Tuesday, December 30, 2014

...and the follow-up

Following my blog post below, a friend brought it to the attention of officials in the Health Department who took a serious view of the matter and ordered an inquiry. All the nurses on the evening shift that day were called, and Meera's case sheet was also reviewed.

The day before the inquiry, Meera's husband received a call from a woman who said she knew they had complained, and that they should come the next day to the committee and withdraw the complaint as it was a question of possibly losing her job. Meera and her family were too scared to testify or even to stand in front of a committee to deny anything. (In fact, they had not formally complained -Meera's sister had told me about their experience as a matter of course when I asked about Meera). They did not turn up at the inquiry to identify the nurses.

The nurses (as expected), all denied that they had taken any money, alleging that the family had  complained since they did not see Meera as often as the family felt they should.

An examination of the chart revealed no entries apart from admission details a day before the delivery, and the delivery details (over 24 hours later) about the baby weight and condition. There were no notes about her progress of labour,  nor any notes about the baby and mother during the 48 hours Meera remained in hospital after the delivery. The first page does not even have the date on which she was discharged from the hospital.

All the nurses on shift that day have been transferred out of the labour room and the maternity ward, pending a more formal inquiry.


One of Meera's neighbours who recently delivered at the same hospital said she had heard someone had complained and there was an inquiry and nurses had been transferred. The ones now in the labour room had treated her very politely and no one asked for any money, she told Meera.

A good first step, sending out a message that such actions will not be condoned. One hopes that the quality of care and record keeping is also pursued with equal vigour. 

Sunday, December 7, 2014

a hospital delivery

The young woman who helps me in the kitchen was pregnant with her second child and went to one of the Government facilities in the city here in Bhopal for the delivery. She is an undernourished woman who works much more than she should. In her first delivery she bled heavily and needed three units of blood transfused. This is her second child after a gap of seven years. Let us call her Meera.

She was in hospital for three days, having had leaking of the amniotic fluid, and therefore unable to just stay at home. A doctor saw her once on the second day of her admission and told her all was well. When she was in pain and wanted to go to the labour room, the nurses repeatedly turned her away, saying they would call her when necessary. Four other women were admitted in the same room as her. Her older sister (who is also expecting her second child) stayed with her in the evenings after she finished her round of domestic work. On the second day, one of the women delivered a dead baby, which worried the remaining women. On the third day (Wednesday) Meera's pains increased in intensity and the nurses would still not examine her.

Meanwhile, the woman in the next bed (a primi - first pregnancy - who had been admitted for eight days) went to report to the nurses that she could not feel the baby move for the past hour. The nurses scolded her and sent her back to the bed. When her husband arrived in the evening, she informed him and he went and raised a ruckus at the labour room door. At this, one of the nurses came to examine the primigravida, listened for the baby's heartbeat, and then informed her that the baby was no longer alive.

Hearing this, the remaining two women in the room were taken away by their relatives to some private nursing home. Meera remained alone in her room, and when her sister arrived, told her all about this, as well as about her increasing pains. Her sister was scared now, and they did not have the means to go to a private nursing home. She went up to the labour room nurse and offered her Rs. 200, asking her to examine her sister. The nurse told her the amount was not enough. Meera's sister assured her that she would bring the rest of the money later, and the nurse told her that in that case she would also examine Meera later. The sister collected some more money and finally offered the  nurse Rs. 500, after which she allowed Meera to enter the labour room. A second nurse was standing and glaring at them, so she was given Rs. 500 as well. She was warned not to tell anyone that she had given them money, or else "acchha nahi hoga" (it won't be good for you). The delivery then proceeded, and Meera gave birth to a healthy baby boy on Wednesday night.

"That was the only expense at the hospital", Meera's sister told me yesterday when her sister was discharged  -"the hospital provided good food three times a day to my sister, and all the medicines were free. Only problem is that the nurses are very rude, and to enter the labour room we had to pay the nurses Rs. 1000. I had saved it for my own expenses during delivery, but had to spend it.You can be sure I am not going there for my delivery. I don't know where I will go but not to that Government hospital."