We want an eye for an eye,” the poster said. “We don’t want a stone eye.”

Holding it up was 60-year-old Shatrugan Madhav, a tractor driver who had travelled from a village in Muzaffarpur district, Bihar, to take part in a protest on February 14 outside the Shri Krishna Medical College Hospital, the largest public hospital in the city of Muzaffarpur.

There were eight other men and women in the group, all of whom had travelled from villages across Muzaffarpur, Vaishali, and East and West Champaran districts. They worked either as small farmers or daily wage labourers, and many belonged to backward caste groups.

They all held up posters, supplied to them by a local political leader. But the grievance was their own.

Last year, on November 22, they attended an eye surgery camp at Muzaffarpur Eye Hospital, a charitable private hospital. They wanted to get rid of cataract, a cloudy layer that settles on the lens of the eye due to the breakdown of proteins, and causes blurred vision. The surgery to treat cataract involves replacing the clouded lens with an artificial lens.

But the surgeries in Muzaffarpur went terribly wrong.

Of the 328 patients who were treated in the camp, between November 22 and November 27, at least 36 people, aged between 40 and 85, contracted severe eye infections in the operation theatre, and developed endophthalmitis, an inflammation of the eye caused by bacteria, often from infected surgical instruments.

Seventeen of them, Madhav among them, went on to lose vision in the eye that was operated on – the eyeballs had to be removed to stop the spread of infection.

At Shri Krishna Hospital, where many of them had been referred for eyeball removal, the medical superintendent Dr BS Jha gave them the option of getting “stone eyeballs” installed in their vacant eye sockets – referring to a lay term for a prosthetic eye that does not restore vision, but is used for cosmetic reasons.

In the park outside the hospital on February 14, the political leader, from the local Rashtriya Jan Jan party, urged the patients and their families to reject the doctor’s offer. The leader, a man named CK Parashar, had offered them support on behalf of the party and his non-profit organisation, the Bihar Civil Society. In pamphlets that his workers distributed among the families, the organisation listed demands for “real” eye transplants and compensation of Rs 20 lakh for each patient from the state government. “We will tell them that we only want a real eye, not a stone eye, otherwise we will stage a big protest,” Parashar told them.

Jha told Scroll.in that the blindness caused after the November 22 eye camp was unfortunate, but that no one could be blamed for it. “Cluster infections happen sometimes, even in cases where 100% care is taken,” he said.

When he met the protesting families, the doctor immediately dismissed the demand for “aankh ke badle aankh” – an eye for an eye.

“Eye transplants are only possible for the cornea, not the full eye,” Jha said. “But all of you please get stone eyes installed and bring me the receipt. I will personally pay for it, on humanitarian grounds. It will not give you sight, but it will make your face look better.”

In February, a group of men and women who had lost vision in one eye after contracting infections at an eye camp at Muzaffarpur Eye Hospital, gathered to protest against the hospital. Photo: Aarefa Johari

This story is part of Common Ground, our in-depth and investigative reporting project. Sign up here to get a fresh story in your inbox every Wednesday.

The story of those who lost their eyesight in Muzaffarpur may seem extraordinarily tragic, but what is perhaps even more tragic is that such incidents are not uncommon in India.

Scroll.in filed a Right to Information request to the central health ministry, seeking information on instances where patients had contracted infections. According to the response, since 2006, 469 people have either been blinded in one eye or had their vision “seriously affected” after undergoing surgery at eye camps. The ministry also forwarded the query to state health departments, noting that health is a state subject. Responses from the states, further enquiries by Scroll.in and information from news reports indicated that, in fact, this figure stood at 519 at the least.

It is typically the poorest in the country who opt for free surgeries at mass eye camps, which are funded by a government programme specially designed to reduce blindness in India. But it is also typically in such settings that things often go terribly wrong – and nearly always, no one is held accountable.

Among those who lost sight in their eyes in the Muzaffarpur eye camp was Bharat Paswan, a farmer from the village of Askaranpur, in Bihar’s Vaishali district. Until the surgery, 57-year-old Paswan, an agricultural labourer, would earn between Rs 400 and Rs 500 a day by working on different farms around his village. With this income, he supported his wife and two daughters.

