Patna: Bihar’s public healthcare service, which often grabs headlines for the lacunae of resources at its hospitals and health centres, can now add another notch to its lengthy belt of shame. With the coronavirus pandemic underway, communalism has allegedly cost a pregnant woman the life of her first child.
Gulshan Khatoon, 22, who hails from Kazipur village of Simri block in west-central Bihar’s Buxar district, allegedly lost her baby due to denial of health services, first at the nearest primary health centre (PHC) in Simri, and again at the Sadar Hospital in Buxar, the main hospital of Buxar district.
Khatoon’s patient slip issued at Sadar Hospital, Buxar on April 29, 2020 .
Khatoon felt labour pains begin in the wee hours of April 29, 2020, and was rushed to the Simri PHC by her mother and aunt. On admission, she was attended to by the auxiliary nurse midwife (ANM), who commenced primary treatment. However, Khatoon alleges that, on learning that she was Muslim, the ANM stopped treatment and subjected her to abuse and prejudice. Khatoon also alleges that the ANM compelled her to leave the hospital.
“When my labour pains began, my mother and aunt rushed me to Simri PHC in an auto. It was 3 am when we reached and I was attended to by the ANM. But the moment the ANM learned my name, she yelled at and abused us, saying ‘I won’t treat a Muslim as you can spread corona infection’, and ordered us to leave for Sadar hospital. She compelled me to leave the bed. Despite our requests, she stubbornly refused,” a grief-stricken Khatoon alleged, while speaking to The Wire over the phone. With no ambulance service available, she had to continue to the larger, government-run Sadar Hospital in Buxar in the same auto.
Shockingly, Khatoon alleges she was again refused treatment at Buxar Sadar Hospital, though more subtly than at the Simri PHC. Khatoon says she was left isolated and untreated in a separate ward for hours. The only ‘treatment’ she received was the suggestion of an ultrasonography test. Later, a nurse told her that the ultrasonography facility was not available at the Sadar hospital and suggested she get it done at a private hospital.
Khatoon by the time was overcome with labour pains and the three women had to run from pillar to post in search of treatment. They travelled out of Buxar, but found that all clinics and hospitals were closed. Only after asking locals were they able to find that the private Aditya Emergency Hospital in Kerat, 30 km away from Buxar town, was open. There, Khatoon delivered a stillborn baby.
Sources at the hospital alleged to The Wire that, while the baby could have been stillborn for any number of reasons, the mother being denied immediate treatment, being forced to rush from place to place while undergoing labour pains, and the exhaustion and mental stress she suffered, certainly did not help. Gulshan being a primigravida, i.e. a woman who is pregnant for the first time, should have been treated at the earliest opportunity after intense labour pains began, but this did not happen. This could be a reason for the death of the foetus in the womb itself, a doctor at the hospital alleged to The Wire.
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Khatoon’s family had to cough up Rs 2,000 for the auto and Rs 10,000 at the private hospital, a huge burden for the women who had no immediate savings. Both Khatoon’s husband and father are migrant workers stranded in Hyderabad, left without work due to the total nationwide lockdown.
“This devastation hit us at a time when my husband and father are stranded in Hyderabad. They are migrant labourers engaged in stone-crushing work. My hope and happiness turned into horror and sorrow. Hate for Muslim identity was prioritised over treatment of the needy,” said a sobbing Khatoon.
Gulshan Khatoon’s patient slip from a private hospital.
Declining treatment to Khatoon allegedly on the basis of her Muslim identity is a complete violation of the rules of the National Human Rights Commission (NHRC). Any prejudice against Muslim patients violates their rights adopted by the health ministry in March, 2019. As per the eighth right in the Charter of Patients’ Rights for adoption by NHRC, a patient cannot be denied treatment on the basis of their religion.
Mishandling cases of pregnant women has become a norm in Buxar. On April 26, a pregnant Neelam Devi reportedly died after having to rush from a government health centre to another hospital. It has been alleged that Devi was first denied treatment because she had come from Naya Bhojpur village, reportedly a COVID-19 hotspot.
On April 23, Chandini Khatoon, also of Kazipur village, was also allegedly denied a check-up and treatment by ANMs and doctors at Simri PHC, The Wire has learned. A couple of months ago, Sanjay Yadav and Pooja Kumar of Purana Bhojpur village reportedly lost their baby at the sub-divisional hospital in Dumraon, Buxar, allegedly due to doctor’s negligence and oxygen unavailability. The 60-bed hospital allegedly runs with just a few medical staff on hand at any given time.
Buxar district, despite being among the major hotspots of COVID-19, has provided faulty health services at its PHCs, sub-division level hospitals and main district hospital. In the midst of a health emergency like the coronavirus pandemic, the Dumraon sub-divisional hospital was found closed for eight days from April 22 to 29, during the complete nationwide lockdown.
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“There is a sinister design against minorities and backward castes at government hospitals and health centres. Gulshan Khatoon’s case is an example of identity-based prejudice. Such derogatory incidents regularly occur. The patient’s identity (Muslim, Dalit, Mahadalit) is the reason behind discrimination in health service delivery. It is a matter of shame and grave concern. The state government must take note and also stern action against this,” alleged Dr Shakeel-ur-Rahman, convener of the Bihar Chapter of the Jan Swasthya Abhiyan network, to The Wire.
Dr Shakeel-ur-Rahman added that the Buxar Civil Surgeon, after being informed about Gulshan Khatoon’s case, constituted a team to investigate the matter. The Wire tried to contact both the Buxar Civil Surgeon and Aman Samir, the Buxar District Magistrate, but have received no response from either at the time of publishing.
Apart from the state government and district administration, such poor facilities and denial of treatment should also annoy the Bharatiya Janata Party member of parliament for Buxar, Ashwini Kumar Choubey, who also happens to be the Union Minister of State for Health and Family Welfare. The ground reality in his home district stands contrary to Choubey’s announcement in August last year, that doctors will soon be available to the common people at their doorstep under the ‘Chikitsa, Chikitsak Aapke Dwar’ scheme. Doctors, however, still remain far from the common man’s reach.
According to the National Family Health Survey for 2015-16, poor socio-economic groups prefer public hospitals for institutional deliveries over private ones, because they can’t afford private health care. But delivery rooms in government hospitals are plagued by staff absenteeism and dearth of essentials such as oxytocin – a natural hormone administered to mothers right after childbirth to stop bleeding – and medical equipment including surgical gloves.
Amidst the COVID-19 pandemic, pregnant women of marginalised communities in Buxar are facing disrespect, abuse and denial of treatment due to their identity. This reflects even more poorly on Bihar’s already woeful condition of public health services.
Saurav Kumar is an independent journalist.