Fact-finding Report on Infant Deaths in Sardar Ballav Bhai Patel P.G.
Institute of Paediatric (Sishu Bhawan), Cuttack of Odisha
Having
gone through the repeated news about series of child deaths since few days in Sardar Ballav
Bhai Patel Paediatric Hospital (Sishu Bhawan), Cuttack, the premier Institute in the state, the Civil Society
Groups felt concerned about the incident and decided to visit the Hospital
on fact-finding mission to ascertain the
fact and factors responsible for such deplorable incident of huge child
causalities in old hospital of the
state. The eminent members of Civil Society Groups who visited the
Hospital were as follows.
1. Rabi
Das, Eminent Journalist
2. Pradip
Pradhan, State Convener, Right to Food Campaign, Odisha
3. Sudhir Mohanty, Advocate, Odisha High Court
4. Khirod
Rout, Advocate, Odisha High Court
5. Debendra
Sutar, eminent Social Activist
6. Rohan
Mohanty, RTI Activist and President, Odia Yuva Manch
7. Miss
Prativa Das, Woman Activist
It
is needless to mention here that this
paediatric Hospital is recognised as one of the best Child Care and Research Hospital in Eastern India. The
416-bedded Hospital has only 21 ICU
(Intensive Care Unit). The parents from
different districts and other states like Jharkhand carry their children to this hospital with
hope to get best treatment for their infants in every day. Since few years,
there is wild allegation by the common people and patients about negligence of the doctors and the staff of
the hospital in respect of treatment to the patients i.e., infants. It is reported
that due to negligence of Medical staff, corruption, poor infrastructure,
mismanagement, the death toll of the patients is rising every year. Within four days, 29 infant deaths were reported
by Hospital authorities. The details of causalities in ICU are as follows.
Year
|
Admitted in Hospital
|
Death of Infants
|
Percentage
|
2010-11
|
1972
|
412
|
20.89
|
2011-12
|
1982
|
454
|
22.91
|
2012-13
|
1820
|
278
|
15.28
|
2013-14
|
2016
|
326
|
16.17
|
2014-15
|
2183
|
564
|
25.84
|
The
Details of the patients admitted and
died in Ssihu Bhawan are as
follows
Year
|
Outdoor
|
Indoor
|
Death
|
Percentage
|
2010-11
|
88563
|
10995
|
488
|
4.44
|
2011-12
|
91227
|
11268
|
527
|
4.68
|
2012-13
|
92790
|
12560
|
837
|
6.66
|
2013-14
|
107796
|
14023
|
903
|
6.44
|
2014-15
|
110381
|
17899
|
1114
|
6.22
|
Details of the Visit of the Team
On
25. 8.15, the Team reached at Hospital at around 11.30. The campus was crowded
with the presence of representative of Political parties and electronics
media. After reaching the campus, the team members rushed to the Wards
and ICU of the hospital to see the condition of the children admitted for treatment
and inspect the surroundings of the hospital.
During interaction with ICU staff, Smt. Sanjukta Mishra, ICU In-charge
appraised the team about number of the problems. There is only 30 Nursing Staff against
requirement of 70 staff in ICU for 3-shift duty in a day. As per medical norm,
there should be one attendant per each patient in ICU. Similarly, there is huge shortage of doctor
in the hospital. The Hospital is generally
managed by PG Students. The treatment of
patients is also affected due to shortage in supply of syringe, gloves and supply of medicine to the hospitals. She also
shared three circulars with the Team
which is one of the reasons for damaging health system and making health service costly and depriving the poor people to access the health service in ICU of the hospital.
A. Circular No-1: The office order dated 21.9.10 issued by the Superintendent
of the Hospital mentions that the bed charges of ICU and Ventilator charges will be
collected from the patients as mentioned below.
1. Bed
Charges for first 5 days @ Rs. 250/- per day and 6th day onwards @
Rs.500/- per day.
2. entilator
charges will be collected @ Rs. 500/- per day.
B. Circular No.-2
- The office order ( No.
1244/SVPPGIP,CTC dated 10.4.15 ) issued
by the Superintendent indicates
that the charges for ABG with Electrolyte, Glucose and Lactate
will be from Rs. 350/- to Rs. 400/-. The Charges with Electrolyte
(chemical method) will remain same Rs. 200/- per test.
