Bengal's hospital paradox Struggle for space in ward, beds vacant outside

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By SANJAY MANDAL
  • Published 4.07.11
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Scene I: Rows of paediatric beds (cots) lie abandoned outside a ward where babies, children and mothers are jostling for space at MR Bangur Hospital in Calcutta’s Tollygunge.

Scene II: A Group D employee relaxes on a bed meant for a sick baby in the paediatric ward at Barasat District Hospital, North 24-Parganas. No doctor visible at the emergency ward where, too, beds lie vacant.

July 3: Part of the reason for the heavy burden on the BC Roy hospital for children, which is coping with a high death count, is poor utilisation of infrastructure in many other hospitals.

When critically ill babies arrive, even hospitals quite high up the pecking order in Bengal simply wash their hands of them and send them packing to the BC Roy Post-Graduate Institute for Paediatric Sciences in Phoolbagan, Calcutta.

One reason is that these hospitals lack equipment and infrastructure, which their authorities are only too keen to emphasise. The other appears to be a lack of desire to make the most of what they have, an inspection by The Telegraph has revealed.

BC Roy officials said around 80 per cent of the babies referred to the state’s premier referral hospital for children come from North and South 24-Parganas and Howrah.

On paper, the Barasat District Hospital and M.R. Bangur Hospital (which is technically in South 24-Parganas despite being located in a bustling city area) should be treating many of these very sick babies after they are referred by primary health centres and subdivisional hospitals in the districts.

A visit to the two hospitals yesterday revealed why they are reluctant to tackle serious cases.

MR Bangur

Cots in perfect condition are lying unoccupied on a corridor outside a crowded, dirty paediatric ward.

Officials explain that the cots are from a portion of the 46-bed ward that is being renovated and converted into a separate, sterilised room for neonates (babies aged up to a month). Till the work ends, which could take months, the cots will lie unused while sick babies, children and hapless mothers jostle for space in a shrunken ward.

Asked why the cots haven’t been used to convert the corridor itself, and some of the other empty rooms, into temporary paediatric wards, the officials have no answer.

There are enough doctors for the paediatric ward — five senior doctors and a group of juniors — but everything else seems to be in short supply. There are no ventilators for children or newborns, no separate ward for paediatric surgery. After surgery, the children are sent to the female surgical wards with their mothers.

At one corner of the paediatric ward, three newborns share a radiant warmer (cradle with a heater). “One warmer is meant for only one baby. If more share it, the heat distribution becomes uneven and there is risk of cross-infection,” a neonatal expert says.

Hospital officials say matters will improve when a 46-bed sick newborn care unit (SNCU) is completed and the sterilised room for neonates built. “A breast milk bank is also being set up,” medical superintendent Kajal Krishna Banik says.

Sick newborns need a separate, sterilised room because they have very poor immunity and may catch infections if kept with children over a month old. “This is why we don’t risk admitting newborns in critical condition,” a doctor says.

Officials confirm that well over 10 per cent of the babies brought to MR Bangur — that is, the worst cases — are referred to BC Roy or the medical college hospitals.

Barasat

The district hospital, around 25km from Calcutta, has 60 beds in the paediatric ward, with four senior doctors and three juniors.

BC Roy, to which this hospital refers babies, has 360 beds but still two children share one bed there. Here at Barasat, many of the beds lie vacant, so much so that around 3.30pm on Saturday, a Group D employee is seen lying on one of the paediatric cots.

Medical superintendent Pushpendu Sengupta explains: “At least 10 per cent of sick neonates need specialised treatment with a ventilator, suction pump and other equipment. We don’t have any; nor do we have a specialised biochemistry or pathology laboratory for neonates.”

He, however, adds that an SNCU with 20 beds is coming up.

According to BC Roy principal M.K. Chatterjee, “secondary-level hospitals” need to be upgraded. “Only this can relieve the pressure on BC Roy and other city hospitals,” he said.

“Ideally, a primary health centre should refer a sick baby first to a subdivisional hospital which, if it can’t treat the baby, should refer it to a district hospital... and so on,” a health official said.

Such a referral path now would mean more delay, so the poorly equipped district healthcare centres often directly refer babies to BC Roy.