Outlook English - Print Subscribers Copy Outlook English, 02 July 2018 | Page 25

NANDAN DAVE
Gujarat
THE SHADOW
ON THE SHINE
Where health infrastructure
lags behind economic growth
LIFE-SAVER A baby under treatment in the neonatal
ward of a hospital in the desert district of Kutch
by Darshan Desai in Ahmedabad
G
UJARAT was in for a shock this May when the news broke
that 111 newborns had died over the past five months at the
grassroots survey in 18 out of Gujarat’s 33 districts put together
G.K. General Hospital in Bhuj. Run by the Adani Education and
by the JSA points to acute shortage of specialists and paramedi-
Research Foundation, this hospital in the desert district of Kutch
cal staff in district-level health facilities.
was the first under the state government’s public-private exper-
In community health centres across the state, 1,196 of the
iment in the health sector. A few months earlier, 18 infants had
1,272 positions of specialists needed are vacant. In the primary
died at Asia’s biggest government hospital—Civil Hospital, Ahm­
health centres, there is a shortfall of 400 doctors. The shortfall of
edabad. “Five or six children die here every day,” H.H. Prabhakar,
nurses in primary and community health centres is 679. “Besides
medical superintendent at the Ahmedabad hospital, had said
these, there is a big shortage of sub-centres, besides auxiliary
during the thick of the controversy. And at the government-run
nurses and midwives,” says Khanna. “These figures are worse in
K.D. Children’s Hospital in Rajkot, hometown of CM Vijay Rupani,
Gujarat than several other states.” In fact, Gujarat lags behind
164 children died over the first four months of this year.
Maharashtra, Andhra Pradesh, Karnataka, Tamil Nadu, Punjab and
These instances may have shocked people, but scratch the
West Bengal in infant mortality rate, maternal mortality ratio,
surface a bit and such deaths come across, tragically, as quite
total fertility rate, juvenile sex ratio and anaemia among women,
routine. The government’s inquiry found a
among several other indicators.
common thread running through all three
According to the latest data available in
Under-five mortality: 28
instances: most of the infants were referred to
the Sample Registration System Statistical
these hospitals from far-flung rural areas in the
Report 2015 and the National Family Health
Number of PHCs with no doctor
last stage of survival. “This is simply because
Survey 2015-16, 39 per cent children in
in March 2016: 107 out of 1,314
of the pathetic public health infrastructure in
Gujarat are underweight against the national
57.2% households don’t use
the rural districts,” points out Renu Khanna,
average of 35. The state ranks 25th among 29
government healthcare
chief coordinator of Jan Swasthya Abhiyan
states in underweight children under five and
(JSA), a state-level collective of organisations
17th in infant mortality rate, wi th 30 deaths
IMR in Gujarat: 30
and individuals working in the health sector. A
per 1,000 live births. O
Source: Rural Health Statistics, NFHS, SRS
PHCs and CHCs in UP than Kerala or Tamil Nadu, and
these cater to a population that’s double the combined pop­
ulation for Tamil Nadu and Kerala. Also, in 2017, UP had one
allopathic doctor per 3,467 persons. The norm is 1:1,000.
T
HE consequence of such pervasive deprivation? Soon after
birth, Kamla’s grandson’s foot turned blue. This is usually
a temporary condition indicating poor blood circulation.
Oxygen helped, but the family had to shift out from two
private hospitals, unable to afford either. They sought referral
to BRD, where treatment is free. Records state the baby was
premature and had low birth weight. On August 8, doctors told
Kamla the child would be ready for breastfeeding the next day.
On August 9 was scheduled a visit by Chief Minister Yogi
Adityanath. In preparation for his arrival, the hospital closed
its gates. “We were not allowed inside. All parents were out
on the road,” says Kamla. The families were allowed inside
only at 4.30 pm. “The same night, children started dying. We
are very poor and in debt. For eight years, we took loans for
(fertility) treatments and this child was born. Modi-Yogi took
even that from us.” She and her daughter Rina weep, recalling
a nurse telling them: “Tumhara babu mar gaya—your baby is
dead.” Neither the grief nor the bewilderment at the unex­
plained twist has left them.
Gorakhpur is a symptom. Health, as a consumer choice, is
in your face. The town offers virtually limitless options to
the rich sick. A paying customer can walk into any of its 100
private hospitals. For those beyond the pale, there’s either
the jhola-chhap or the BRD, where roughly 7,000 patients
die every year. O
2 July 2018 OUTLOOK 25