The sudden public indignation and media coverage dealing with horrific deaths in the G B Pant Pediatric Hospital was prompted by simultaneous editorials in the Greater Kashmir and the Rising Kashmir in mid May 2012, and yet the author became aware of the issue during his trip to the valley in February 2012. He discussed the alarming rate of infant deaths at the hospital 5 weeks before the publication of the two editorials at a University seminar which evoked no response from Kashmiris in the audience.
A collage of reports is presented below beginning with authors report, followed by other reports, including those by Iftikhar Ashraf, Nazir Ganaie, Manzoor-ul-Hassan, Junaid Mattu, Mohammad Ashraf, Javaid Malik and a closing news item that reinforces the functionality of the State.
STATEMENT BY DR. VIJAY SAZAWAL
I could not hold back my sadness when I read the following two editorials in the Rising Kashmir and the Greater Kashmir that appeared on the web today - I cannot fathom the feelings in mothers who were robbed of their delight and joy.
But my sadness has another perplexing dimension. You may recall that I gave precisely the same news as the following editorials during my talk at the UNT over a month back (http://kashmirforum.org/news.htm). You can check the youtube recording of my 6th April lecture if you want to see me talk about the G B Pant Hospital (http://www.youtube.com/watch?v=_dSw4cbYWdU). What I said during my lecture was that horrific as this tragedy is, it is mostly ignored by Kashmir's civil society and represents another measure of dysfunctionality of the state. So finally today, in a surprising manner, both the two leading newspapers in Srinagar have published editorials on the subject.
But why now? I do not know - but if I have to guess it is become, possibly, a "big wig" lost a child and hence it has became a story. The tragedy of Kashmir is that on one side you have local elites hogging a good life, on the other side you have local intellectuals and mostly outside scholars promoting their political and social agendas while indifferent to ground realities, and somewhere ignored in between the two are ordinary people of Kashmir bearing the brunt of a woeful life in the valley of sorrows.
Regards,
Vijay Sazawal
http://www.risingkashmir.com/news/hospital-or-morgue-26837.aspx
Hospital or Morgue? (Editorial in Rising Kashmir)
Sunday: What GB Pant admin is doing to counter this alarming situation is intriguing Kashmir is perhaps the only place where death is so frequent. In the last week alone seven deaths were reported from G B Panth, Valley’s lone pediatric hospital. It may be a figure for government or statisticians but it is an irreparable loss of the families.
According to hospital sources 22 deaths were recorded between June-December 2010. 2011 was no different; the year also reported high infant mortality. This year it looks the figures will exceed all the limits. The prime reason for these deaths is medical negligence; however there are other important factors which have contributed for this appalling situation. The hospital completely lacks infrastructure, emergency medical care and equipments.
Though projected as the tertiary health centre for children the hospital lacks a full-fledged centrally connected oxygen plant. Besides the corruption and embezzlement of hospital funds have put brakes on the development of the hospital. The hospital is also short of important medicines and vaccines and diagnostic facilities. What the hospital administration is doing to counter this alarming situation is intriguing. The protests and demonstrations have become a norm rather than an exception in the hospital, what is surprising is the lackadaisical attitude of the government that has failed to overcome the infrastructural requirements and in bringing the culprit to the book.
The state government is under the constitutional obligation to provide quality healthcare to its citizens. How can government turn a blind eye to the grievances of the people? What has aggravated the problem further is lack of accountability and internal bickering that has brought the hospital on the verge of disaster. Early in the year, 65 officials from the hospital where found absent from their work. This shows how our hospitals and health centres work. However it is never too late to mend. The time has come to set GB Pant hospital on the right track; the state government has a job in hand if it has to made the hospital, a tertiary health centre, it has to work at the infrastructure, provide it with latest and advance medical equipments and importantly it has to act on the complaints filed by the attendants. It is time to fix the responsibilities and weed out the menace of corruption.
Though the state government started this hospital in collaboration with army, it is time to revisit the terms and conditions. If the state government can spend crores on dog rehabilitation, why can’t it work in improving pediatric healthcare in the valley?
http://www.greaterkashmir.com/news/2012/May/14/g-b-pant-deaths-64.asp
G B Pant Deaths (Editorial in Greater Kashmir)
For the past some days, Valley’s only children healthcare institution, G B Pant Hospital is in news. But not for good reasons. There are reports of several children dying from lack of the timely attention by the doctors. Notably, drawing attention to this messy state of affairs at the hospital is a Bangalore based businessman Sahil Bhat who claims that twenty children died of neglect in ward No 4 in 24 hours.
The report carried by this paper on Friday quotes an attendant witnessing the death of six children on the night of Monday last. And on Saturday evening, one more child was reported dead. Statistics are shocking. Surprisingly, the hospital administration has done little to explain the rise in deaths. It almost appears that the hospital regards these deaths as normal. True, being the only children hospital in the Valley, G B Pant has to cater to a huge rush of ailing children, many of them newborn. In fact, there is little space and the infrastructure to accommodate the unbroken throng of children, their parents and other relatives. On any given day, the wards are crowded, with sometimes three to four babies occupying one bed.
While the hospital has only a sanctioned strength of 170 beds, the occupancy on any given day is upwards of 350. Attendants who don’t have a proper space to sit also crowd the beds and wards. Shortage of doctors and paramedic staff only worsens the problem. This creates a suffocating environment of noise, disease and desperation. Ironically, there is hardly an effort to highlight the hospital’s grave problems. In fact, the government has been the most indifferent. Since its creation through late seventies, the government has hardly done anything to strengthen the hospital and expand its infrastructure. The best way out would be the construction of a new children hospital to keep up with the increase in population and the growing demand for the children’s healthcare. But as things stand, such a prospect appears remote. And with no commensurate alternative available in private sector, all we are left with is G B Pant.
Kashmir’s Healthcare Mess
Iftikhar Ashraf (Kashmir Times)
During my college days (outside valley) I used to boast of Kashmir having the world class doctors. Whenever there was an argument with respect to valley not being able to sustain itself on its own, the quality of Kashmir's doctors, leading to medical tourism, was always one of my key points for rebuttal. I would use the case of Cuba to prove my point, of how Cuba even being under U.S sponsored embargo for almost 52 years (now), became the world leader in healthcare, biotechnology, Cancer treatment, Drug research & development etc.
The first step towards the continuation of the tradition of producing world class doctors is the selection process. But of late some people have been able to bypass or fox the selection process through money, reach or appropriate connections. The people from this lot magically get transformed into a serial number on the qualified candidates list. All among us personally know at least one of these “Munna Bhai's” , somehow we all expect the medical education system either to weed them out or make them well trained and educated for the profession they choose.
What we can currently see of our healthcare has proved both these assumptions wrong, almost every serial number on the qualifying list sooner or later gets a degree and regarding making them better qualified for the profession I have my reservations. Regarding the current status of Kashmir's healthcare, there seems to be no better word to describe it then "Chaos". Kashmir sans a proper referral system, which leads to overcrowding of the major hospitals or by the time the patient reaches a specialist precious time has been wasted.
A patient even with minor ailments wants to visit the major hospital in Srinagar as no or few specialists are available at Sub District Hospitals (SDH). Due to lack of grass-root infrastructure couple of hospitals are being forced to coup up with the requirements of the whole state. It is humanly impossible to try to deliver healthcare services through only couple of hospitals. Even these highly vital hospitals are not well equipped to help our doctors serve better. SHMS hospital's CATH lab is ill equipped so all the procedure can't be performed despite one of the most renowned specialist being available.
Recently patients died in SKIMS because oxygen supply was stopped due to some technical snag, the G.B Pant Children Hospital has recently transformed a graveyard for the want of ventilators and what can one say about Lal Ded Maternity Hospital, which happens to be Kashmir's only Maternity Hospital! Taking into consideration that every doctor in any major hospital is working extremely hard, at times working for at a stretch for 48 hours or more! We have to commend them for their excellent services. With everyday our doctors challenging the humanly limits, the least they deserve are "better working condition" Government needs to keep politics aside and help doctors and other stakeholders in improving Healthcare practices and facilities. We all know what happened to Dr. Shawl’s dream project of a super specialty cardiology hospital. If government instead of creating hurdles would have only ignored, not even supported or encouraged the initiative Kashmir would have a Cardiology Hospital by now. Who knows it might have even encouraged some other people to take some other initiatives, but now it is what deters them from making any such efforts.
Only encouraging private sector to invest in healthcare won't solve the problem here, it is high time that this sector is regulated properly through laws and regulations, which should be implemented with rigorous zeal. The enactment of Drug policy with proper implementation seems to be a good beginning but we have long way to go. We need to look into our medical education system, try to restore the past glory of Government Medical College, Srinagar, which in near future has too often come too close to de-reorganization from Medical Council of India. Unless we take thing as seriously as they are, a poor man will continue to pay with his blood and the saviors will continue to be enticed to embrace their darker side.
