Trigger warning: This story contains details about the deaths of infants. Please avoid reading if you’re distressed by the subject.
On the night of November 15, Dharmendra Raikwar, 31, and Bhagwati, 27, were seated in the waiting area outside the neonatal intensive care unit (NICU) of Jhansi’s government-run Maharani Laxmi Bai Medical College Hospital. Their week-old son had been admitted there with a fever. Suddenly, they heard screams about a fire.
“When we went inside, we saw that someone had broken the windows of the ward and had started handing out babies,” Dharmendra says. Babies were lifted out of incubators and their needles and tubes removed, to save them from the fire. Amid the pandemonium, an infant was thrust into their arms. Relieved that they had been reunited with their son, the couple admitted him in the district hospital in Lalitpur district, located about two hours away.
However, their happiness was short-lived. The next morning, the authorities called them, along with the parents of other children who had been admitted in the NICU, back to Jhansi to identify their babies.
“I could not believe my ears when they said that my baby had died in the fire and that the baby we had got was someone else’s,” says Bhagwati, sobbing. “Nobody can understand the pain of a mother who has lost her child. They even did a post-mortem on our child.” The family lives in the Bar block of Lalitpur in a mud house with a broken roof and damaged walls. Their three-year-old daughter plays nearby.
The fire claimed the lives of 10 newborn babies. The Uttar Pradesh government has ordered a multi-level probe into the incident and also formed a four-member committee, headed by the Director General of Medical Education and Training, Kinjal Singh, to investigate it. The team arrived in Jhansi on November 18 and is yet to submit its report to the government. The government announced an ex gratia of ₹5 lakh to the family of each deceased baby and ₹50,000 to the families of injured babies.
U.P. Deputy Chief Minister Brajesh Pathak, who also holds the health portfolio, went to the hospital to take stock of the situation on November 16. However, his visit became controversial after videos emerged on social media showing workers cleaning the premises and sprinkling lime powder on the roads — a practice commonly seen before welcoming VIPs, in India.
A horrific night
At 10.20 p.m. on November 15, several families sat in the waiting area outside the special newborn care unit (SNCU) of the medical college hospital. Others were preparing to sleep. No parent is allowed inside the unit unless they are called by the hospital staff to feed their child. The SNCU is divided into three sections based on the child’s criticality. The NICU is the inner-most room.
When a few families went in to feed their babies, they saw that a fire had broken out. Kripal Singh was waiting outside the SNCU with his daughter who had been called inside to breastfeed her newborn. As he walked in, he says, he saw a nurse running out with one of her legs on fire. “There were more nurses there. So we just started picking up children in whatever condition they were, and handing them to the people outside,” he recalls.
Megha James, 32, a nurse posted at the NICU, was among the first to spot the fire. “I was preparing an injection while a doctor was treating a child. Suddenly, an oxygen concentrator caught fire. We tried to control it. We called a ward boy, who tried to douse it with a fire extinguisher. But the flames had spread by then,” she recalls.
James says plastic from equipment was falling everywhere. The hospital staff tried to douse the burning plastic on the floor with their footwear, but failed. “My uniform also caught fire,” James says. “So I removed it and threw it away.” She was treated at the hospital’s burns unit.
The medical college principal, Dr. Narendra Singh Sengar, says the oxygen concentration in critical childcare units is kept at 49% as compared to the 21% in normal atmosphere, to help children breathe easily. This, he believes, could have worsened the fire in a short span of time.
The Paediatrics Department at Jhansi’s Maharani Laxmibai Medical College Hospital.
| Photo Credit:
A.M. Faruqui
Hearing the chaos, more family members rushed inside the SNCU. Some of them wrapped infants in blankets and ran out. Soon, black smoke blocked the entrance.
In about 20 minutes, a fire tender arrived at the scene and put out the fire, according to hospital authorities. While 39 of the 49 children admitted in the three rooms were rescued, the fire, suspected to have started from a short-circuit, killed 10 infants in the NICU. Among the rescued babies, 16 suffered injuries.
