PADMA RAWAL is at the centre of a tense circle of people inside the sprawling compound of the J K Lon government hospital in Rajasthan’s Kota district. In her early 20s and accompanied by her husband Sanjay, Rawal speaks animatedly, caught between anger and despair.
“I got a child after so many prayers, I have lost him now,” said Rawal, whose five-month-old son died on December 23, a day after he was admitted to the hospital for severe pneumonia.
“The hospital staff would tell us to check whether the oxygen pipes were running. How are we supposed to know that? Isn’t that the duty of the nursing staff? Also, there’s no cleanliness here,” said Sanjay, who works at the local seed market.
The Rawals are among the parents of 100 children who have died at the hospital in December — 10 of them within 48 hours between December 23 and 24.
The government’s defence is that this isn’t an unusual spike. That the 963 child deaths in 2019 at J K Lon government hospital is lesser than in the preceding years — 1198 (2014), 1260 (2015), 1193 (2016), 1027 (2017) and 1005 (2018), an average of close to 100 deaths a month.
Numbers don’t tell the story
State’s defence is that the toll has dipped in 2019. But infrastructure at the neonatal ICU, parents’ experiences and its sudden revamp after the controversy broke tell a story of neglect.
For the traumatised parents, though, that’s cold comfort.
No wonder that the deaths have set off a political firestorm with the BJP slamming the Congress government that came to power in Rajasthan last year and Union Health Minister Dr Harsh Vardhan writing to Chief Minister Ashok Gehlot to flag the issue. Gehlot, in response, invited Vardhan to visit the hospital and “get himself apprised of the facts”.
Last week, Vaibhav Galriya, Secretary, Medical Education Department, visited the hospital and ruled out medical negligence as a reason. But he did acknowledge several other problems, including improper maintenance of equipment and shortage of oxygen lines.
When The Indian Express visited the hospital Thursday, families of patients pointed to the dismal facilities, and complained that their calls for help are not being heard.
Indeed, outside the Neonatal Intensive Care Unit (NICU), an open dustbin contained remains of food and used surgical masks while oxygen cylinders lay scattered around. A long line of people, mostly parents and relatives of patients, waited for assistance.
“The cleanliness is very poor and nobody pays heed to the requests or queries of patients’ families. My nephew was born in this hospital around a fortnight ago. After nearly a week, he and his mother were discharged. But within two-three days of going home, he developed breathing problems and has been admitted once again,” said 32-year-old Wasim Khan, a resident of Kota.
According to the hospital’s Department of Paediatrics, since January 2019, at least 60 children have died every month. In some months, the number has been close to 100 — August (87), September (90), October (91), November (101) and December (100).
“Timely maintenance is of immense importance as it keeps the body temperature of a child within the required parameters. I have been called here since yesterday to repair these machines. It appears that no maintenance of these machines was done since a long time,” said Mahesh Kumar Sahu, who was repairing a baby warmer machine along a narrow corridor clogged with patients.
At another ward, fresh painting was being done, with workers confirming that the work started only after the deaths made the national headlines.
At the emergency ward, two mothers shared one bed along with their infant children. After his visit to the hospital last week, Galriya said that shortage of oxygen lines had led to patients being provided cylinders inside the NICU, which is “risky from the infection perspective”.
“There are so many problems with the hospital. Everyone is allowed inside the NICU. I have seen flies swarming inside and we have had to brush them off. The doctors don’t come regularly,” said Deepak Kushwaha, whose one-and-a-half-month-old daughter died on December 24, a day after she was referred from another hospital.
In its initial report on the deaths, dated December 27, the paediatrics department wrote that most of the equipment was functional and none of the patients died due to lack of resources. The report said that many of the children were admitted in critical condition after being referred from other hospitals.
The J K Lon Hospital is the biggest such facility for children in the Kota division with hundreds of patients coming every day from adjacent districts such as Baran, Bundi and Jhalawar — even from neighbouring Madhya Pradesh.
While the BJP has accused the Congress government of failing to handle the situation, the state government has hit back. State Health Minister Raghu Sharma alleged that the during its tenure, the previous BJP regime in the state didn’t do enough for the hospital. “If you see the percentage for child rates in the previous years, we have brought it down,” said Sharma.
In his letter to Gehlot, Harsh Vardhan said: “The available information from Special Newborn Care Units online software established under the National Health Mission, and the relief from the state has been reviewed and it showed higher mortality rate of 20.2% in J K Lon Hospital, Kota during 2019 in comparison to the preceding two years (year 2018 = 14.3%; year 2017 = 4.3%). Besides that, it has also been noted that in J K Lon Hospital, 70% of the radiant warmers are not functional and bed nurse ratio is 13:1 against the standard of 4:1.”
In response, Gehlot tweeted urged him to visit. “Harsh Vardhan ji is himself a doctor and if he visits the hospital in #Kota, it will also clarify the situation for people, who are giving reaction mischievously, knowingly, unknowingly and also innocently,” he said.