C. Circular No.-3
- There is instruction by the Superintendent in his office order dated 14.7.15 that the dues for 3 ( three days) in advance
from the parents during
admission in I.C.U. will be
collected and the
Sister-in-Charge will collect the dues on day to day
basis.
The
above-mentioned fees charged by the Hospitals have made the treatment very costly and
unbearable on the part of poor patients. The Team members also visited the ICUs
and General Wards and found the condition of the most of the infants critical
and did not notice any vacant bed in the hospital. The Sister-in-Charge also reported that there
are around 15 patients in queue to be admitted
in the ICU.
Meeting with patients
Then,
the Team members interviewed the parents of patients asking few questions about their
native place, reason for admitting their children in hospital, level of
their satisfaction on treatment made by the doctors. The response of the parents of the patients
is as follows.
Sl.
No
|
Name
of parents
|
Native
place
|
Testimony
|
1
|
Chaturbhuja
Mohanta
|
Keonjhar
|
The
Doctor of Keonjhar district Hospital referred his 13 year son to Sishu
Bhawan for treatment, as his condition go critical. His son has been admitted in hospital since four days. He has not been supplied any medicine free
of cost. Every day, he is purchasing medicine.
|
2
|
Pinki
Devi
|
Badbil of Keonjhar district
|
As
she could not get proper treatment at Keonjhar district hospital, she has
brought her 7 month old child to this Hospital for better treatment on
25.8.15. Her child has been admitted in ICU. His condition is critical. He has already purchased medicine of Rs. 2000/- as per prescription issued
by Doctor.
|
3
|
Laxmi
Jena
|
Jajpur
Road, Jajpur district
|
She
has admitted her 3 day old baby in hospital.
The reason is the new born baby is having respiratory problem.
As she does not faith on CHC,
she brought her baby to Sishu Bhawan for treatment. The Treatment is groining on since 4 days.
The condition of her baby is still
critical.
|
4
|
Manoj
Kumar Mohapatra
|
Sundaragarh
|
He
carried her child to admit in Rourkela Hospital. Having not been satisfied with the
treatment, he got her baby admitted in
Keonjhar District Hospital. Then, the
Doctor referred to Sishu Bhawan. Every day, he is purchasing medicine
of Rs. 1200/- to Rs. 1800/- for treatment of her child.
|
5
|
Harapriya Behera
|
Kandarpur
of Cuttack district
|
She
had admitted her 6 month old baby in Hospital
since 22 days. Every day, she spends Rs. 2500/- towards the cost of treatment.
She has already spent Rs. 40,000.00
till now with no result.
|
The
Team members experienced deplorable and
pathetic condition of the parents who have come to this hospital from far way
area with the hope to get proper treatment for their children. But their hope
has been dashed out due to serious negligence of the medical staff and demand
of huge expenditure, fees charged by the medical etc.
Meeting with Superintendent and Medical Staff
The
Team tried to meet Dr. Niranjan Mohanty , Superintendent of Sishu Bhawan
but found absence. It was informed that
he had gone to attend high-level meeting called by the Minister for Health and
Family Welfare to review the incident of
infant death in the hospital. Then, the Team members met Manager of the
Hospital and discussed about reason of the huge child causalities. He said that
most of the cases and the children getting admitted in hospital are referred by the
district hospitals from different areas. These babies are
admitted with critical condition. So the chances of survival always remain doubtful. He preferred to
remain silence on other critical issues raised by the Team.
Experience of the Team with a BPL Patient and story of his harassment
by Medical staff
The
Team members came across a BPL Patient loitering in verandah of the Hospital and
demanding return of the fees charged from his, though he is BPL hard
holder. On query, it was
found that he is a man from
Jajpur who had come with 3 years
baby for treatment. He met the doctor at outdoor and the
Doctor wrote the prescription and advised
him to go for different test by depositing fees at counter. He went to Medial counter to get the blood
tested. But the staff sitting at the counter demanded the payment of the fees. When he showed his
BPL Card and demanded his entitlement of free treatment, the staff abused him and asked him either
pay money or leave the place. After
exchange of arguments and counter-arguments for few minutes, he was forced to pay the amount of Rs. 190/-
and got money receipt. Having heard the
story, one of the Team members carried him to the staff claimed to be person hearing
grievances. After hearing the
grievances, he said that the outdoor BPL patients were required to pay the fees
unless they are admitted in hospital. It
was found that the people who are covered under Rastriya Swasthya Bima Yojana,
Biju Krushak Kalyan Yojana are also entitled to get free treatment. But the doctors are not aware about this provision
for which the eligible patients could not get free treatment. Though the BPL patient demanded return of the
money, he was denied. This the test
case and brings to limelight how the BPL people are getting harassed ad denied
free treatment despite production
of proof of the documents.
