Down to Earth - - COVER STORY -

Du­larin Pa­tel, 27, of Lokhandi vil­lage in Takhat­pur was one of the 13 women who died. “She was fine till Mon­day af­ter­noon when she vis­ited us.She had taken medicines on Satur­day night and twice on Sun­day,” says Gorabai, Du­larin’s mother. “She started vom­it­ing from 4 o’clock in the evening. Then, we got a call from her in-laws, who stay 70 km away, that the mi­tanin (lo­cal health worker) has asked her to go to the hos­pi­tal.By 3 o’clock on Tues­day morn­ing, she was in Ch­hat­tis­garh In­sti­tute of Med­i­cal Sciences (cims).”

“I fed my daugh­ter black tea and bread toast be­fore she left home. I did not know that was go­ing to be her last meal,” says Du­larin’s mother, not be­ing able to con­tain tears in her eyes. By early evening on Tues­day, Du­larin was de­clared dead.

Pre­lim­i­nary re­sults of the post-mortems of the vic­tims have been sub­mit­ted to the in­ves­ti­gat­ing agen­cies. They have not been dis­closed to the pub­lic but a se­nior med­i­cal of­fi­cer who closely mon­i­tored the post-mortems told Down To Earth (dte) that Du­larin had de­vel­oped sep­ti­caemia. “She had in­flam­ma­tion of the peri­toneum, the mem­brane form­ing the lin­ing of the ab­dom­i­nal cav­ity.T here was half-a-litre of thick yel­low­ish fluid in her lungs and sep­tic foci was found in all or­gans,” said the source, re­quest­ing not to be named. “This is a clear-cut case of post­op­er­a­tive in­fec­tion.”

dte has ac­cessed seven post­mortem re­ports. Five of th­ese are of women who died on Novem­ber 11, one of a Novem­ber 12 vic­tim and one of Novem­ber 13. All five re­ports from the first day showed in­fec­tion of the ab­domen. The re­port from the sec­ond day showed high in­fec­tion in the body.The re­port from the third day showed sep­tic shock.

“This shows the in­fec­tion kept in­creas­ing among women who were ster­ilised on Novem­ber 8. The re­sults show defini­tively that the women got in­fec­tion which must have come through un­ster­ilised in­stru­ments,” says a foren­sic ex­pert at Lady Hardinge Med­i­cal Col­lege in Delhi.

The ad­min­is­tra­tion’s beau­ti­fully crafted story of con­tam­i­nated medicines col­lapses.The women were pre­scribed one tablet each of two medicines, twice a day for five days.One of the medicines was the an­tibi­otic ciprofloxacin, which the ad­min­is­tra­tion claimed was con­tam­i­nated with rat poi­son, zinc phos­phide.

Zinc phos­phide is linked to kid­ney fail­ure. “We did not get any re­nal fail­ure in our post-mortems,” in­formed the source.He said the in­fected la­paro­scope must have been the rea­son for the deaths.

As the foren­sic ex­pert in Delhi ex­plains, zinc phos­phide poi­son­ing shows up as ul­cer­a­tion of the gas­troin­testi­nal tract.The source con­firmed that signs of this were miss­ing in post-mortems. How­ever, con­fir­ma­tion of poi­son­ing can only be through vis­cera re­port, which is awaited.

The health depart­ment’s sec­ond as­ser­tion too falls flat. It said apart from the women who un­der­went ster­il­i­sa­tion op­er­a­tions,26 more peo­ple fell sick after

I fed my daugh­ter black tea and toast be­fore she left home. I did not know that would be her last meal

con­sum­ing the same medicine. Six of them died. dte ac­cessed the post-mortem re­ports of three of the six. “There was no pe­cu­liar find­ing in their post­mortems. Th­ese can only be con­firmed after the chem­i­cal anal­y­sis of vis­cera,” said the source.

Though the of­fi­cials claim that medicines are the cul­prit, they refuse to pro­vide the de­tails, say­ing the mat­ter is sub ju­dice.The only in­for­ma­tion they are ready to part with is that two lab­o­ra­to­ries have con­firmed that the medicines were con­tam­i­nated with zinc phos­phide. They would not say what was the con­cen­tra­tion of the con­tam­i­nant.

Ex­perts do not be­lieve this the­ory. “Ac­cord­ing to stan­dard books, an adult fe­male needs to con­sume 4.5 g of zinc phos­phide to die,” says B L Chaudhary, from the Depart­ment of Foren­sic Medicine and Tox­i­col­ogy at Lady Hardinge Med­i­cal Col­lege. The Ch­hat­tis­garh ad­min­is­tra­tion claims that 500 mg tablets of the an­tibi­otic were con­tam­i­nated.For the sake of ar­gu­ment, even if one as­sumes that the en­tire 500 mg was zinc phos­phide, a woman would have to con­sume nine tablets for the poi­son to prove fa­tal. Most women started to com­plain from Mon­day. By this time, they had taken three to five doses of the an­tibi­otic. This casts doubt on the poi­son­ing ar­gu­ment.

Cit­ing some of th­ese gaps, this re­porter asked

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