Shravasti: At Shravasti, perched on eastern Uttar Pradesh’s border with Nepal, the state’s ground zero of child deaths, the fight to save extremely frail newborns – born to anaemic, undernourished mothers at the 10-bed sick and newborn care unit or SNCU of the district hospital – involves zero full time doctors.
When NDTV visited the hospital, Dr Imran Moin and Dr Pradeep Kumar, two child specialists who also manage other sections of the hospital including the Out Patient Department, are trying to convince the parents of a just-born baby to shift to Gorakhpur’s medical college – over 200 km away. The baby is severely underweight. It has turned blue and every breath seems to be under tremendous pain. The family of the child refuses, but relents after an hour.
Waiting For Equipment
This critical unit has also been waiting for months for the latest life-saving equipment. In the last month, 101 babies were admitted here, 15 died. About 100 newborns have died this year. A similar number of deaths were reported in 2016 as well.
“Whatever we can do, we are doing. I have to look at OPD, NRC, deal with the public, listen to my bosses, even do post-mortems. We have been asking for full time paediatricians at this ward but so far there has been no luck,” said Dr Imran Moin, one of the two child specialists at the hospital.
Dr Pradeep Kumar, the senior Child Specialist at the hospital, describes in detail the need for latest equipment at the ward. “We get a lot of babies suffering from respiratory syndrome. We do not have a C PAP machine. That machine is very useful in pumping oxygen into these kids. If we had that machine, we could have saved many more kids. We asked for it four months ago. But I am unaware of the progress on it. We hope it will be sanctioned soon. It’s not part of normal protocol for us to get this machine but I have made a special request,” said Dr Kumar.
Highest Child Deaths In The Country
More children below five years die in Uttar Pradesh than anywhere else in the country. Within UP, Shravasti’s death rates are alarming. According to data from the National Family Health Survey 4, of every 1,000 children born alive here, 130 are dead by the age of 5 – the number of similar deaths for the rest of UP is 78. Ninety-six children out of 1,000 die in Sravasti by the age of 1 and 49 out of 1,000 are dead within 28 days of birth.
Shravasti’s district hospital – extremely crucial in an area with hardly any private healthcare, is supposed to have 35 doctors, but there are just 13 available.
UP has a total shortfall of 7,338 doctors in different government hospitals in the state, according to government data. At smaller government hospitals, like the 30 bedded community health centre in Shravasti’s Sirsiya block, the shortfall is even more alarming.The hospital caters to a 2.2 lakh people – double than what it should, but has just two MBBS doctors – none of them are specialists.
Across Uttar Pradesh, such hospitals have a crippling 84 percent shortage of doctors. Yogi Aadityanath’s government says it is trying to address this emergency, by raising the retirement age of government doctors from 60 to 62 and by conducting walk-in interviews to fill at least 2,000 vacant posts for doctors. This process has been initiated but it’s not clear how soon the appointments will be made.
Malnourishment, Sponsored By Red Tape
On the other end of the child death spectrum in Shravasti and other parts of UP are abysmal nutrition statistics for both mothers and children. According to data from the International Food Policy Research Institute, UP has a 46.3 per cent rate of stunting among children up to five year of age, the third highest after Bihar and Jharkhand. In Shravasti, the stunting rate is 63 per cent. Uttar Pradesh’s rates for anaemia in pregnant women – a condition that poses extreme danger to newborns and mothers – remained almost the same between 2006 and 2016 at over 50 per cent.
Recent government initiatives, to improve nutrition among mothers and children, are caught up in political tussles. In 2016, then Chief Minister Akhilesh Yadav launched an ambitious Rs 800 crore scheme called the Hausla Poshan Yojana from this village – Motipur in Shravasti to provide daily cooked meals to undernourished children and pregnant women and also monthly quotas of ghee, milk and other nutrients.
Shravasti was allotted Rs 5 crore for 2016 – 17. The district failed to spend over Rs 1 crore and returned that money at the end of the financial year. Then, after the Yogi Adityanath government came to power in April this year, the funds for the scheme were stopped altogether.
“A joint account was opened in the pradhan and the anganwadi worker’s name. We got money for a few months and then the money just stopped coming,” said Ram Ji, Motipur’s 25-year-old Pradhan or village chief.
The Yogi Adityanath government’s intervention has been to bring in an entirely new scheme altogether – a Rs 262 crore scheme called Shabri – where young children will be weighed – health cards issued to them and nutritional interventions given. But there is no explanation on why an existing and just-launched scheme like the Hausla Poshan Yojana has been put on the backburner shortly after its launch.
“The state nutrition yojana was started by the earlier government, and the Hausla Poshan Scheme was a sub scheme. Maybe the new scheme, Shabari will be a modification of the earlier scheme… currently we have been asked to collect data on nutrition status, what the government intervention will be, we are not sure,” said Deepak Meena, District Magistrate of Shravasti.