Many a people have been asking for banning of private practice of doctors, well it won't be possible till there is a demand for it and there will always be demand. So why not try to better regulate private practice. As long as the doctors sincerely deliver their duties in their respective hospitals or places of posting, no one should have a problem with what they do after their duty hours. What needs to looked into is the undue advantage that some doctors take of their position and reputation. Some well established and reputed doctors in Srinagar (and other towns) in their quest for a complete monopoly, have trained their wards in complementary services like radiology or pathology and they don't accept reports from any labs other than the ones they recommend. So among the family members a patient is sucked till the last drop of blood. May I ask what gives the doctors the right to declare all labs, other than their wards (or recommended) to be pieces of junk. Can government dare to take some action against such doctors and also raise the standard to labs in government hospitals?
With healthcare becoming costlier with each passing day, every single J&K resident needs to be given access to a Health insurance. Government had started this initiative for its employees but suddenly it has lost all steam, May we ask why? For this dismal state of Healthcare government is more responsible than doctors. The government apathy is such that it many a times it sends rules and regulations flying through the window. In government hospitals we find Ayurvedic (Unani) doctors practicing homeopathic medicine, which happens to be completely against Supreme Court guide lines.
There is also no proper planning while identification of sites for new hospitals or even when implementing these projects. I would like to ask the government, pardon my language, who was the idiot who approved the construction of Unani (Ayurvedic) Hospital at the HMT chowk (square), didn't he know that the road widening will happen. Does environment of one of the busiest squares on a national highway qualify for a site for any Hospital? Regarding how efficient our government machinery is in implementation of projects let's take the example of Sub-district Hospital (SDH) Sopore, the founding stone of this hospital was laid in 1984 and still it has not been completed! Well we can say it confirms another entry for Sopore in Guinness Book of World Records, first one being for it’s yet to be completed by-pass bridge. SDH Sopore is operating through its OPD Block, which itself is not complete!
Coming back to comparison of Cuban Healthcare with that of Kashmir's, there are many similarities (having large number of qualified, hardworking and intelligent doctors and paramedic staff etc) but there is one major difference that hinders our transformation into one of the leaders of healthcare and that is government will.
Deaths At GB Pant Hospital: Govt Or Docs To Blame?
Nazir Ganaie (Kashmir Observer)
Srinagar: Lack of infrastructure, inadequate staff and insanitary wards, compounded by the growing number of referred neonates – three times higher than its current capacity - has added to the woes of the GB Pant Children’s Hospital where nearly 45 babies have died in the past fortnight, experts say.
Doctors at the hospital strongly refute charges of negligence over the deaths, putting the onus on the government which, according to it, acts only when the issue boils over. “This hospital is a big mess and government does not pay any heed to its development. If the government can macadamize and paint roads when it move its durbar here, why can’t it see the dismal condition of hospitals?” an attendant, Syed Mashkoor of Habba Kadal, asks “When doctors don’t have ventilators available, when they are running short of medical supplies and life-saving drugs, or equipment, what can doctors do? What can you expect? This is not doctors’ negligence, but government’s negligence towards patients,” he adds.
According to official records, the hospital admitted 4274 neonates (new-born patients) in 2011. While as in the same year the hospital recorded 475 neonatal deaths including 320 pediatric deaths, which they say was higher than this year. The officials due to the inspections by the higher authorities couldn’t trace the data of the last three years.
“This is certainly not an alarming mortality rate in Kashmir. This happens in developing countries and it is considered normal. In Kashmir when you have such heavy rush in the hospital every day, how can you manage? Even then doctors have been trying their best that patient care doesn’t suffer,” registrar, department of anesthesia at SMHS Hospital, Dr. Masood Rasheed, said. “I don’t understand the move from the government. If they can announce 300 more beds to maternity care LD hospital, why cannot they shift this Pediatric hospital to that place, which would benefit and improve patient care and I am sure the mortality rate will also come down,” he said.
Official records at the GB Pant Hospital (January 1, 2012) show that around 358 children died during the period in the hospital against 1229 admissions. A large number of 105 deaths occurred in March. The number of deaths in January was 68 while in February the figure stood at 66. In March 105; in April 85; in May (up to 12th) 34 deaths occurred. But paradoxically, there are only five ventilators catering to around 1700 patients on average at G B Pant Hospital. “We will be adding more trained and technical staff, and soon tenders would be floated to add some more infrastructures to the hospital. We would be happy if the government provides us more equipment, but unfortunately the G.B Pant Hospital has become a victim of official apathy,” a senior pediatrician at the hospital said, asking not to be named.
The Valley’s staff-starved GB Pant Children’s Hospital has a capacity of admitting 135 patients (135-beded hospital), however records say that the hospital receives 110-120 patients on an average every day including back admissions, leaving the hospital in extremely difficult conditions. “In G.B Pant Hospital, we have a pouring-in from Kupwara, Baramulla, Banihal, Doda, Bhaderwah and Kargil. And in some cases the patients’ condition deteriorates after traveling a long distance- so government should have taken measures that would give relief to the patients as well as improve patient care. I think the onus lies with the government and they need to address the issue,” said another noted pediatrician at the hospital, wishing anonymity.
According to the doctors, over the years, the hospital has witnessed a huge rush from the peripheral district hospitals, which, they say, is a huge challenge for its administration. Authorities said that around 62 doctors have already been posted in the hospital. “The government is already in the process to engage more para-medics and also to upgrade the existing equipment so that patient care is substantially improved,” minister for medical education R S Chib said.
It may be recalled that 45 children have died at the hospital over the past last fortnight, after which the Jammu and Kashmir government on Wednesday ordered an inquiry under the director of the SKIMS, Dr. Shaukat Zargar.
Talking to the Kashmir Observer, Dr. Zargar said that the government needed to work on some alternatives to ease the pressure on the hospital. He said that he had suggested some measures to the hospital administration during a three hour meeting. “There are some flaws in the hospital on issues like ventilation and insanitary conditions. Besides, the security staff can’t be seen discharging their duties properly, which adds to the problem,” he said.
Pertinently, the Valley’s only pediatric hospital runs on an annual budget of Rs 13 crore, of which Rs 9 crore alone is spent on staff salaries. With a mere Rs 4 crore being spent on drugs and equipment, patient-care has invariably become a casualty, courtesy official apathy. Observer News Service
Infants Continue to Die at GB Pant Hospital - 9 More Fatalities In 24 Hrs
Manzoor-ul- Hassan (Greater Kashmir)
Srinagar: At a time when the authorities at GB Pant hospital continue to be in a denial mode on alarming increase in infant fatalities there, the hospital shockingly recorded 9 deaths of newborns in the last 24 hours – reportedly highest ever in the institute. With the latest deaths, the infant fatalities at the hospital during the past 15 days have shot up to 41.
While official records said that 32 infants in the age group of 0-1 year (neonates) had died at the hospital in the last 14 days, death of 9 infants on May 14 and May 15 presents the gory picture of the shoddy healthcare and administrative affairs at the valley’s lone children’s hospital. “Nine babies mostly new born in the age group of 1day and 4 months died in the NICU Unit of the hospital during the past 24 hours mostly due to the flawed management,” sources told Greater Kashmir.
A four month old baby boy, Mohsin son of Muhammad Riyaz (MRD no 2785) of Islamabad died this morning at around 7am after remaining admitted in the hospital for 17 days. Another 40 day old baby, daughter of Hilal Ahmad of Shopian, died this morning at around 11:30 am in the NICU ward of the hospital after she was admitted there on May 3 with MRD no: 4179. Similarly, the babies with MRD number: 3941, 4285, 4295, 4296, 4146, 8311 and 4151 died during past 24 hours in the hospital’s intensive care unit.
“Though the neonatal deaths is a common phenomenon, lack of facilities and the dual control of the GB Pant hospital involving state government and the Cantonment Board adds to the mess there,” sources said. The civil society in the Valley is fuming over the mounting deaths in the hospital. “Our children are on death beds as hospital has turned into a graveyard as possibility of infants coming out alive is remote,” the attendants said. An attendant from Pulwama said the condition of his daughter deteriorated due to the callous approach of administration. “She was admitted in the ward no.5 and was crying with pain but doctors never come to see her,” he said.
When contacted, Medical Superintendent of the Hospital Dr Javaid Choudhary said there had been no deaths in the hospital due to negligence. Asked whether the administration had ordered any inquiry into the increasing infant deaths in the hospital, Dr Choudhary said: “We have not ordered any inquiry.”
Pertinently, the Children hospital was established in year 1976 at Hazuribagh adjacent to LD hospital with 185 bed capacity. In 2005 it was shifted to its present location at Sonwar. Ironically, the bed capacity over a period of 36 years instead of increasing to the requirement got declined to 135. As one of the main referral hospitals for Children including infants the staff strength was never increased to cater the referral flow of patients.
An official wishing anonymity said that while the Pediatric Department of GMC got MCI recognition subjected to sub-specialty and various other improvements and developments in the department, but very less has been attained till date. “Residential staff hostels are not available that is the basic and important need of the hospital. The lack of hostel facility often results in delayed treatment of patients during odd hours,” he said.
