The room is comfortably warm — a welcome change from the cold outside. The heat is generated by electronic heaters installed over tiny beds, occupied by 11 infants, only a few days old. But the warmth is a chilling contrast to the fact that not one of them is stirring. They are only just alive, their chests rising and falling in faint rhythmic intervals. Most have few chances of survival.
Except for one woman, no other mother can be seen in the ward. A baby marked ‘Sana’ lies on her back, dangerously still. Her head is turned on one side, and like the other babies she has a thin tube of oxygen inserted into her nose.
“She was born at seven months,” explains the ward’s staff. “She was born with bronchopneumonia. In fact, all these babies have a serious illness.”
The case of the eight babies who died overnight at Sargodha’s DHQ Hospital has been shocking. The Punjab government termed it ‘criminal negligence’. Meanwhile, the death toll has been rising. Till Tuesday morning at least 21 babies had died.
Doctors there openly admit this figure is nothing — babies die all year round. “Out of the 15 babies we admit everyday about four die,” says Dr Sikandar Hayat Warraich, vice president the PMA Punjab and PMA Sargodha’s president.
He says on that particular night, there were 45 babies with only one nurse and no ward boys. There are only five incubators and although the oxygen supply system works, it was not enough. “The nurse had to give one baby some oxygen, then take it away to give to another,” says a local journalist, an eyewitness that night.
It is not that the babies were uncared for, says Dr Warraich. But doctors can only do so much. “Despite spending millions on a new DHQ building, the government has not made any sort of system for it to be used,” he says. “The new building does not have oxygen supply lines. In the old building we have a serious lack of machinery, facilities and staff. We have several doctors but there are hardly any nurses and ward boys. There is a dearth of beds, so infants often have to share beds. I would say it is the doctors who have kept this hospital in working condition.”
True enough, the new DHQ, although huge and spotless, is also almost empty.
The children’s ICU in the old DHQ building is shabby and time-worn. Right opposite it is the paediatric ward where sick newborns are admitted.
While DHQ does not deliver babies, it has an affiliated gynaecological wing next door, the Maula Bux Hospital, whose assistant medical superintendent Dr Adeeba Samar reveals that the childbirth situation in and around the district is grim.
“Often we end up seeing women from other districts who come randomly or when their situation is dire,” she says. “We refer premature or sick infants to DHQ, though none of the babies deceased that night came through us,” she says.
According to the Family Planning Association of Pakistan, 225,450 infant deaths happen yearly, ie 618 newborns die every day. As of 2012-13, the infant mortality rate is 74pc per 1,000 children. So claims by doctors that four babies die in DHQ daily may be correct.
“This is a teaching hospital which caters to Khushab, Bhakkar, D.I. Khan, Jhang, Mandi Bahauddin, and Mianwali, besides some small villages on the outskirts of Sargodha itself,” says Dr Warraich. “Women travel from these districts only in serious situations due to long distances. Sometimes the infants have already been delivered by local midwives or dais and are either premature or have not received proper antenatal care.”
Diseases including anaemia and birth asphyxiation (not crying after birth) may leave the baby with a high chance of either disability or death.
Antenatal care coverage is an MDG indicator of access and usage of healthcare during pregnancy. The antenatal period gives pregnant women a chance to improve their own health and their babies’. WHO recommends receiving antenatal care at least four times but most women do not even receive it once.
“WHO has also indicated that there should be three nurses at a time in the ward,” says Dr Warraich. “But for some reason the government is not hiring any. Nor have they sent any incubators since the incident except one, that too from a rural health centre which will suffer without it.”
Ikhlaq Ali Khan, Punjab health department’s information officer, says: “The health department should take serious note of the issue. I understand that the new building is still not being used and though we cannot give a time frame, we are slowly working to make it functional.”
“Even if we provide 20 incubators, where will the 21st child be put? We will always be in need of more. As for fatalities, if records from the Children’s Hospital in Lahore or any other hospital are taken out it will become obvious how common these deaths are all year round.”
He blames private hospitals for not having nurseries and other facilities to retain their newborns; instead they refer them to state hospitals. “Doctors in state hospitals cannot refuse admissions,” he says.
Published in Dawn, November 30th , 2014