One year on, no lessons learnt

The Delhi government, in a characteristically knee-jerk reaction following the public outrage at the failure of trauma care services to respond to the situation, had announced the setting up of a dedicated 50 bed trauma centre near Indra Prastha College “within a few months”. This was to have been followed up by half a dozen other trauma wards in existing hospitals.

Despite the fact that the government was donated a ready-built structure for the dedicated trauma centre, this is yet to become operational. The others still remain proposals.

“The 12 months since have been lost in sprucing up the building and providing it with a centralised airconditioning system,” says Dr N.P. Singh of the Blue Cross, who specialises in training for trauma care. The fate of the one that was originally supposed to come up on a sprawling 14 acres near the All India Institute of Medical Sciences (AIIMS) about 18 years ago is even worse.

The ultra-modern trauma centre was to set standards in trauma and emergency health care. Eighteen years later, it is still in the blueprint stage.

K.T.S. Tulsi, former additional solicitor general who has taken up the cases of Uphaar victims, says wryly: “There should be a thorough inquiry into the reasons that led to such an inordinate delay in setting up the trauma centre and those responsible should be made to pay for the life and limbs lost due to it in all these years.”

Since 1966, there have been at least 13 commissions who inquired into the state of emergency health care in the city and have clearly highlighted the urgency of setting up such a trauma centre. But the reports of all these commissions seem to have been consigned to the dust bin.

As for the facilities for treating burns victims, the less said the better. The status can be ascertained from the very fact that the Capital’s most `prestigious’ centre at Safdarjung Hospital for treating burns patients is currently the subject of a Public Interest Litigation (PIL) in Delhi High Court over the “pitiable” state of health care services.

Dilapidated wards, unkempt toilets, soiled sheets, lack of basic medical equipment have all, in fact, left the Union Health Minister feeling “sick” during his surprise visit to the hospital recently. According to Padamshri Dr J.L. Gupta, who is credited with setting up the facilities for burns patients in Delhi were established way back during 1960’s at Safdarjung Hospital.

Two more centres at the Lok Nayak and Ram Manohar Lohia Hospitals followed closely and by 1980, the Safdarjung centre had established itself as the largest and the best facility for treating burns patients in Asia. Now, it is one of the worst.

“The crux of the problem is not the absence of facilities, but their super saturation. The facilities that we created then were adequate for the population they were targeted to serve. While the population has gone up from around 40 lakh to one crore during these two decades, the number of centres for burns patients have remained the same,” Gupta states adding, “as a result, the whole system has collapsed under the overload of patients.”

Setting up of the satellite facilities in peripheral areas to reduce the patient burden, considering that a majority of them come from the satellite towns and other faraway areas, is also among the ideas that were strongly recommended but never implemented.

“Burns, unlike bypass surgery, are a problem usually affecting poor people and doctors consider treating these patients dirty work. These days, they want to take up more respectable and better paying areas like plastic or cosmetic surgery. Naturally, trained manpower for setting up such centres is missing,” says Dr Gupta.

Following the Uphaar tragedy, several people could have been saved if there had been a well coordinated rescue action, backed by full-fledged infrastructure for handling the trauma at a disaster scale. But those at the helm have done precious little to set right the shameful record of June-1997.