What are the Priorities of This Political System?
Junaid Azim Mattoo
The Valley’s only neonatal care hospital, as it turns out, has become a disguised butchery. With around 360 plus deaths in the last 5 months, the G. B. Pant Children’s Hospital in Srinagar has achieved the dubious distinction of a slaughterhouse. Our sick children have apparently been dying for lack of care and facilities while our Government has cut no corners in constructing and refurbishing ministerial and bureaucratic residences with the finest construction materials and interior furnishings known to man.
Various voices, both within and outside the system, have been crying hoarse about the plight of our only Children’s Hospital for the last so many years. A single trip to the G. B. Pant Hospital is enough to indict this and previous governments for criminal negligence and ruthless malfeasance. The last two decades have seen Kashmiris being deprived of basic governance while successive governments have been swimming neck deep in rampant and blatant corruption. The Children’s Hospital mess is just another heart rending example of how a certain section of our society has inflicted grave misery on a people who have, as it is, been at the receiving end of depravity and disempowerment.
Successive State Governments in J&K have spent hundreds of crores of rupees to construct and refurbish palatial Chief Minister Mansions. Be it Azad Sahab, Mufti Sahab or more recently Omar Sahab, our successive Chief Ministers have chosen to build huge, grand palaces for themselves while ordinary Kashmiris have been starved for healthcare, public services and infrastructure. Our Chief Minister turned Emperors live in the verdant lap of luxury. For them, the plight of sick, dying, unattended children at G. B. Pant is a reality that is stranger than fiction. If we compare the costs incurred by the Estates and Protocol department on the upkeep, protocol and residential services extended to our bureaucrats and ministers to the dismal spending on our Hospitals, Schools and Roads, we come face to face with a shocking, haunting revelation – we are all second class slaves in a system, in a polity that works for the interests of a select few.
Governments that deliberately choose not to equip our only Children’s Hospital with adequate ventilators, oxygen cylinders and incubators for so many years are legally liable for criminal negligence. If an accidental fire in a hospital elsewhere in India indicts the management and owners of the hospital for gross and criminal negligence, why can't 350 plus deaths in 5 months be enough for the judiciary to indict this administration for a bumbling failure to protect and save the lives of our young children?
Mufti Sahab gave Kashmir a renovated estate on Gupkar Road – renovated at a great cost to the tax-payers. Azad Sahab gave Kashmir a beautiful, breathtaking Tulip Garden. Omar Sahab gave this city another luxurious, royal residence constructed at a cost to the exchequer. Why did our three successive Chief Ministers so conveniently forget to give us ONE single Children’s Hospital where parents take their children for a hope of life, not an apprehension of death and negligence? Why have our politicians chosen to impersonate medieval emperors and dictators by prioritizing walls of china and castles over the succor and survival of our children?
The lack of ventilators at our hospitals is an immaculate metaphor for where our State lies today. Our nation is struggling and gasping for air on dilapidated ventilators as our policy makers are either too incompetent or too corrupt to take notice of our day-to-day struggle for a dignified survival. Our nation needs an urgent dialysis to filter our system for leadership impurities. We need to flush out our traditional politicians for they and they alone are responsible for our miseries. The sick need to become this nation’s doctors and treat it by throwing our garbage out.
When will, you might ask, Kashmiris get good hospitals and schools for their children and blossom in an atmosphere of dignity and prosperity? The day a government department shows as much efficiency and eagerness in procuring ventilators for our children as it does in clearing the gate for a CM’s residence at the excise toll booth. The day a Minister is as concerned about the quality of our schools and education as he is in ensuring his son passes an examination by hook or by crook. The day a Minister allocates half as much money he allegedly dished out to buy a villa in Dubai to construct a modern, well-equipped hospital in Kashmir. The day Kashmiris come out to vote for the interests of their nation, not for their individual interests. The day we say – ‘Enough is Enough’ and get our act straight as a people. That day is as near as it seems far as long as we remember that the first step is the longest leap. (Greater Kashmir)
Children of a lost God!
M. Ashraf
In any pediatric hospital anywhere in the world single death of an infant sends alarm bells and an automatic enquiry starts to pin point the causes to enable remedial measures. Imagine 359 infants dying in a matter of just four months! It is not only gross criminal negligence but rather mass murder. Some people have termed it genocide. Well, even if we call it genocide, it has not been perpetrated by a foreign power but by our own people! The height of callousness is the administrator saying nothing is wrong in the hospital and everything is working well. How can one administer a facility staying sometimes hundreds of kilometres away from it? Well, the responsibility does not end at the level of the administrator. It goes all the way up. The least that should have happened on moral grounds was for the health minister to submit his resignation. Not to speak of the western countries, if such an incident had taken place in any other state or even in any other developing country, the entire government itself would have been toppled. It is a pity that a single dog’s death in Kashmir starts alarm bells ringing from Srinagar to Delhi but the death of over 300 Kashmiri children due to criminal negligence has not even sent a ripple. If no one else, at least the Union Health Minister should have been himself at the hospital to look into this tragedy beyond belief. Have Kashmir’s new generations become so cheap and expendable? People deserve an answer and that too fast!
As usual the government has ordered an enquiry. However, the enquiry has not to remain confined to the hospital infrastructure but has to go beyond. The moot point is why should so many infants die? It has been alleged that the hospital is short of equipment and staff. They have only 4 ventilators and need 34. But the question is why so many infants need ventilators? Are these all pre-maturely born infants? Why have so many infants developed breathing problems? Is their delivery in order? There is a possibility of some epidemic within the hospital premises. Some years back one of the hospitals had an epidemic of tetanus. Normally, in such an eventuality, the hospital needs to be totally burnt down but this thing does not happen in our part of the world. In any such eventuality, the enquiry needs to be conducted by a team of experts in the field including people responsible for infection control. Here it needs to be emphasized that the Indian government had been aiming to get the neo-natal mortality rate down from 60 per 1000 births to 30 per 1000 by the year 2000 itself. The rate has already been reduced 30 per 1000 births in many southern states. In the present case in Kashmir, the average works out to almost 3 deaths per day! It is not known as to what is the proportion in relation to births and total admissions in the hospital. This needs to be ascertained by a medical audit. It is reported that apart from lack of equipment and mismanagement the hospital does not have a blood bank most essential for such a tertiary facility.
Another important aspect of the mismanagement of the hospital administration is that the entire burden of managing the services without any supervision is on the shoulders of junior interns while the senior consultants are busy with their private practice. There has been lot of dithering going on regarding banning of private practice by doctors working in government hospitals. This has happened in spite of court directions in the matter. The tragedy is as usual being taken hold by politicians of various hues and shades to grind their own axe. Kashmiris should be in mourning and should not get swayed by vested interests. It is a tragedy of immense proportions and needs unity from all sides to ensure tangible steps are taken by the government visibly to save our future generations. (Greater Kashmir)
Infant Deaths
Javaid Malik (Greater Kashmir)
More than 350 babies dying in G B Pant hospital since January this year has once again brought to fore the poor state of healthcare in the Kashmir Valley. These deaths were going unnoticed till media highlighted these. Soon after the news reports appeared politicians cut across the party lines and demanded action against the people responsible for these deaths. Even separatists joined the chorus.
Hue and cry raised by the Kashmiri leadership and the civil society made government acknowledge neglect. It swung into action and axed the Medical Superintendent. The government also gave approval for purchase of ventilators and medicines. At last government woke up from a deep slumber. Why government took so long to react? Why didn’t it act on its own rather than waiting for media to highlight the issue of infant deaths? Had it acted on its own many kids could have been saved.
Commissioner Secretary Health and Medical Education M K Diwedi while addressing a news conference here earlier this week said that preliminary inquiry has established the institute lacks capacity on all fronts like manpower, equipment and overall management of the services. One fails to understand why it took government so long to establish that hospital lacks capacity on all fronts. Why did it sleep over these issues for such a long time? It seems deaths only can rattle the government. It doesn’t wake up till fatalities take place.
Government leaves no stone unturned to claim that Health Sector is a priority and crores are being spent to develop this sector, but it seems to be a mere rhetoric. Plight of the lone children hospital of the Valley proves that lot needs to be done to improve the health sector.
Certain issues like healthcare have got nothing to do with politics. These are the issues which touch everyone’s skin and cannot be taken lightly. Healthcare has got nothing to do with resolution of Kashmir issue nor can the people at helm say that turbulence in Kashmir for past two decades is responsible for poor state of healthcare. It seems the “lackadaisical attitude” of the people at the helm has pushed the health sector in Kashmir towards stone age.
