Gasping for breath

THE TRAGIC DEATHS of twelve infants in a hospital in Lucknow within a span of forty-eight hours last week is an alarming signal of the poor state of post-natal care available to the general public. Given that some of the largest hospitals in the country undertake on an average 40-50 deliveries daily and the instance of mortality is in the region of just two or three in a whole month. Equally worrisome is the fact that the reason adduced by the families for these deaths - that want of adequate supply of oxygen cylinders - does not jell with the official explanation of the cause involving the lives of twelve infants simply as ``sudden death''. Worse still, there seems to have been no preventive strategy put in place even after the first incidents of deaths of five or six infants were reported. Of course, the need for oxygen supplements in these cases suggests complications at birth which in themselves can potentially be fatal and hence caution should be exercised so as not to impute criminal negligence without sufficient basis. This point is especially worth emphasising since doctors have in recent years been implicated (very often wrongfully) for criminal negligence in relation to maternal mortality, particularly after the advent of legislation on consumer protection and the medical profession was brought under its purview. If indeed the lack of oxygen cylinders is a credible cause for the deaths, it surely reflects poorly on the level of coordination between different departments within the hospital whose responsibility it is to ensure speedy and effective delivery of appropriate treatment.If such a basic requirement like oxygen was indeed in short supply, it raises serious doubts about the state of preparedness of established hospitals to deal with contingencies and this is an area where remedial efforts need to be concentrated. The further course of action on the incidents would in any case have to be determined on the basis of the findings of the enquiry instituted by the Vice-Chancellor of the University of Lucknow and the team of doctors from the Prime Minister's Office. But it is clear that those in charge of the provision of essential and emergency medical supplies should be held accountable immediately so that similar lapses do not go unpunished.

The Lucknow incident is a grim reminder of the appalling state of affairs in the public institutional health care sector in the country. The fact that the tragedy occurred in the Prime Minister's own constituency and has thus attracted attention from the highest quarters should be seized upon to put the spotlight on the rapidly deteriorating health care administration. This is of utmost importance considering that public confidence in the state-run health care infrastructure is already at its lowest ebb. It is time perhaps to address seriously the question whether certification from the International Standards Organisation (ISO) in the area of services should be considered mandatory for hospitals. Short of such a measure, it may be hard to ensure efficient and minimum quality of service for the poor and the needy and accountability among medical and paramedical professionals. In addition to the ISO certification, the introduction of a system of accreditation of hospitals along the lines of the hotel and tourism industry based on the quality of medical services and levels of efficiency would go a long way towards enhancing the overall health care standards in the country. This would also facilitate greater transparency in their functioning.

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Section  : Opinion
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