For Black September mothers, wounds will not heal

Twenty-four-year-old Rameeja Bee vividly remembers the fateful night when she carried her four-day-old son to the first floor of the Pediatric ward in Kurnool Government Hospital where the infamous Neonatal Intensive Care Unit (NICU) was located, in which eleven infants died in a matter of 36 hours.

During the day on September 1, 2011, the couple from the remote Remata village of Kodumuru mandal, some 45 km from here Kurnool, took the infant to the Mandal hospital and then to a private clinic that confirmed that it was Meconium Aspiration, a serious condition in which a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time of delivery. Rameeja delivered the baby boy at her mother’s place on August 29 in Remata.

“At the hospital we were made to wait, as the Junior Doctors on duty could not accommodate our child due to severe shortage of ventilators,” Rameeja said. Only four ventilators were working out of the six in the intensive care unit that had at that time a minimum of 20 infants in waiting. “Almighty took him during the early hours, just before a ventilator was made available. I was numb and did not cry as I could not bear to see his little lungs gasping for air any more,” a burqa-clad Rameeja said with tears in her eyes, holding her two-year-old daughter close to her. Now she regularly brings her daughter to Kurnool for health check up.

Growing numbers

While the number of infants waiting for critical care was increasing, the underweight son of Sunitha of Palamanchala village of Jupadu Bangla mandal was having epileptic fits. “It took almost four hours in a shared auto to bring my son to Kurnool. He was born and died on the same day. There were no doctors to attend as it was festival time. While the nurses tried to save him, he was so puny I could hold him in my palm,” Sunitha said.

Rani of Kurukunda village of Atmakur mandal, 70 km from Kurnool town, lost her day-old boy suffering from lung infection. Renamma of Chennupadu of Narayanapuram mandal of neighbouring Mahbubnagar district, Hemalatha of Kodumuru (Kurnool) and Saraswathi of Atmakur were among the other mothers who have seen their little ones dying one after another while the hospital staff shrugged their shoulders, pointing to the dysfunctional and truant ventilators.

The intervening night of August 31 till the wee hours of September 2, eleven infants died inside the NICU. The reason - the hospital was simply not equipped to deal with the rush of low-birth weight babies who needed critical care. There were 20 beds whereas the demand was for over 30 and only two ventilators were functioning.

Hemalatha, unlike other illiterate mothers, knows that her 2-day-old boy died due to lack of oxygen supply from the ventilators. Some parents of the children have alleged that the hospital passed on the care of the infants to them, which caused the tragedy. The hospital   insists there was no negligence. They say the deaths were due to complications common in premature babies. Government officials add that they did not have the facilities to cater to so many infants.

Growing numbers

Dr G S Ram Prasad, Head of the Paediatric department told Deccan Herald: “This hospital caters to patients from not only five districts of Rayalaseema and Telangana, but also from Bellary in Karnataka. We cannot turn away patients though we do not have the infrastructure to meet the demand. We are bringing it to the notice of the government to increase the facilities here.”

The government is not willing to buy the hospital’s self-defence. D L Ravindra Reddy, Health minister, said, “The Collector in his report also said those in supervisory role at the hospital were practicing privately in family-owned hospitals.” This led to negligence for which action will be taken, he said.

No negligence?

However, the AP government which had sent a team led by Director of Medical Education Sampath Kumar to hold a preliminary inquiry said that prima facie  there was no negligence or mistake by doctors or hospital staff. The medical team submitted that of the 11 infants, only one was born in the hospital, four were cases of premature birth and the common cause for admission was "birth asphyxia - high grade II/III”.

“On an average, 25 deliveries are performed every day. Most babies are treated under standard protocol...Average mortality is 35 per cent in the neo-natal ward,” says the team’s report.

“Now the situation has improved a lot. Under National Rural Health Mission (NRHM), 20 beds and additional staff were sanctioned. Earlier we were given sub-standard equipment. Now we have high quality ventilators,” Dr Ram Prasad said. However, the doctor and his neonatal unit are still waiting for the four doctors they were promised. “I was also assured of additional funds to the tune of Rs1.5 crore, which the authorities say is in the pipeline,” the ever hopeful government doctor said.