Gorakhpur tragedy: Blame game points to larger healthcare failures

Last Updated: Mon, Aug 14, 2017 16:59 hrs
Gorakhpur deaths

An unimaginable tragedy has now got the attention of the country. The Uttar Pradesh government has initiated a probe to investigate if the shortage of oxygen led to the deaths of 60 children undergoing treatment at the Baba Raghav Das Medical College in Gorakhpur.

Chief Minister Yogi Adityanath faces a tough test for his leadership. On Sunday, he said a special team has been constituted to investigate the deaths and that those found responsible will be given “exemplary punishment”. The Health Minister for the state Siddharth Nath Singh said the lack of oxygen did not seem to be the reason for the deaths; the CM too has taken this line blaming the deaths on Japanese Encephalitis instead; a disease that has plagued Gorakhpur for a long time.

The Indian Express editorial called it criminal apathy stating –

The latest tragedy confirms that the Yogi Adityanath government has treated the festering public health crisis in Gorakhpur — which also happens to be the chief minister’s constituency — with the same criminal apathy, even as it seems to have prioritized polarizing issues, like setting up anti-Romeo squads and devising patriotism tests for madrasas in the state.

The editorial goes on to state how this is an example of failing public health facilities in the country –

The hospital, itself an example of all that continues to be wrong with public health management in the country…last year, Prime Minister Narendra Modi laid the foundation stone of an AIIMS at Gorakhpur. While the setting up of such an institution is welcome, encephalitis can be best combated by strengthening primary healthcare facilities.

While the state government has launched a probe, there are reports that the hospital and State administration ignored requests by the private firm that supplied oxygen for payment of outstanding dues of Rs 69 lakh. There were also warnings of falling levels of liquid oxygen in its plant from employees that were ignored.

The explanations given to the public varied from official to official. There was initial news about the cause of death which was suffocation due to lack of oxygen according to a report of the district magistrate.

The Hindu editorial demanded a prompt inquiry –

This was an entirely preventable tragedy. It will take an independent inquiry to establish why children perished at the BRD Medical College in Gorakhpur between August 7 and 11. Such an inquiry should examine whether and to what extent the disruption of oxygen supply to those who were extremely sick was a cause for the deaths.

Chief Minister Yogi Adityanath’s immediate assertion that no deaths took place due to lack of oxygen was inappropriate as it would prejudice any administrative probe. The way forward would be for the Indian Council of Medical Research to launch a special commission for UP, treating it (Japanese encephalitis) as a public health emergency.

It is also an appropriate moment for the Centre and the States to consider their poor record. They trail even other developing economies, such as neighbouring Thailand and some African countries, in moving to universal health care.

The shifting explanations only point towards the fact that an independent investigation would provide clarity. Was it negligence on part of the hospital or was it a disease that has ravaged Gorakhpur? It shines a light on the dismal state of healthcare infrastructure and systems that are currently in place and the inefficiency of government officials to get their stories and facts straight; which sadly may not bring much comfort to the parents.

The Times of India editorial criticized the state of Uttar Pradesh’s public healthcare system –

The stark reality of UP’s failing public healthcare system has been highlighted by the Gorakhpur tragedy. But on the most disturbing charge that children died in the neonatal and encephalitis wards because their oxygen supply was cut off, government’s denials remain unconvincing. If this charge is proved, it would be a case of criminal negligence or worse.

Government inquiry into the Gorakhpur tragedy must not pre-judge the matter but find out the truth about whether the infants’ oxygen supply was indeed cut off for non-payment of dues to the supplier. Such a crime must not go unpunished.

One person who was hailed as a hero is Dr Kafeel Ahmed Khan who decided to spend his own money to arrange for oxygen cylinders as children in his ward collapsed. He was removed as the Nodal Officer for BRD Medical College's Department of Pediatrics and was quoted in the Times of India saying “It's a smear campaign against me. I was only trying to help the children. I did everything from getting in touch with oxygen firms to ensuring prompt help to patients.”

Among the charges leveled against him is dereliction of duty; but also the allegation that he ran a private clinic. Many on social media pointed towards an unverified twitter profile having anti Modi tweets and attributed them to Dr.Khan. However, amongst the praise he’s getting now, his past actions are being scrutinized. Some reports indicate that Dr. Khan, who is a member of the supplies department, did not inform the CM of the dwindling supply of oxygen cylinders.

The Deccan Chronicle editorial urged there to a fix for the rot in healthcare –

…it’s immaterial whether lack of oxygen supply was the direct cause for some deaths or not. The fact that it wasn’t available at a big medical college hospital, in a constituency from where Yogi Adityanath, UP’s chief minister, was earlier elected to Parliament, only indicates the carelessness of the hospital administration and bureaucracy.

This issue goes far beyond politics. Even if we accept that viral infection may have caused encephalitis, the fact that analysis points to lack of cleanliness is a severe indictment of society. We can’t even provide basic living conditions. Government spending on healthcare and education are minimal across the country.

The issue however did not escape the light of politics. The Shiv Sena criticized their ally, the BJP for the tragedy in its editorial mouthpiece Saamna saying the Gorakhpur tragedy is an insult to the nation's Independence Day and stated that despite there being a new government in place in Uttar Pradesh, “achhe din” hasn't come for the poor. Congress leader P Chidambaram said, “Gorakhpur is a man-made tragedy. The nation waits to see if any honorable man will take responsibility.”

As many reports have pointed out, the issue also points to the larger faults and inefficiencies in the healthcare system in India. Spending on healthcare at various levels points to what type and quality of infrastructure is available. A Livemint editorial stated some of the problems facing Indian healthcare system as a whole –

…the fact is that what has happened in Gorakhpur isn’t merely about oxygen cylinders and unpaid bills—it is a symptom of many deeper problems. At the top of the list is India’s abysmally low public spending on healthcare. That at least partly explains why the country’s healthcare system is in a shambles. Public spending has increased but only marginally over the past two decades—from 1.1% of gross domestic product in 1995 to 1.4% in 2014.

The editorial goes on to state that there is a manpower shortage in the Indian healthcare system and a lack of health insurance –

The country has only about one doctor for every 1,700 patients whereas the World Health Organization (WHO) prescribes at least one for every 1,000 patients. A third problem is that a vast majority of people do not have health insurance in a country where the public health system has collapsed.

The real question to ask is: will these children’s death galvanize the people to demand that their leaders fix the country’s broken healthcare system? Will it force the politicians to make healthcare a serious campaign platform? Here, there is some soul-searching to be done.

More columns by Varun Sukumar

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