Death of twin babies: Who are to share the blame?

The death of two babies during the maiden childbirth of the mother from Kondotty, Malappuram is sad pointer to the shortcomings of our healthcare system as much as the lopsided mindset of our medical community and institutions. The bereaved couple, Mohammed Shareef and Shahla Tasni had to run from pillar to post when Shahla had her labour pains, and obstetric care was denied to her at three hospitals in succession, on the basis of an unscientific and unwarranted application of Covid protocol. And that brought to an end the couple's dreams woven over months, but not before the woman spent over 14 hours with twins in her womb, going in and out of hospital corridors, including Manjeri Government Medical College. Although she was subsequently rushed to Calicut Medical College, that was too late to save the lives of the babies. The mother now is in intensive care, and at the time of writing this still not declared out of danger. State health minister and the state Human Rights Commission have both ordered probe into the incident. Needless to say, those who caused such a tragedy through an inhuman approach, whoever that be, ought to be brought before law.

Even then some questions remain unanswered: was it only the apathy of a few doctors that brought about this tragedy? Or in a broader sense, did the the faults in the special health machinery set up in the context of Covid, play any part in leading to this disaster? When we open the information shared by Mohammed Shareef, who is also a journalist, and the doctors who had treated Shahla, that will compel a conclusion that both the factors above have been responsible. Shahla, who had tested Covid positive, had fully recovered and also completed her post-recovery quarantine. It was after this that she returned to the same hospital for labour. Following advice by doctors that a childbirth at such a hospital, which was designated as a dedicated Covid care centre, would not be safe, she had approached another private hospital, only to be told that her Covid negative certificate issued by the government on the basis of an antigen test would not be acceptable. That brought her again to the Manjeri Medical College hospital. Following severe labour pains, after she was admitted there early morning on Saturday, and was even taken to the labour room, the doctors there advised her to be shifted to another hospital. At the next facility, i.e. the Women and Children Hospital in Kottapparambu, Kozhikode, she was again forced to go to a private medical college. Then again, when the next shift was made to the Calicut Medical College hospital, it was too late.

The act of applying a purely mechanical approach in the name of Covid protocol while handling a patient seeking urgent treatment, is undoubtedly a failing of health workers and doctors. They had a moral obligation to recognise that the human beings before them had also hearts that beat, and to give them the immediately needed medical care. Each time when the mother was sent away, and shown the fine print of regulations, that amounted to showing the twin babies their way to the alley of death. But that said, it would be unfair to blame the doctors alone for this; our health machinery has also a major blame to bear. What can be gleaned from the details of the incident is that the health department does not have a clear blue-print for precautions to be adopted when patients post-Covid recovery have to approach hospitals including for childbirth or of the hospital regulations related to such situations. It is not clear on what basis private hospitals insist that the antigen test result issued by the government will not be sufficient for subsequent treatment and that a PCR result itself is required. The government and its health department have an obligation to clarify whether there has been any official directives on this point. It also needs to probed why the patient was sent back by the Kottapparamb hospital.

The unfortunate deaths are also a tragedy caused by the fact that when the Manjeri medical college hospital was converted to a dedicated Covid care centre, the authorities totally ignored the segment of patients with other ailments. At the time this hospital, already deficient in facilities, was turned into a Covid care centre, over 30 obstretic patients were given compulsory discharge. And to make matters worse, several doctors were transferred to other facilities, thereby throwing out of gear the functioning of specialties including gynecology. At one point, even the very existence of that department was under threat of closure. Currently, it has only three doctors against a requirement of six. Although this was highlighted many times, officials including the medical college superintendent adopted a posture that everything was hunky dory. Even at present there are Covid patients under treatment in that hospital who are five and six months pregnant. Recalling what befell Shahla, they are understandably anxious that once they get back home after recovery, and if they go to any other hospital for maternity, they might be entertained or rejected from there. This is not a concern that can be easily dismissed, and raises a question that the medical community and the health department should find an immediate answer for. Only then will the just-announced enquiry will have any positive outcome.