But today he is largely restricted to a charpoy outside his home. The only task he can perform now, he said, is feed cattle, which he does by groping to find his way around.

Bharat Paswan used to earn between Rs 400 and Rs 500 a day as an agricultural labourer. After his botched surgery, he can only feed cattle, by groping to find his way around. Photo courtesy: Bharat Paswan

Paswan lives 30 km from Patna, but on the advice of a neighbour, chose Muzaffarpur over the state capital to treat his cataract. On November 22, he travelled 65 km, underwent a blood test and was wheeled into the operation theatre of Muzaffarpur Eye Hospital. The surgery lasted a few minutes. His eye was bandaged and he was discharged the same day with the instruction to return a week later.

Within 24 hours, Paswan began to suffer pain. When he removed the bandage a day later, he found that his eyes were swollen.

On November 24, he returned to Muzaffarpur Eye Hospital. “Initially a doctor assured me that I would be alright and told me to go home,” he said.

Paswan’s account suggests that the hospital could have acted sooner to help the patients. Dr S Natarajan, managing director of Mumbai’s Aditya Jyot Eye Hospital described endophthalmitis as being like “a fire in a building”.

He pointed out that, “The faster you put out the fire, the less the damage,” adding that vision loss could be avoided in some cases if the doctor immediately treated the patient.

A trustee of the Muzaffarpur hospital, Dilip Tulsyan, told Scroll.in, “When patients started returning, doctors may not have realised the seriousness immediately. So they gave medicines and asked patients to go home. Later we started referring them to a higher centre in Patna. We treated four patients whose eyeballs had to be removed.”

Of the 328 patients who were treated in the eye camp in November at the Muzaffarpur Eye Hospital, at least 36 people contracted severe infections and developed endophthalmitis. Photo: Aarefa Johari

When Paswan’s pain persisted, a doctor at Muzaffarpur Eye Hospital referred him to the privately run Drishti Hospital in Patna, where a doctor prescribed some medicines and sent him home.

When the pain still did not subside, he went to Shri Krishna Medical College and Hospital in Muzaffarpur almost a week after the surgery. There, he was diagnosed with endophthalmitis. “Doctors told me I was very late,” he said. “They removed my eyeball to stop the infection spread.”

In East Champaran, 80 km from Muzaffarpur, Tetri Devi was among those who lost vision in November. The 60-year-old, who had cataract in her left eye, was taken to Muzaffarpur Eye Hospital by her son Jaginder Yadav for surgery. When she was wheeled out, the nurse told him to remove the bandage after 24 hours. Yadav said that when he did, his mother could not see anything.

“We rushed her back. The hospital did not treat her immediately. They asked us to visit Patna,” he said.

Yadav took his mother to the city’s Indira Gandhi Institute of Medical Sciences, where doctors said the eyeball would have to be eviscerated or surgically removed to limit the infection. “What option did we have? Nothing,” Yadav said. Tetri Devi now has blurry vision from her right eye and needs help to walk around.

After complaints poured in from patients following the camp, on 29 November, the then district civil surgeon Dr Vinay Kumar Sharma formed a four-member committee of doctors and government health officials to conduct a preliminary inquiry into the matter.

On November 30, the team visited the Muzaffarpur Eye Hospital’s operation theatre and collected swabs from trolleys, operating beds, walls and instruments. They also visited Shri Krishna Hospital and collected eviscerated eye tissue of patients whose eyeballs had been removed.

On December 6, the committee submitted a preliminary report to the government, confirming that two kinds of bacteria, Pseudomonas aeruginose and Staphyllococcus aureus, which they found in swabs from the operation theatre, were also found in the infected patients. The presence of these bacteria can lead to endophthalmitis.

Sharma told Scroll.in, “It does not seem that the hospital had adhered to prescribed infection control protocol.”

After a preliminary probe, the district health department of Muzaffarpur ordered a detailed inquiry into the incident. Sharma has since been promoted as additional director in the state health department and a new civil surgeon is monitoring the probe, which is still underway.

