FROM THE PRESS


Horror in hospital

In a shocking tale of medical negligence, a 28-year-old woman suffered burn injuries after being cleaned with a toxic chemical following her delivery.

The incident occurred at Lalbag sub-divisional hospital in Murshidabad district of West Bengal on November 1, 2011 after the woman, Sikha Biwi, apparently delivered a dead child.

Initially it was suspected that carbolic acid was used to rub her clean. Deputy chief medical officer health Birendra Kumar Show issued a statement: “It was not done intentionally. The attendants washed the patient with the acid by mistake. The colour of the acid and the anti-infectant is almost similar. The bottles somehow got mixed. A sweeper must have kept the bottle of the acid there.” It now seems that the liquid may not have been acid but some other toxic chemical.

Even as the hospital claimed that the child was born dead; allegations that the baby boy died due to the toxicity of the chemical have forced the Lalbag sub-divisional officer to probe further into the matter.

Meanwhile, West Bengal continues to hog the news for the highest number of reported infant deaths in its state-run hospitals. In a re-run of the July 2011 incident when 21 babies died in three days at the B C Roy Hospital, Kolkata, 45 babies died in one week at two state-run hospitals in Kolkata and Burdwan from October 25 to 28, 2011. While 16 babies died at the BC Roy Children’s Hospital, the Burdwan Medical College and Hospital reported 12 infant deaths.

Giving the hospitals a clean chit, the Minister of State for Health, Sudip Bandopadhyay, said, “I’ve totally given them a clean chit because I believe that this is not due to negligence of the authorities…. Infant mortality rate in West Bengal is 33 per thousand live births which is much better than other states.” Hospital authorities too maintain that there is “nothing abnormal” or “unusual” in the deaths because the babies, they claim, were brought in in an “extremely critical” condition.

However, underlining the poor health infrastructure in the State once again, six more babies died in a Malda district hospital between November 9 and 10, 2011.

While probes are routinely ordered, the government is busy defending the hospital authorities, amidst the rising public frustration at medical negligence.

NDTV Correspondent, 45 infant deaths in one week in West Bengal, Mamata silent NDTV, November 1, 2011. Available from: http://www.ndtv.com/article/india/45-infant-deaths-in-one-week-in-west-bengal-mamata-silent-145579?curl=1374831905. PTI, Nurses clean woman with acid after childbirth, msn News, November 2, 2011. Available from: http://news.in.msn.com/national/article.aspx?cpdocumentid=5563140. The Times of India, November 3, 2011. Available from: http://timesofindia.indiatimes.com/city/kolkata-/Toxic-wash-Nurse-suspended/articleshow/10600340.cms. Indo Asian News Service, Six more babies die in Bengal Hospital, NDTV, November 11, 2011. Available from: http://www.ndtv.com/article/india/six-more-babies-die-in-bengal-hospital-148773

Gujarat’s polluted fields

In some villages of Gujarat, borewells spew reddish brown water. Irrigated fields are contaminated with industrial effluents. Yet, say the villagers, the authorities have failed to bring to book those responsible for this situation.

Residents of Nodhana in Bharuch district complain that seepage from a nearby effluent channel has been contaminating their fields for the last two decades. The Mukteshwar Mahadev Temple lake in Bharuch district has turned violet. 46 industries, mainly manufacturing chemicals and dyes, in Bharuch and Vadodara districts, release treated effluent into the channel. Residents claim that a number of these industries discharge untreated or partially treated wastewaters into the effluent channel.

The channel was built by Effluent Channel Project Limited (ECPL) in 1983 to carry treated effluent to the Gulf of Khambhat. Currently, it is said to discharge 300 million litres of effluent treated at a common plant, every day into the Gulf.

Following complaints from the villagers, the ECPL was reduced from 55 km to 46.5 km in 2004 and the route of the remaining part of the channel passing through Nodhana was diverted using an underground PVC pipeline. In May 2011, following a complaint from Nodhana panchayat that the pipeline had put irrigated fields and water sources at risk, the Bharuch district administration, along with the Gujarat Pollution Control Board, sent a notice to ECPL. ECPL, on the other hand, denies receiving any such notice.

Luna, a village situated along the 55 km long effluent channel, once known as the vegetable basket of western India, tells a similar story. The residents of the village and its surrounding areas in Padra taluk, Vadodara district, claim that their borewells are not just contaminated but also filled with industrial effluents. Luna, in fact, faces pollution not only from the channel but also from the industries located nearby. In May 2011, the Central Pollution Control Board tested the groundwater and surface water in the region and found that of the 108 borewells, as many as 45 were contaminated by effluents comprising lead, mercury and ammoniacal nitrogen.