Critical Issues ad Recommendations
1. This Sishu Bhawan is one of the prestigious
premier paediatric hospitals for treatment of the infants in eastern
India. This Institute has gained
reputation because of huge infrastructure, well-equipped staff and trained
doctors, nursing staff. The patients
from different parts of Odisha and neighbouring states also come to this
hospital with the hope to get better treatment of their children. But in
due course of time, this Institute has lost its credibility and respectability
due to maladministration, mismanagement, corruption, lack of fund, apathetic
attitude of the state administration
and disgruntled and corrupt staff of the Hospital. The reason of the preset death of
infants cited by the authority is that
most of the patients are admitted in hospital on referral basis. It means, many
patients are referred to this hospital from different hospitals, CHC, PHC
across the state. But the reason is not at all acceptable and convincing. The patients who failed to get proper
treatment due to lack of infrastructure
or expert and efficient surgeon in any place of the state or their
condition got critical find no option
but to come to Sihsu Bhawan with the hope to get best treatment. It is obvious and expected to get best treatment
from the Hospital for the children suffering from multiple diseases and whose conditions are
critical. As because there is
huge shortage of doctor and staff
and mal-administration, the standard of the treatment in the Hospital
has deteriorated which has
resulted in rise of death of
infants in large numbers in different
preceding years. So keeping in view the demanding situation and expectation of
the people of the state for better treatment of their children, the State Govt. is
recommended to intervene immediately to reform the administration in the Institute with filling up all vacancies in the
post of Doctor, Nursing Staff and other
staff. The required financial support should be provided for development of infrastructure to meet the need of the Hospital.
2. The State Govt. with commitment for restoring
the glory of the Institute should order
for a Judicial enquiry or a
third party enquiry by AIIMS or
ICMR and mismanagement of the Hospital. The Govt. should be omitted to implement the recommendation of the agency
in letter and spirit for the improvement of this premier institute.
3. As the standard of the Treatment in District hospitals, Community Health Centre, Primary Health centre is deteriorating in all the districts due to
shortage of doctor, staff and corruption, the people are found reluctant to carry their
patients to these hospitals and rushing to
this Institute for better
treatment. That’s why, this Institute is
getting crowded and the number of patients increasing every year. So, the Team recommends that the State Govt. should take steps
on war footing way to
revamp and reform the District Hospitals, CHC, PHC with
appointment of required doctors and Staff
to make it well-equipped to
render best health service to the patients in different districts. The
effective attention should be paid to revamp the
hospitals and Health centres in
tribal regions of the state.
4. The State
Govt. should make a
mandatory provision for all the
MBBS passed doctors of all the Medical Colleges to work at least 5 years in Govt. hospitals in
different districts prior to join in PG Course.
5. The State Govt. should strictly
implement the provision of
providing free treatment to the people
living below poverty line
and the people covered under
Rastriya Swasthya Bima Yojana in any
Govt. and private hospital across the
state. Serious action should be
taken against those staff
or authority violating it.
Members of the Team
Rabi
Das Pradip Pradhan
Eminent
Journalist, Bhubaneswar State
Convener, Right to Food Campaign, Odisha
Sudhir
Mohanty Khirod Rout
Advocate,
Odisha High Court Advocate,
Odisha High Court
Debendra
Sutar Rohan
Mohanty
Eminent Social Activist RTI Activist & President, Odia Yuva Manch
Miss
Prativa Das, Woman Activist
--------------------------------------------------------------------------------------------------To
Sri S.C. Jamir Date-27.08.2015
Hon’ble Governor
Raj Bhawan, Bhubaneswar
Sub- Seeking direction to State Govt. To take prompt action
to save the life of infants dying due to negligence and mal-administration in
Sardar Ballav Bhai Patel P.G. Institute of Paediatric (Sishu Bhawan), Cuttack
of Odisha
Esteemed Sir
We, the
representatives of Social Action Groups bring
to your kind notice the
following matter seeking your
urgent intervention and
necessary action.
