शुक्रवार, 12 जून 2015

Fact-finding on Infant Deaths in Kandhamal

Fact-finding Report on 
“Infant Deaths in Kandhamal district, Odisha”

Alarmed over Media Reports about death of hundreds of Infants in Kondhamal district of Odisha,  a  four-member  Fact-finding Team  of Right to Food Campaign, Odisha  (  Sri Pradip Pradhan, Social Activist, Prof. Jantrana Parikhit, President, Odisha Nagarik Samaj,  Sri Sudhir Ranjan Mohanty, advocate, Odisha High Court and  Sri Khirod Rout, Member, Right to Food Campaign, Odisha )  had visited  Kondhamal district on  7.6.15  to ascertain  fact about the  causalities  and  factors responsible for it.
Kondhamal, which came into existence on 1st January, 1994, after Phulbani District is one of the most underdeveloped and backward tribal districts in the state. It stands infamous for its highest infant mortality rate in the country (84 per 1000 child). To ensure food security of the   tribals and   check health hazards in the district, the state Govt. undertakes a number of development schemes under tribal sub-plan and food security programme with allocation of crores of rupees.  But it has failed to check infant mortality rate and maternal mortality rate in the district.  The tribals are seen quite vulnerable entity and susceptible to any common disease.

It is needless to mention here that the team members were quite aware about bad governance, mal-implementation of food security programme, huge corruption and irregularities in development project like NREGA and pathetic health situation in the district. However, the team  visited  with open mind  to find out the reasons behind  the  series of infant deaths within a period of five months in  District Hospital, Phulbani, district head quarter of Kondhamal (as reported  105 infants died within 5 months in district  hospital).

Visit of District Hospital by the Team
On 7.5.15, the Team members  reached  at  district  hospital  at 11.30 AM   and  rushed to  Paediatric Ward  to  look  into the health condition of the  infants  admitted  in the hospital. The Team came across Special New-burn Care Unit ( SNCU)  functioning  as special Unit for treatment of infants  in Paediatric Ward.  The Nursing staff engaged for SNUC did not allow the team to enter into it as the Unit is restricted for outsiders. However, the Team members visited the Ward and came across horrible condition of the ward.  The latrine was found locked for two years. There is not drinking water. The Ward is very dirty, unhygienic and sanitation is very bad. No patients i.e., infants admitted in the ward have not been provided bed-sheet by the hospital authority.

Then, after inspection of the Ward, the Team met  Dr. Satya  Ranjan Mallik, only paediatric doctor in the District  hospital ad Dr. Mamata Mohapatra, ADMO ( Medical) and interacted  with them to understand the reason of magnitude of the death of infants in the hospital.  Narrating his plight as single paediatric doctor in the whole district (the district has 14 Community Health Centre and 34 Primary Health Centre with no paediatric  doctor)   and pitiable situation in the district hospital, Dr. Mallik said that there is no paediatric doctor  against sanctioned post of 3 doctors  for SNCU. He is assigned with multiple works like managing OPD, Indoor patients, SNCU, Nutrition Rehabilitation Centre, Isolation, attending VHND (village Health and Nutrition Day). It is not practically possible to pay attention to SMCU only. He also enlightened the Team that the Mothers are seen suffering from maternal infection, severe anaemia, haemoglobin short etc.  which is the one of the reasons  for the infant deaths. The conditions of the mothers also affect the new burn baby and posed threat to their life. It was also found that the Nursing staffs appointed in SMCU are not well-trained to look after the infants.

The Team members wanted to know from Dr. Mamata Mohapatra, A.D.M.O.( Medical)  about  horrible  condition of  paediatric Ward. She expressed her ignorance about it. The Team members got astonished and asked how she is unaware about it.   Dr. Mohapatra called Matron and wanted to know the problem of the ward.  Matron admitted the problem and said that nobody is working. It was found that the administration and the staff is not under the control of the authority. Sweeper and Attendants of the medical do not care the authority.  They do not attend hospital regularly. There is only 6 Nurse against sanctioned post of 10 in paediatric Ward.  There is also no malaria specialist in the hospital. It was also reported that total no. of 226 children have died in thedistrict within 5 months. Dr. Mallik accompanied the Team to visit NRC (Nutrition Rehabilitation Centre) and found the highly malnourished children admitted in it. Their condition is just like Somalia ad Ethopia children. While verifying the records of infant deaths, it was found that the reason of the death cited by the doctor was due to Aspasia.