In parallel with these inquiries, the state government ordered another preliminary probe by a three-member committee. Dr Harishchandra Ojha, an eye specialist who monitored the state inquiry, told Scroll.in, “There is clear negligence. Sterilisation protocol was not followed. But the district officials will decide who is at fault in their detailed report.”

This wasn’t the only problem that emerged. According to the National Health Authority’s norms, as recommended by the All India Ophthalmology Society, a surgeon should conduct no more than 20 cataract surgeries a day. “On November 22, the surgeon performed more than what is recommended,” Sharma said.

According to the inquiry report, consultant Dr ND Sahu performed 65 surgeries on November 22 – it was patients from this group that later reported infections. Other days, too, saw a high number of surgeries. Sahu and another surgeon, Dr Nirupama (referred to only by one name) are jointly listed as having performed 82 surgeries on November 23. A third surgeon, Dr Samiksha (referred to by one name) conducted 63 procedures on November 24.

“We were amazed at how fast the doctor operated upon so many patients,” said Suman Singh, the daughter of Sukhdev Singh, one of the patients who underwent surgery on November 22 and lost vision. She recalled that on November 22, all patients were operated upon between 11 am and 1.30 pm.

“How could they get time to sterilise instruments in between surgeries if they were doing back-to-back operations?” she said.

Tulsyan, the hospital’s trustee, told Scroll.in that the hospital had conducted an internal inquiry into the incident. “We did not find negligence by any of our staffers,” he said. “The infection spread on one particular day, not on all days of our camp. It is possible one patient was infected and it spread from him or her to others.”

Sahu told Scroll.in that he was not officially attached to the eye hospital. “The doctor who was supposed to carry out the surgery was absent, so I was called in,” he said. “I don’t want to further comment on the incident, since there is a police inquiry.”

Following the incident, the state government shut the hospital’s operation theatre on December 4. Twelve hospital staffers, including Sahu, have been named in a first information report filed at Brahmapura police station. Senior superintendent of police Jayant Kant told Scroll.in that no arrests had been made in the matter. “We will be waiting for the subject expert committee to submit their report,” he said.

The preliminary probe, which found bacteria in the operation theatre and a lack of adherence to sterilisation protocol, specifically stated that, “The operating surgeon is not responsible.”

Suman Singh is furious over the lack of action against the hospital and its staffers. “The hospital is shut for now, but they will soon restart surgeries,” she said. “That is what happens here in small towns.”

But what matters the most to the patients is not the lack of culpability – it is the loss of vision, and the crippling loss of livelihood and income that has accompanied it.

“I can hardly walk on my own in the field,” Paswan said. “My daughters can’t do farming, we don’t know how we will manage.”

His wife, Indira Devi, tries to look after the wheat cultivation work he did on other farms, but is paid only Rs 100 a day – four times less than what Paswan earned. “It has been very difficult to survive in these past three months,” she said. “If the government doesn’t give us support, what are we going to do? How will we get our daughters married?”

The Muzaffarnagar camp was run under the National Programme for Control of Blindness and Visual Impairment, or NPCBVI, a government programme that aims to reduce blindness in India. The hospital has conducted 442 camps under the NPCBVI over the past five years, in which 45,703 people have been operated on, data from the district health office shows.

The NPCBVI was launched in 1976 by the central government to reduce prevalence of blindness to 0.3% by 2020.

Dr Rajesh Hans, additional director general in NPCBVI, explained that the Centre funds 60% of the budget for the programme, while states provide the remaining 40%, except in north-eastern states, where the Centre funds 90% of the budget. “The implementation is by state governments,” Hans said. “When infection is reported, the state has to take action. They only submit their final report to us.”

Cataract accounts for 62.6% of blindness cases in India. In India, in 2020-’21, 35.5 lakh cataract surgeries were performed under the programme, against a target of 50 lakh set by the NPCBVI for the year. The previous year had seen 64.3 lakh cataract procedures, but the Covid-19 pandemic led to a steep decline in the number of surgeries performed.

According to the programme guidelines, the state government has to appoint a “district health authority”, with 15 members, to oversee its implementation. It carries out this work in partnership with hospitals, individual doctors and NGOs, which sign memorandums of understanding with the government, and are then empanelled under the programme.

