Thursday, August 30, 2007

Shocking


A child is taken to the health centre of a premier institution for emergency care and first aid. He is refused treatment, and he dies while being taken to another hospital.

Why was he denied emergency medical assistance? He was just a construction worker's child. In other words, he was not "officially" associated with the institution, so he was not 'entitled' to treatment at the health centre.

The following mail (which I received through an anoymous tip, but Mridula has confirmed the events described in it) is truly devastating, and needs no further commentary. Read on:


A Tragic Death at IIT Kanpur

Students of IIT Kanpur were shocked to receive a mail on Monday forwarded by the President of the Students' Gymkhana. The mail is attached below and a brief description of the later developments are given after the mail.

This is to share an incident which reflects the state of affairs for the disenfranchised in our Institute of excellence. I suspect this incident could not be reported by anybody in authority in the Institute and hence would not reach most of us. In this case too we got to know of it just by chance, as would be evident from the account, which makes us believe that occurrence of such incidents may not be a rarity after all, but that is just not shared with the community. A similar incident happened a month ago and the sequence of events are much similar. This account is to inform the community of this incident, acknowledge a feeling of collective shame that this could occur in an Institute which claims to be the best, and hopefully to evoke some collective action to prevent such occurrences in future. I am sure of the facts, as I got to know of it from a first person account and yet would not name anybody to avoid unnecessary personal vilification. This is the system and not the individuals involved.

On Sunday morning at about 4.15 am one of the canteen owners of one of the Halls was going back after work when he chanced upon a crowd of migrant workers at the security crossing near the Motor Transport/Air-Strip road. Apparently a boy, whose family had been employed in the construction site of the Environment Engineering building had been bitten by something poisonous (they were not sure whether it was a scorpion or a snake), in his sleep. The workers including the family consisting of the father a brother and a younger sister (his mother is no longer alive) had come to the SIS (institute security service) for help. The boy who was around 12-13 seemed to have been bitten around 3 in the morning and was alive though unconscious. The SIS guards (there were around 20-25 of them there) kept urging the workers to take the boy to the city hospital but refused to extend any help. The group of migrant workers did not know anything about the city, and this is usual because they are brought from far of places like Malda and Chhattisgarh by the contractor and are herded back at the end of their term. The canteen owner requested the SIS to lend their jeep for transporting the boy to the Health Center. The SIS guards refused to ask for their jeep (though several of them had their walkie talkie) and instead told this man that the boy would not be treated in the institute Health Center and hence has to be taken to the city. At this point the Canteen Owner decided to take the boy in his motorcycle, along with another worker to hold the inert form, to the Health Center.

At the Health Center, the person at the desk refused to entertain the case, when he came to know that the boy was not related to an Institute employee and was neither a student. The canteen owner tried to impress upon the person that the case was very serious and the boy may just survive if only the hospital intervened and the formalities and the expenses could be handled later. He also volunteered to get the health card of his father who is an Institute employee, as treating guests is routinely done in the HC. The attendant at the desk refused to comply but conceded to give the phone number of the doctor on duty. He told the canteen owner that he may call up the doctor to check if she would treat the boy, but not to mention that he was calling from the HC, but tell her that he was calling from one of the hostels.

The canteen owner called the doctor, who when she realized that it involved the child of worker, was extremely annoyed and said that this facility was not available to them. When the canteen owner pleaded that the case was serious and may turn fatal she apparently shouted 'which language do you understand?' and slammed the phone down. After that the canteen owner decided to take the child to the city and requested the hospital attendant to provide the services of the ambulance so that he could be taken as soon as possible and anyway it is extremely difficult to negotiate the GT road with an unconscious person. But he was refused even that. The boy was still alive till that point.

The rest of the story in short - the canteen owner took the boy to a nearby nursing home in Kalyanpur (about 2 kilometers from the institute) but that setup was not equipped to handle snake bites. Then he drove with the unconscious boy all the way to the Hallett (medical college) - the doctor on duty was much more prompt and immediately attended to the boy, but unfortunately he had already died. Then this canteen owner drove all the way back to the campus with a dead child in the pillion. As he ended his account 'bilkul kuch achcha nahin lag raha hai tab se - health centre hote hue ek chote se bachche ko marne de sakten hain - kyun ki woh ek mazdoor ka bachcha hai sirf isiliye?'

