The Telegraph
Since 1st March, 1999
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District pressure on child hospital

The findings of the inquiry into the baby deaths at the B.C. Roy Memorial Hospital for Children have not been declared, but a prime reason for the fatalities is obvious — “overcrowding”.

With three children sharing a bed along with their mothers, there is no denying that chances of cross-infection are very high. Fatal diseases, like septicaemia and respiratory tract infections, can be easily transmitted from one baby to another.

The doctor-staff-patient and other ratios have reached unmanageable proportions. The hospital has 250 beds, but at the time of the deaths on September 1 and 2, the number of admitted patients was 330. In fact, the sanctioned bed strength is only 175. Being the only public sector referral paediatric hospital in the state, it is supposed to be equipped with latest procedures and competent staff, so that it can tackle complicated cases.

If patients who could have been treated at district hospitals occupy beds and avail of other resources, the quality of treatment at a speciality hospital is bound to suffer. This is also common to teaching hospitals in the city.

The hospitals, meant to be super-speciality or tertiary treatment centres, are taking care of patients who could and should have otherwise been treated at block primary health centres or district (sadar) hospitals, which have been categorised according to the severity or type of case.

The main aim of the World Bank-funded Rs 701-crore Health Systems Development Project, initiated in 1995-96, was to restructure and fortify secondary-level hospitals in the districts. This was being done to make quality treatment available to the people of rural Bengal and, thus, reduce the pressure on the tertiary-level hospitals.

But the results of the five-year project are yet to be seen. Handicapped by a delayed take-off, several components of the elaborate scheme are yet to fall in place:

nModern equipment, like USGs, blood-gas analysers, endoscopes and ventilators, among others, are yet to be utilised in many of the district hospitals

nThe hold-up at first was because of the delay in civil projects, with no buildings to house the equipment. The delay is now due to the absence of trained doctors and technicians to use this equipment

nOf the Rs 12 crore allocated under the training component of the project, only Rs 2 crore had been spent. A scheme to train doctors at speciality centres outside the state has been stopped

nAn elaborate referral guidebook, enumerating when and under what circumstances a patient has to be referred to a higher-grade hospital, is not being used by most doctors as (a) they are either not conversant with the procedures detailed in it, or (b) the equipment and facilities at the next-stage hospital are not in place.

Besides, the people are largely unaware about the improvement, as a result of the project, in some district and rural hospitals. And, if they are, they are not confident of the new services they would get there.

“For treatment of serious diseases, we have to go to Calcutta,” is the refrain of the majority.

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