GORAKHPUR: Inside the decrepit children’s ward at an Indian hospital where 85 infants died last week, Ram Prasad prayed his two-year-old daughter would escape the same fate as he scanned the overcrowded hallways for a doctor.

His plight in ‘ward 100’, where the death of so many children has sparked outrage, is emblematic of a healthcare crisis where doctors are stretched to breaking point and hospitals run out of oxygen due to unpaid bills.

Authorities have launched an inquiry into the causes of the oxygen disruption at the now-notorious Baba Raghav Das Medical College in Gorakhpur, which Indian media has linked to the deaths of 30 infants last Thursday and Friday.

Local officials have blamed an outbreak of encephalitis for the deaths and denied a lack of oxygen was responsible.

But doctors and medical experts point to woeful underfunding in public health in eastern Uttar Pradesh, one of India’s poorest regions, where just a handful of specialists are available to treat millions.

“This [deaths] won’t change soon, as it isn’t a simple oxygen issue. The rot is deep and the system needs to be overhauled,” a senior hospital official told AFP in Gorakhpur, speaking on condition of anonymity.

India was spending just 1.4 per cent of its GDP on public health in 2014 — far below the global average of six per cent.

In Gorakhpur, there are just 529 primary health care clinics — less than half the number needed to cater for nearly 4.5 million people living in the district, July data from Brookings India shows.

There are just five paediatricians and 22 encephalitis treatment centres, despite the mosquito-borne illness wreaking havoc in low-lying areas of the state every year during the monsoon.

India’s most populous states of Uttar Pradesh and Bihar are ravaged by encephalitis every year.

The disease, which affects mainly malnourished children, causes brain inflammation and can result in headaches, seizures, fever and even brain damage.

Professor K.P Kushwaha, who headed Baba Raghav Das Medical College until mid-2015, said the hospital could not cope with the volume of patients.

“The government now needs to make at least five such hospitals across the region to tackle this load and get better results,” he told AFP.

Life and death

Prasad, a poor farmer from Uttar Pradesh, travelled roughly 65 kilometres with his wife and two-year-old daughter after the infant suddenly ran a high fever.

He arrived at Baba Raghav Das Medical College just hours after hospital authorities declared that another 25 infants had died over the weekend.

Prasad’s daughter was found a bed in the overcrowded ward, where many parents were forced to squat on the floor in nearby corridors. It was worse in the neo-natal unit, where three to four infants crowded a single bed.

“We take turns to go out in the corridor and hall to rest, while the other one stands here,” Prasad told AFP, gesturing to his wife and ill daughter. “She probably has pneumonia, I don’t know, the doctors haven’t told me anything.”

Just days earlier, panicked parents used manual pumps to help their stricken children as the supply of oxygen fizzled out.

Prof Kushwaha’s successor was stood down over the oxygen debacle, which allegedly stemmed from nearly $100,000 in overdue bills, some dating back to November.

His replacement, P.K Singh, promised conditions at the hospital would improve “whatever the shortcomings”.

“I understand that the hygiene situation here is very bad and there is a risk of infection,” Singh told AFP.

But the district’s chief medical officer Ravindra Kumar told AFP nothing could change as long as encephalitis plagued the poor eastern region.

“So far we have only been shooting in the dark without much idea about its causes, prevention or the cure,” he told AFP.

A lack of primary health centres meant illnesses were not detected early and by the time patients arrived at hospitals it was too late, said a local government official, gesturing to beds full of sickly children.

“If people like them get the right advice and prompt referral, it can make the difference between life and death,” he told AFP on condition of anonymity.

Published in Dawn, August 17th, 2017