— Partha Ghosh
Shuvam Dutta, aged only 2 years, had a serious chest infection and was admitted to a government hospital in Kolkata. The attending doctor advised an immediate chest X-ray as he suspected a huge collection of pus in Shuvam’s chest. But it could not be done because it was a Sunday and the X-ray department of the hospital was closed. Shuvam gasped and died. He was not the only one to die like this. Altogether 14 children, either neonates or 2-5 years old, died in quick succession in 36 hours in the ill-fated Dr. B C Roy Memorial Children’s Hospital (BCRMCH) either due to faulty and inadequate supply of oxygen or due to under-treatment. This is the only referral children’s hospital of the state. Media-persons rushed to the hospital and interviewed the members of the bereaved families. When they asked the state health minister Suryakanta Mishra, himself a doctor, as to what went wrong, the minister’s cool response was that there was ‘nothing unnatural’ about it.
It was only after the print and electronic media and the opposition parties condemned this highly insensitive and arrogant attitude of the health minister despite so many tragic deaths, the stupor of the state administration broke. It took 72 hours for the ‘super sensitive’ chief minister Mr. Buddhadev Bhattacharya to travel the 6 km distance from Writers’ Buildings to BCRMCH and pay a courtesy visit. Poor Suvam, Raj, Isha and others who died in this hospital were too young to understand the inner meaning of high-sounding words like “transparency”, “sincerity”, “competence”, “swiftness” and “responsibility”, catchwords of the election manifesto of the “improved” Left Front and the guiding mantras enshrined in the ‘Left Front and Our Tasks’, the special document adopted in the 20th West Bengal state conference of the CPI (M). One may recall the former chief minister Mr. Jyoti Basu’s irresponsible remark dismissing the rape and lynching of one Ms. Anita Dewan, a government employee, at Bantala a few years back: “such things happen so often”. One fails to understand the difference between of the “improved” and unimproved varieties of the Left Front.
Being the only referral government hospital for children in the state, BCRMCH gets referred cases from about 22 municipal areas around the Kolkata Municipal Corporation. The out patient attendance here is about 1000 plus per day, going up to 1300-1400 per day for seasonal variation of diseases of children. It has only 200 indoor beds (175 for medicine department and 25 for surgical department), but admits as many as 300-400 patients per day. As 15-20 per cent of the indoor beds are now paying beds, there is always overcrowding in the free beds. Sometimes in one cot 3-4 babies are ‘adjusted’ along with their mothers. So there remains every possibility of cross infection among the children. A child with broncho-pneumonia shares his/her cot with other babies who have viral infection or septicemia. Socialisation of diseases indeed!
The BCRMCH is the only ‘modern’ government hospital for children. But there is no Casualty Block, no ITU, nor ICCU. The Orthopedic, the ENT, the Eye departments have no senior doctors for the last 3 years. Even the 33 posts that are lying vacant after retirement of GDA (class IV) staff have not been filled up for the last 3 years. One would be astonished to see sweepers of the hospital cooking the diet for children. There is not even an incubator, essential for maintaining the baby’s body temperature, although in modern clinics incubators are regarded obsolete and radiant warmer with servo control are used instead. The ventilator and the blood-gas analyzer, indispensable for treating a child with severe respiratory disease, are not available in the BCRMCH or in any other government hospital in Kolkata.
All this explains why the death-curve in this hospital is on the rise. Over the last 8 months 955 babies have died, the average being 4 deaths per day. On 31st August and 1st September the death rates were above normal even for this hospital. To our health minister, however, there is ‘nothing unnatural’ about it. His comment was that in our climatic conditions incubators are not needed at all, for a mother’s lap is a better substitute. A unique defense for lack of infrastructure indeed! One wonders, is it a people’s communist representative, and a doctor at that, or a seasoned bureaucrat who has lost all human values?
The BCRMCH is not the only hospital where such high rates of death take place. The only functional nursery in the Eden Hospital of Calcutta Medical Collage has no baby warmer, no ventilator, no blood-gas analyzer; and the 3 incubators are out of order for the last 8 months. The old nursery has 70 indoor beds to accommodate 90-100 babies with their mothers. Here also the death curve shows that 52 babies died in the month of August and 16 died in last 6 days of first week of September. One can imagine the death rates of children in the rural hospitals in distant districts like Malda or Bankura.
After the tragic deaths of 14 children on 31st August and 1st September in the BCRMCH, the state government reluctantly ordered a departmental enquiry (not judicial enquiry as demanded by us and many others) to be headed by the health director Mr. Pravakar Chatterjee (i.e. head of the accused department). As happened many times in the past, some scapegoats will be found and the real causes will be wrapped under the carpet. One may recall the observations and recommendations of the West Bengal Assembly’s Standing Committee on health and family welfare headed by the former CPI (M) MLA Dr. Gouripada Dutta in 2000-01, which have been thrown to the winds:
a) Healthcare system in the state is far from efficient and co-ordination between different groups of health personnel is poor.
b) The Rs. 701 crore World Bank assistance for secondary healthcare development of 214 hospitals across the state was welcomed by the committee, “until it was noticed that this assistance is a loan with 13% interest”. The government could not complete the project as per schedule in 2000 and sought a 2-year extension.
c) To provide better healthcare to the people in the state, the health budget, which is 5.06% of the state budget, should be increased.
d) The problem of drainage system in the hospitals is acute and disposal of hospital waste is defective.
e) Larger budgetary provisions are recommended for mofussil medical colleges and hospitals for specialised treatment of serious diseases.
f) The list of drugs prescribed by the health department should be displayed at appropriate places.
Between 1988 and 2001, 19 such reports have been tabled in the Assembly and the government has accepted these observations and recommendations in principle. But instead of any improvement the situation is worsening day by day.
The state government has so far paid Rs. 90-95 crores as interest on the World Bank loan. And to make it up the government hike the hospital fees recently. The ‘free bed’ patients have to pay for all types of investigations (and the charges for these investigations are more or less equal to those in private clinics) and also for their diets. Rather than increasing budgetary allocations for healthcare, the government is privatising the whole system. While in 1990-91 the spending on health and family welfare was 1.46% of the state domestic product, it came down to 1.14% in 1998-99. The per capita expenditure for health in West Bengal is Rs. 740 per annum only, while in 15 other states it is Rs. 870.
In a welfare state, health, primary education, supply of drinking water is regarded as a state responsibility. Even in Britain the government takes primary responsibility for basic health needs of the people. But here instead of taking health services as a necessity for the people especially for the poor and the middle classes, it has now become a demand, subject to the laws of the market, as per World Bank and IMF prescriptions. Left Front government in West Bengal is following the same path, which has resulted in the tragic episodes in the BCRMCH and other hospitals. These are “natural” only in the sense that the poor will get no free modern facilities, and, therefore, such tragic events will recur every now and then.