A hospital in Kolkata has just witnessed 12 crib deaths. In eastern Uttar Pradesh, 474 persons died of encephalitis this year. These are cases that have made it to the news because the number of those who’ve died is large and is concentrated in one hospital or a small region. Elsewhere in the country, “silent” deaths due to a dysfunctional and crumbling health infrastructure are the norm. The gap between the demand for healthcare and its supply has never been as large as it is now.
At the top of this pyramid are health ministers at the Union and state levels. At both levels, the bankruptcy of ideas is plainly visible. In Kolkata, for example, the hospital where 12 babies died had witnessed 18 deaths in similar circumstances in June, after which an enquiry had been ordered. But enquiries don’t lead to changes in India. In the case of encephalitis deaths in UP, Union health minister Ghulam Nabi Azad favours the creation of an inter-ministerial coordination committee. As in the case of the Kolkata enquiry, a coordination committee is the wrong remedy.
This is, no doubt, a difficult situation that warrants action on more than one front. In UP for example, contaminated water is a big contributory factor in the large number of cases of encephalitis. That is more of a public health problem than a mere medical situation. The question is, why is a coordination committee required in the first place when doctors, officials and politicians are aware that action is required on more than one front? Clearly, such action should have come before and not after so many deaths.
One part of the problem is administrative. There is no accountability at any level and hence, after the initial outburst of anger, there is no remedial action to prevent the recurrence of such incidents. Another aspect is the huge gap between what the system can deliver and what is demanded of it. Simply devoting more resources will not solve the problem in a system where there’s no accountability. In both cases, the ultimate responsibility for failure lies at the level of political heads of these ministries and departments.
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