Neonates die due to lack of ventilators, other facilities at GB Pant hospital

Nothing seems to have changed in the lone children’s hospital in Kashmir ever since the shocking revelations of recurring neonate deaths there came to the fore in 2012.

Even as the then government woke up and made some changes at the helm, newborns at the GB Pant hospital here continue to die due to lack of ventilators and other vital equipment.

The Hospital, apart from addressing different health-related issues of children, essentially specializes in handling complex respiratory distress syndrome (RDS) in premature newborn babies. It has two specialized intensive care units—NICU (Neonatal Intensive Care Unit) and PICU (Pediatric Intensive Care Unit) where critical patients are admitted.

The NICU, according to medicos, has two sections: NICU-A and NICU-B where neonates are treated. There are nine beds in NICU-A and 14 in NICU-B. However, the number of patients admitted in these two units exceeds the bed capacity. The ventilators there are also less, risking the lives of patients.

We have accessed information about these critical care units through recorded visuals and notes of an attendant of a newborn, who was admitted to the hospital on May 29, 2015. The baby was referred to the hospital from Modern Hospital after birth with RDS.

DrMushtaq Khan, dental surgeon and social activist, said he is witness to deaths of “dozens of neonates” in NICU-A and NICU-B during his 18-day stay at the two units.

Mushtaq said his daughter was the lone surviving neonate in NICU-A after being admitted and treated there for 18 days. “During those excruciating days, I saw how mismanaged this hospital is and how the Health department in not paying any attention to the grave issue of deaths of neonates there,” he said.

“I thought as if Allah had sent me to the hospital to see and record common man’s plight. Right from the day my daughter was admitted at the hospital, I could only see mismanagement. I could see what ails this hospital where, on an average, five to seven neonates die daily,” Dr Mushtaq told.

The pattern of these deaths, as per the available data, is similar to the one seen in 2012 even though officials cite a number of reasons for the casualties.  Most of those deceased neonates, as per the data, hail from rural Kashmir and rarely raise their voice on the causes of deaths in the NICU units.

In NICU-A, there are only five ventilators while neonates admitted there, on an average, are 60 per-day. Among these, 20 patients require life support facility which is not available, thus resulting in higher mortality rate in the unit.

There are no ventilators in NICU-B while five ventilators are available in PICU.

“Even for these ventilators, there is pull and pressure from VIPs to accommodate their acquaintances while those from poor strata or far-off places are left to fend for themselves,” said DrMushtaq, who candidly admitted he called MoS Health to intervene in his baby’s case on Sunday “when most of the staff was at home or having off day.”

The minister’s intervention saw the hospital administration act promptly, but DrMushtaq said not everyone among the admitted lot is “fortunate to ensure this kind of an intervention and they die for want of critical care.”

Accusing the government of neglecting the hospital, DrMushtaq said the Health Minister Lal Singh on a visit to the hospital recently to inaugurate an oxygen plant didn’t even bother to inspect the available infrastructure. “There were only customary photo ops with refreshments and the inaugural function,” he said.

Not only is lack of ventilators taking toll on neonates, there are hardly any monitors for patients.

As per the WHO standards, there should be one monitor for one neonate in NICU-A and B. The G B Pant hospital, however, has only 18 monitors for 60 patients admitted on an average, reflecting the status of infrastructure there. The cost of monitor, according to medicos, is less as compared to that of a ventilator.

“The non-availability of ventilators and monitors in NICU is directly responsible for higher mortality rate in these units,” argues DrMushtaq, who says he is witness to deaths of five neonates on one bed during the intervening night of June 2 and 3 “when I was present in NICU-A to take care of my baby in absence of staff in the unit.”

“I was frustrated to see babies die one after the other and that too on the same bed where my baby was fighting for her life. Sensing my baby won’t survive, I thought of committing suicide given the way things were going on in the hospital,” said DrMushtaq, adding, “It was the most painful experience of my life as a doctor and as a common Kashmiri.”

According to him, these deaths occur due to lack of proper care in ICU coupled with no monitoring system in place and shortage of skilled manpower at the NICU-A and B.

When asked to comment on the deteriorating healthcare at G B Pant Hospital, former Medical Superintendent DrMuneerMasoodi, who was heading the institute from May 2012 to March 2015, said he worked “with dedication” to check the mortality rate at a time when it was 100 deaths per month, in 2012.

“It was not me alone, but my team which helped in checking the mortality rate and we brought it to 50 percent in one and a half year.  14 ventilators were available when I was in-charge and I don’t know the status of these right now,” DrMuneer, who is being credited by the staff of the hospital in managing its affairs, said.

The seriousness of government towards healthcare can be gauged from the fact that the hospital is without a Medical Superintendent since March 2015. The MS of LalaDed Hospital has been given additional charge to look after it.

Minister of Health LaL Singh and Commissioner/Secretary, Health department Mandeep Bhandari were not available for their comments on the state of “healthcare” at G B Pant Hospital.