NGOs commonly organise the camps, which include the screening of patients, and then surgeries. They do this in collaboration with public or private hospitals, primary health centres and individual doctors.

As on February 22, 680 government hospitals are empanelled under the programme. The highest number are from Karnataka (117), followed by West Bengal (93) and Tamil Nadu (89). Uttar Pradesh and Maharashtra, despite having the largest populations, account for less than 5% of government hospitals in the country under this programme. Apart from this, 25 private medical colleges and 186 private doctors in India are also empanelled under the programme, along with 1,392 NGOs.

The government makes payments for this work depending on the number of patients treated. For surgeries carried out at private hospitals or clinics, the government pays Rs 2,000 per patient.

This model encourages organisers to try and increase the number of surgeries that are performed. In most camps where infections broke out, a high number of surgeries were conducted in a short span of time, flouting the prescribed limit.

The NPCBVI has little to offer those who lose their vision because of negligence or error.

In the RTI reply to Scroll.in, a programme officer stated that, “there is no provision for compensation to persons affected in eye mishaps under NPCBVI.”

According to the RTI response, Madhya Pradesh saw the highest number of incidents in which patients contracted infections at eye camps – five incidents in all, in which a total of 139 affected people were either blinded or had their vision seriously affected. In one hospital, Indore Eye Hospital, complaints of post-surgical infection were reported twice – first in December 2010, when 18 people were affected, and again in August 2019, when three people were affected, according to the RTI response. News reports from 2019, however, indicate that as many as 11 patients lost vision, or had their vision severely affected.

From RTI responses, conversations with health officials in various districts, and news reports, Scroll.in found that there were numerous similarities between the different incidents. In 13 out of 25 camps, adequate sterilisation procedures were not followed in the operation theatre as per norms laid down by the NPCBVI. In ten camps, doctors and organisers failed to follow up with patients promptly once they started complaining of pain.

Of the 25 instances of infection in eye camps, perhaps none is as revealing of the extent of negligence that has been displayed as that of the Indore Eye Hospital – it is the only hospital among those listed in the RTI response that saw not one, but two such incidents play out.

In December 2010, 197 people were operated for cataract surgery in the hospital, during which an infection spread, leading to vision loss in 18 patients. An inquiry was conducted, following which the health department ordered the hospital to close its operation theatre. Three months later, the district civil surgeon granted permission to the hospital to reopen the operation theatre and resume surgeries.

Nine years later, in August 2019, 11 people lost their vision after undergoing cataract surgery at the same hospital. Dr TS Hora, who was the nodal officer for NPCBVI in Indore district during both incidents, was suspended following this incident. The state government offered compensation of Rs 50,000 to those who were affected in the 2019 camp.

Further, the health department cancelled the hospital’s license and the state government cancelled the lease it had granted the hospital, for the land on which it stood.

An FIR was registered against hospital authorities, the operating surgeon and support staff, but no arrests were made. In the RTI response, the Madhya Pradesh government noted that the “departmental inquiry is still ongoing” in the matter.

Dr Sudhir Mahashabde, the hospital’s medical director told Scroll.in that the hospital had “followed all infection control protocol”. He added, “State has submitted a preliminary report of negligence and we are contesting it.” The hospital petitioned the Madhya Pradesh High Court and obtained a court order allowing it to function.

Dr Hemant Sinha, nodal officer of the NPCBVI in Madhya Pradesh, refused to comment over why there was a delay in the inquiry. State health secretary Mohammed Suleman did not respond to calls or text messages.

There was a similar lack of firm action after an eye camp in November 2015 in the district hospital in Barwani, three hours from Indore: RTI responses from the Madhya Pradesh government stated that 68 out of 86 patients at this camp lost vision or had their vision seriously affected. Six years since, no conclusive inquiry report has been submitted yet by the state to the Centre.

In the immediate aftermath of this incident, seven people, including the district civil surgeon and district hospital superintendent Dr Amar Singh, and surgeon Dr RS Palod, were suspended. Salaries of five others, including four nurses, were stopped for a year. The state government offered a compensation of Rs 2 lakh to each infected patient.