Having
gone through the repeated news about series of child deaths since few days in Sardar Ballav
Bhai Patel Paediatric Hospital (Sishu Bhawan), Cuttack, the premier Institute in the state, the Civil Society
Groups felt concerned about the incident
and visited the Hospital on fact-finding mission to ascertain the fact and factors responsible for such deplorable incident of huge child
causalities in old hospital of the
state.
The Team
met and discussed with Medical staff, relatives of patients and
the authority and wanted to know
from the reason of the infant causalities and factors
responsible for it. After
inspection of Wards and ICU and the
condition of the children, the Team
felt that the situation is completely
worst due to shortage of staff and doctors, mal administration and
corruption. This disaster is man-made and the administration is completely
responsible for large scale infant deaths in the Hospital.
Having
been deeply concerned over the disastrous
situation in
this Institute, we make the
following suggestions for
reforming and revamping health
care system in the State in general
and Sishu Bhawan in particular.
The suggestions are as follows.
1. This
Sishu Bhawan is one of the prestigious premier paediatric hospitals for
treatment of the infants in eastern India. This Institute has gained reputation because of huge infrastructure,
well-equipped staff and trained doctors, nursing staff etc. The patients from different parts of Odisha
and neighbouring states also come to this hospital with the hope to get better
treatment of their children. But in due course of time, this Institute has
lost its credibility and respectability due to maladministration,
mismanagement, corruption, lack of fund, apathetic attitude of the state
administration and disgruntled and
corrupt staff of the Hospital. The
reason of the preset death of infants cited by the authority is that most of the patients are admitted in
hospital on referral basis. It means, many patients are referred to this
hospital from different hospitals, CHC, PHC across the state. But the reason is
not at all acceptable and convincing. The
patients who failed to get proper treatment due to lack of infrastructure or expert and efficient surgeon in any place
of the state or their condition got critical find no option but to come to Sihsu Bhawan with the hope to get best
treatment. It is obvious and expected to
get best treatment from the Hospital for the children suffering from multiple diseases and whose conditions are
critical. As because there is
huge shortage of doctor and staff
and mal-administration, the standard of the treatment in the Hospital
has deteriorated which has
resulted in rise of death of infants in large numbers in different preceding years.
So keeping in view the demanding situation and expectation of the people of the
state for better treatment of their children, We suggest
that the State Govt.
Be directed to intervene
immediately to reform the
administration in the Institute with
filling up all vacancies in the
post of Doctor, Nursing Staff and other
staff. The required financial support should be provided for development of infrastructure to meet the need of the Hospital.
1. The State
Govt. Should be directed to
order for a Judicial enquiry or a
third party nquiry by AIIMS or
ICMR about the incident. The Govt. should be comitted to
implement the recommendation of the agency in letter and spirit for the
improvement of this premier institute.
2. As the standard of the Treatment in
District hospitals, Community Health Centre, Primary Health centre is deteriorating in all the districts due to
shortage of doctor, staff and corruption, the people are found
reluctant to carry their
patients to these hospitals and rushing to
this Institute for better
treatment. That’s why, this Institute is
getting crowded and the number of patients increasing every year. So, the Team recommends that the
State Govt. should be directed to take steps
on war footing way to
revamp and reform the District Hospitals, CHC, PHC with
appointment of required doctors and Staff
to make it well-equipped to
render best health service to the patients in different districts. The
effective attention should be paid to revamp the
hospitals and Health centres in
tribal regions of the state.
3. The State
Govt. should be directed to make a mandatory
provision for all the MBBS passed out doctors of all the Medical
Colleges to work at least 5 years in Govt. hospitals in different
districts prior to join in PG
Course.
4. The State Govt. should be directed to strictly implement the provision of providing
free treatment to the people living below poverty line and the people covered
under Rastriya Swasthya Bima Yojana in
any Govt. and private hospital across the state. Serious action should be taken against those
staff or authority for violating it.
5. All the Office orders issued by the
authority for collection of
different kind of fees towards different type of tests,
ventilator charge etc. Should be withdrawn immediately.
N.B.- Fact-finding Report is attached for reference
Signature of Members of the Team
