Child Mortality in Shishubhavan: TV Channels worsen the situation

Subhas Chandra Pattanayak

Shishubhavan, Orissa’s topmost tertiary centre of pediatric treatment has all on a sudden emerged as a child mortality centre because of irresponsible TV hubbub that has led to demolition of public confidence in this super-specialty institute, which has the history of putting back smiles to at least 98 percent of parents by curing their critically ill children.

There is no abnormal rise in mortality rate in the period under television focus. But the TV channels have behaved very abnormally irresponsible. They have created panic in public by reporting on how many children have died, but have never revealed how many critically ill children have been cured in the corresponding period. And they have never reported under what condition and in what stage and manner the children who died were brought to Shishubhavan.

I have studied the situation. The death rate is as usual – 1 to 2 percent.

I have studied the report, which the CDMO, Cuttack has sent to the Government basing upon the result of enquiry conducted by three senior most physicians namely Dr. Ramesh Chandra Panda (ADMO, FW), Dr. Abani Kumar Pattanaik (ADMO, Medical) and Dr. Bhaskar Kar (Spl.Paediatric, DHH,Cuttack). This report, covering the period from August 20 to 24, 2015 as referred to the CDMO clearly says that “adequate treatment was given to all the patients as per requirement” and “all the babies were critically ill at the time of admission“.

The enquiry team should have reported how many babies were admitted in the hospital during the period under reference and/or how many babies were discharged from the hospital on being cured in that time. Sadly, the reference was deficient in this regard and resultantly the enquiry did not cover this aspect. Another enquiry is being conducted by the DMET as the above report has suggested for investigation into “the cause of death” by “a panel of experts (Prof. of Paediatrics)”. We shall wait and watch what the experts would say.

But at this stage we may say that, Shishubhavan is receiving baby patients in critical / terminal stage when survival chances are almost nil.

Due to political and bureaucratic mismanagement the Health Mission has almost failed.

Under the mission, there are 682 Delivery Centres (DC) all over the State, where rural and semi-urban mothers are supposed to be helped with “trained” personnel. The mission is to help expectant mothers reach these Centres through free ambulance service under the care of ‘Asha’ assistants and get physicians’ help in delivery. In any case of complications, the patient is to be taken care of in First Referral Units (FRU). There are 49 such FRUs. Yet, if complications continue, Neonatal Intensive Care Units (NICU) established in every district headquarters hospitals would take care of the newborns. There are 24 NICUs in Orissa.

When all these centers fail, the child is referred to the Shishubhavan, where, obviously it reaches in terminal stage. Despite this, 98 to 99 percent children survive by treatment in this hospital.

The TV channels are intriguingly silent over this splendid achievement. They have never let us know in which of the centres like DC, FRU or NICU, in what stage and condition, the child suffered wrongful treatment and why it took turn towards the worse. They have only irresponsibly focused on the Tertiary Centre – Shishubhavan – in a way to project it as a centre of child mortality.

Had the TV Channels done a bit research, they could have easily marked where the defect lies in child care that leads to death even after admission in the Shishubhavan. They have done nothing of this sort, except scathing attack on Shishubhavan. It helps only the private clinics.

I would like to point out two aspects of death, which the noising TV channels have not bothered to deal with.

In respect to the first aspect, I will cite two instances of neonatal deaths occurred during the focused period (20 to 24 August 2015). One is, a 3 days old baby of Anjulata Das of Kultia, Bhadrak who was a case of ‘Birth Asphxia’. The other is, a 4 days old baby of Sebati Bibhar of Mahulpali, Bheden, Bargarh, who succumbed to ‘Septicemia DIC’. In such critical stage, they had undergone long tedious journey on dusty roads in severely unhealthy vehicles from Bhadrak and Bargarh districts respectively. They were at the verge of death, but were not denied admission; because the tertiary centre cannot do that. They were admitted into the Intensive Care Unit (NICU) where despite all available super-specialty treatment, they succumbed to ‘birth asphyxia’ and ‘septicemia DIC’ respectively. The TV channels bent upon to defame the Shishubhavan have never discussed the environment of death the babies were subjected to before reaching the tertiary centre.

