The leafy, unhurried campus of the North Delhi Municipal Corporation-run Maharishi Valmiki Infectious Diseases Hospital (MVIDH) masks an ugly truth. Witness to 31 child deaths due to diphtheria last month, with the number of cases and the death toll continuing to rise, this medical facility has become the face of everything that can go wrong with India’s Universal Immunisation Programme and its subsequent disease management.
Highly contagious
The 31 deaths, caused by the highly contagious disease of the upper respiratory system, could have been prevented through vaccination and strict surveillance. According to the findings of a probe committee set up by the Municipal Corporation, the children died despite being brought to the 150-bed general hospital in the capital due to lack of anti-diphtheria serum, which wasn’t procured on time.
An enquiry has revealed that stocks of 1,400 vials at the MVID Hospital were exhausted by December 2, 2017, and the next batch of 200 anti-diphtheria serum arrived here only by September 23, 2018. By this time, several children were dead.
Services at the hospital also suffer on account of lack of staff to attend to critical patients, absence of basic medical facilities such as isolation wards, intensive care units, ventilators, laboratories, X-ray services and ambulances.
According to corporation records, over 550 people have died due to diphtheria in the capital between 2012 and 2017 — 56 deaths in 2012, 71 in 2013, 110 in 2014, 88 in 2015, 133 in 2016, and 102 in 2017.
Most of the diphtheria patients, said doctors at the MVID Hospital, come from western Uttar Pradesh, and some are from within the city. Those from the city are mainly migrant labourers.
“Almost all the children who are admitted have had no vaccination or [have undergone] incomplete vaccination. They come for treatment a week or more after the infection has set in, by which time it becomes difficult to help them,” said a doctor at MVID’s diphtheria unit.
Regular recurrence
Speaking about the regular recurrence of diphtheria cases in north India, mainly among children under nine years of age, Professor of Paediatrics, and Dean, Maulana Azad Medical College (MAMC), Dr. Siddarth Ramji, said: “It is time we looked at some hard-hitting questions. We need to understand where these patients are reaching as first contacts [whether private or public facilities], whether the Infectious Diseases Hospitals in their districts are capable of handling such cases, why they are being referred to Delhi, and the status of anti-diphtheria serum availability in the States adjoining Delhi.”
To these questions, the Health Department officials in Uttar Pradesh, the State from which the maximum number of diphtheria cases come to Delhi, have a standard answer — “No comments.” Several officials disconnected the calls when The Hindu persisted with queries on diphtheria cases being referred to Delhi.
The North Delhi Municipal Corporation, meanwhile, has suspended MVID Hospital Medical Superintendent Dr. S.K. Gupta, but has failed to put in place a plan to prevent diphtheria deaths.
The Corporation’s investigation report states that all children coming to Delhi in an advanced stage of diphtheria die from heart complications and airway obstructions, and that each of them have been administered anti-diphtheria serum procured from private chemist outlets.
“We are a bunch of bewildered parents, running from one shop to another, trying to get the most basic health care for our children,” said Mohammed Chottey from Uttar Pradesh. Four of Mr. Chottey’s children were admitted to MVID, while three of his brother’s children died at the hospital due to diphtheria.
“Two of my children are still under treatment and the other two have gone back home,” he said.
He claimed that even bedsheets are not changed at the hospital when one child dies and another is brought in. “We have to fight for basic human respect,” he said.
While parents blame hospitals and hospitals blame parents for the deaths of children due to diphtheria, studies show that from 2001 to 2015, nearly half of the diphtheria cases reported globally were from India.