Editorial | Twin negligence: On the Jhansi hospital fire
The hospital and the district authorities moved the remaining infants to the emergency ward, say officials. On November 16, most children were moved to the paediatric ICU of the hospital, while others were admitted to other government and private hospitals in the city.
Since the tragedy, five more children, who were rescued from the fire, have passed away. However, Dr. Sengar claims that they died from illnesses. The families allege negligence.
Confusion amid the chaos
As family members and hospital staff recall the tragic turn of events, they say everyone was only focused on one task, which was to save as many babies as they could.
Yakoob Mansoori and Nazma Bano gave birth to twin daughters on November 9. Mansoori was able to save about seven children from the fire, but not his own. His little girls were charred beyond recognition, he says.
Dharmendra’s father, Munna Lal Raikwar, says there was no time to think. “All the children, dead or alive, were lying on a sheet on the floor outside the unit,” he says.
When infants are admitted in hospital, they are given tags with details such as their parents’ names, and their weight and other measurements. But given the emergency, the parents say they did not check these tags while rescuing the infants or taking them to the emergency ward. Some tags got lost, too. Consequently, children got swapped or remained missing for a couple of days before being reunited with their parents.
Kuldeep Singh from Parsaha village in Mahoba district stayed put outside the paediatric intensive care unit (PICU) as his child had gone missing. “My wife was constantly sobbing. We did not move from here (outside the PICU) and kept asking the doctors about him. When a doctor called us to identify our child and we saw him, we started crying,” he says, as he helps out parents of other children with formalities. The 15-day-old, who had suffered minor burn injuries, had been handed to another family.
Similarly, Kripa Ram Yadav, a resident of Bamer village in Jhansi district, had to wait until the next evening to be reunited with his seven-day-old son.
Anger everywhere
Many families fault the hospital staff for the tragedy as well the administration for poor crisis management.
Guddi Devi stares at a photo of her grandson near the hospital’s emergency ward. The infant was rescued from the fire, but passed away on November 17.
Devi’s husband, Satte, says that there was not enough medical staff to rescue the children. “We rescued him ourselves and his oxygen supply was cut for a while. Many children were bleeding as their drip had to be removed during the rescue,” he says. The child’s father, who had suffered a paralysis attack just a day before his son was born, is undergoing treatment in Lucknow.
Many people also claim that most of the fire extinguishers were dysfunctional and that the staff was not trained to use the ones that were functioning.
Dr. Sengar says the expired extinguishers were kept in a storage room nearby and were brought out by people to break the windows amid the chaos. He contends that a fire safety audit was conducted in June and an electric audit was done in January this year. Ahead of the safety audit in June, 126 fire extinguishers were refilled, he says.
Fire extinguishers, some of them past their expiry dates, are kept outside the neonatal ICU of Maharani Laxmibai Medical College Hospital.
| Photo Credit:
A.M. Faruqui
Days after the tragedy, a few small capacity extinguishers, manufactured in 2019, are placed outside the window of the SNCU. While the average life of an extinguisher is 10-12 years, the equipment requires annual servicing, usually signified by a sticker with details. Only two large extinguishers had stickers that said that they had been serviced and refilled in June 2024. They are valid until June next year. The rest did not have details about an expiry date.
Some people also allege that once the blaze grew, some staff members “fled the scene”.
Dr. Sengar denies the charge. “There were eight staff members, including two doctors and two nurses, in the ward. They all saved children,” he says.
An overburdened hospital
The SNCU, which had 12 incubators, can admit 18 children, says Dr. Sengar. At the time of the incident, it had 49 infants. Hospital officials say that the count sometimes increases to nearly 60 — three times the limit.
It is common practice in hospitals in U.P. to fit two or three infants in a large incubator, Dr. Sengar says. In the medical college hospital, going by the calculation, some incubators had up to four.