But the suspension of civil surgeon Singh was revoked in June 2016 by the public health and family welfare department, which cited as justification a delay by the police in filing a chargesheet in the matter. The RTI response from the Madhya Pradesh government noted that a departmental inquiry against the civil surgeon and operating surgeon is still underway.

“We still don’t know if anyone was at fault,” Singh said. “I am retired now, and I don’t like to discuss that episode anymore.”

On whether too many surgeries had been performed, Palod, who is also retired, said he could not turn away patients who had sought surgery, and that he had conducted as many as 50 surgeries a day in his career. He added that the government had never questioned the number of surgeries he performed until 2015. After the incident, the government “took a knee jerk action and suspended several of us without our fault,” he said.

The Jan Swasthya Abhiyaan and Narmada Bachao Andolan carried out an independent inquiry into the Barwani eye camp. “When the first batch of patients complained of pain and swelling, the hospital continued to operate new patients and tried to hide the news of infection,” Amulya Nidhi, national co-convenor of Jan Swasthya Abhiyaan, told Scroll.in. “There was gross negligence. The hospital was not following infection control, it was not sterilising the instruments, and there was bacterial growth in the operation theatre.”

In their joint report, the two NGOs observed that “proper process of follow-up by doctors/medical team/hospitals was not done” when patients complained of eye irritation after surgeries.

Dr Arvind Setiya, the current civil surgeon of Barwani noted that no report had been submitted in the government inquiry, and declined to comment on the NGOs’ inquiry.

Poor follow-ups were also seen in a camp in Mandla, Madhya Pradesh, in 2010, organised by Yogiraj Trust Hospital, when 113 people were operated on. The incident came to light at a public hearing by the district collector a month later. A total of 38 patients were blinded in one eye, or had their vision seriously affected. The hospital, however, continues to operate.

In March 2014, in the village of Kandwal in Himachal Pradesh, 60 patients underwent cataract surgeries in a camp conducted in association with the Salaria Eye Hospital, Pathankot. Of these, 15 patients were blinded in one eye or had their vision seriously affected. The incident only came to light six months later, in December 2014 when five of the patients visited a government hospital in Kangra for a check-up.

The state of Chhattisgarh took relatively more decisive preventive action against such camps – though it only did so after two tragic incidents.

In September 2011, the Indian Medical Association held a camp for 334 people in the town of Balod, in association with district officials. Instruments were not properly sterilised, and the surgeries took place in a make-shift operation theatre, leading to 44 being blinded in one eye, or having their vision seriously affected. The Chhattisgarh government paid Rs 50,000 as compensation to each of the affected patients, and at least nine doctors and staffers were suspended.

Dr Subhash Mishra, nodal officer of the NPCBVI in Chhattisgarh, said that in the 2011 Balod case, “The sterilisation was poor and the medicines used were spurious.” He added, “In this case, nurses and doctors responsible were suspended, but we did not cancel the doctor’s license. There is also an ongoing court case against the drug manufacturer.” The Indian Medical Association did not respond to a query on poor infection control protocol at this camp.

In 2012, Chhattisgarh recorded another episode of infection in an eye camp, this time in Bagbahara community health centre, organised by an NGO named Shri Krishna Agarwal Samiti. At this camp, 145 people were operated on, of whom 16 were blinded or had their vision seriously affected. The state government banned the NGO for three years and wrote to the state medical council to cancel the licenses of the two operating surgeons.

After this, Mishra said, Chhattisgarh became the first state to introduce strict protocol for eye surgeries.

“We banned camps,” Mishra said. “Surgeries were only to be done on routine basis in medical colleges and hospitals. We also laid down the responsibility of each person involved in the surgery. That has helped prevent such mishaps.”

Punjab, too, is trying to shift away from the model of camps – in the state’s Gurdaspur district, a camp in 2014 led to loss of vision or seriously affected vision in 29 patients. The current nodal officer of the NPCBVI in Punjab, Dr Areet Kaur, said, “When camps are involved, scope of infection rises because of poor follow up. We are now encouraging government hospitals to do more eye surgeries than NGOs.”

