Lack of oxygen at hospital points to corruption, mismanagement
GORAKHPUR, India — It was around 6 a.m. on Aug. 11, said Mohamed Jahid — the father of a very sick little girl being treated at a government hospital — when the oxygen stopped. The situation was desperate, but the parents of children in the intensive-care unit did not panic, because they had no idea what was going on.
Most, like Jahid, were villagers, who said they all thought it was normal procedure when the nurses unhooked the ventilators that had been helping keep their children alive, handed out small plastic handoperated resuscitators and quickly showed the parents how to use them.
With his daughter gasping for air, Jahid got right to work.
“I pumped and pumped,” he said. He looked around the ward. All the parents were pumping and pumping. What they didn’t know: The hospital’s supply of oxygen had been steadily dwindling, after the supplier cut off shipments of liquid oxygen for lack of payment.
That day, despite repeated warnings from the supplier and hospital technicians, the oxygen ran out.
By the time the flow was stabilized, more than 60 children had died. Many were sick with Japanese encephalitis
and other tropical diseases and might have died from other causes, but doctors admit that the oxygen interruption is likely to have claimed at least several lives.
The government hospital, part of the larger Baba Raghav Das Medical College in Gorakhpur, was considered the area’s best, a beacon to millions of people. It is now a symbol of India’s swamped, mismanaged and often corrupt public healthcare system. As this episode underscored, the system is so enormous and has so many people moving through it that mistakes are often not corrected until many lives are lost.
The medical college is a monument to that sense of scale. It is a hulking, sprawling network of buildings with nearly 1,000 beds and 10-foot-wide corridors a city block long. With such a deluge of patients, some coming from hundreds of miles away, doctors sometimes work 36-hour double shifts with just a six-hour break, and children are crammed two or three to a A hospital staff member checks newly arrived oxygen cylinders at Baba Raghav Das Medical College Hospital after the company providing oxygen refused to deliver more because the hospital owed money. Some eventually came after a partial payment was made. bed. Families are camped out everywhere, their bedrolls, blankets, water jugs and round steel food tins clogging the hallways.
The state government’s initial response to the oxygen fiasco was to imply that it was perfectly normal for 10 children to die every day at the Gorakhpur hospital, especially at this time of year, the rainy season, when swarms of mosquitoes spread deadly Japanese encephalitis, a virus that causes brain swelling and seizures.
That explanation was
widely criticized as the height of insensitivity. “Who have we become?” asked Pratap Bhanu Mehta, a leading commentator, in a recent column. “In our republic poor children are fated to die.”
Brahamdev Yadav, a rice farmer, had never heard of Japanese encephalitis. But by putting his hand to the foreheads of his newborn twins, he could tell they were sick.
He checked them into the hospital on Aug. 3, around the same time that the hospital’s oxygen supplier was issuing increasingly
urgent pleas for payment. In a string of letters to the medical college, the Indian media reported, the supplier insisted it had its own bills to cover and could not keep delivering liquid oxygen for the hospital’s central oxygen system unless a $100,000 bill was settled.
In India, public officials often squeeze their vendors for “commissions.” It is widely acknowledged that even after public contracts are awarded, vendors have to grovel for payment, and that the best way to lubricate the bureaucracy is to give the officials in charge a 2 percent to 5 percent cut. When asked whom they blamed for the tragedy, several parents of children who died in the oxygen shortage said simply, “corruption.”
The head of the medical college, R.K. Mishra, who has resigned, was under suspicion of misusing public money, Indian news outlets reported. In this same part of India, millions of dollars have vanished in other public health corruption scandals.
The night before the oxygen was cut off, Jahid had arrived at the medical college with his 5-year-old daughter burning with fever and struggling to breathe. “They told me, ‘Take her to the medical college, where there are good doctors and machines, and she’ll be OK,”’ he recalled. He said the oxygen cut out five times Aug. 11.
Around that time, Yadav’s newborn twins died. Both of them had been on ventilators. They were 10 days old. “I thought about killing myself,” Yadav said.
As news of the children’s deaths spread, the hospital scrambled to make a partial payment. Liquid oxygen was delivered the next morning and hospital officials insist there was only a two-hour gap without a central oxygen supply.
Jahid is haunted by thoughts about what he could have done differently. Sitting at home, holding a picture of his daughter, Khushi, he said he had squeezed the manual resuscitator as best he could.
“She was so affectionate,” said her grandfather, Ilahi. “She would bring me tea, she would bring me food, she would bring me water.”
He gazed into the alleyway in front of the family home and said softly, “She was like my hand.”