To call the post-natal deaths of five women in the same institution - Ballari Medical College and Research Centre (BMCRC) - in a span of a few days “a serious issue”, would be a brazen understatement.
It is a tragedy beyond “shocking”, calling into question the capability of the government medical facilities to ensure safe childbirth specifically, and safe health practices in general.
Linked to these tragedies is an emotional dimension - that each of these five women bore healthy newborns who will never know their biological mothers.
Four maternal deaths were reported between November 9 and 11. The fifth death occurred on Thursday when the patient, who was admitted to BMCRC on November 11 and underwent a Caesarian to deliver her baby, subsequently experienced severe hypotension (lower than normal blood pressure, serious forms of which deprive the heart, brain, and vital organs of adequate blood and oxygen), despite being on double inotropes (drugs supporting the heart muscles to beat with more power, in this case), and suffered a cardiac arrest at 7:45 pm.
Two days before the fifth death occurred, the Karnataka Government wrote to the Drugs Controller General of India (DCGI), requesting a probe and urging initiation of action against a West Bengal-based pharmaceutical company - Paschim Banga Pharmaceuticals - the manufacturer of the RL solution. This was amid suspicions attributing the deaths to the use of alleged substandard RL solution from the company.
The letter from Harsh Gupta, Principal Secretary of the Karnataka’s Health and Family Welfare Department, drew DCGI’s attention to the supply of several batches of “Compound Sodium Lactate Injection I.P (Ringer’s lactate 1.P)” by Paschim Banga Pharmaceuticals (PBP) to the Karnataka State Medical Supplies Corporation Limited (KSMSCL - Govt Supply) for consumption in government hospitals through district drug warehouses.
While these tragedies have shaken the public conscience, in the background are political developments, as is expected considering the intense — and almost inimical — rivalry between Congress, the party in power, and the BJP, the main Opposition party in Karnataka.
Karnataka Health Minister, Dinesh Gundu Rao, has said he is willing to resign “if it can set things right”, and expressed the commitment “to making all necessary efforts to improve the system”. He has also rightly sought the Opposition’s support towards this end.
But the issue threatens to mushroom into another Centre Vs State contest, considering the political equation with BJP ruling at the Centre and Congress at the helm in the state. Which is why Gundu Rao’s appeal to the Opposition in Karnataka seeking support gains significance.
The deaths of the five women is getting politicised. It was found that RL batches supplied by the manufacturer PBP to KSMSCL had been used in all five cases at BMCRC. The Drug Testing Laboratory, Karnataka, had found two of the batches frozen by KSMSCL as ‘Not of Standard Quality’ (NSQ). But when these reports were challenged by the manufacturer, and the Central Drugs Laboratory (CDL) in Kolkata tested these batches after being referred to by a competent court, these were found to be of ‘Standard Quality’ (SQ).
According to the Karnataka health department, different batches of the drug were drawn for test and analysis by the Drugs Control officers across Karnataka from the district drug warehouses. Of these, 22 batches had failed in various parameters. But few of these NSQ reported samples were found to be SQ by CDL Kolkata later.
According to health secretary Gupta, since August, some earlier frozen batches that were not yet tested by the Drugs Control Department, but certified as SQ by the National Accreditation Board for Testing and Calibration Laboratories-empanelled laboratories, were released by KSMSCL, and used in the hospital where the deaths took place. The batches have been frozen after the deaths.
The state health department has questioned the Central Drugs Standard Control Organisation (CDSCO) why the central laboratories were certifying drugs “rejected by Karnataka”. These are symptoms of this issue blowing into a Centre Vs State flare-up on political lines. But politicising the issue most certainly will hijack it from the main objective of ensuring safe health practices, which is prime on the public mind — the same mind which is called upon by politicians to vote for them when elections arrive.
The way ahead is not to politicise the issue, but for the ruling disposition and the Opposition to work together to fix the problem, by conducting a fair and thorough probe, bringing the culprits to book, and convincing the general masses about the reliability of government health machinery. The political entities need to realise that healthcare is prime, and there are no two ways about it.
Nirad Mudur
Deputy Resident Editor, Karnataka
niradgmudur@newindianexpress.com