Students have investigated the reported event and their representatives are in possession of the names of all the people who are involved in this incident. The students arranged a condolence meeting yesterday evening and marched to the Health Center to demand an explanation from the Chief Medical Officer. After a long standoff and hours of deliberations with the authorities the CMO met the students but failed to answer many of the questions students had about the issue. Students are presently planning to get the whole campus community involved in the protest. What saddens the entire student community and me is the reluctance of the institute administration letting the entire campus community know and the tax-payers know about the incident. The reasons they give are beyond any sane argument. Witnessing a few incidents during my stay at IIT Kanpur has led me into thinking that this time too, the incident and related issues shall be buried to bask into what I feel is vacuous feeling of glory.

22 Comments:

  1. N said...

    IISc isn't that much better!

    The health centre refused to pick up the post-mortem bill for the recent suicide which was 23K, a hefty sum the father had to pay. I don't know if the situation has changed. His colleagues were going to plead with the director.

    IISc's medical insurance doesn't cover students anymore, only staff and faculty.

    A colleague who was bitten by a snake and was treated had to run around for nearly a year to be reimbursed.

    When yet another colleague had organised a single days health check-up for the children of construction labour on campus, the only doctor who agreed to provide her time was Dr. Sharada, the rest refused. The health centre refused medicines, etc, which the doctor and a few students bought themselves.

  2. Rahul said...

    These are cases where I think "name and shame" is merited. The doctor's name, in particular, should be publicised and he should be debarred -- clearly he has no medical ethics.

    I'm not sure what the law is, but I thought hospitals cannot refuse emergency treatment -- I seem to remember some such law being made some years ago after too many hospitals started refusing treatment to accident victims because they were afraid of police complications.

    As for IISc, I am shocked by that too. When I was a student there, a student attempted suicide and was in hospital for a few days; IISc footed the bill, as far as I remember. At that time there had been a spate of suicides and the admin was extremely concerned. Maybe today they're not bothered. 23K is a trivial amount for IISc, even if it's a large amount for the father.

  3. Anonymous said...

    Rahul said:
    "I'm not sure what the law is, but I thought hospitals cannot refuse emergency treatment -- I seem to remember some such law being made some years ago after too many hospitals started refusing treatment to accident victims because they were afraid of police complications."

    Yes, Rahul is right. It is against law to deny medical facilities in any emergency situations, whether the police is involved or not. We, the students at IIT Kanpur, have confirmed this.

    The further developments in this matter are mentioned as follows:

    The institute administration has still not informed the campus community, officially, although they have issued a notice (skipping the details, the doctor's name and all other anomalies) that they have constituted a committee to investigate the matter. Most of the students feel that the committee is not impartial. Students are most likely to demand a third party to investigate the matter. But frankly, there is nothing that needs to be investigated, as everything is clearly mentioned.

    Personally, I think that this is another attempt from the institute to bury another very serious matter.

    Thanks a lot Dr. Abinandanan for blogging the matter.

    -The same 'nanopolitan' fan.

  4. Niket said...

    I took the liberty of posting your message on our email group. Since its a moderated group, I don't know if they will post it.

  5. Anoop Saha said...

    Absolutely shocking Abi. I hope they don't once again try to push this incident inside the rug to carry on the facade of brilliance. Can you share the name of the boy who died and that of his father?

  6. Anonymous said...

    This is sick and appalling.

    To think that administrators of an elite institution stoop to such lows in trying to bury this story.

  7. Anonymous said...

    This post bothers me. This is a horrible incident, no questions about that. However:

    1. The fact that IITK treats "construction workers" differently is no different from other institutions, including the very leftist JNU. There was a student demonstration - well, at least, some students demonstrating - there too with regard to construction workers. I think this was related to those workers not being paid the minimum wage by their employer. JNU's position was exactly that of IITK - that these workers are not employees of JNU and hence, not JNU's responsibility. So what makes IITK different from JNU? Merely that it has pretensions to being "brilliant" which JNU (presumably) doesn't have?

    2. If the Health centre staff is told that the facility is meant for use by students/staff/employees, what exactly would you have the receptionist do when someone who is a "non-worker" shows up? If we are honest with ourselves, most of us would probably do the same as what that guy did, no matter how much we might want to pretend that we would have acted differently. We all like to pretend that "we would have done the right thing", don't we?

    3. If the doctor denied someone emergency treatment and there is a law to this effect, then the book should be thrown at her. I suspect this will not happen. Merely another instance of non-implementation of law.

    4. The fact that IITK has chosen to not disclose information is no different from any governmental institution. When have any of our governmental institutions been forthcoming with information?

    Yes, all this makes me out to be some sort of a defender of IITK's management. I have no such intention. (I am a non-IITian, btw.) What I am trying to point out is that what happened at IITK is exactly what happens elsewhere - only they don't get reported. Notwithstanding whether they are "brilliant" or not, in such issues, IITK is no better or worse than any of our other governmental institutions.

