: NCPCR to govt

Over the past week, NCPCR has written to the Union Ministry of Health and Welfare (MoHFW) as well as the Indian Council Medical Research (ICMR) asking them to start preparing keeping in mind the projections.

Written by Esha Roy | New Delhi |
Updated: May 21, 2021 7:07:29 am
A child being tested for coronavirus at a Noida government hospital on Thursday. (Express photo by Gajendra Yadav)

Taking note of projections of a third wave of Covid-19 infections in the country which is projected to impact children adversely, the National Commission for Protection of Child Rights (NCPCR) has sounded the alarm for the government to put in place the necessary medical infrastructure and equipment, so that the cases and fatalities may be limited.

Over the past week, NCPCR has written to the Union Ministry of Health and Welfare (MoHFW) as well as the Indian Council Medical Research (ICMR) asking them to start preparing keeping in mind the projections.

On Thursday, the commission also sent directions to all states to supply information on facilities available in their districts to treat children for Covid-19.

Officials said the commission aims at getting paediatric infrastructure in place by July, so as to minimise the damage that may be caused by the third wave.

On May 15, the NCPCR wrote to Union Health Secretary Rajesh Bhushan pointing out an urgent need for changes in the country’s medical infrastructure. “The ongoing Covid-19 pandemic is impacting several children and adolescents as India grapples with escalating virus cases in the second wave of this pandemic situation. Doctors have confirmed that even newborns and infants are testing Covid-19 positive, though their condition remains under control and rarely turns fatal. Further, a third wave of Covid-19 is projected to hit the country and according to experts, it may affect children in large numbers. There are guidelines on the management of the new born in a maternity ward and in the Neonatal Intensive Care Unit (NICU), but there is an urgent need to reorganize a Neonatal/children Emergency Transport Service (NETS) to prepare specifically for neonatal [cases] and children for third wave of Covid-19,” said the letter to Bhushan, adding that “necessary directions for emergency transport services/ambulances suitable for children and neonatal” be issued by the Centre.

Sources in NCPCR say there are particular specifications for ambulances for children, to be equipped with ventilators and incubators, but there are hardly any manufacturers of such ambulances in the country. “But if specifications are to be issued right now and the MSME sector, or other sectors, could be brought in and start manufacturing as soon as possible, then we will be able to avoid untoward incidents involving children when the third wave hits,” said an official.

NCPCR chairperson Priyank Kanoongo said that from the commission’s own past experience, they have felt a need to verify medical equipment and machinery in neonatal and paediatric hospitals and wards in the country.

“In 2019, the Commission investigated the deaths of 100 children in Kota’s JK Lon Mother and Child Hospital in December in Rajasthan. What we found was that a lot of the equipment and machinery at the hospital were not functioning. Very often, across states, this is the case. Annual maintenance contracts are not renewed by hospitals, and equipment lies in disrepair. Very often, these hospitals also do not have enough trained paramedical staff that can operate the machinery. These things, if rectified, can save the lives of a large number of children,” said Kanoongo.

In its letter to states on Thursday, NCPCR directed them to furnish details of the total number of Sick new-born Care Units, paediatric intensive care units and neonatal intensive care units in each district, the number of beds and incubators in each of these units, the total number of functional beds and incubators, number of dedicated beds for high dependency care, number of resident paediatricians, on call paediatricians, nurses, paramedical staff and support staff.

The NCPCR has further asked states to furnish details of medical equipment including Radiant warmers, basinets, Phototherapy, Irradiance meter, Self-inflating reservoir bag, Laryngoscope, oxygen cylinders and concentrators, pulse oximeters, ECG units, transport incubators, Bilirubinometer, Nebulizer (Electric) etc. The states are to submit this information to the Commission within a week.

A third letter has been sent to ICMR director general Balram Bhargava asking him to share protocols and guidelines developed by ICMR for treatment and clinical management of children with Covid-19.

“This is so that we can begin an awareness campaign as soon as possible. If there are additional guidelines specific to the treatment of children suffering from Covid that the ICMR has drawn up, or will draw up, we want to be able to disseminate this as well – not just to medical practitioners but also to parents, so that they have information, such as when to take a child to the hospital and what kind of treatment needs to be done at home. Our aim is to monitor all infrastructure and make sure that we are ready for the third wave by July this year, so that children can be saved,” says Kanoongo.

ICMR protocols are to be further shared by NCPCR with the State Commissions for Protection of Child Rights (SCPCRs) for dissemination.

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