In Indian state, poor hospital care hinders a generation

DELHI -- Hundreds of infant deaths in India have been blamed on poor-performing rural hospitals in West Bengal. One doctor highlights severe malnutrition as the root of the unfolding tragedy.
Written by Betwa Sharma, Correspondent

DELHI -- While India showed off its military might in its annual Republic Day parade on Jan 26, babies were dying in state-run hospitals of Malda district in the eastern state of West Bengal. More than a 100 babies have died in January due to lack of medical facilities and negligence by untrained hospital staff.

TV-news channels have been showing images of unhygienic spaces, dismal infrastructure and devastated parents. The Times of India, an English daily, reported that poor parents are being forced  to sell their property to afford treatment in private hospitals.

The Trinamool Congress party, which blames the previously-ruling Communist party for the awful condition of rural hospitals, has come under considerable flak.  The health minister Chandrima Bhattacharya reportedly noted a three percent drop in the infant mortality rate of the state during the past eight months. A blame-game has ensued between the incumbent party and its predecessor. Despite the intense media coverage, the deaths have continued unabated.

Amitava Chowdhury, a doctor specializing in community health, has been witnessing baby deaths in West Bengal for decades now. Chowdhury sees the media attention on the recent deaths in Malda both superfluous and unhelpful. With the exception of 4-5 districts in West Bengal, babies dying is an everyday occurrence in badly-run hospitals of the state. "The media decides to do a story every five years when there is no other news," he said. "This is not news for the average reader in West Bengal."

In an interview with SmartPlanet, Chowdhury stressed that if the media really wants to help then it needs to investigate the causes of severe malnutrition, which is why thousands of babies are landing up in hospitals. "Malnutrition lowers the immunity that makes them vulnerable to  all diseases especially in unhygienic conditions," he said. "These hospitals are able to cure most of them, but still babies die every day because so many are falling ill." The winter season is particularly bad as babies, which lack the immunity of adults, die of respiratory diseases.

About 5.9% of children in West Bengal do not live beyond 5 years, according to the International Food Policy Research Institute (IFPRI) 2008 report. Although this is lower than national average, malnutrition among children in the state is very high. Close to 39% of the children in the state are underweight while 18.5% of the population is undernourished.

Chowdhury explained that even the small amount of food, which poor families can afford, have a bit of
carbohydrates but lack proper nutrients that comes  pulses, eggs, fruits and fish. "They have never had a balanced diet in their whole life." These families, the doctor continued, have no conception of a healthy meal even if they had the resources to prepare one.

The pressures created by the malnutrition-induced lack of immunity does not detract from the pathetic conditions of the hospitals, which have been captured by the Indian media in recent days. One channel reported the presence of stray dogs and cats along with the patients. Another report showed that nurses did not know how to use medical equipment.

And West Bengal isn't even the state with the highest infant mortality rate in India. The national average of infant mortality is 47 per 1000 live births. West Bengal is far lower at 31, according to the latest government figures, Business Standard reported. Other worse states have infant mortality ratios between 48 and 60. The state of Madhya Pradesh has the highest IMR at 62.

From a doctor's perspective, bringing change to the present state is colossal challenge. Even the impact of the proposed Food Security Bill, which will provide really cheap food to more than 63% of the country, faces considerable opposition. Chowdhury also questioned how does one start improving the hospitals when there is no electricity in the villages or no roads leading up to the hospital. The doctor pointed that most of the funds, earmarked for health investment in West Bengal, are returned back to the central government unspent. "This is not corruption," he said. "This is a crime on part of the state."

This post was originally published on Smartplanet.com

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