Incidents were reported from further south, too. In Maharashtra, in 2015, 171 people underwent cataract surgery in Washim Civil Hospital, of whom 22 lost vision or had their vision seriously affected. When the patients complained of pain they were first sent to Akola Government Medical College, where there was no retinal surgeon to operate on them.

After a delay of 10 days, they were referred to Mumbai’s JJ Hospital. Dr Ragini Parekh, head of the hospital’s ophthalmology department, said that by this time it was too late to help the patients.

Dr Avinash Aher, who occupied the post of district health officer in Washim until last month, said the inquiry report found that infection control protocol was not followed during the cataract surgeries and instruments were not sterilised. “Doctors, civil surgeon, nurses and technicians were suspended following the incident,” Aher said. “They have joined back work now after completing suspension.”

Among those who were suspended were the operating surgeon Dr Prashant Chavan, civil surgeon Dr Sulekha Mendhe, a staff nurse and two technicians. “After my suspension I stayed at home. There is a shortage of doctors, so when the health department asked me to join after suspension, I agreed to join,” Mendhe, who now works in Thane district, told Scroll.in.

State nodal officer Dr Padmaja Jogewar said following the incident, the government sent existing guidelines to every district again, with “instructions to strictly follow them”. No compensation was offered to the patients.

The state that took the most serious action against those responsible for such tragedies was Tamil Nadu. In July 2008, 66 people were operated on at Joseph Eye Hospital in Tiruchirapalli, of whom 29 lost their vision. Following this, the state government requested a CBI enquiry into the incident. The enquiry found a series of violations, including a lack of trained staff to carry sterilisation, and a failure to follow sterilisation protocol. Seven hospital officials, including doctors, were accused of negligence. In 2015, a chief judicial magistrate of the district held three people, including two doctors, responsible for the incident and sentenced both to one year’s imprisonment. The magistrate also ordered that they pay a penalty to patients ranging from Rs 2.28 lakh to Rs 5.75 lakh, depending on their age.

Dr Shakeel, from Jan Swasthya Abhiyaan, emphasised that it was this kind of action that could ensure that doctors, nurses and technicians ensured adherence to protocol in future eye camps. “The current procedures are long,” he said. “In a few months doctors get back to their business and inquiry continues. The inquiry must be quick and fix responsibility.”

In Muzaffarpur, debates rage over the culpability of the surgeon who had operated on the patients on November 22.

Infection during a surgery can be caused by multiple factors, such as a patient’s poor personal hygiene, contaminated surgical supplies, faulty sterilisation protocols and environmental bacteria. The central government, along with Vision 2020: The Right to Sight, a global World Health Organisation program that seeks to eliminate blindness, has laid out guidelines to be followed during cataract surgeries.

According to these guidelines, instrument trolleys, operating tables, saline stands, and surgeon seats must be cleaned with concentrated antiseptic liquid each day before surgeries begin. Microscope heads and other equipment must also be sprayed with disinfectant each day. Between surgeries, all the instruments used in the procedure must be sterilised using short cycle autoclaving, a sterilisation process where high pressure steam is used to kill bacteria. The operation platform must be wiped with a disinfectant between surgeries, and the floor must be mopped if there are fluid spills. At the end of each day, instruments must be sterilised using long cycle autoclaving. Needles and syringes have to be changed for every patient.

But Dr Harishchandra Ojha, the eye specialist who monitored the state inquiry, said there was a lacuna in the guidelines when it came to the aftermath of a tragedy. “There is no set guideline for specific action to be taken against doctors or hospitals when infection spreads in mass eye camps,” he said. “In such a case, each state decides a course of action.”

It is unsurprising, therefore, that there is no clear consensus on whom to blame for the Muzaffarpur tragedy.

The Indian Medical Association has backed Sahu, stating it is not a surgeon’s duty to sterilise instruments. But Dr Natarajan, of Aditya Jyot Eye Hospital, argued that since a surgeon heads a team, it is their responsibility to ensure that infection protocol is adhered to. A surgeon “can refuse to conduct a surgery if proper protocol is not followed by the hospital staff,” Natarajan said.