The G B Pant hospital was thrown open for public amidst lot of fanfare a few years ago. The government had promised that it would have all the facilities and would become a model institute of healthcare. But tall claims have remained confined to papers only. It is shocking to know that there are not enough ventilators and other machines to accommodate neonates. Suddenly government has realized that there is shortage of paramedical staff in the hospital and institute lacks capacity on all fronts. One wonders why it took so many years for the government to realize the shortcomings and why weren’t any steps taken till date to overcome these problems. The government has woken up after the disaster has struck, had it anticipated the trouble the disaster could have been averted. Soon after the news about infants dying in G B Pant came to fore, the chairman of Hurriyat (M), Mirwaiz Umar Farooq issued a statement saying that if government has no money it should tell the separatist leaders. “Our next generation is very dear to us. We can collect lakhs from people as donation to save their lives,” Mirwaiz had said.
People of Kashmir need to consider his suggestion and they should try to put in efforts to build one more Children hospital in the Valley and handover its management to some Trust so that people who reach the G B Pant with lot of hopes do have an alternative. The G B Pant being the only place where children are treated has made the administration and doctors complacent.
People who run the G B Pant hospital should realize that patients and attendants who reach there after Almighty pin their hopes on doctors and the staff members present there. They need to be polite and assuring rather than being ignorant and uncooperative.
358 Deaths Since Jan: Chib Calls it Normal
Firdous Hassan (Kashmir Monitor)
Srinagar: In a shocking admission the state government on Wednesday said that 358 infants had died since January this year. This was revealed by Minister for Medical Education R S Chib who toured the GB Panth Hospital on Wednesday. Though as an afterthought Chib tried to downplay the issue terming the deaths as 'normal'.
According to documents handed over to the media at GB Panth Hospital, in the month of January out of 2315 admissions in the hospital 68 children including neonatals died. In the month of February out of 2517 admissions 66 deaths were reported. In March 2012, 2705 admissions were reported and 105 deaths. In April 2012, 3021 admissions were reported with 85 deaths. Finally in May so far 1229 admissions have been reported with 34 deaths. In total, 358 deaths have taken place this year only.
The Minister said that a team of Government Medical College specialists would conduct a thorough probe into the functioning of G B Panth Hospital and file their report within a week. “If these deaths occurred due to the negligence of the doctors then an inquiry committee will be established, that won’t be from this hospital, to look into the matter and they will be asked to submit the report within a week to the government and after that any action will be taken”, Chib told reporters while paying a visit to the GB Panth Hospital. Chib said that the deaths in the hospital were 'normal' according to the previous records .He said that blaming these deaths on negligence of the doctors would be premature as some of the children have died of encephalitis. “I went through the records of the previous six months where I found that the death rate was normal .Even if there is a single death we can’t stay silent we have to look into it, ”said Chib. Ironically minutes after Chib left another infant died at the hospital.
When asked about the matter of the dual administration over the G.B Panth Hospital , he said, “I agree that there might be sort of misunderstanding between the Medical superintendent and the deputy superintendent and now we need to bridge that. There is dual administration but both these units come under the medical college.” He further said that the infrastructure as well as the facilities of the hospital will be improved to promote the smooth functioning of the hospital. “We have a dearth of the nursing staff and we are now going to recruit them on the casual basis to the hospital. Apart from that many facilities will be upgraded to the hospital as we are going to introduce some more ventilators in the hospital,” added Chib. The hospital has literally become a death trap as in the past two weeks alone, 30 infants have allegedly died due to doctors' negligence and inadequate health equipment to tackle the crisis.
The doctors claim that they are unable to cope with the huge overload because of a shortage of trained staff and machines. In the ICU, as against a required 20 to 30 ventilators, there are only five which is affecting the services. For grieving relatives, coming to terms with the loss has not been easy. Infuriated by the lack of infrastructure and support that resulted in so many deaths, many assaulted the doctors present.
Srinagar’s only paediatric hospital runs on an annual budget of Rs 13 crore, of which Rs 9 crore alone is spent on the staff salaries. With the remaining Rs 4 crore being spent on drugs and equipment, patient-care has invariably become a casualty. But the death of 62 infants in the past 90 days is a grim reminder to the Omar Abdullah government and the Union Health Ministry of the unhealthy state of affairs in Jammu and Kashmir.
CIVIL SOCIETY FORUM DELEGATION MEETS CHIB
Srinagar: A dlegation of Civil Society Forum Kashmir led by prominent doctors, educationists and people from other walks of life on Tuesday met Minister for Medical education R S Chib, Commissioner Health and Principal GMC on the reports of deaths of infants at G B Panth Hospital.
A CSF statement said the Forum highlighted that in the year 1976 first Children Hospital was established at Hazuribagh adjacent to LD Hospital with 185 beds capacity and population at that point was 30 lakh. “In the year 2005 Children hospital was shifted to G.B Panth Hospital but the bed capacity over a period of 36 years instead of increasing to the requirement got declined to 135 only. The inflow of patients has increased to a huge number but infrastructure remains same.”
The delegation mentioned that district level Hospitals should be strengthened to reduce the referral flow of patients. “In the year 2010 Pediatric Department got MCI recognition subjected to sub-speciality and various other improvements and developments in the department, but very less has been attained till date,” the statement said, adding that residential staff hostel facilities are not available which is the basic and important need of any hospital. “The lack of hostel facility often results in delayed treatment of patients during odd hours. It was also brought in the notice of Minister that in a Hospital where there is tremendous inflow of patients both in OPD and in House admission, the responsibility and role of HOD and Medical Superintendent have been put on the shoulders of a single person which even is against the rules and regulations of (MCI) Medical Council of India.” Further the problems like poor sanitation, poor drainage, lack of ambulance services etc were discussed. Responding to the issues, the Minister assured that all the important issues will be addressed. The statement added that Chib committed to immediate increase in the number of ventilators in ICUs, increase in the number of beds, improvement in the nursing staff and various other issues. Speaking on the occasion, Vijay Dhar said the basic thing is that doctors on duty should be patient sensitive and should immediately attend to the problems of patients.
The Minister directed the Secretary Health & Medical Education Department to prepare a proposal for making available one critical care ambulance for both G.B. Pant Hospital and L.D. Hospital in consultation with the Principal, Government Medical College, Srinagar. “The defense authorities will be approached to acquire the piece of land adjacent to G.B. Pant Hospital for its further expansion,” he said.
Chib stressed upon the need to carry out surprise check of the Children Hospital by the Medical Education Authorities including the Principal, GMC, Secretary Health and Medical Education to keep a vigil on the functioning of the institution. He agreed with the suggestions of the delegation that an Advisory Committee consisting of Civil Society Members, Medical Faculty, and Cantonment Authorities will be constituted in order to advise the Medical Superintendent, G.B. Pant Hospital for its effective functioning.
Among others, Secretary, Health and Medical Education M. K. Dwevidi, Principal, Government Medical College, Srinagar, Dr. Qazi Masood, Dr. Bilqees Jamila, member of civil society Omar Tramboo, Vijay Dhar were present in the meeting.
GB Panth in Mess, JLNM Gets Children Ward
Mudassir Kuloo (Kashmir Monitor)
Srinagar: It is a classic example of how the bureaucrats and political workers can misguide the political leadership. Last Monday the Chief Minister Omar Abdullah 'inaugurated' the child specialty unit at the Jawahar Lal Nehru Memorial Hospital (JLMN) hospital in Rainawari. This inauguration went ahead despite valleys only child specialty hospital, GB Panth Hospital recording nonstop deaths due to lack of life saving equipment. .
While the Chief Minister inaugurated the child specialty unit of JLNM on Monday, The Kashmir Monitor on visiting the JLNM hospital on Thursday found out that the block was still under construction and all the sensitive child care equipment was rendered useless under locks. This state of the art equipment includes four photo therapy machines and three ventilators. All the seven are lifesaving equipment'
A senior officer in the state medical education department told Kashmir Monitor that due to misguidance by a few officials and the cold war between R S Chib and Sham Lal, this much needed equipment is lying without use at JLNM hospital." Ideally there was no need for a new children’s block as we have GB Panth Hospital. These machines would have made much more sense at the GB Panth hospital considering its state. It is a sorry state of affairs", he told Kashmir Monitor wishing anonymity.
The functioning of GB Panth Hospital has raised eyebrows as till now 358 deaths have been reported since January 2012. The children’s ward at JLNM fares no better as there is still no admission in the ward. Four phototherapy machines and three ventilators were procured for this hospital however these machines are yet to be functional, which are ‘locked’ in a room.
Even the police persons who were standing outside the gate of IPD new block at JLNM hospital are restricting the public movement. Sources said that the newly inaugurated building is still under construction and the hospital authorities have only taken control over SNCU unit for children which itself is not in use.
Sources in the Health and Medical Education department insist that this equipment should be shifted to the GB Panth hospital at the earliest but we unsure if that would happen." Everyone knows that Sham Lal and Chib are out to outdo each other. Chief Minister must intervene and take the equipment to GB Panth hospital. It is rotting at JLNM", a senior official told Kashmir Monitor. “I fail to understand why government has first procured machines for the JLNM hospital when there is an immediate need for upgrading facilities at the G B Panth. On an average five children dies daily here due to lack of machinery and negligence by the hospital authorities,” says a parent at GB Panth Hospital adding," It is surprising that Chief Minister first inaugurated the child care unit at the JLNM hospital and paid no heed towards the G B Panth hospital, which craves for attention".
