Need to strengthen peripheral hospitals in Karnataka

Experts say hospitals in state are short of NICUs, beds and staff. 
Sixty per cent of the NICU cases come from other hospitals across the city and neighbouring cities too.
Sixty per cent of the NICU cases come from other hospitals across the city and neighbouring cities too.

BENGALURU: It is not only the parents that go through the nightmare whenever they are met with a shortage of beds. Most doctors at these hospitals go through several levels of frustration and helplessness as well. “We are desperately short all over the state. Our NICUs that care for premature and ill babies and our Paediatric ICUs that look after older, seriously unwell children are grossly inadequate all over the state to meet basic needs,” said a superintendent of the paediatric wing of Vani Vilas hospital.

While one might assume there is a shortage of equipment, the doctors point towards a lack of space. Vani Vilas for example, has, 48 warmers, 16 ventilators, 6 CPAPs (Continuous positive airway pressure) and four incubators. “We don’t have space to accommodate new equipment or skilled staff to operate these,” Dr Geetha added.

Sixty per cent of the NICU cases come from other hospitals across the city and neighbouring cities too. Dr Sahana Devdas, professor and in-charge of the NICU at Vani Vilas says, “Many times people bring dead babies to the hospital and we have to declare death.”  Dr Geetha adds that the only way to meet the demand and prevent such case is strengthening the peripheries. “Ensure that all district and city hospitals are well equipped so that we don’t have to deal with extra referrals.”

Meanwhile, the Indira Gandhi Institute of Child Health, which serves as an apex institute, has 60 beds and 17 ventilators. While the hospital is sophisticated and there are excellent doctors, with no in-house delivery services, it is specialised for treatment only. Babies here come from referrals from many cities. Dr Naveen Benkappa, the in-charge of the NICU and Medical Superintendent of the hospital said that the hospital is able to take about 120 cases per month. “We receive cases from Andhra Pradesh, North Karnataka, Tumakuru, Balgalkot and many such places, the government needs to provide better access and facilities at those places,” he said.

“The sad reality is that we have to make painful and heart-wrenching decisions every day; some children, especially tiny premature babies, that could be saved are not offered care because we just don’t have the beds. In addition we waste a lot of resources, time and energy to transport children all over the state; from one city to another just because there is bed shortage; often dislocating parents and families and causing more hardship,” he added.

Dr Naveen explained that the immediate need of the hour is to create NICUs in all the hospitals attached with medical colleges. A department of paediatrics should be created and hire good doctors with degree of neonatology. “Unfortunately all good doctors are joining the private sectors. We must create department of perinary medicine and ensure that we employ doctors there and provide not only infrastructure but staff too.”

Short-staffed  hospitals
A report regarding this situtaion was submitted to the government in 2018 and it was suggested that it is very important that Bowring, KC General and Jayanagar hospitals have the potential to reduce the burden of Vani Vilas Hospital and the peripheral centres has to be strengthened but looks like what is being done is not enough. Meanwhile, another inconvenient truth is that these are very short of nurses too. There have been days according to nurses when one nurse takes care of three ICU babies/children at night. While the recommended norm is one to one.

“In the daytime we can manage one nurse looking after two ill children but at night it is a crisis. A simple analysis of deaths in children who died in our ICUs will show that the rate of death is much higher at night. In addition there is the enormous stain on our nursing staff both physically and emotionally. Managing three intensive care children at one time, night after night takes a toll on you,” a nurse in Vani Vilas hospital grieved on condition of anonymity.

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