Dr Arun Virdhe, a retired NPCBVI officer from Maharashtra, maintained that if the operating surgeon was found at fault, their license to practice should be suspended or cancelled by the state medical council, which registers doctors.

Dr Shakeel, of Jan Swasthya Abhiyaan, argued that prompt action was key. “Delay by the state machinery is a classic way to make people forget about the episode,” he said.

Those who cannot forget the tragedy, though, are the ones directly affected by it.

In Muzaffarpur, Sukhdev Singh and his wife are now entirely dependent on their son, a migrant worker in Delhi, who already has a wife and six children to support. “In any other country, the government would have taken action and helped poor families within a week,” said his angry daughter Suman Singh, who had accompanied her father to the gathering of aggrieved eye patients at the Shri Krishna Hospital on February 14. “Yahaan toh sarkaar kaan mein tel daal ke soyi hui hai” – here, the government is turning a deaf ear. “They are not listening to our pleas for help at all.”

After contracting an infection at the Muzaffarpur eye camp, and losing an eye, Sukhdev Singh and his wife are now entirely dependent on their son, a migrant worker in Delhi. Photo: Aarefa Johari

The family of Shatrugan Madhav, the tractor driver, has had its dreams crushed. In August 2021, they had secured a loan of Rs 40,000 that they had desperately awaited, under the Pradhan Mantri Awas Yojana, a central government housing scheme. The Dalit family had been living in makeshift huts in the village of Jhapaha in Muzaffarpur for years, and had hoped the loan would allow them to build a permanent structure. But after the loss of Madhav’s vision, this future seems impossible to achieve.

“I was the only one in my family who could hire contractors and oversee the construction of the house,” said Madhav. “My sons don’t work.” Of his two sons, one has a mental illness and the other suffers from severe diabetes. “I had purchased the bricks and materials for the house before my vision started getting blurry.”

Shatrugan Madhav and his family had dreamed of building a house using funds from a government scheme. This dream was crushed after Madhav lost his vision at the Muzaffarpur eye camp. Photo: Aarefa Johari

Apart from their future, the botched surgery has destroyed even their past life. “I used to earn Rs 7,000 or Rs 8,000 a month as a tractor driver, but now I cannot work at all,” Madhav said. “I have very little vision left in my other eye – I need help with everything.”

While his sons and daughter-in-law are now struggling to make ends meet, the family has received two notices from Pradhan Mantri Awas Yojana officials in the past two months. “They say they will take the loan money back if we don’t start building our house,” said Gunja Kumari, Madhav’s daughter-in-law. “But how are we supposed to do it all?”

Patients also complained that promised compensation had not reached them.

In East Champaran, Tetri Devi’s son Jaginder Yadav said that Bihar chief minister Nitish Kumar had announced compensation, but that “nobody came to our house for it.”

Dr Anjani Kumar, civil surgeon in East Champaran district, said 17 people from the district went to Muzaffarpur Eye Hospital, of whom eight lost their vision. “We are waiting for the state government to sanction funds for compensation. We have not heard anything from top officials yet,” he told Scroll.in.

In the town of Vaishali, 65-year-old Jamila Khatoon is as worried about her husband as her own near-blindness after an operation at the Muzaffarpur camp. “My husband used to work as a tailor, but for the past few years, he has been bed-ridden and I looked after him,” said Khatoon, who developed cataract in both her eyes in mid-2021 and went to the eye camp because it was free. “Now I myself need to be looked after, so who will look after him?”

After she contracted an infection at the Muzaffarpur eye camp, Jamila Khatoon is unsure of how she will take care of her bed-ridden husband. Photo: Aarefa Johari

Khatoon’s only daughter has been caring for her parents since November, but knows she will eventually have to return to her marital home.

Khatoon’s only hope is her 23-year-old grandson. “I don’t want any compensation from the government, but I want them to give my grandson a job,” she said. “If he has an income, then he can get married and live with us and we will have someone to look after us.”

Aarefa Johari contributed reporting from Muzaffarpur, Bihar.