A collage of reports is presented below beginning with authors report, followed by other reports, including those by Iftikhar Ashraf, Nazir Ganaie, Manzoor-ul-Hassan, Junaid Mattu, Mohammad Ashraf, Javaid Malik and a closing news item that reinforces the functionality of the State.
STATEMENT BY DR. VIJAY SAZAWAL
I could not hold back my sadness when I read the following two editorials in the Rising Kashmir and the Greater Kashmir that appeared on the web today - I cannot fathom the feelings in mothers who were robbed of their delight and joy.
But my sadness has another perplexing dimension. You may recall that I gave precisely the same news as the following editorials during my talk at the UNT over a month back (http://kashmirforum.org/news.htm). You can check the youtube recording of my 6th April lecture if you want to see me talk about the G B Pant Hospital (http://www.youtube.com/watch?v=_dSw4cbYWdU). What I said during my lecture was that horrific as this tragedy is, it is mostly ignored by Kashmir's civil society and represents another measure of dysfunctionality of the state. So finally today, in a surprising manner, both the two leading newspapers in Srinagar have published editorials on the subject.
But why now? I do not know - but if I have to guess it is become, possibly, a "big wig" lost a child and hence it has became a story. The tragedy of Kashmir is that on one side you have local elites hogging a good life, on the other side you have local intellectuals and mostly outside scholars promoting their political and social agendas while indifferent to ground realities, and somewhere ignored in between the two are ordinary people of Kashmir bearing the brunt of a woeful life in the valley of sorrows.
Regards,
Vijay Sazawal
http://www.risingkashmir.com/news/hospital-or-morgue-26837.aspx
Hospital or Morgue? (Editorial in Rising Kashmir)
Sunday: What GB Pant admin is doing to counter this alarming situation is intriguing Kashmir is perhaps the only place where death is so frequent. In the last week alone seven deaths were reported from G B Panth, Valley’s lone pediatric hospital. It may be a figure for government or statisticians but it is an irreparable loss of the families.
According to hospital sources 22 deaths were recorded between June-December 2010. 2011 was no different; the year also reported high infant mortality. This year it looks the figures will exceed all the limits. The prime reason for these deaths is medical negligence; however there are other important factors which have contributed for this appalling situation. The hospital completely lacks infrastructure, emergency medical care and equipments.
Though projected as the tertiary health centre for children the hospital lacks a full-fledged centrally connected oxygen plant. Besides the corruption and embezzlement of hospital funds have put brakes on the development of the hospital. The hospital is also short of important medicines and vaccines and diagnostic facilities. What the hospital administration is doing to counter this alarming situation is intriguing. The protests and demonstrations have become a norm rather than an exception in the hospital, what is surprising is the lackadaisical attitude of the government that has failed to overcome the infrastructural requirements and in bringing the culprit to the book.
The state government is under the constitutional obligation to provide quality healthcare to its citizens. How can government turn a blind eye to the grievances of the people? What has aggravated the problem further is lack of accountability and internal bickering that has brought the hospital on the verge of disaster. Early in the year, 65 officials from the hospital where found absent from their work. This shows how our hospitals and health centres work. However it is never too late to mend. The time has come to set GB Pant hospital on the right track; the state government has a job in hand if it has to made the hospital, a tertiary health centre, it has to work at the infrastructure, provide it with latest and advance medical equipments and importantly it has to act on the complaints filed by the attendants. It is time to fix the responsibilities and weed out the menace of corruption.
Though the state government started this hospital in collaboration with army, it is time to revisit the terms and conditions. If the state government can spend crores on dog rehabilitation, why can’t it work in improving pediatric healthcare in the valley?
http://www.greaterkashmir.com/news/2012/May/14/g-b-pant-deaths-64.asp
G B Pant Deaths (Editorial in Greater Kashmir)
For the past some days, Valley’s only children healthcare institution, G B Pant Hospital is in news. But not for good reasons. There are reports of several children dying from lack of the timely attention by the doctors. Notably, drawing attention to this messy state of affairs at the hospital is a Bangalore based businessman Sahil Bhat who claims that twenty children died of neglect in ward No 4 in 24 hours.
The report carried by this paper on Friday quotes an attendant witnessing the death of six children on the night of Monday last. And on Saturday evening, one more child was reported dead. Statistics are shocking. Surprisingly, the hospital administration has done little to explain the rise in deaths. It almost appears that the hospital regards these deaths as normal. True, being the only children hospital in the Valley, G B Pant has to cater to a huge rush of ailing children, many of them newborn. In fact, there is little space and the infrastructure to accommodate the unbroken throng of children, their parents and other relatives. On any given day, the wards are crowded, with sometimes three to four babies occupying one bed.
While the hospital has only a sanctioned strength of 170 beds, the occupancy on any given day is upwards of 350. Attendants who don’t have a proper space to sit also crowd the beds and wards. Shortage of doctors and paramedic staff only worsens the problem. This creates a suffocating environment of noise, disease and desperation. Ironically, there is hardly an effort to highlight the hospital’s grave problems. In fact, the government has been the most indifferent. Since its creation through late seventies, the government has hardly done anything to strengthen the hospital and expand its infrastructure. The best way out would be the construction of a new children hospital to keep up with the increase in population and the growing demand for the children’s healthcare. But as things stand, such a prospect appears remote. And with no commensurate alternative available in private sector, all we are left with is G B Pant.
Kashmir’s Healthcare Mess
Iftikhar Ashraf (Kashmir Times)
During my college days (outside valley) I used to boast of Kashmir having the world class doctors. Whenever there was an argument with respect to valley not being able to sustain itself on its own, the quality of Kashmir's doctors, leading to medical tourism, was always one of my key points for rebuttal. I would use the case of Cuba to prove my point, of how Cuba even being under U.S sponsored embargo for almost 52 years (now), became the world leader in healthcare, biotechnology, Cancer treatment, Drug research & development etc.
The first step towards the continuation of the tradition of producing world class doctors is the selection process. But of late some people have been able to bypass or fox the selection process through money, reach or appropriate connections. The people from this lot magically get transformed into a serial number on the qualified candidates list. All among us personally know at least one of these “Munna Bhai's” , somehow we all expect the medical education system either to weed them out or make them well trained and educated for the profession they choose.
What we can currently see of our healthcare has proved both these assumptions wrong, almost every serial number on the qualifying list sooner or later gets a degree and regarding making them better qualified for the profession I have my reservations. Regarding the current status of Kashmir's healthcare, there seems to be no better word to describe it then "Chaos". Kashmir sans a proper referral system, which leads to overcrowding of the major hospitals or by the time the patient reaches a specialist precious time has been wasted.
A patient even with minor ailments wants to visit the major hospital in Srinagar as no or few specialists are available at Sub District Hospitals (SDH). Due to lack of grass-root infrastructure couple of hospitals are being forced to coup up with the requirements of the whole state. It is humanly impossible to try to deliver healthcare services through only couple of hospitals. Even these highly vital hospitals are not well equipped to help our doctors serve better. SHMS hospital's CATH lab is ill equipped so all the procedure can't be performed despite one of the most renowned specialist being available.
Recently patients died in SKIMS because oxygen supply was stopped due to some technical snag, the G.B Pant Children Hospital has recently transformed a graveyard for the want of ventilators and what can one say about Lal Ded Maternity Hospital, which happens to be Kashmir's only Maternity Hospital! Taking into consideration that every doctor in any major hospital is working extremely hard, at times working for at a stretch for 48 hours or more! We have to commend them for their excellent services. With everyday our doctors challenging the humanly limits, the least they deserve are "better working condition" Government needs to keep politics aside and help doctors and other stakeholders in improving Healthcare practices and facilities. We all know what happened to Dr. Shawl’s dream project of a super specialty cardiology hospital. If government instead of creating hurdles would have only ignored, not even supported or encouraged the initiative Kashmir would have a Cardiology Hospital by now. Who knows it might have even encouraged some other people to take some other initiatives, but now it is what deters them from making any such efforts.
Only encouraging private sector to invest in healthcare won't solve the problem here, it is high time that this sector is regulated properly through laws and regulations, which should be implemented with rigorous zeal. The enactment of Drug policy with proper implementation seems to be a good beginning but we have long way to go. We need to look into our medical education system, try to restore the past glory of Government Medical College, Srinagar, which in near future has too often come too close to de-reorganization from Medical Council of India. Unless we take thing as seriously as they are, a poor man will continue to pay with his blood and the saviors will continue to be enticed to embrace their darker side.