Guddi Devi stares at a photo of her grandson near the hospital’s emergency ward. The infant was rescued from the fire, but passed away on November 17, 2024.
| Photo Credit:
A.M. Faruqui
Dr. Sengar says the SNCU had been in use for 12 years. A new 51-bed unit is under construction and is expected to begin operation in the next five months. He says most departments receive a high footfall as the hospital caters to the healthcare needs of at least 10-12 districts of the Bundelkhand region that covers parts of U.P. and Madhya Pradesh.
The patient influx has increased over the years. According to official data shared by Dr. Sachin Mahur, Chief Medical Superintendent of the medical college hospital, the patient footfall in the outpatient department and emergency wing was 6.4 lakh in 2023 compared to 4.9 lakh in 2022. This year, between January and August, it was already 4.14 lakh. Similarly, the number of patients who were admitted went up from 41,615 in 2022 to 49,089 in 2023; and 31,650 patients were already admitted till August this year.
As per 2021 data, U.P. has a doctor-patient ratio of 1:2,158, which is much higher than the national ratio of 1:836 and more than twice the World Health Organization norm of 1:1,000.
This burden reflects the lacklustre healthcare system across the Bundelkhand region and the high costs of private facilities. Dr. Sengar says he receives patients from districts including Jhansi, Mahoba, Lalitpur, Hamirpur, Jalaun, and Banda in U.P.; and Shivpuri, Datia, Chhatarpur, Tikamgarh, Panna, and Niwari in M.P. Patients and their families, most of them from poor socio-economic backgrounds from outside Jhansi, travel 80-250 kilometres to get to the hospital. They come mainly for critical care, he adds.
Why people came to Jhansi
Apart from Dharmendra and Bhagwati, Sanjana and Sonu Kushwaha, who are also from the Bar block of Lalitpur, lost their son in the fire. Both families ended up at Jhansi’s medical college hospital after being denied treatment at the community health centre (CHC) in Bar and in government hospitals in Lalitpur city.
Sanjana’s child could not be delivered at the CHC and she was referred to Lalitpur. “They did not have a bigger machine (in Lalitpur) to operate on him, so they asked us to take him to Jhansi,” she says. Similarly, Bhagwati’s son was referred to Laliput, as he had a fever.
While the CHC in Bar looks clean, the staff say it lacks many basic facilities, equipment, and even doctors. The CHC got an X-ray machine about two years ago but does not have a technician to operate it. A brand-new ultrasound machine set has been lying in its box for over six months. The CHC also does not have the reagent used for the blood tests, says senior treatment supervisor, Amit Singh.
A senior doctor at the CHC says the hospital also does not have a permanent MBBS female doctor for years; deliveries are done by the nursing staff. “If there is even a minor complication, we have no option but to refer the patient to another place,” the doctor says.
“Our permanent paediatrician was posted here over two years ago but has barely visited the CHC. He runs his private practice in Banda and has managed his attendance here,” says Singh.
The seeds of a tragedy
Days after the tragedy, at the medical college hospital, electricians install new transformers and workers paint corners and walls to cover the stains of gutka (flavoured tobacco). While some buildings in the premises appear new, older structures look worn out. Loose and naked wires hang on most of the walls of the C.V. Raman and Dhanvantri hostels for undergraduate male students. The plaster has come off at many places and so have bricks. Water drips out of the ceilings and walls in and around toilets — sometimes, dangerously close to electric wires.
“We have got our rooms repaired by spending our own money,” says a third-year student.
While students say they are accustomed to living in these conditions, they admit that a minor trigger could turn into a tragedy. Barely 20 metres inside the C.V. Raman hostel, a wall is black. A student, who is rushing for class, says there was a short-circuit about two years ago.
Vinod Kumar, a cleaning worker at the hostel, says many posts of caretakers and cleaning staff have been vacant for years, but the “government takes its own time to recruit fresh people”.
mehul.malpani@thehindu.co.in
Published – November 23, 2024 04:47 am IST
