While replying to a question in state assembly, the government of Madhya Pradesh, a state in central India, recently admitted to the death of 72,000 children in the Special Newborn Care Units (SNCUs) of government hospitals in the state. The data from the National Health Mission further revealed that these deaths took place between 2009 and 2017.
Though the unbelievably high numbers of the deaths are unacceptable in themselves, coming only from the government hospitals they must be a serious underestimation of the extent of real crisis in a state in which only 80.8% deliveries are institutional as per National Family Health Survey 4 data, the real numbers of neo-natal deaths are bound to be much higher.
Sadly, the revelation is essentially an indictment not only of the government of the state but of governance itself. Even a cursory look at the statistics exposes the criminal apathy that pervades throughout the health care system in India. It also exposes the indifference of government authorities to the lives of the people they are constitutionally bound to protect.
To begin with, neither the deaths nor the shortage of doctors have come suddenly out of nowhere, catching the government by surprise. The truth is that the government of the state was well aware of both. It knew that the state witnessed 3,281 infant deaths in 2010-2011 and the numbers have been only increasing since then- 5,600 in 2011-2012 followed by 7,499 in 2012-2013and 9,785 in 2013-2014. In fact, 2014-2015 was the only year which showed a very minor dip in infant deaths at 9,683 after which they started rising again to 11,481 and 12,963 in 2015-2016followed in 2017-2018 by 11,978 deaths. There is no way the state authorities can stay unaware of around 300 infant deaths per month in 2010 reaching to over 900 a month in 2017 in government hospitals!
Neither can it remain unaware of the shortage of doctors to run the public health care system in the state. As of March 2017, the state had only 4,367 doctors as against the sanctioned strength of total 8,156 government doctors. 47% of the posts of the government doctors being vacant makes the writing on the wall clear- that the government gives a damn to public health services. Add to this the fact that public health services are often only available health care for the poor and the marginalized in India with health care getting increasingly privatized and unaffordable for the poor.
Dig deeper and things get even gloomier. The shortage at the level of specialists like surgeons, paediatricians, obstetricians and so on with only 1,126 posts out of total 3,273 sanctioned are filled. That takes the vacancy levels to a whopping 66%! Further, as many as 277 senior doctors of the state government are not working in the hospitals, they are rather posted in administrative capacities in various state departments. The recipe for the health catastrophe is thus complete.
The deaths, however, do not only hint at the total failure of the government alone in protecting the lives of its children. It also hints at the general apathy larger Indian population has developed towards the weakest sections of society forced to rely on increasing dysfunctional public institutions. Unfortunately, the apathy seems to have also been rubbed on the civil society which has repeatedly failed to build a sustained campaign for ensuring the rights of the citizens abandoned by the state and have rather shown the tendency of moving from one outrage to another. What else, if not apathy, can explain almost near total silence of the civil society and media over such huge numbers of the deaths of children?
So what can be done to snatch the children back from the claws of the death? More so when Madhya Pradesh seems to have quite a robust public health care infrastructure in place on the surface level? It has 51 districts hospitals, 66 civil hospitals, 335 community health centres, 1170 primary health centres, 9192 health sub-centres and 49864 gram aarogya kendras in the state catering to the health needs of the people after all. Evidently, it does not lack infrastructure. It lacks political will for putting that infrastructure to function for what it is meant for in the first place.
The authorities know that people do not really put a great premium on public institutions in India. They also know that barring some great exceptions like All India Institute of Medical Sciences or Indian Institute of Technology, most of the government institutions are often the last recourse only for the poor (or politically powerful for whom the same dysfunctional institutions start working with miraculous efficiency!). They, finally, also know that the poor have no access to even a functioning redress system so it can run away with anything, even 72,000 dead bodies of the children.
It is high time for the authorities to put their act together and for the civil society to invest in public institutions. Lest it gets too late!
