Death by I-V?
- 15 pregnant women died of post-partum complications at the government-run Umaid Hospital, Jodhpur, between February 13 and March 6
- NHRC has sought a detailed report from the Rajasthan govt
- Infected I-V fluid procured from Parenteral Surgical India Ltd, Indore, seen as possible cause of deaths
- A Rajasthan govt-appointed panel says some deaths due to natural causes or pre-existing complications
- Rs 5 lakh compensation announced
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It was a late pregnancy for 33-year-old Anita Kashyap of Shikargarh, Jodhpur, but a planned one. A post-graduate, she took care, followed the advice of her gynaecologist and got each test done on the prescribed date, despite the limited resources at the disposal of her lower middle class family. “She was absolutely healthy, had a haemoglobin count of 12.5,” recalls her 35-year-old husband, Narendra Kashyap, who works in a private office. On February 14, Anita went to the government-run Umaid Hospital and was wheeled into the operation theatre on February 16 after spending two days in the labour room. She had given birth to a boy but began bleeding profusely after the caesarean section. Despite 18 units of blood being pumped into her, and a hysterectomy to check bleeding, she succumbed by evening. All that a shell-shocked Kashyap can remember now is that, soon after she was put on the drip in the labour room, Anita’s lips had swollen and she was feeling unusually hot despite the winter chill.
A similarly horrific story played out for 28-year-old Narendra Kumar of Harijan Basti, Masuriya, Jodhpur. His 24-year-old wife Bhavana gave birth to a girl—their third child—on February 19 at Umaid but three hours later, after being put on drip, she started bleeding excessively. She too went through a hysterectomy, was shifted to the ICU at Mahatma Gandhi Hospital and given 20 units of blood, but died a week later, on February 26. “The doctors never informed us about anything, kept us in the dark. Till date we don’t know what went wrong,” says Narendra Kumar, an unemployed graduate, who survives on daily wages.
Bhavana and Anita were two of the 15 full-term pregnant women who died between February 13 and March 6 in Jodhpur of a similar, unexplained condition. They were all patients of Umaid, the region’s largest, most advanced, super-speciality hospital for women and children. Most died of post-partum haemorrhage, that is, excessive bleeding after childbirth, and some of septicaemia, jaundice and renal failure. While contaminated I-V fluid procured from Indore-based Parenteral Surgical India Ltd has been held responsible for the deaths, the results of samples sent to the Central Drugs Laboratory, Calcutta, are awaited at the time of going to press.
In this inexcusable, heinous game of death, as many as six agencies have been conducting separate probes: the police, the drugs control organisation, the divisional commissioner, a committee from Umaid Hospital, a two-member committee sent from Sawai Madho Singh Hospital, Jaipur, and a committee from the Union health ministry. Meanwhile, the NHRC has issued notice to the government of Rajasthan, seeking a detailed report within four weeks. Last heard, the Jaipur probe team concluded that toxic fluids were the probable cause of deaths but also pointed out that six of the cases could have died from natural, pre-existing causes. On the other hand, the central team’s report to the health secretary is learnt to have blamed the hospital for its appalling lack of basic critical-care. Last year, the hospital was in the news for administering HIV-infected blood to thalassaemic children, resulting in eight children testing positive for HIV, and 43 contracting hepatitis-C. But the hospital administration, in a report to the government, had said the infection may have been contracted elsewhere.
The central team has cast suspicion on the competence of the hospital’s microbiology lab and also stated that senior doctors are usually missing at the time of deliveries and junior doctors and nurses are left to handle the cases. In fact, Kashyap has filed an FIR against Dr Uma Bissa, a gynaecologist. He alleges that she refused to attend to his wife Anita despite her deteriorating condition.
What’s amply clear is that these women have been victims of blatant neglect, misconduct and collapse of the medical system at all levels. In the recent incidents, relatives have not been given medical records. Despite the severity of the tragedy, no post-mortems were conducted save on Anita, that, too, on the insistence of the family. Moreover, the hospital authorities woke up too late to the enormity of the situation. The whole affair points at a larger malaise in the government healthcare and the fact that there could be collusion between doctors, pharmacists, laboratories and drug manufacturers over procurement and supply of dubious medicines.
The tragedy is compounded by the fact that most of these victims come from poor families, with no voice, no influence. Twenty-five-year-old Mohammed Arif, of Khandaphalsa, a depressed locality of Jodhpur, has studied till Std X and is a dyer who earns about Rs 100 a day. He claims to have run up a debt of Rs 2.5 lakh in the treatment of his 20-year-old wife, Ruksana. “She bled to death despite receiving 32 bottles of blood in the four days she was in the hospital,” he says. Ibrahim Khan, 32, from Lawa in Pokhran, is an illiterate daily-wager who borrowed Rs 60,000 for the treatment of his 28-year-old wife Naju.
The families of the victims complain that Umaid Hospital is overcrowded, understaffed, unfriendly and unhygienic (which is true of most hospitals in the region). “We handle as many as 20,000 deliveries a year, mostly complicated cases from rural areas,” says Dr N.G. Changani, the hospital superintendent. Those in the know point out that when it was established in 1945, Umaid was an efficiently managed hospital. “In the last 20 years, it has deteriorated. Now the situation is such that there are 2-3 patients on one bed and some are made to sleep on the floor,” says Suryakanta Mishra, BJP MLA from Soor Sagar, Jodhpur.
The recent incidents also show the larger failure of the government health initiatives. “Janini Suraksha Yojana lays emphasis on preventing maternal deaths and encourages women to deliver safely in hospitals. That scheme is obviously failing if such incidents are occurring,” says Dr Narendra Gupta, member of an independent fact-finding team constituted by the Rajasthan chapter of the People’s Union for Civil Liberties (PUCL), Jan Swasthya Abhiyan, Pravah, Vikalp, Urmul and others. “The incident makes a mockery of the various schemes for women and kids and indicates a total breakdown in our institutional support and response to them,” says Kavita Srivastava, general secretary, PUCL.
In the interim, the government has initiated some face-saving measures. Two middle-level hospital employees have been suspended, the Indore-based firm that supplied the I-V fluids and Anshul Pharma, a drugs supplier, have been blacklisted. Also, cheques of Rs 5 lakh each are being distributed to the families of the victims. Now, only if this money could buy back the 15 lives.
