Public healthcare:​ Lessons from the Gorakhpur tragedy​​

By Nabeela Khan Inayati

Published on August 19, 2017

It is still not clear what really caused so many deaths.  A sudden cut in oxygen supply by a private firm due to non-payment of funds by hospital is believed to be the main cause. But what has happened in Gorakhpur isn’t merely about oxygen cylinders—it is a symptom of many deeper problems.

India has been boasting about its vaccination drives but has not been able to achieve huge improvements in vaccination rates especially in Uttar Pradesh.

While immunisation is the most effective way to combat Encephalitis which is a viral disease and causes inflammation of the brain. Yet according to government figures about 20 million children are not vaccinated on time in UP. This data reflects that almost 29% of children in the UP did not receive vaccination last year.

Every year encephalitis outbreaks in Gorakhpur and Kushinagar are widely reported. Encephalitis is a 30-year old disease that usually strikes between July to October mostly in parts of Eastern UP and affects children usually between the age 1-15 years, yet Gorakhpur was not prepared.

This tragedy once again exposed shortage and unavailability of doctors, nurses and support staff. 

The state has only 3% of nurses out of the total 26,39,2299 registered nurses in India. There is a need for nurses who should be trained in neonatal and paediatric advanced life support. 

Patients who require artificial ventilation can be helped through ‘handbagging’ in emergency situations. And handbagging is a skilled job which is to be done by a professional.

The Gorakhpur case is a classic case of medical negligence and lack of basic facilities such as oxygen.

Imagine an estimated Rs. 1015.74 Cr worth of existing medical equipment in government hospitals and dispensaries including those in U.P are dysfunctional.

The dysfunctional equipment includes everything from a weighing machine or ECG machine to a dialysis machine or X-ray in public facilities. UP is still in the process of finalizing the tenders for maintenance of medical equipment as announced by the health minister in December 2016. Effectively dealing with non-functional equipment is the need of the hour. This will not only help in improving the overall public health facilities but also help in improving diagnostics services thereby reducing disease burden.

Another problem that exist is that a huge population in India is without any health insurance cover.

The poor families are left with no option but to have no treatment or to borrow money to seek even basic health treatment.    Only 21.6 crore people - less than one-fifth of India's population - are covered under health insurance. Even among those who have some form of coverage, 67% are covered by public insurance companies.

One of the biggest lessons to learn from this tragedy is we need to be prepared for such healthcare crises.

Public healthcare systems across rural areas remain poorly funded and healthcare financing remains a complex model in India. Even when funds are sanctioned, corruption, exploitation and political developments prevent their fair utilisation. 

In Gorakhpur, like elsewhere, government must improve and strengthen the sinking public health. This is a major lesson from the Gorakhpur disaster.