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Gorakhpur Tragedy Shows How States Like UP Deprive Millions Of Basic Health Care

The Health Care deprivation in Uttar Pradesh has failed the people and chief minister Yogi Adityanath must accept responsibility for the death of more than 70 children so far at the Baba Raghav Medical College Hospital in Gorakhpur. 
The cause was the dreaded encephalitis -- a condition of shortage of oxygen causing inflammation of the brain leading to death.
It is an all too familiar story of waking up to an alarming situation when the water has risen over one's head. What is worse is that children died in the neonatal and encephalitis wards on the inexcusable ground that the oxygen supply was cut off because the requisite payment had not been made to the vendor amounting to criminal negligence. 
The unfortunate statistics of baby deaths doled reveals that from a dozen to one score or more children dying in that hospital every thirty odd days spread over the last four months. 
Yogi Adityanath represented the Gorakhpur constituency in the Lok Sabha for nearly two decades till he resigned a few weeks back. Thousands of deaths having taken place at this centre since encephalitis was first detected there four decades back. 
In a span of six days earlier this month no less than 63 deaths had occured in the hospital. A high alert should have been sounded under these circumstances. Several letters were written to the authorities concerned in the last five months about the lack of oxygen in the hospital but to no avail. 
The situation became so serious in the hospital that constant supply of oxygen was unavailable being the only lifeline for seriously infected children. 
The Prime Minister dispatched experts from the national capital for extending medical support to the hospital. At the same time the ever persisting insitutional shortfalls remained rather than being corrected expeditiously.  .   
The blame must rest squarely with the state administration for the terrible state of affairs on the civic side. Gorakhpur, as is the problem with sprawling Eastern UP is prone to severe encephalitis because of poor sanitation facilities and other problems including overflowing sewers and open defecation. 
The hospital leaves much to be desired in terms of public health management and happens to be the only institution in a widespread area treating infectious diseases. Last year Prime Minister Narendra Modi laid the foundation stone for an AIIMS at Gorakhpur.
There is imperative need to redouble efforts in strengthening primary health care facilities in the state. The tragedy is fast gaining political colour with opposition parties including the Congress accusing the state government of trying to suppress matters and find scapegoats. 
Amid differences of opinion between the UP health minister Siddharth Nath Singh and his junior Anupriya Patel, the former denied that there was any shortage of oxygen. He attributed the death of children to sepsis, pneumonia and other infections.  
It was only in April this year amid much fanfare that the Yogi Adityanath government decided to go in for a major revamp of the healthcare system in the state. The endeavour is to bring the most marginalised and the poor into the health net by use of technology. 
It proposed introducing telemedicine along with mobile medical units moving from place to place with doctors and medicines. Notwithstanding these grandiose plans negligence has led to irreversible consequences which should have been anticipated and dealt with in an effective and timely manner. 
Studies reveal that in the last 15 years, UP's population increased by 25 per cent but its public health care decreased by eight per cent. Rural health statistics indicate how successive state governments have neglected affordable, accessible and quality healthcare for the country's most populous state of 20 crore people. 
Studies reveal that a newborn in UP is expected to live four years fewer than in neighbouring Bihar, five years fewer in Haryana and seven years fewer in Himachal Pradesh. 
UP contributes the largest of almost all communicable disease deaths. Universal immunisation plays a key role in decreasing child mortality. Is it any surprise that about half of the state's children are not vaccinated.
Healthcare has been low on the priorities of successive governments in Lucknow. The per capita expenditure on health increased in UP from Rs 260 to Rs 372 over four years in 2010. Compare this to Rs 356 to Rs 560 in Kerala and from Rs 299 to Rs 579 in Tamil Nadu over the same period. 
As state governments have failed to increase public health institutions to match population growth, millions are deprived of basic healthcare. Consequently, existing facilities are overcrowded, made worse by substandard health facilities. 
It is a matter of serious concern that no health sub centre meets the government's quality and staffing norms. 
(The views are personal.)

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