Many a people have been asking for banning of private practice of doctors, well it won't be possible till there is a demand for it and there will always be demand. So why not try to better regulate private practice. As long as the doctors sincerely deliver their duties in their respective hospitals or places of posting, no one should have a problem with what they do after their duty hours. What needs to looked into is the undue advantage that some doctors take of their position and reputation. Some well established and reputed doctors in Srinagar (and other towns) in their quest for a complete monopoly, have trained their wards in complementary services like radiology or pathology and they don't accept reports from any labs other than the ones they recommend. So among the family members a patient is sucked till the last drop of blood. May I ask what gives the doctors the right to declare all labs, other than their wards (or recommended) to be pieces of junk. Can government dare to take some action against such doctors and also raise the standard to labs in government hospitals?
With healthcare becoming costlier with each passing day, every single J&K resident needs to be given access to a Health insurance. Government had started this initiative for its employees but suddenly it has lost all steam, May we ask why? For this dismal state of Healthcare government is more responsible than doctors. The government apathy is such that it many a times it sends rules and regulations flying through the window. In government hospitals we find Ayurvedic (Unani) doctors practicing homeopathic medicine, which happens to be completely against Supreme Court guide lines.
There is also no proper planning while identification of sites for new hospitals or even when implementing these projects. I would like to ask the government, pardon my language, who was the idiot who approved the construction of Unani (Ayurvedic) Hospital at the HMT chowk (square), didn't he know that the road widening will happen. Does environment of one of the busiest squares on a national highway qualify for a site for any Hospital? Regarding how efficient our government machinery is in implementation of projects let's take the example of Sub-district Hospital (SDH) Sopore, the founding stone of this hospital was laid in 1984 and still it has not been completed! Well we can say it confirms another entry for Sopore in Guinness Book of World Records, first one being for it’s yet to be completed by-pass bridge. SDH Sopore is operating through its OPD Block, which itself is not complete!
Coming back to comparison of Cuban Healthcare with that of Kashmir's, there are many similarities (having large number of qualified, hardworking and intelligent doctors and paramedic staff etc) but there is one major difference that hinders our transformation into one of the leaders of healthcare and that is government will.
Deaths At GB Pant Hospital: Govt Or Docs To Blame?
Nazir Ganaie (Kashmir Observer)
Srinagar: Lack of infrastructure, inadequate staff and insanitary wards, compounded by the growing number of referred neonates – three times higher than its current capacity - has added to the woes of the GB Pant Children’s Hospital where nearly 45 babies have died in the past fortnight, experts say.
Doctors at the hospital strongly refute charges of negligence over the deaths, putting the onus on the government which, according to it, acts only when the issue boils over. “This hospital is a big mess and government does not pay any heed to its development. If the government can macadamize and paint roads when it move its durbar here, why can’t it see the dismal condition of hospitals?” an attendant, Syed Mashkoor of Habba Kadal, asks “When doctors don’t have ventilators available, when they are running short of medical supplies and life-saving drugs, or equipment, what can doctors do? What can you expect? This is not doctors’ negligence, but government’s negligence towards patients,” he adds.
According to official records, the hospital admitted 4274 neonates (new-born patients) in 2011. While as in the same year the hospital recorded 475 neonatal deaths including 320 pediatric deaths, which they say was higher than this year. The officials due to the inspections by the higher authorities couldn’t trace the data of the last three years.
“This is certainly not an alarming mortality rate in Kashmir. This happens in developing countries and it is considered normal. In Kashmir when you have such heavy rush in the hospital every day, how can you manage? Even then doctors have been trying their best that patient care doesn’t suffer,” registrar, department of anesthesia at SMHS Hospital, Dr. Masood Rasheed, said. “I don’t understand the move from the government. If they can announce 300 more beds to maternity care LD hospital, why cannot they shift this Pediatric hospital to that place, which would benefit and improve patient care and I am sure the mortality rate will also come down,” he said.
Official records at the GB Pant Hospital (January 1, 2012) show that around 358 children died during the period in the hospital against 1229 admissions. A large number of 105 deaths occurred in March. The number of deaths in January was 68 while in February the figure stood at 66. In March 105; in April 85; in May (up to 12th) 34 deaths occurred. But paradoxically, there are only five ventilators catering to around 1700 patients on average at G B Pant Hospital. “We will be adding more trained and technical staff, and soon tenders would be floated to add some more infrastructures to the hospital. We would be happy if the government provides us more equipment, but unfortunately the G.B Pant Hospital has become a victim of official apathy,” a senior pediatrician at the hospital said, asking not to be named.
The Valley’s staff-starved GB Pant Children’s Hospital has a capacity of admitting 135 patients (135-beded hospital), however records say that the hospital receives 110-120 patients on an average every day including back admissions, leaving the hospital in extremely difficult conditions. “In G.B Pant Hospital, we have a pouring-in from Kupwara, Baramulla, Banihal, Doda, Bhaderwah and Kargil. And in some cases the patients’ condition deteriorates after traveling a long distance- so government should have taken measures that would give relief to the patients as well as improve patient care. I think the onus lies with the government and they need to address the issue,” said another noted pediatrician at the hospital, wishing anonymity.
According to the doctors, over the years, the hospital has witnessed a huge rush from the peripheral district hospitals, which, they say, is a huge challenge for its administration. Authorities said that around 62 doctors have already been posted in the hospital. “The government is already in the process to engage more para-medics and also to upgrade the existing equipment so that patient care is substantially improved,” minister for medical education R S Chib said.
It may be recalled that 45 children have died at the hospital over the past last fortnight, after which the Jammu and Kashmir government on Wednesday ordered an inquiry under the director of the SKIMS, Dr. Shaukat Zargar.
Talking to the Kashmir Observer, Dr. Zargar said that the government needed to work on some alternatives to ease the pressure on the hospital. He said that he had suggested some measures to the hospital administration during a three hour meeting. “There are some flaws in the hospital on issues like ventilation and insanitary conditions. Besides, the security staff can’t be seen discharging their duties properly, which adds to the problem,” he said.
Pertinently, the Valley’s only pediatric hospital runs on an annual budget of Rs 13 crore, of which Rs 9 crore alone is spent on staff salaries. With a mere Rs 4 crore being spent on drugs and equipment, patient-care has invariably become a casualty, courtesy official apathy. Observer News Service
Infants Continue to Die at GB Pant Hospital - 9 More Fatalities In 24 Hrs
Manzoor-ul- Hassan (Greater Kashmir)
Srinagar: At a time when the authorities at GB Pant hospital continue to be in a denial mode on alarming increase in infant fatalities there, the hospital shockingly recorded 9 deaths of newborns in the last 24 hours – reportedly highest ever in the institute. With the latest deaths, the infant fatalities at the hospital during the past 15 days have shot up to 41.
While official records said that 32 infants in the age group of 0-1 year (neonates) had died at the hospital in the last 14 days, death of 9 infants on May 14 and May 15 presents the gory picture of the shoddy healthcare and administrative affairs at the valley’s lone children’s hospital. “Nine babies mostly new born in the age group of 1day and 4 months died in the NICU Unit of the hospital during the past 24 hours mostly due to the flawed management,” sources told Greater Kashmir.
A four month old baby boy, Mohsin son of Muhammad Riyaz (MRD no 2785) of Islamabad died this morning at around 7am after remaining admitted in the hospital for 17 days. Another 40 day old baby, daughter of Hilal Ahmad of Shopian, died this morning at around 11:30 am in the NICU ward of the hospital after she was admitted there on May 3 with MRD no: 4179. Similarly, the babies with MRD number: 3941, 4285, 4295, 4296, 4146, 8311 and 4151 died during past 24 hours in the hospital’s intensive care unit.
“Though the neonatal deaths is a common phenomenon, lack of facilities and the dual control of the GB Pant hospital involving state government and the Cantonment Board adds to the mess there,” sources said. The civil society in the Valley is fuming over the mounting deaths in the hospital. “Our children are on death beds as hospital has turned into a graveyard as possibility of infants coming out alive is remote,” the attendants said. An attendant from Pulwama said the condition of his daughter deteriorated due to the callous approach of administration. “She was admitted in the ward no.5 and was crying with pain but doctors never come to see her,” he said.
When contacted, Medical Superintendent of the Hospital Dr Javaid Choudhary said there had been no deaths in the hospital due to negligence. Asked whether the administration had ordered any inquiry into the increasing infant deaths in the hospital, Dr Choudhary said: “We have not ordered any inquiry.”
Pertinently, the Children hospital was established in year 1976 at Hazuribagh adjacent to LD hospital with 185 bed capacity. In 2005 it was shifted to its present location at Sonwar. Ironically, the bed capacity over a period of 36 years instead of increasing to the requirement got declined to 135. As one of the main referral hospitals for Children including infants the staff strength was never increased to cater the referral flow of patients.
An official wishing anonymity said that while the Pediatric Department of GMC got MCI recognition subjected to sub-specialty and various other improvements and developments in the department, but very less has been attained till date. “Residential staff hostels are not available that is the basic and important need of the hospital. The lack of hostel facility often results in delayed treatment of patients during odd hours,” he said.
What are the Priorities of This Political System?