The Team also got opportunity to interact with Social Activists Sri Ashok Kumar Parida and Muhammad Jiauddin Ahmmad, concerned citizens and journalists of the districts about the condition of Hospital and disastrous health scenario of the district. They said that total no. of 226 children  have died in the district within 5 months. AMNs hardly stay in sub-centres throughout the district. Village and Health Nutrition Day is not observed properly.  Low quality of Chhatua under ICDS is given to the children ad mothers. Morning breakfast and food is not properly served to the children. The State Government is completely responsible for it.  The Pregnant and lactating women have not got their dues under Mamata Yojana since 2 years. As per information obtained through RTI, Rs.14, 000.00 is spent for washing bed sheet in every month. But the bed sheet is not available in the Wards.

Filed visit of the Team
The Team members visited Dudki, around 10 km distance from Phulbani to interact with the Parents whose child died in the hospital. Srihara Behera said that he admitted her wife in District hospital on 25.5.15. She delivered a baby at 6 PM in SMCU. It was reported by doctor that his child was having breath problem and died on 26 5.15 at 8 AM. The Team also tried to meet other parents but found their absence in the village. ANM was also found absence in the area, as she does not stay there.

Analysis of the findings
A.   Large- scale infant deaths in Kondhamal proves the callousness, indifferent and apathetic attitude of the state Government and its failure  to provide proper health care  to  the citizens. It is no doubt a matter of concern for the concerned citizens and Civil Society who has   moral responsibility to react on it.  The State has completely failed to provide required infrastructure, doctor, para-medical staff in the hospital.  
B.    There is no paediatric doctor   in CHCs ad PHCs of the district. It means the mechanism for the treatment of the children has completely failed in the district. The infants who suffer from any disease   is bound to die due to lack of treatment.  The huge deaths of children also go unnoticed as they   are not allowed to be admitted in the CHC and PHC. As the death of infants occurred in huge scale that too in hospital this time, it came to the public notice. Otherwise, the authorities are quite habituated to under-report the death of the children in kondhamal.

C.    The reason cited by the doctor for the death of infant needs to be examined by the experts. The death may be due to negligence of the doctor and nursing staff. As only paediatric doctor in Hospital is assigned with multiple works.

D.   Mal-administration and mismanagement of the hospital by the authority is another contributing factor for death of the children.  Paediatric Ward is running without latrine, drinking water and bed sheet, sweeper etc.

E.    As the team feels the biggest reason of the ill-health of the Mother and children is lack of proper food. Food insecurity is the major threat to their survival in the district.  It has been reported by the doctor that most of the women are found suffering from maternal infection, severe anaemia, haemoglobin shortage etc. the implementation of ICDS is disaster in the district.

Recommendation
Keeping in view the pitiable and disastrous health situation in district hospital in general and throughout the district in particular, the teams makes the following recommendation to check infant death and improve health service in the district.

A.   In view of absence of paediatric doctor throughout the districts, the Team strongly recommends to State Govt to appoint required doctors ad fill up the vacancies in SMCU,   all CHCs and PHCs on war footing way.

B.    Repair of Latrine and making it complete functional, availability of drinking water, bed sheet need to be ensured at any cost.

C.    Effective monitoring and grievance redressal mechanism should be in place with participation and engagement of the Civil Society like    rehired officials, social atavists, journalists, concerned citizens etc.

D.   Regional Medical Research Centre (RMRC) may be requested to send Expert team to find out real reasons behind the instant death of infants in large scale in Kondhamal district.  

E.     Infant death should not been seen in isolated way only from the health ground.  The State  Government   may constitute a judicial  Commission   to enquire into  the  rampant health hazards,  deteriorating health condition of women and children,  status of implementation of food security programme  like  PDS, ICDS, MDM and other  programme   and recommend for revamping and restoring  health system  in the district.  

F.     The Team has also decided to approach the High Court, if the State Govt. fails to take ay measures   for improvement of health situation of the district.

Signature of Team Members

Pradip Pradhan                                                             Prof. Jantrana parikhit
State Convener                                                             President
Right to Food Campaign, Odisha                                  Odisha Nagarik Samaj
M-9937843482                                                               M- 9937234088

Khirod Rout                                                                 Sri Sudhir Mohaty
Member, Right to Food Campaign, Odisha                  Advocate, Odisha High Court


Contact Address:
Right to Food Campaign, Odisha
393/2035, Padmavativihar, P.O. Sailashreevihar, Bhubaneswar, Odisha,
Email: foodrightsodisha@gmail.com

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