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Sixteen infants reportedly died at the Malda district hospital in northern West Bengal between May 22 and 26. The deaths prompted National Human Rights Commission (NHRC) to take suo moto action by issuing notices to the chief secretary and the district magistrate, asking them to explain the deaths within a month.
This is not the first time that the Malda district hospital is in news. Between January 9 and 15 this year, 36 infants died at the hospital. Last year over 200 infants died at the hospital; in 2011 the figure stood at 109.
The infants have died due to septicaemia, respiratory distress and asphyxia, informed Uchchal Bhadra, principal of the medical college and hospital. “But the underlying cause is undernourishment. The district hospital receives over 30 children on an average every day and families often travel over 50 km, putting the already sick infant under stress. Can you imagine an infant travelling long distances after being sick, malnourished or dehydrated?” asks Bhadra.
Preventive healthcare and nutrition needed
Patients come to the medical college from neighbouring Jharkhand, across the border from Bangladesh and other north Bengal districts like Dinajpur. “We receive over 1,100 patients daily in the out patient department. At times two patients share a single bed. Increasing the number of beds will not solve the problem as we need preventive healthcare and better nutritional status,” adds Bhadra.
Back in November 2011, the state government set up a high-level task force with a mandate to monitor state run hospitals, set up special newborn care units (SNCUs), improve labour room protocols and suggest remedial measures to revamp the child care system.
Chairperson of the task force, Tridib Banerjee, says the spurt in infant deaths is “insignificant” and due to a cluster effect of a number of deaths within in a small span of time. “We have set up SNCUs and two neo-natal wards at the hospital. 35 SNCUs with state of the art facility is functioning across the state,” he informs.
Last year, the repeated infant deaths prompted Chief Minister Mamata Banerjee who handles the health portfolio to point that 40,000 infants die every year in West Bengal. She had vowed to cut the numbers by 25 per cent. Saying that the deaths were due to malnourishment, she infamously observed that many of the mothers conceived during the previous Left Front regime.
How to check crowding in big hospitals
According to Anuradha Talwar, advisor to the Supreme Court Commissioners on right to food, “families prefer to visit the district hospital or are referred there as the primary health care infrastructure is in a shambles. There is no reason why primary healthcare centres (PHCs) cannot handle a normal delivery or a case of diarrhoea.” The Integrated Child Development Services (ICDS) regularly fudges data to show lower numbers of severely malnourished children, she says.
Statistics reveal as much. As against the requirement of 2,148 PHCs in the state, only 909 were in place according to National Rural Health Mission figures till March 2011. As many as 736 of these 909 PHCs were served by a single doctor. Each PHC catered to a whopping 64,442 people in rural Bengal (the all India average is 34,876 persons per PHC).
Dilip Ghosh, former National Rural Health Mission (NRHM) commissioner of the state, says that motherhood has a long preparatory time and needs regular monitoring. “With proper ante-natal care, chances of a newborns' survival will increase,” he says.
Ghosh adds that the state government needs to handle delivery cases at the PHCs or set up more first referral units (FRUs). “With better road connectivity, people are crowding bigger hospitals. Together with the push factor from PHCs, maternity wards in district hospitals are overcrowded. This impacts the mother—if a hospital with a capacity to conduct 20 deliveries is handling double the numbers, the ways to induce labour may cause damage to the child,” he adds.