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Monday, July 22, 2013

Newborn twins in city die for want of ventilator, neonatal care

Mumbai: Premature twins born in a private nursing home in Ghatkopar and urgently requiring neonatal care, died days after they were turned away by the city's three biggest public hospitals for lack of ventilators. 

    Vijay Jaiswal (31), an autodriver, was advised by the nursing home to shift his twin daughters to a civic hospital as it lacked ICU facilities. Also, he 
couldn't afford a private hospital. He took the twins, born on June 13, to KEM, Sion and Wadia hospitals the same day, 
but was sent back saying there were no neo-natal ventilators available then. He got the babies back to the nursing home, where their condition worsened and they died on June 18. 
    Ironically, the BMC has been unable to buy new ventilators for its hospitals for over two years because of legal issues. 
'Most difficult five days of my life, watching my children die' 
Civic Hospitals Cite Lack Of Beds, Auto Driver Forced To Admit Twins To Private Clinic 

    A file on procurement of more neonatal ventilators for civic hospitals, pending with the BMC for over two years, has finally been expedited and all sanctions should 
be in place in a month. But it will be of no help for Vijay Jaiswal (31), an auto-rickshaw driver, whose newborn twins were turned away by three civic hospitals citing inadequate ventilators. The baby girls, later admitted to a private nursing home, died within five days. 
    The premature twins were born on June 13 at the Ghatkopar nursing home, which advised Jaiswal to take them to a government hospital with a neonatal intensive care unit. The treating doctor at the nursing home, who refused to be named, said it did not have adequate intensive care facilities which the babies required. Jaiswal went to KEM, Sion and Wadia hospitals, only to bring the babies back to the nursing home as no neonatal ventilators were available at the civic hospitals. While the hospitals assured they would call him when the ventilators were available, he got a call from Parel's KEM Hospital when the babies died on June 18, informing him that only an incubator was available, but not a ventilator. "Those five days were the most difficult for me, to see the health of my children deteriorate and watch them die," said Jaiswal. 
    KEM Hospital's 37-bedded NICU has six invasive and an equal number of non-invasive ventilators. "KEM being a tertiary care centre, our warmer beds in the NICU are packed to capacity. Some days we even place two babies on one bed," said head of neonatology at KEM Hospital, Dr Ruchi Nanavati. Both KEM and Sion hospitals said there was no formal waiting list of babies for NICU beds. "Eight to 10 babies born in the hospital itself need NICU care and are always given preference. Besides, at least two to four babies are referred to the hospital from outside on a daily basis," said head of neonatology at Sion Hospital, Dr Jayashree Mondkar. The hospital has 40 infant warmer beds with eight invasive and six non-invasive ventilators at their disposal. She suggested that hospitals in neighbouring municipal areas should strengthen their infrastructure. 
    Rais Shaikh, Samajwadi Party corporator, who gave financial aid to the family, said, "It is sad that people are being turned away from civic-run hospitals which have a huge budget. The BMC has been sitting on a number of files pertaining to medical equipment for at least three years now." A senior civic official said, "There has been a delay in procurement of certain equipment. But the backlog will be cleared by the end of this month." 

Corporators and activists allege around 50 files on the purchase of medical equipment, including neo-natal ventilators, general ventilators, X-ray, ECG and ultrasound machines, are pending with the civic administration for over two years 

    The BMC admitted to the delay and has now shifted responsibility of following up on the files and procurement from doctors to the central purchase department. The department will have to bring a file for approval to the standing committee within six months 
Times View: A wake-up call 
    The exact cause for these two babies' death is not so important here. Far more relevant is the set of problems that have held up, specifically, the entry of more ventilators into the system and, more generally, the addition to the city's publichealth infrastructure in this critical sector. The deaths should serve as a wake-up call to the government to plan better and cut through red tape that holds up requisitioning of absolute essentials

Mamta Jaiswal (25) wife of auto driver Vijay (31), delivered premature twin girls in a Ghatkopar clinic

The nursing home lacked facilities essential for the twins and advised that they be taken to a civic hospital

Jaiswal took them to KEM, Sion and Wadia hospitals the same day, but found no neonatal beds vacant

He had no option but to bring his daughters back to the Ghatkopar clinic where on June 18, the twins died


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