Jaipur: Nearly two years after the infant deaths at the state-run BRD Medical College in Uttar Pradesh made headlines, Rajasthan’s JK Lon government hospital in Kota has reported a similar spate of deaths.
According to hospital reports, 10 infants died between December 23 and 24, 2019. Thus far, 77 babies have died in December alone, another 101 in November, and a stunning 940 in 2019.
The problem came to light when Lok Sabha speaker Om Birla, the member of parliament from Kota, tweeted, “The untimely death of 10 infants in 48 hours in my parliamentary constituency’s JK Lon Hospital is a matter of concern. Rajasthan government should take action immediately and handle the situation sensitively.”
संसदीय क्षेत्र कोटा-बूंदी के जेकेलोन मातृ एवं शिशु चिकित्सालय एवं न्यू मेडिकल कॉलेज चिकित्सालय में पहुंचकर व्यवस्थाओं का जायजा लिया।48 घंटे में 10 नवजात शिशुओं की असमय मृत्यु दुखद व पीड़ादायक है। घटना की पुनरावृत्ति ना हो इसके लिए पर्याप्त चिकित्सक इंतजाम करने के निर्देश दिये। pic.twitter.com/04XiYV1zOm
— Om Birla (@ombirlakota) December 29, 2019
Rajasthan chief minister Ashok Gehlot’s comment on the issue, attempting to normalise the deaths of infants at government hospitals, was met swiftly with backlash. Gehlot said, “Death of even one child is unfortunate but there have been 1,500-1,400 deaths in a year in the past, this time the figure is 900. There are daily few deaths in every hospital in the state and the country, nothing new. Action is being taken.”
The opposition has called his statement “insensitive” even as Gehlot has insisted that his remarks were taken out of context.
Data from the JK Lon Hospital does indicate that the number of infant deaths has been falling. This said, the 2019 figure is significantly higher than the number of deaths in 2016, 2017 and 2018: 901, 752 and 723, respectively.
Most of these babies had died due to suffocation at birth, followed by low birth-weight and infections.
The Government of Rajasthan has set up a high-level committee to look into the deaths at the hospital. Vaibhav Galriya, the secretary of the medical education department, also paid a visit to the institution, and noticed out several lapses, including lack of oxygen lines and a shortage of proper equipment. According to Indian Express, he said:
Instructions have been given for maintenance of equipment. We are initiating the process right away and have sufficient money for it. Shortage of oxygen lines in the neonatal intensive care unit (NICU) has also come to light. When there is no line for oxygen, patients need to be provided oxygen cylinders inside NICU, which is a bit risky from infection perspective. Orders have been issued for installation of oxygen lines in the NICU … It has also come to light that during monitoring of infection, the frequency of sampling was not adequate.
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He added that there was a “lack of coordination between the head of the [paediatric] department … Amrit Lal Bairwa and the superintendent H.L. Meena in the past one year. We have found supervisory negligence on part of Meena and he has now been replaced.”
Hospital-acquired infections
The reports from the JK Lon government hospital are both disappointing and unsurprising, echoing the longstanding state of affairs in state-run healthcare centres around the country. For example, consider the JK Lon hospital’s infection monitoring report. Fourteen samples that doctors collected from various sensitive and critical parts of the hospital were found to have disease-causing bacterial and fungal populations. Some of these contaminated surfaces were found in such sensitive areas as the NICU, the paediatric intensive care unit and the emergency operation theatre.
Hospital-acquired infections, acquired from contaminated surfaces, are one of the major causes of mortality among infants.
According to reports in the local media, some 320 out of 533 pieces of critical equipment at the hospital, including ventilators, nebulisers, resuscitation machines, sleep apnea machines, spirometers, infusion pumps and heaters, were found to have been in disrepair.
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“Out of 20 ventilators, 14 were not working. Out of 71 warmers, 44 were not working. Out of 28 nebulisers, 22 were not working. No CPAP and BiPAP machine was found to be in working condition. Even the single resuscitation machine[footnote]Resuscitation is used in the case of cardiac arrests among infants.[/footnote] available in the hospital was not working,” Dainik Bhaskar reported.
Data from India’s Sample Registration System for the period 2015-2017 shows that the maternal mortality rate – the number of maternal deaths per 100,000 live births – was highest in Uttar Pradesh (20.1), followed by Madhya Pradesh (17.5), Bihar (16.9), Rajasthan (16.8) and Assam (15.2).