Junaid Azim Mattoo
The Valley’s only neonatal care hospital, as it turns out, has become a disguised butchery. With around 360 plus deaths in the last 5 months, the G. B. Pant Children’s Hospital in Srinagar has achieved the dubious distinction of a slaughterhouse. Our sick children have apparently been dying for lack of care and facilities while our Government has cut no corners in constructing and refurbishing ministerial and bureaucratic residences with the finest construction materials and interior furnishings known to man.
Various voices, both within and outside the system, have been crying hoarse about the plight of our only Children’s Hospital for the last so many years. A single trip to the G. B. Pant Hospital is enough to indict this and previous governments for criminal negligence and ruthless malfeasance. The last two decades have seen Kashmiris being deprived of basic governance while successive governments have been swimming neck deep in rampant and blatant corruption. The Children’s Hospital mess is just another heart rending example of how a certain section of our society has inflicted grave misery on a people who have, as it is, been at the receiving end of depravity and disempowerment.
Successive State Governments in J&K have spent hundreds of crores of rupees to construct and refurbish palatial Chief Minister Mansions. Be it Azad Sahab, Mufti Sahab or more recently Omar Sahab, our successive Chief Ministers have chosen to build huge, grand palaces for themselves while ordinary Kashmiris have been starved for healthcare, public services and infrastructure. Our Chief Minister turned Emperors live in the verdant lap of luxury. For them, the plight of sick, dying, unattended children at G. B. Pant is a reality that is stranger than fiction. If we compare the costs incurred by the Estates and Protocol department on the upkeep, protocol and residential services extended to our bureaucrats and ministers to the dismal spending on our Hospitals, Schools and Roads, we come face to face with a shocking, haunting revelation – we are all second class slaves in a system, in a polity that works for the interests of a select few.
Governments that deliberately choose not to equip our only Children’s Hospital with adequate ventilators, oxygen cylinders and incubators for so many years are legally liable for criminal negligence. If an accidental fire in a hospital elsewhere in India indicts the management and owners of the hospital for gross and criminal negligence, why can't 350 plus deaths in 5 months be enough for the judiciary to indict this administration for a bumbling failure to protect and save the lives of our young children?
Mufti Sahab gave Kashmir a renovated estate on Gupkar Road – renovated at a great cost to the tax-payers. Azad Sahab gave Kashmir a beautiful, breathtaking Tulip Garden. Omar Sahab gave this city another luxurious, royal residence constructed at a cost to the exchequer. Why did our three successive Chief Ministers so conveniently forget to give us ONE single Children’s Hospital where parents take their children for a hope of life, not an apprehension of death and negligence? Why have our politicians chosen to impersonate medieval emperors and dictators by prioritizing walls of china and castles over the succor and survival of our children?
The lack of ventilators at our hospitals is an immaculate metaphor for where our State lies today. Our nation is struggling and gasping for air on dilapidated ventilators as our policy makers are either too incompetent or too corrupt to take notice of our day-to-day struggle for a dignified survival. Our nation needs an urgent dialysis to filter our system for leadership impurities. We need to flush out our traditional politicians for they and they alone are responsible for our miseries. The sick need to become this nation’s doctors and treat it by throwing our garbage out.
When will, you might ask, Kashmiris get good hospitals and schools for their children and blossom in an atmosphere of dignity and prosperity? The day a government department shows as much efficiency and eagerness in procuring ventilators for our children as it does in clearing the gate for a CM’s residence at the excise toll booth. The day a Minister is as concerned about the quality of our schools and education as he is in ensuring his son passes an examination by hook or by crook. The day a Minister allocates half as much money he allegedly dished out to buy a villa in Dubai to construct a modern, well-equipped hospital in Kashmir. The day Kashmiris come out to vote for the interests of their nation, not for their individual interests. The day we say – ‘Enough is Enough’ and get our act straight as a people. That day is as near as it seems far as long as we remember that the first step is the longest leap. (Greater Kashmir)
Children of a lost God!
M. Ashraf
In any pediatric hospital anywhere in the world single death of an infant sends alarm bells and an automatic enquiry starts to pin point the causes to enable remedial measures. Imagine 359 infants dying in a matter of just four months! It is not only gross criminal negligence but rather mass murder. Some people have termed it genocide. Well, even if we call it genocide, it has not been perpetrated by a foreign power but by our own people! The height of callousness is the administrator saying nothing is wrong in the hospital and everything is working well. How can one administer a facility staying sometimes hundreds of kilometres away from it? Well, the responsibility does not end at the level of the administrator. It goes all the way up. The least that should have happened on moral grounds was for the health minister to submit his resignation. Not to speak of the western countries, if such an incident had taken place in any other state or even in any other developing country, the entire government itself would have been toppled. It is a pity that a single dog’s death in Kashmir starts alarm bells ringing from Srinagar to Delhi but the death of over 300 Kashmiri children due to criminal negligence has not even sent a ripple. If no one else, at least the Union Health Minister should have been himself at the hospital to look into this tragedy beyond belief. Have Kashmir’s new generations become so cheap and expendable? People deserve an answer and that too fast!
As usual the government has ordered an enquiry. However, the enquiry has not to remain confined to the hospital infrastructure but has to go beyond. The moot point is why should so many infants die? It has been alleged that the hospital is short of equipment and staff. They have only 4 ventilators and need 34. But the question is why so many infants need ventilators? Are these all pre-maturely born infants? Why have so many infants developed breathing problems? Is their delivery in order? There is a possibility of some epidemic within the hospital premises. Some years back one of the hospitals had an epidemic of tetanus. Normally, in such an eventuality, the hospital needs to be totally burnt down but this thing does not happen in our part of the world. In any such eventuality, the enquiry needs to be conducted by a team of experts in the field including people responsible for infection control. Here it needs to be emphasized that the Indian government had been aiming to get the neo-natal mortality rate down from 60 per 1000 births to 30 per 1000 by the year 2000 itself. The rate has already been reduced 30 per 1000 births in many southern states. In the present case in Kashmir, the average works out to almost 3 deaths per day! It is not known as to what is the proportion in relation to births and total admissions in the hospital. This needs to be ascertained by a medical audit. It is reported that apart from lack of equipment and mismanagement the hospital does not have a blood bank most essential for such a tertiary facility.
Another important aspect of the mismanagement of the hospital administration is that the entire burden of managing the services without any supervision is on the shoulders of junior interns while the senior consultants are busy with their private practice. There has been lot of dithering going on regarding banning of private practice by doctors working in government hospitals. This has happened in spite of court directions in the matter. The tragedy is as usual being taken hold by politicians of various hues and shades to grind their own axe. Kashmiris should be in mourning and should not get swayed by vested interests. It is a tragedy of immense proportions and needs unity from all sides to ensure tangible steps are taken by the government visibly to save our future generations. (Greater Kashmir)
Infant Deaths
Javaid Malik (Greater Kashmir)
More than 350 babies dying in G B Pant hospital since January this year has once again brought to fore the poor state of healthcare in the Kashmir Valley. These deaths were going unnoticed till media highlighted these. Soon after the news reports appeared politicians cut across the party lines and demanded action against the people responsible for these deaths. Even separatists joined the chorus.
Hue and cry raised by the Kashmiri leadership and the civil society made government acknowledge neglect. It swung into action and axed the Medical Superintendent. The government also gave approval for purchase of ventilators and medicines. At last government woke up from a deep slumber. Why government took so long to react? Why didn’t it act on its own rather than waiting for media to highlight the issue of infant deaths? Had it acted on its own many kids could have been saved.
Commissioner Secretary Health and Medical Education M K Diwedi while addressing a news conference here earlier this week said that preliminary inquiry has established the institute lacks capacity on all fronts like manpower, equipment and overall management of the services. One fails to understand why it took government so long to establish that hospital lacks capacity on all fronts. Why did it sleep over these issues for such a long time? It seems deaths only can rattle the government. It doesn’t wake up till fatalities take place.
Government leaves no stone unturned to claim that Health Sector is a priority and crores are being spent to develop this sector, but it seems to be a mere rhetoric. Plight of the lone children hospital of the Valley proves that lot needs to be done to improve the health sector.
Certain issues like healthcare have got nothing to do with politics. These are the issues which touch everyone’s skin and cannot be taken lightly. Healthcare has got nothing to do with resolution of Kashmir issue nor can the people at helm say that turbulence in Kashmir for past two decades is responsible for poor state of healthcare. It seems the “lackadaisical attitude” of the people at the helm has pushed the health sector in Kashmir towards stone age.
The G B Pant hospital was thrown open for public amidst lot of fanfare a few years ago. The government had promised that it would have all the facilities and would become a model institute of healthcare. But tall claims have remained confined to papers only. It is shocking to know that there are not enough ventilators and other machines to accommodate neonates. Suddenly government has realized that there is shortage of paramedical staff in the hospital and institute lacks capacity on all fronts. One wonders why it took so many years for the government to realize the shortcomings and why weren’t any steps taken till date to overcome these problems. The government has woken up after the disaster has struck, had it anticipated the trouble the disaster could have been averted. Soon after the news about infants dying in G B Pant came to fore, the chairman of Hurriyat (M), Mirwaiz Umar Farooq issued a statement saying that if government has no money it should tell the separatist leaders. “Our next generation is very dear to us. We can collect lakhs from people as donation to save their lives,” Mirwaiz had said.