However, according to the local administration in both the districts, a survey on the health effects of the contamination is still pending.

Anupam Chakravartty, Stinking for two decades, Down to Earth, November 30, 2011. Available from: http://www.downtoearth.org.in/content/stinking-two-decades Anupam Chakravartty, Polluters get away by making ad hoc payments to farmers. Down to Earth, November 29, 2011. Available from:http://www.downtoearth.org.in/content/polluters-get-away-making-ad-hoc-payment-farmers

Pill of contention

Yasmin and Yaz, Bayer Pharmaceutical Company’s popular oral contraceptives, also prescribed in India, are fast gathering lawsuits in the West. Several women have taken the company to court for misleading them about the health risks posed by the pills. While Yasmin has been available in the US market since 2004, Yaz, a spin-off of Yasmin, was approved by the US Food and Drug Administration (FDA) in 2006.

Research on the pills has reportedly revealed that women consuming them are prone to blood clots, heart attacks and strokes. Bayer faces more than 10,000 lawsuits over problems allegedly caused by these pills. The latest in the string of accusations against Bayer is that it may have pitched the Yasmin family of birth-control pills for unapproved use.

According to company emails that were made public following litigation, Bayer officials had discussed how to promote Yaz as a treatment for all kinds of premenstrual syndromes (PMS) not just for premenstrual dysphoric disorder, for which regulators had approved it. Apparently Bayer officials sent emails to their sales people in 2006 saying that they should cite a Women’s Day magazine article which said that Yaz was a safe PMS treatment.

According to the copy of the email produced, Matt Sample, a Bayer unit sales consultant wrote, “This article is a nice way of using Yaz for PMS treatment instead of just focusing on the specific” class of women struggling against the most severe form of PMS, that is.

Besides the off-label marketing allegations, lawyers representing women suing Bayer have alleged that company officials withheld information from patients, doctors and regulators about the drug’s risk of causing blood-clots in their rush for profit. Apparently, Bayer’s contraceptives generated $ 1.58 billion in sales last year, making them the company’s biggest-selling drugs after Betaseron, a multiple sclerosis medication.

An FDA study reveals that contraceptives that contain a particular synthetic hormone called drospirenone carry higher-than-previously-thought-of risks of blood clots. Drospirenone is an active ingredient in Bayer’s line of products. A study of 1.3 million Danish women revealed that pills containing drospirenone were linked to a six-fold increase in dangerous blood clots. In a review of 800,000 American women’s medical histories, the FDA found that women using Yaz had significantly higher rates of blood clots than women using the older pills. However, women using Johnson & Johnson’s patch, Ortho Evra, and Merck’s NuvaRing also experienced a higher rate of complications, the FDA said, thus opening up debates about newer contraceptives available for women.

Jef Feeley and Margaret Cronin Fisk, Bayer may have pitched birth control pill for unapproved use, Bloomberg, November 22, 2011. Available from: Tracy Staton, FDA study: newer contraceptives carry higher risks, Fierce Pharma, October 28, 2011. Available from: http://www.fiercepharma.com/story/fda-study-newer-contraceptives-carry-higher-risks/2011-10-28

Nursing their discontent

Around 250 nurses of the Asian Heart Hospital and neighbouring hospitals in Mumbai went on strike on October 19, following the suicide of a 22-year-old nurse, Beena Bebi, of the same hospital. Beena was said to have been driven to suicide following harassment after she misplaced a patient’s ultrasound report. However, the tragedy set off a wave of frustration among the nursing staff on issues such as a two-year bond they were compelled to sign, the confiscation of their original certificates, and the condition that they pay Rs 50,000 in case they wished to leave their jobs at the hospital before completing two years of service. They also complained of abusive treatment from their seniors at work.

During the strike period the nurses were lathi-charged by the police and 20 on-call nurses were evicted from their residential quarters at the hospital. As the majority of nurses were from Kerala, two Members of Parliament from that state visited Mumbai in an attempt to intervene and settle the dispute. They also wanted the management to take responsibility for Beena’s death and send her body to her home in Kerala for the last rites. Ultimately, the strike was called off after four days, with some demands being granted: the revocation of the two-year bond and work experience certificates to those with less than two years’ service. These certificates had earlier been given only to those with more than two years of service at the hospital. However, the nurses are said to have had to undergo interviews and sign fresh contracts at the end of the strike, as also pay a deposit of Rs 10,000. This was to be further supplemented by Rs 1,000 being cut from their salaries every month, the whole amount being forfeit in case they gave up their jobs in less than two years. The strike brought out the simmering resentment among the nursing cadre in even the more reputed private hospitals in the city.

