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Bilaspur sterilisation tragedy: Hospital trust had no clue about camp

The laparoscopic tubectomies took place without the knowledge of the trust that ran the facility.

Written by Ashutosh Bhardwaj , Abantika Ghosh | Bilaspur/new Delhi | Updated: November 13, 2014 7:36:45 am
protest Villagers protesting outside the state health minister’s residence against underwent sterilization surgeries, in Bilaspur, Chhattisgarh on Tuesday. (Source: PTI)

Four days after the Chhattisgarh government’s Health Department held a sterilisation camp in Bilaspur that led to the death of 13 women, two more chilling clues have emerged that could further unravel the story behind the tragedy.

The laparoscopic tubectomies, conducted inside the crumbling premises of a private charitable hospital that was shut down in April, took place without the knowledge of the trust that ran the facility.

Preliminary reports obtained by the Union Health Ministry suggest that the deaths were caused by the use of non-sterilised surgical equipment. Several doctors of the State Health Department, including some of those who were suspended for their role in the camp, told The Indian Express that the government used to conduct camps at Nemichand Jain Charitable Hospital, when it was operational, with the permission of the management. They admitted that these camps continued to be held there even after the facility was shut down six months ago.

“We have no information that they conducted surgeries in the hospital. We locked the hospital down in April,” the trust told The Indian Express in a statement. “We do not know how they (health officials) entered inside and did it.”

The trust added that the hospital was “never fully functional” and was closed because of a lack of enough patients and qualified medical personnel. Sources said that the chief trustee Nemichand Jain was unwell and is recovering in a Delhi hospital.

Bilaspur Collector Siddharth Komal Pardesi did not respond to phone calls and messages from this newspaper seeking comment on the issue.

Records confirm that this was not the first time that such camps were held here since the hospital shut down. In fact, Dr R K Gupta, who headed the camp four days ago, had conducted similar sterilisation camps in the premises at least twice in the recent months – in July and September.

The abandoned hospital is now surrounded by thick bushes, and the facility itself presents a grim picture with cracking floors and rusted furniture strewn around inside the rooms.

Not surprisingly, preliminary reports available with the Union Health Ministry show that the women who died had gone into “hypovolemic shock” (haemorrhagic shock) caused by excessive blood loss, which suggests they might have suffered from an infection. A credible picture will emerge only after the blood culture reports are obtained.

On Saturday, Dr Gupta conducted laparoscopic tubectomies on 83 woman, 50 of whom are still in various hospitals in the city. According to the central government’s guidelines, a medical team cannot conduct more than 30 such tubectomies in a day, with three separate laparoscopes ? that means not more than 10 tubectomies with a single instrument, as each instrument needs to be properly sterilised after every operation.

A team of doctors from Delhi’s AIIMS is now in Bilaspur to conduct a probe into the reasons behind the deaths, and the state government has suspended a number of officials involved in organising the camp, including Chief Medical and Health Officer (Bilaspur) R K Bhange;, State Programme Convener (family planning) Dr K C U Rao; Block Medical Officer (Takhatpur) Dr Pramod Tiwari; and surgeon Dr R K Gupta.

“Preliminary reports received from the state government suggest that the unfortunate incident happened because they did not sterilise the surgical instruments properly. We have to wait for the results of some more tests to say with certainty but one thing is certain – this is a huge setback for our sterilisation programme,” said a source in the Union Health Ministry.

Sources in the State Health Department said that the symptoms could also signal a reaction to the drugs used but added that all the drugs in the camp were procured in August 2014 with an expiry date of a year later.

“Our initial suspicions are of septic shock, likely caused by faulty sterilisation of equipment. We are exploring all possible angles and all the drugs are being checked. None of them had expired, nor were there any new drugs introduced that could cause a sudden reaction in so many women,” said a senior official in the State Health Department.

Meanwhile, Chhattisgarh’s Director (Health Services) Dr Kamalpreet Singh, who was transferred Tuesday by Chief Minister Raman Singh, has now been given the additional charge of Director, Food and Civil Supplies, and Joint Director, General Administration Department. Asked if the “punishment transfer” was actually a promotion for the senior official in charge of health services in the state, Health Minister Amar Agarwal said, “He had already served his tenure of over three years (so he had to be transferred). This incident was a coincidence, (but) it was also one of the reasons.”

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