People of Kashmir need to consider his suggestion and they should try to put in efforts to build one more Children hospital in the Valley and handover its management to some Trust so that people who reach the G B Pant with lot of hopes do have an alternative. The G B Pant being the only place where children are treated has made the administration and doctors complacent.
People who run the G B Pant hospital should realize that patients and attendants who reach there after Almighty pin their hopes on doctors and the staff members present there. They need to be polite and assuring rather than being ignorant and uncooperative.
358 Deaths Since Jan: Chib Calls it Normal
Firdous Hassan (Kashmir Monitor)
Srinagar: In a shocking admission the state government on Wednesday said that 358 infants had died since January this year. This was revealed by Minister for Medical Education R S Chib who toured the GB Panth Hospital on Wednesday. Though as an afterthought Chib tried to downplay the issue terming the deaths as 'normal'.
According to documents handed over to the media at GB Panth Hospital, in the month of January out of 2315 admissions in the hospital 68 children including neonatals died. In the month of February out of 2517 admissions 66 deaths were reported. In March 2012, 2705 admissions were reported and 105 deaths. In April 2012, 3021 admissions were reported with 85 deaths. Finally in May so far 1229 admissions have been reported with 34 deaths. In total, 358 deaths have taken place this year only.
The Minister said that a team of Government Medical College specialists would conduct a thorough probe into the functioning of G B Panth Hospital and file their report within a week. “If these deaths occurred due to the negligence of the doctors then an inquiry committee will be established, that won’t be from this hospital, to look into the matter and they will be asked to submit the report within a week to the government and after that any action will be taken”, Chib told reporters while paying a visit to the GB Panth Hospital. Chib said that the deaths in the hospital were 'normal' according to the previous records .He said that blaming these deaths on negligence of the doctors would be premature as some of the children have died of encephalitis. “I went through the records of the previous six months where I found that the death rate was normal .Even if there is a single death we can’t stay silent we have to look into it, ”said Chib. Ironically minutes after Chib left another infant died at the hospital.
When asked about the matter of the dual administration over the G.B Panth Hospital , he said, “I agree that there might be sort of misunderstanding between the Medical superintendent and the deputy superintendent and now we need to bridge that. There is dual administration but both these units come under the medical college.” He further said that the infrastructure as well as the facilities of the hospital will be improved to promote the smooth functioning of the hospital. “We have a dearth of the nursing staff and we are now going to recruit them on the casual basis to the hospital. Apart from that many facilities will be upgraded to the hospital as we are going to introduce some more ventilators in the hospital,” added Chib. The hospital has literally become a death trap as in the past two weeks alone, 30 infants have allegedly died due to doctors' negligence and inadequate health equipment to tackle the crisis.
The doctors claim that they are unable to cope with the huge overload because of a shortage of trained staff and machines. In the ICU, as against a required 20 to 30 ventilators, there are only five which is affecting the services. For grieving relatives, coming to terms with the loss has not been easy. Infuriated by the lack of infrastructure and support that resulted in so many deaths, many assaulted the doctors present.
Srinagar’s only paediatric hospital runs on an annual budget of Rs 13 crore, of which Rs 9 crore alone is spent on the staff salaries. With the remaining Rs 4 crore being spent on drugs and equipment, patient-care has invariably become a casualty. But the death of 62 infants in the past 90 days is a grim reminder to the Omar Abdullah government and the Union Health Ministry of the unhealthy state of affairs in Jammu and Kashmir.
CIVIL SOCIETY FORUM DELEGATION MEETS CHIB
Srinagar: A dlegation of Civil Society Forum Kashmir led by prominent doctors, educationists and people from other walks of life on Tuesday met Minister for Medical education R S Chib, Commissioner Health and Principal GMC on the reports of deaths of infants at G B Panth Hospital.
A CSF statement said the Forum highlighted that in the year 1976 first Children Hospital was established at Hazuribagh adjacent to LD Hospital with 185 beds capacity and population at that point was 30 lakh. “In the year 2005 Children hospital was shifted to G.B Panth Hospital but the bed capacity over a period of 36 years instead of increasing to the requirement got declined to 135 only. The inflow of patients has increased to a huge number but infrastructure remains same.”
The delegation mentioned that district level Hospitals should be strengthened to reduce the referral flow of patients. “In the year 2010 Pediatric Department got MCI recognition subjected to sub-speciality and various other improvements and developments in the department, but very less has been attained till date,” the statement said, adding that residential staff hostel facilities are not available which is the basic and important need of any hospital. “The lack of hostel facility often results in delayed treatment of patients during odd hours. It was also brought in the notice of Minister that in a Hospital where there is tremendous inflow of patients both in OPD and in House admission, the responsibility and role of HOD and Medical Superintendent have been put on the shoulders of a single person which even is against the rules and regulations of (MCI) Medical Council of India.” Further the problems like poor sanitation, poor drainage, lack of ambulance services etc were discussed. Responding to the issues, the Minister assured that all the important issues will be addressed. The statement added that Chib committed to immediate increase in the number of ventilators in ICUs, increase in the number of beds, improvement in the nursing staff and various other issues. Speaking on the occasion, Vijay Dhar said the basic thing is that doctors on duty should be patient sensitive and should immediately attend to the problems of patients.
The Minister directed the Secretary Health & Medical Education Department to prepare a proposal for making available one critical care ambulance for both G.B. Pant Hospital and L.D. Hospital in consultation with the Principal, Government Medical College, Srinagar. “The defense authorities will be approached to acquire the piece of land adjacent to G.B. Pant Hospital for its further expansion,” he said.
Chib stressed upon the need to carry out surprise check of the Children Hospital by the Medical Education Authorities including the Principal, GMC, Secretary Health and Medical Education to keep a vigil on the functioning of the institution. He agreed with the suggestions of the delegation that an Advisory Committee consisting of Civil Society Members, Medical Faculty, and Cantonment Authorities will be constituted in order to advise the Medical Superintendent, G.B. Pant Hospital for its effective functioning.
Among others, Secretary, Health and Medical Education M. K. Dwevidi, Principal, Government Medical College, Srinagar, Dr. Qazi Masood, Dr. Bilqees Jamila, member of civil society Omar Tramboo, Vijay Dhar were present in the meeting.
GB Panth in Mess, JLNM Gets Children Ward
Mudassir Kuloo (Kashmir Monitor)
Srinagar: It is a classic example of how the bureaucrats and political workers can misguide the political leadership. Last Monday the Chief Minister Omar Abdullah 'inaugurated' the child specialty unit at the Jawahar Lal Nehru Memorial Hospital (JLMN) hospital in Rainawari. This inauguration went ahead despite valleys only child specialty hospital, GB Panth Hospital recording nonstop deaths due to lack of life saving equipment. .
While the Chief Minister inaugurated the child specialty unit of JLNM on Monday, The Kashmir Monitor on visiting the JLNM hospital on Thursday found out that the block was still under construction and all the sensitive child care equipment was rendered useless under locks. This state of the art equipment includes four photo therapy machines and three ventilators. All the seven are lifesaving equipment'
A senior officer in the state medical education department told Kashmir Monitor that due to misguidance by a few officials and the cold war between R S Chib and Sham Lal, this much needed equipment is lying without use at JLNM hospital." Ideally there was no need for a new children’s block as we have GB Panth Hospital. These machines would have made much more sense at the GB Panth hospital considering its state. It is a sorry state of affairs", he told Kashmir Monitor wishing anonymity.
The functioning of GB Panth Hospital has raised eyebrows as till now 358 deaths have been reported since January 2012. The children’s ward at JLNM fares no better as there is still no admission in the ward. Four phototherapy machines and three ventilators were procured for this hospital however these machines are yet to be functional, which are ‘locked’ in a room.
Even the police persons who were standing outside the gate of IPD new block at JLNM hospital are restricting the public movement. Sources said that the newly inaugurated building is still under construction and the hospital authorities have only taken control over SNCU unit for children which itself is not in use.
Sources in the Health and Medical Education department insist that this equipment should be shifted to the GB Panth hospital at the earliest but we unsure if that would happen." Everyone knows that Sham Lal and Chib are out to outdo each other. Chief Minister must intervene and take the equipment to GB Panth hospital. It is rotting at JLNM", a senior official told Kashmir Monitor. “I fail to understand why government has first procured machines for the JLNM hospital when there is an immediate need for upgrading facilities at the G B Panth. On an average five children dies daily here due to lack of machinery and negligence by the hospital authorities,” says a parent at GB Panth Hospital adding," It is surprising that Chief Minister first inaugurated the child care unit at the JLNM hospital and paid no heed towards the G B Panth hospital, which craves for attention".
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