Outlook English - Print Subscribers Copy Outlook English, 02 July 2018 | Page 16
COVER STORY
a month before monsoons, when the encephalitis rush begins.
How many and when are key variables, and therein lies an
essential part of the story. Of the 3,000 patients who visit BRD
daily, many arrive too late, after first having visited ‘jho-
la-chhap’ doctors, as quacks are known here. Which means,
essentially, that rural healthcare has failed them. It either isn’t
there, or is grossly inadequate. This is a common theme across
India. In the hinterland around Nashik visited by Outlook,
whatever exists by way of primary healthcare is so under-
staffed, so poorly provided for, that doctors can only refer
patients down the line. So, parents head from primary to sec-
ondary to district hospital, and they crumble under thousands
of sick children (see ‘The Broken System That Kills the Kids’).
But, Gorakhpur first. During several visits by Outlook to BRD
early in June, the hospital appeared far from combat-ready.
The usual dereliction is everywhere: bulbs hang from naked
wires, a disgracefully unhygienic water tap sits next to the
principal’s office. Inside, Ganesh Kumar is a tad stoic. “We
could get the same number of
patients this year, or we could
get twice as many,” he says. Not
reassuring, considering things
look as creaky as before, if not
worse. In February, BRD was
ravaged by fire. Then there’s
that chilling and conspicuous
absence: no doctors are to be
seen in its paediatric wards.
The hospital has 950 beds, of
which 500 are for children. Yet,
it has only six paediatricians.
Of its 163 posts for doctors, 27
are vacant as of June. Every
doctor handles up to 400 patients on some days. “I recently
appointed 12 doctors, but only two showed up. Doctors fear
being suspended so they don’t come here,” says Kumar, allud-
ing to the nine doctors arrested last year, seven of whom are
still in Gorakhpur jail, following the oxygen fiasco.
BRD Medical College
has 950 beds, of
which 500 are for
children. Yet, it has only
six paediatricians. Of its
163 posts for doctors, 27
are vacant as of June.
I
T’S a curiously Indian paradox: medical colleges are
proliferating, but doctors can’t be found in key nodal
hospitals that service entire rural swathes around it. It’s as
true of Karnataka (see ‘Where Fewer Babies Die Now’) as it
is of UP, where there’s an unmet need for 7,000 doctors! “It’s a
contradiction for which our public healthcare suffers badly,”
says A.K. Sharma, professor of sociology at IIT Kanpur. “Every
government department—health, education, sanitation—has
staff shortages even as unemployment persists,” he says.
How do these contradictions exist—why does the
demand-supply dynamic not plug this gap? In his research,
public p
olicy and planning expert Santosh Mehrotra, who
teaches at JNU in Delhi, found systemically created short-
ages everywhere. In a 2017 study, he notes that only three of
13 UP medical colleges had regular principals. Incidentally,
BRD’s last principal, Rajeev Mishra, was an ad-hoc man—he is
currently in jail, facing trial for the oxygen fiasco.
The lack of prioritisation shows everywhere. In its latest
budget, UP hiked the outlays for roads and electricity the most.
Mirroring the national trend, the smallest increases were res
erved for health and education. “And they already have much
16 OUTLOOK 2 July 2018
Odisha/Calcutta
SANJIB MUKHERJEE
HOPE & FATALISM (Above) Shishu Bhawan,
Cuttack; Nilratan Sarkar Hospital, Calcutta
THE CHILDREN’S
WARD IS FULL
From the east, tales of entrenched
neglect and its usual victims
by Dola Mitra in Calcutta
and Sandeep Sahu in Cuttack
T
HE sun, they say, has been setting on India’s east. It has
caught up with the benighted north, in terms of the acronym
that was meant to connote sickness: BIMARU status. The
little girl doesn’t know all this. All she knows is that her cot
has bedbugs. And that rats are scuttling between the beds. Her
mother sleeps on the floor, with the rodents and mites. Hassan
Haji, a 30-year-old farmer from Hooghly, had first taken his four-
year-old girl to a local clinic, but they couldn’t diagnose why she
had excruciating stomach pain. The two-hour journey to Calcutta
brought a new kind of “nightmare”—but also salvation.
Here, in Nilratan Sarkar Hospital, there’s anger, hurt and ulti-
mately resignation to every horror. “You’re lucky your daughter
got a bed,” says Enait Younus, a young labourer from Howrah. His
two-year-old son, bleeding from the nose, was crammed onto a
bed with others. Come dawn, men pace nervously on the dusty
lawns outside. Fathers, grandpas, uncles—males spend their
night under the open sky. Women jostle on the ward floor. But
they’re all relieved—their kids are in good hands. Hassan’s daugh-
ter’s pain has subsided. Enait’s son’s nosebleed has stopped.
What conclusion can be drawn: that even if offered in squalor,
the quality of childcare has improved? There are other times to
recall, days and nights of death. People can’t forget September
2013, when 35 children died within five days in the east’s biggest