The Gorakhpur tragedy

It is nearly five months since more than 50 people died over just a few days in the Baba Raghav Das Medical College and Hospital in Gorakhpur, Uttar Pradesh. Several doctors at the state-run hospital were arrested after an enquiry found that at least some of the patients had died for lack of oxygen. It is not known, however, if the facilities at the hospital have improved since and whether measures have been taken to ensure that a similar tragedy does not occur.

Twenty three children and eight adults died in the hospital on August 10. The deaths coincided with reports that the oxygen supply had been cut because the hospital administration had failed to pay the supplier. By the next day, the death toll rose to 34 children and 18 adults.

Although the state government initially denied the deaths had anything to do with the shortage of oxygen, subsequent investigations found otherwise, and several doctors, hospital administrators and the oxygen supplier were arrested. But what of the hospital itself? It is the largest tertiary hospital in eastern Uttar Pradesh. Severely ill patients come from neighbouring districts and states, and even from Nepal. The hospital is overburdened and under-equipped.

As found in August, the neonatal intensive care unit has 40 beds, but accommodates over 100 children at any given time. Two or three children are crammed into a bed, increasing the risk of infection. Many children brought to the hospital are admitted with encephalitis, which is endemic in eastern Uttar Pradesh.

But even after the tragedy in August, almost nothing about public healthcare in Gorakhpur, and Uttar Pradesh generally, appears to have been fixed.

A man holds pictures of his twins who died in Baba Raghav Das Medical College, Gorakhpur, on August 10 Photo credit: Menaka Rao

The Zika cover-up

On May 26, the World Health Organisation issued a statement that India’s Ministry of Health and Family Welfare had reported three laboratory-confirmed cases of Zika in Ahmedabad, Gujarat, 10 days earlier.

This came as a surprise to most people in India, including health officials in Ahmedabad who found out about the cases from the WHO announcement. The health ministry subsequently put out a press release saying it had not made the information public because it did not want to cause panic. Moreover, even while carrying out surveillance for Zika, health officials had said the exercise was for malaria control.

Health activists criticised the government’s handling of the situation. Instead of issuing warnings about the risk of infection and advisories about how people in the affected area might protect themselves, they pointed out, the government chose to suppress important public health information.

Residents of Bapunagar where Zika was detected had no idea how to protect themselves from the infection. Photo credit: Priyanka Vora

Pitting public health against national interest

In April this year, the Ministry of Home Affairs barred the health advocacy organisation Public Health Foundation of India from receiving foreign funding by revoking its registration under the Foreign Contribution Regulation Act. Among the grounds for the ban, the ministry cited the organisation’s work on tobacco control.

The foundation is a public-private initiative that provides technical support to the health ministry on public health matters. The irony of the home ministry’s action was that the foundation had been running anti-tobacco programmes at the behest of the health ministry since 2010. In June this year, Health Minister JP Nadda even accepted a WHO award for tobacco-control initiatives.

In October 2016, the government had cancelled the Foreign Contribution Regulation Act licence of the Institute of Public Health in Bengaluru and the Voluntary Health Association of Assam, without citing specific reasons. Both organisations have done considerable work on tobacco control. While the home ministry claimed to be acting in the interests of tobacco farmers and bidi makers, it would appear it was actually protecting the interests of the influential tobacco industry. While appearing to act in national interest, the home ministry has, in fact, been imperilling India’s health.

A farmer with oral cancer who has quit chewing tobacco and wants to quit growing it but cannot. Photo credit: Menaka Rao