DNA correspondent, Mumbai’s Asian Heart Hospital nurse commits suicide; others strike work, DNA October 19, 2011. Available from: http://www.dnaindia.com/mumbai/1600768/report-mumbai-s-asian-heart-hospital-nurse-commits-suicide-others-strike-work 1600768 HT Correspondent, Asian Heart Hospital nurses call off four-day-long strike, Hindustan Times, October 23, 2011. Available from: http://www.hindustantimes.com/India-news/Mumbai/Asian-Heart-Hospital-nurses-call-off-four-day-long-strike/Article1-760527.aspx

What’s the right age for bariatric surgery?

Bariatric surgery on an eleven-month-old child in Mumbai’s Breach Candy Hospital has set off a heated debate among doctors on the ethics of such surgery on an infant. The child, already weighing 19 kgs at eleven months, was suffering severe respiratory problems. She is said to have monogenic syndrome, a genetic disorder, which claimed the life of her brother at the age of 18 months. Given the loss of one child in the family, and the inability to control the weight gain as she grew older, the family decided to go in for a sleeve gastrectomy, performed by Dr Sanjay Borude. The doctor is quoted as saying that the surgery should control the baby’s weight gain for at least the next three or four years.

However, others in the profession have expressed the view that since this is not a case of overeating, bariatric surgery may not have been the best option. They have said that since the genetic disorder continues to exist, merely reducing the size of the stomach is unlikely to do much good. Another area of doubt relates to the age of the patient. While India has no guidelines in place on the minimum age for bariatric surgery, in the US the minimum prescribed age is 18 years.

According to Dr Borude, “She has already developed respiratory problems due to which she has been suffering from breathlessness. A little more weight can prove bad for her.” He added, “The surgery could have been done later but the child has to survive till then. We did not want to take any chances.” The child’s parents, who are not well off, are happy that the surgery, which was done free of charge, seems to have given her some hope of a normal future.

Jyoti Shelar, Infant’s fat surgery leaves docs divided, Mumbai Mirror.com, November 25, 2011. Available from: http://www.mumbaimirror.com/index.aspx?page=articleid=15&contentid=2011112520111125090939157b01b23a8

Surviving an archaic test

Desperate for a job, Balaji Trimanwar, the son of a Yavatmal farmer, took part in a 26-km run, a required test for aspirants to jobs as forest guards. Just 23, he collapsed in a pit and died the next day, apparently of exhaustion. Balaji’s family said he received medical aid only after a couple of hours. While thousands took part in this archaic test, 1,240 candidates fainted in the heat, according to Kishore Tiwari of the Vidarbha Jan Andolan Samiti. Tiwari stated this to counter the forest officials’ claim that Balaji may have died due to a kidney ailment. The Samiti has approached the state human rights commission to review the case and recommend compensation for Balaji’s family. It has also demanded that the Forest Department revise its recruitment rules and cut the length of the race.

On the intervention of the state human rights commission, the department has now agreed to check all candidates after the first five km before allowing them to continue. It will also make it compulsory for applicants to produce a fitness certificate before running. The department has defended itself saying that the stringent provisions of the Forest Conservation Act and the Wildlife Protection Act prohibit the building of roads in the forest area, hence the work requires men who are fit enough to function under such conditions. They claim such tests help them to gauge a person’s capacity for the job. The Commission is said to have asked for the rules to be revised in writing.

Meanwhile, the department has paid compensation of Rs two lakh to Balaji’s family.

Yogesh Naik, 5-km ‘risk test’ in forest job marathon, Mumbai Mirror, October 26, 2011. Available from: http://www.mumbaimirror.com/article/2/2011102620111026020201404bc6fe9f5/5km-%E2%80%98risk-test%E2%80%99-in-forest–job-marathon.html. Mumbai Mirror Bureau, Yavatmal youth dies while chasing forest job, Mumbai Mirror.com, September 21, 2011. Available from: http://www.mumbaimirror.com/article/2/2011102620111026020201404bc6fe9f5/5km-%E2%80%98risk-test%E2%80%99-in-forest–job-marathon.html?pageno=1
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