Opinions

A Dignified Health Care System Reflects a Dignified Society: But is Sikkim Dignified?

Regarding the recent incident at our ‘super multi-speciality hospital’ STNM, there are two factors to be taken note of. Firstly, it is a sheer case of medical negligence to which almost everyone would agree. Secondly, what also often goes unchecked, unnoticed and unquestioned is that a woman is being mistreated and her basic right to a proper and respectful maternal health care experience has been ripped off her and instead been met with abuse, neglect and disrespect.


My first visit to the STNM ‘super multi-speciality hospital’ happened to be just a year ago. The premise looked anything but a usual hospital that we most often find. The well-trimmed garden, and its timely watered plants, greenery all around, its clean and well-kept walls, it all looked sheer elegance. For someone like me who has loathed the poor and untimely health care system and its availability in our state, this seemed something of a silver lining. Its freshly painted high walls and enormous buildings seemed promising enough to its broad banner of providing ‘super multi-speciality health service’ to its people and especially having its door open to the poor and the marginalized. The thought only brought in a feeling of pride where hitherto, all I had encountered in the name of health care was its complex web of systematic failure resulting in poor supervisory structures, insufficient staffing patterns inadequate supply chains, poor physical conditions and no proper policies in place.


Anyone would fall prey to the physical splendour of STNM, looking promising enough for anyone to envisage that something new will soon be born out of our states improving health care system. My RTPCR test was done, and I was done with my bit of experience with the ‘super-speciality spot’.
However, my bird’s eye view experience that day was merely enough to have any conclusions. I was viewing the premise from the position of a privileged individual, only smitten by its outlook and its promising declarations. But would its beautifully maintained gardens afford to comfort a poor and a marginalized person with the sheer assurance that their loved ones would be taken care of when in its vicinity? Does its well ‘equipedness’ mean that it would now be able to equip one and all in need of its care? Or do its splendid walls and doors ensure feasibility to the marginalized without a tinge of a feeling of intimidation? Well, if it hasn’t then surely the concerned group need to find more creative ways of catering to their people and not just busying themselves in the beautification project of something as vital as health.
Sonam Tshering Lepcha, a relative of the deceased was reported staying- “STNM hospital is not only for the rich and famous people. This hospital is also for poor like us” (Sikkim Chronicle, 2022). There is no denying that the hospital spaces have been intimidating for people outside of them. To add to it all, such anxieties are further escalated by the indifference, callousness and lack of proper attention given by the concerned people, ironically more so towards the poor and helpless. We have to a certain extent learnt to accept such ill-treatments, for the sake of the wellbeing of our loved ones, whose only hope rests with the medical fraternity. Where in the name of proper health care a person is further referred to expensive private hospitals a 4 to 5-hour drive outside the state. Let’s face it we have all been a victim of the nexus between the medical sector and the private clinics.


Sikkim is not new to cases of medical negligence. In August 2020 the state witnessed a series of death caused by such negligence, reported from Central Referral Hospital in Manipal, in less than a week. The recent such incident reported on the 14th of January 2022 according to which a 36-year-old pregnant woman lost not just her second child but also her own life, only echoed and brought forth such past numerous cases still not acted upon and most often long forgotten. It brought to the surface the experiences of numerous poor people who run from post to pole to save their loved ones. With no ‘on duty’ doctors available at that given hour, on performing an ultrasound at the advice of an ‘on duty’ nurse, it was discovered that the baby had no heartbeat. Sadly, such an urgency did not prompt the concerned doctor to arrive and save the mother still holding the dead baby insider her. The next morning at 6 am, the doctor’s arrival ironically also coincided with the woman passing away in a few hours. Amidst the crucial time window from 3 pm to 6 am there were no medical interventions made, despite its complexity, with the mother both physically and mentally affected after the death of yet another child.
Medical negligence in simple words occurs when a medical professional deviates from the standard of care that is required. Therefore, any deviation from the accepted standards of medication and care is considered medical negligence, and if it causes further harm to a patient, then the doctor concerned along with other staff and the hospital may be held responsible. Section 304A, Section 337 and Section 336 of Indian Penal Code 1860, state that whoever causes the death of any person through any negligent act not amounting to culpable homicide, shall be punished with imprisonment for a term which may extend from six months to two years, or with a fine, or with both.


According to India Medical Times, around 52 lakh medical injuries are recorded every year in India among which 98,000 people lose their lives. Every minute 10 people fall victim to medical negligence and more than 11 people are faced with death every hour due to the same.
Regarding the recent incident at our ‘super-speciality hospital’ STNM, there are two factors to be taken note of. Firstly, it is a sheer case of medical negligence to which almost everyone would agree. Secondly, what also often goes unchecked, unnoticed and unquestioned is that a woman is being mistreated and her basic right to a proper and respectful maternal health care experience has been ripped off her and instead met with abuse, neglect and disrespect.


In this case, the woman’s basic right to maternal health care, which includes having adequately equipped staff, proper privacy and timely attention, seemed a distant dream, leading to something as extreme as her death. She was left unattended, dehumanized, disrespected and abused both mentally and physically, thereby disempowering her further amidst a society where she is already doubly marginalized, first as a woman and as a poor individual.


Such mistreatments meted by women during her crucial period of pregnancy, become not just a question of the quality of the health care system existing in our society but rather demonstrates sheer human rights violation. Going by the internationally adopted human rights standards and principles, this case has led to a violation of a woman’s fundamental human rights.


If one is to look at the the WHO’s quality of care framework for mothers and newborns, it clearly states the significant need for more evidence and action on good communication, respect, dignity, and emotional support in efforts to improve the quality of care. This approach can empower women, and also promote women’s rights to positive, dignified, respectful and proper maternal health care experience throughout pregnancy, during childbirth and also thereafter. Such efforts are necessary not only to protect women’s fundamental human rights as mentioned earlier but also to promote a women-centric approach to the provision and experience of quality health care. Similar such efforts will also be instrumental in exploring the mistreatment of women during other maternal health services, such as antenatal and abortion care, which hitherto had gone unnoticed and unquestioned.


There is an urgency needed towards introducing policies and interventions in making health care spaces more approachable and feasible, more so for the marginalized. Everyone has the right to dignity and to enjoy the highest attainable standard of health care. As merely putting oneself under the banner of being a ‘super-multi speciality’ spot does not amount to being one, when the sections most marginalized are ill-treated and not catered to. We surely cannot afford callousness on the part of our health sector at the cost of our people’s lives. As the success of a state is sadly not measured by its buildings and gardens but rather by its happy and healthy people. It is the inside working of the health care service that needs more polishing than its outside.

By Rinzing Ongmu Sherpa is a Doctoral Candidate at Jawaharlal Nehru University, New Delhi. She is a resident of Pelling, West Sikkim can be contacted at [email protected]

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