Delay in the procurement of life-saving vials of antitoxins, for treatment of diphtheria-related complications, by the Maharishi Valmiki Infectious Diseases Hospital at Kingsway Camp here from the Central Research Institute in Kasauli is being cited as the alleged immediate cause of 21 deaths at the hospital.
The Kasauli institute manufactures the antitoxin.
Thursday morning at the hospital was no different, as over 23 seriously ill children were brought here from Delhi, Haryana and Uttar Pradesh. The municipal hospital has seen over 170 diphtheria-related admissions since September 6.
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The government recently suspended the Medical Superintendent, and also set up two panels to look into procurement delays and other causes of death.
Meanwhile, parents, mostly from the economically backward sections of society, wait outside diphtheria wards 4 and 5 in the double-storey infectious diseases building. They complain about bedsheets in the children’s wards not being changed, being forced to run around to buy expensive antitoxin vials from private medicine suppliers for nearly ₹10,000 and lack of toilet facilities, among other issues.
However, these issues are not what has shocked and frightened the group, which prefers to sit in a huddle.
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“Children are dying daily,” sobbed Uttar Pradesh resident Sharif, whose daughter has been in the hospital for 11 days now.
His six other children are healthy and have not shown any symptoms of diphtheria so far.
“We watch everyday as tiny bodies wrapped in white sheets are taken from the wards. However, their bed do not stay empty as another child immediately replaces the previous occupant. It’s heart-wrenching,” he added.
To a question on whether his children were vaccinated against diphtheria, Sharif said: “I am a truck driver. I go home for a week after every three months. I am unaware of injections and other such things.”
Similar stories are told over and over again. Some parents even claim that they are unaware of booster doses required for diphtheria prevention.
Immunisation
Explaining why these deaths take place each year, Professor of Paediatrics and Dean at Maulana Azad Medical College Siddarth Ramji said: “Under the Universal Immunisation Programme, all children below one year of age are supposed to get three doses of the Diphtheria-Tetanus-Pertussis [DTP] vaccine, followed by two booster doses between 1-2 years and 5-6 years. This clearly did not happen. You will see that most of the deaths that have happened were cases where the child was not vaccinated or slipped through the vaccination net and did not get full coverage.”
“The second very important cause of death is the fact that most of these children were brought to the hospital very late, by which time toxins from the diphtheria bacteria have already affected their heart and nerves. The anti-diphtheria serum does not work after that,” he said.
The challenge then is to ensure full vaccination coverage and that parents are educated, the doctor said, adding that they must admit their children in the hospital as soon as symptoms surface. India has had a diphtheria vaccination programme since the 1980s. But coverage of the three primary doses is inadequate (at 80%) across the country, as per government data, with many people opting to step out of the vaccination coverage. “It is this patchy coverage that has caused the death of children, who are mainly between 6 and 9 years of age,” said Dr. Ramji.