The second aspect is that, all the 30 children, who died during the focused period, are of economically weaker class. Not a single one of them was of the wealthy class.

So, the political economy of neonatal and child mortality was the most important aspect on which the TV channels – if they are truly concerned about baby deaths – should have focused. But they have not. Because of them and other wings of rich irresponsible media, the only most efficient and dependable tertiary centre of Paediatric treatment in Orissa having severely been defamed, parents would not dare now to bring their babies to this hospital. Resultantly, avaricious private clinics would get massive flow of patients and child mortality will stupendously rise, though there shall be no reports on that, as ill equipped private clinics mushrooming all over the State are mostly not reachable to luxuriously living TV journalists who have the notorious ability to interfere with thinking process of their viewers.

In such circumstances, it is incumbent upon the government to put TV media under leash in public interest. TV channels must not be allowed to make journalism anarchic.

WHERE HAS NAVIN LANDED ORISSA!

Subhas Chandra Pattanayak

Engrossed in contriving methods to help POSCO and similar other mine mongers, Chief Minister Navin Patnaik has thrown Orissa to such a ruin that in the eyes of the United Nation’s World Food Programme (WFP) four of its districts – Kandhamal, Malkangiri, Gajpati and Rayagada – have been thrown into the ‘geography of hunger’ even as three of them, Kandhamal, Gajapati and Rayagada as well as the district of Nabarangpur are found ‘extremely insecure’ in the matter of food.

When serving the non-Oriya capitalists has remained the priority agenda of the CM Orissa has become a symbol of economic ruin.

More than 15 million people in rural Orissa live below the official poverty line, which constitute 47 per cent of the State’s rural population, says the report prepared by the Institute of Human Development on behalf of the WFP termed Food Security Atlas of Rural Orissa. No other State of India is so wretched.

Noting that the people in Koraput, Nabarangpur, Rayagada and Malkangir have the lowest access to food, the survey exposes that more than five million persons in these districts suffer from calorie undernourishment whereas protein consumption in the State is as low as 48 gm a day per person.

When parents are so pathetically undernourished its impact is bound to play havoc with the children. And it is happening. Before reaching the age of five 90 out of every 1000 children are dieing due to slow starvation in the State.

The report shows, the districts of Kandhamal, Gajapati, Rayagada and Malkangiri have under-five-mortality higher than 160 per 1000 births with more than half of their children being underweight. Similarly, 46 per cent of children under three in the State are underweight, 40 per cent are stunted when 20 per cent children are wasted.

Had health care network of the state not been subjected to subterfuge and corrupt practices by the State administration itself, chances were that the children below five would have a little more hope of excepting death in more numbers. But Navin has been giving an administration that swindles the funds obtained as loans from the World Health Organization and no prompt action is taken against the swindlers when the scams are exposed through audits and intelligence.

Such a Government has given birth to an environment where Less than half of the population has access to primary health facilities. The survey says that the situation is still worse in most of the northern districts and in the southern districts of Rayagada, Malakangiri, Kandhamal and Gajapati where less than 20 per cent of inhabitants have access to primary health cares.

One-third of Orissa’s rural households do not have access to safe drinking water as a result of which water borne diseases such as Cholera and diarrhea are rampant in these areas.

The well known reality is that lakhs of working people from different parts of Orissa are being forced to leave their soil in search of avenues to earn their food and end up as bonded labors out side Orissa. The WPF report has now confirmed the cause. The rate of wages for rural causal labor is very low in the State, it has said indicating that it is further lower in the northern districts, where the rate is often less than Rs.30 a day, which is less than half of the national minimum wages. The Minimum Wages Act is applicable to Orissa; but Navin’s Government never enforces it. The Labor department, which is the administrative department, is most inadequately manned and habitually lethargic. It never serves the workers in right earnest.

Where has Navin landed Orissa!