42 Children Dead in 2 Months in Assam

Why does rural Assam have one of the highest mortality rates among children? Ratnadip Choudhury looks for answers
Shankar Chanda with one-year-old Priyanka Photo: Partha Seal Shankar Chanda, 35, holds his one-year-old child Priyanka close to his heart as a team from the UNICEF state office inspects the 10-bedded paediatric ward at the Karimganj Civil Hospital in Assam’s Barak Valley. Shankar does not want to let go of his child, who is suffering from acute diarrhoea. “I am very scared to get my child treated here in this hospital, but a poor villager like me cannot afford to go to a private nursing home, and this is the only hospital in the district. But infrastructure here is pathetic, and now it has become a death bed for children,” says a worried Shankar. With as many as 42 children dying in a span of two months, the situation is alarming in this very remote and poor district. The only 100-bedded civil hospital, is witnessing an abnormal increase of deaths; all in the age group of 1 to 12 years. Almost all children referred to the hospital from rural health care centres were in critical conditions.

Assam Health Minister Himanta Biswa Sharma has ordered a probe, after UNICEF stepped in and flew in its paediatric expert to the region.

The Assam Human Rights Commission (AHRC) too sent a notice to the Directorate of Health Services to look into the unfortunate deaths. Preliminary probe points to lack of infrastructure at the Karimganj Civil Hospital, as also the critical stage in which the children were brought to the hospital.

Though Assam boasts of successful implementation of the National Rural Heath Mission (NRHM) scheme, the state has the fourth highest infant mortality rate in the country. The latest records of the Registrar-General of India put it at 61 per 1,000 live births against the national average of 50. It is all the more alarming in rural Assam where the IMR is as high as 64.

“According to child specialists in the hospital, no neo-natal deaths were reported. The children who died were in the age group of 1-12 years and were in a critical condition. Almost all died within a few hours of admission. Our hospital lacks basic infrastructure. We do not even have adequate staff, and at times we also run out of medicines. We have to attend to patients far beyond our capacity because it is the only referral hospital in the district with a population of 12.5 lakh,” says in-charge medical superintendent of the hospital SK Sen.

“We took up the matter with the state government and the issue was raised in the floor of the Assembly on many occasions but nothing has changed. Out of a total of 79 sanctioned posts for medical officers in the hospital, 51 posts are lying vacant,” admits Matiur Rahman, Joint Director of Health Services at Karimganj. He, however, fails to mention the complete absence of rural healthcare infrastructure in the district that is also witness to the large-scale influx of illegal Bangladeshis, many of them cross the border illegally for medical treatment.

The district has five Primary Health Centres (PHC), one Community Health Centre (CHC) and as many as 17 mini PHCs; all of them fall under the NRHM. Locals, however, claim that most of the rural health centres are non-functional in Karimganj. Several PHCs are run by ayurvedic doctors since there is a dearth of MBBS doctors. The Karimganj civil hospital requires 50 doctors, but is now running with only 18. “The problem is not only about infrastructure. The staff on duty does not always work diligently. As always, the Assam government is hardly bothered,” explains Uttam Saha, a senior journalist from the region.

UNICEF feels a proper analysis of the death report chart of children over the last three years, which must feature the cause of death, what medicines were prescribed, time of admission and on top that whether these children were taken to the primary and community level health centers would reveal a lot. “We are not so sure about the working of the PHCs and CHCs here. It is time to re-energise the ASHA workers for better performances along with adequate training stints across the district,” said Sachin Gupte, a UNICEF health expert.

As a face-saver, the Tarun Gogoi government has decided to step up the works for a child care unit to be built at Rs 1.52 lakh for the Karimganj civil hospital, but this would not stop the main opposition party in the state, the All India United Democratic Front (AIUDF), to turn it into a political plank in the minority dominated district.

With additional reporting by Arindom Gupta in Karimganj Ratnadip Choudhury is a Principal Correspondent with Tehelka. ratnadip@tehelka.com