Over the past month, 100 children have died at the JK Lon hospital in Kota, Rajasthan. The government run hospital reported 10 deaths during a 48-hour period last week which prompted a team from the National Commission for Protection of Child Rights (NCPCR) to visit the hospital.
A government panel consisting of three doctors visited the hospital last week to investigate the deaths and found that it was operating at 150% of its capacity and was short of beds for patients. The panel however concluded that the hospital personal and authorities were not to blame for any lapses. The most recent deaths point to the fundamental lack of basic medical infrastructure in government run hospitals and the way in which they are run. The Hindustan Times editorial
states this should be a wake-up call –
“The deaths in December point to a deeper crisis in the primary health care system. The primary and secondary segments need to have better resources and equipment, and more staff to ensure that the first response to critical cases is effective. Their inadequate response means more pressure on tertiary institutes such as the JK Lon Hospital
The government committee, through its investigation stated that the infants were given the routine and proper treatment. NCPCR chairperson Priyank Kanoongo said in part, “It is evident that there was no glass in windows panes, gates were broken and as a result the admitted children were suffering with extreme weather condition”.
The Congress-led government in the state under Chief Minister Ashok Gehlot has come under intense criticism and scrutiny amidst this latest healthcare crisis. As Sonia Gandhi has asked Gehlot to take stock of the situation, the centre announced that a special team comprising of experts from AIIMS to look into the situation and provide information on steps to improve operations at the hospital. The Times of India editorial
points to lack of planning and implementing policies –
“The 91 infant deaths reported in December at a government hospital in Kota, Rajasthan, must put us to shame.No government functionary has condescended to explain the criminal failure to replace so many pieces of faulty medical equipment.With state governments side-tracked by populist policies like farm loan waivers and the economy sliding into a tailspin there is a real danger of investment slipping in critical areas like public healthcare
Chief Minister Gehlot didn’t help his cause too much by his attempt at providing context to the recent events saying infant deaths happen everyday in other hospitals and the total number of infant deaths was lower in 2019 when compared to previous years.
The deaths in Kota point to a larger, grimmer picture of the state of public healthcare services, facilities and infrastructure in the country, While its not new information that government run healthcare facilities and hospitals aren’t of a very high standard, various policies by the centre and state governments over the years haven’t yielded the necessary results. Sadly, the deaths at Kota are now commonplace as past events have provided some indication - deaths at Gorakhpur’s BRD Medical College where more than 70 infants died due to lack of oxygen in 2017 and the encephalitis outbreak in Bihar which killed over 150 children last year.
The main problem isn’t hard to diagnose. Public healthcare lacks basic planning and implementation, apart from investment and spending which also plays a major role. One of the main issues that come up in cases where there are large number of deaths withing a short span of time like the case in Kota, is the lack of personal. The Gorakhpur tragedy as outlined by Kundan Pandey in his 2017 column
shows a clear picture of the state of public healthcare, in which he states – “So the hospital is not only overcrowded, but it also faces a resource and financial crunch”.
The financial aspect is another important problem that needs to be addressed. India spends a little over 1% of its GDP on healthcare. The National Health policy has recommended that this increase to 2.5%. Pavitra Mohan and Sanjana Brahmawar from Basic Healthcare Services, in a column
for The Wire, outline some financial measures to tackle public healthcare in the country –
“We wish that the national and state budget allocations increase by at least 25% in the next year, i.e. the national health budget would receive Rs 80,000 crore. We also wish that bulk of this increased spending will the fund national health mission as well as health and wellness centres that then help improve access to and quality of primary healthcare”.
In 2019, Rs.62,659 crore had been allocated for the department of health and family welfare and Rs 1,900 crores for the department of health research. The National rural Health Mission is also underfunded; which means expenditure on maternal and infant healthcare is sorely lacking in rural India. Pavitra Mohan and Sanjana Brahmawar state that one of the components of the Ayushman Bharat scheme, the Pradhan Mantri Jan Arogya Yojana has received more than the health and wellness centres component.
According to a 2018 report from the United Nations Inter-Agency Group for Child Mortality Estimation (UNIGME) stated that more than 8 lakh infants died in 2017 in India due to a lack of access to water, sanitation, proper nutrition and basic health services. This meant India having the unfortunate distinction of ranking number one in this regard. A multi-faceted problem such as fixing public healthcare is a large undertaking, especially for a country as large and densely populated as India; but events such as Gorakhpur and Kota will only continue in the face of inaction.
More columns by Varun Sukumar