Childcare In Jammu And Kashmir: Small Mercies In A Blighted Land

Under-five mortality: 28

Number of working CHCs: 70 in 2005 and 84 in 2016

Required 336

Shortfall 146

IMR in J&K: 24

Source: Rural Health Statistics, NFHS, SRS

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The lone children바카라�s hospital in Srinagar 바카라�has improved바카라�, but flies buzz close to its gates. Indoors, distraught parents operate nebulisers strapped to breathless little ones. They say the devices are 바카라�not difficult to use바카라�. In Kashmir바카라�s Govind Ballabh Pant Paediatric Hospital, the gap between despair and relief is narrow. Like in many other places, this hospital sets the bar so low and has been trying to overcome neglect so pervasive that almost any improvement is betterment.

Just outside the hospital, a beggar woman leans on a few attendants바카라� personal belongings, while the attendants narrate their stories to her. There is a water outlet nearby, which attracts the flies. Upstairs, in the much-cleaner Ward No. 2, children who are yet to be admitted can be found resting. Their attendants also relax, unmindful of the nurses. The Neonatal Intensive Care Unit ward is off-limits, especially for the press. One neonatal (baby less than 28 days old) is in the incubator.

In 2012, the year there was an uproar after 787 babies died here in nine months, at least two babies used to share an incubator and there was one bed for every three or four children. Though things were worse in the previous years바카라�882 babies had died in 2009 and 883 in 2010바카라�it was in 2012 that the media reported extensively on the casualties. The deaths were due to lack of equipment such as ventilators and baby warmers, and the then Omar Abdullah-led government fired many in the administration for staff absences and general negligence. An inquiry by the then director of the Sher-i-Kashmir Institute of Medical Sciences in Soura, Srinagar, Dr Showkat Zargar, revealed constant infighting among faculty members since 2005. The faculty and head of department would not cooperate with each other.

바카라�Basic infection control guidelines were not followed and life-saving equipment such as incubators, ventilators and warmers were not maintained,바카라� the inquiry found. There were only six ventilators for more than 30,000 patients admitted every year. The infant mortality rate (IMR) in the neonatal intensive care unit was above 20 per cent. The proposal for a new children바카라�s hospital with a 200-bed maternity wing in Srinagar, to make up for the rush of patients from rural Kashmir, was shelved by the government.

바카라�The hospital doesn바카라�t stink the way it used to in 2012,바카라� says medical superintendent Dr Kanwarjeet Singh. IMR is down by 50 per cent. There are 21 ventilators바카라�16 more than in 2012. It also has 11 non-invasive ventilators now, while there were none six years ago. Over the same period, the number of syringe infusion pumps has gone up to173 from 40, and baby warmers, from 25 to 110.

All this happened because a group of lawyers, activists and journalists approached the high court with a public interest litigation (PIL). The high numbers of infant deaths at G.B. Pant Hospital were probed for five years, and directions issued regularly to upgrade the hospital. 바카라�In 2012, 14 babies would die every day. The number is down to three,바카라� says Dr Singh.

The 254-bed hospital receives three lakh children annually. Many are from remote Kishtwar, Doda, Banihal and Poonch. Doctors say congenital malformations, or physical defects at birth, are the leading cause of death, besides birth asphyxia and late referrals.

But basic questions remain. Have the hospital and the government really brought down the IMR? The health and medical education departments are not revealing yearly infant death numbers, except those in the National Family Health Survey (NFHS), a public document.

Dr Saleem Rehman, director general of health services, says J&K바카라�s IMR went down by eight points in 2016-17, the highest fall anywhere in a single year. 바카라�The NFHS shows that mother and child health indicators in Kashmir have improved and are relatively better than the national average,바카라� says Dr Rehman.

바카라�Infant deaths still haunt the G.B. Pant Hospital and other state health institutions,바카라� says Faisal Qadri, who pleaded the 2012 PIL. In the period from January 2016 to September 2017, another 464 infants died at this hospital, say sources. Submissions by the hospital in the high court show 9,118 infant admissions and 428 deaths last year. In 2016, there were 12,680 infant admissions and 492 deaths, while 574 of the 12,876 infants admitted in 2015 died.

바카라�No doubt facilities have been upgraded,바카라� says Qadri. 바카라�The PIL had been launched to stop deaths at the hospital. That has not happened. Five hundred babies still die annually and there바카라�s no plausible answer why.바카라�

By Naseer Ganai in Srinagar