STRANGER THAN THE NEWS

Four- day- old’s death un­masks the rot in Ja­land­har Civil Hospi­tal, the largest state- run fa­cil­ity

India Today - - NATION - By Asit Jolly

The Hindu cre­ma­tion ground at Ja­land­har’s Nur­pur Colony has a new grave. A four- day- old baby girl born to Anita, 30, and San­jiv Ku­mar, 26, was in­terred here just as the sun climbed above the city’s smoggy hori­zon on July 26. There was no rit­ual on the oc­ca­sion. The par­ents, both poor Sched­uled Caste daily wa­gers, could not even af­ford a pri­est.

On July 25, the in­fant, born pre­ma­turely at 30 weeks on July 22, had in­ex­pli­ca­bly died af­ter be­ing treated for in­fan­tile jaundice in the pae­di­atric ward at the Ja­land­har Civil Hospi­tal. Ku­mar was con­vinced his daugh­ter died be­cause he did not have the money to pay a Rs 200- user charge the pae­di­atrics nurs­ing staff had asked him to de­posit. “The nurses re­fused to put my child in the ma­chine ( pho­tother­apy unit) even though she had stopped suck­ing her mother’s milk,” says Ku­mar.

The in­ci­dent quickly mush­roomed into Pun­jab’s big­gest break­ing news. News net­works ac­cused Pun­jab Chief Min­is­ter Parkash Singh Badal and his gov­ern­ment of “cal­lously caus­ing the death of an in­fant by re­fus­ing life- sav­ing treat­ment only be­cause the par­ents did not have Rs 200 to pay”.

An ev­i­dently ig­no­rant and flus­tered state ad­min­is­tra­tion, in a knee- jerk re­sponse, or­dered the sus­pen­sion of a staff nurse pend­ing two sep­a­rate in­quiries— one by the dis­trict au­thor­i­ties headed by Ad­di­tional Deputy Com­mis­sioner Parneet Bhard­waj and the sec­ond by three se­nior doc­tors in­clud­ing the civil hospi­tal’s Med­i­cal Su­per­in­ten­dent ( MS) Iqbal Singh, se­nior gy­nae­col­o­gist Sangeeta Ka­pur and the res­i­dent pae­di­a­tri­cian Jas­min­der Kaur. Badal, who had ini­tially de­scribed the in­ci­dent as “a rou­tine er­ror”, also changed his stance and an­nounced a com­pen­sa­tion of Rs 1 lakh to the par­ents of the de­ceased child.

While the in­quiry re­ports are yet to be made pub­lic, in­ves­ti­ga­tions by IN­DIA TO­DAY have un­cov­ered a re­al­ity that is al­most com­pletely con­trary to news re­ports em­a­nat­ing from Ja­land­har and what the state gov­ern­ment too seems to have con­vinced it­self of.

Anita was ad­mit­ted to the ma­ter­nity ward of Ja­land­har Civil Hospi­tal on July 20 morn­ing. Two days later, in the ab­sence of doc­tors, Nee­lam Sharma, the staff nurse on duty, helped her de­liver a baby girl. As in all cases of poor par­ents opt­ing for gov­ern­ment- in­sti­tu­tion­alised de­liv­er­ies, San­jiv and Anita were handed Rs 1,000 as in­cen­tive money. Hospi­tal records show the child was pre­ma­ture and con­se­quently un­der­weight. She also had a mild af­flic­tion of in­fan­tile jaundice, a con­di­tion com­mon in new­borns. “It was a nor­mal de­liv­ery and we were both thrilled,” says Ku­mar, who even dis­trib­uted bak­shish amongst the Class IV work­ers on duty that day.

On July 23, both mother and baby were moved to the pae­di­atric ward. The nurses ad­min­is­tered in­ter­mit­tent pho­tother­apy and med­i­ca­tion to the in­fant. “My baby was fine and on reg­u­lar breast­feed­ing,” says Anita. How­ever,

NURSES ARE CALLED UPON TO PER­FORM PRE- TERM DE­LIV­ER­IES IN COM­PLETE VI­O­LA­TION OF MED­I­CAL RULES.

there was a ver­bal al­ter­ca­tion be­tween nurse Har­jit Kaur and the child’s fa­ther when she asked him to de­posit Rs 200 at the hospi­tal fee counter for use of the pho­tother­apy unit. “The fee is manda­tory and we have to keep re­mind­ing pa­tients be­cause many of them leave with­out de­posit­ing the money,” says Har­jit, adding that nurs­ing staff is forced to de­posit the money if pa­tients leave with­out pay­ing. Both the MS and res­i­dent med­i­cal of­fi­cer Surinderpal Singh be­lieve “the child died from chok­ing af­ter breast­feed­ing”.

The demise of the four- day- old girl has ex­posed an en­tirely dif­fer­ent scan­dal than is be­ing al­leged— se­ri­ous bu­reau­cratic neg­li­gence and the state ad­min­is­tra­tion’s en­deav­our to run a pub­lic health­care sys­tem with al­most neg­li­gent qual­i­fied man­power. The 400- bed Ja­land­har Civil Hospi­tal, the largest state- run fa­cil­ity in Pun­jab, does not pos­sess an in­cu­ba­tor. Un­der the Janani Shishu Su­rak­sha Yo­jana ( JSSY), a premier Na­tional Ru­ral Health Mis­sion scheme ex­tended to Pun­jab in June 2011, all neona­tal care for both moth­ers and their ba­bies is free up to 28 days af­ter birth. The scheme was never com­mu­ni­cated by the state’s health au­thor­i­ties. Pun­jab Health Sys­tems

Cor­po­ra­tion of­fi­cials is­sued or­ders re­gard­ing JSSY on July 27, two days af­ter the in­fant’s death in Ja­land­har.

The loss of the cou­ple’s first- born has also fo­cused at­ten­tion on the gross un­der­staffing at Pun­jab’s state hos­pi­tals. Jas­bir Kaur Thind, 50, the pres­i­dent of the Pun­jab Gov­ern­ment Nurses As­so­ci­a­tion, says, “Not a sin­gle nurse is posted at the neona­tal care unit in the Ja­land­har Civil Hospi­tal.”

Thind has other such shock­ers: “The 38- bed pae­di­atric ward is manned by a sin­gle staff nurse,” she says, adding that the hospi­tal has just one pae­di­a­tri­cian with no one to fill in for her when she is on leave. On the day Anita’s child died, the pae­di­atric spe­cial­ist was in Chandi­garh for an of­fi­cial meet­ing. Things are worse in the ma­ter­nity ward, where nurses are called upon to per­form pre- term de­liv­er­ies in com­plete vi­o­la­tion of med­i­cal reg­u­la­tions.

Back in their home, Ku­mar and Anita mourn the loss of their first- born firmly con­vinced that the hospi­tal was re­spon­si­ble for their baby girl’s demise. “I had been pin­ing for a baby. Some­body must pay for tak­ing that away from me,” she says.

SAN­JIV KU­MAR ( RIGHT) WITH THE FOUR- DAY- OLD AND HER GRAND­MOTHER

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