    If we feel outraged at this incident, then we should feel outraged at countless others like this too. Somehow I don't think that is the case. And I guess that is what bothers me: the feeling that we (including myself) are outraged not so much because of the needless loss of a young life but merely "because it is IITK that is involved here." Our concern is with IITK, not the boy who died.

    Suresh.

  8. Rahul said...

    Suresh -
    What I am trying to point out is that what happened at IITK is exactly what happens elsewhere - only they don't get reported.

    Au contraire -- the JNU case was reported in the media; this one hasn't been yet (hopefully that will change).

    BTW, sorry for getting doctor's gender wrong above. I read the post earlier, posted reply later without re-reading.

  9. Yogesh said...

    Abi:

    Thanks for posting such heart-rendering news on your website. I doubt main-stream media will publish it, because a prestigeous institute is involved.

    I agree with anonymous that any junior staff would have reacted the same way (refusing to help) for fear of losing their jobs. However, the security senior staff and doctor are guilty for not using their authority to help another human being.

    More guilty is the institute's administration, who does not want to divulge the information about the incident for fear of getting bad publicity for the institute.

    We must praise students of IIT-K to fight against the inhuman practice of their administration.

    Please post such article more frequent in future so that public is aware of such happenings.

    Yogesh K. Upadhyaya

  10. Anonymous said...

    Rahul,

    Just to say that my comment was driven by my (subjective) perception that much of the outrage seemed motivated by the fact that it was IITK, a "prestigious institution" which was involved and not the horror of the incident itself. Perceptions can be wrong, and if I was, then there is nothing to say.

    Regarding the JNU incident, yes, I am aware that the media covered it. Again, my remembrance is that much of it was focused on the rustication of the students [for holding the registrar hostage for seven hours or so] and pleas for it to be withdrawn. I think The Hindu's report is better in that it states that the labourers' rights are being violated. There is no report of any follow-up action regarding the labourers though I know that the students' rustication orders have been withdrawn. If you know of any press report showing the restoration of the labourers' rights, please do let me know.

    Suresh.

  11. Abi said...

    Thank you all for your comments.

    I just want to clarify that the outrage here is about the denial of emergency medical treatment. For routine medical attention, I am sure most places (including those at IIT-K and IISc) would send non-insiders out into the big bad world, and that would be that; I would not have received a message from an insider, and you would not have read about it on this blog.

    Also, this issue does not have anything to do with IIT-K; if such a thing happened at a JNU or a Jadavpur University, it would still evoke outrage.

    I gather that IIT-K has ordered a full-blown inquiry. We will have to wait and see how it pans out.

    I don't know if Medical Council can intervene here to see if the doctor violated any of its rules. It probably can, but I am not sure.

    Finally, the students council at IIT-K and quite a few faculty there have taken this issue up very vigorously, and their activist fight for the rights of the contract labour on their campus is admirable. They deserve our support.

  12. Rahul Mehrotra said...

    I once had to carry our tennis coach who with bit by the snake.
    Two of my friends stumbled on the numb caoch in the tennis courts near hall-3 around midnight
    We ran to HC from tennis courts with the coach on our shoulders - three of us taking turns.
    HC had no anti-venom treatment.
    We talked to the doctor over phone - who expressed quite bluntly (but truely) that they cannot do anything and we need to rush him to the city.
    Then we realized that the HC ambulance was not around.
    So we got a security jeep to take him to Hallet. He was frothing and neural paralysis was setting in. 3 days of intensive care and the guy survived.


    Reflections:
    --> HC staff was not impolite but direct

    --> There seemed to be some competency and facilities set-up issues

    --> What was shocking that IITK HC had no anti vnom when snake bite was a common occurance on campus


    Though no comparison with this incident or the issues - it still highlights a need for change. We may not be able to change the whole country, but change can certainly start from home.


    Possible solution:


    1) Leadership: Someone from faculty / administration needs to provide the leadership to initiate a sustainable change. Students can be the catalysts, but they cannot sustain the process.

    2) Policies: Clear any policies issues that surround rendering services to emergency cases.

    3) Communications: Communicate the policies in effect to every staff member of HC and ensure the same is included in the induction training to any new member of HC staff

    4) Feedback mechanisn: Institutionalize formal feedback mechanisms and action tracking for constant improvement


    Post Script from our case:
    --> The coach was bit when he was hiding in the dark in the tennis court switchroom.

    ---> The coach was hiding there to catch students who turned on the court lights every night for a tennis game without permission

    ---> The students who were the root cause of this episode were my two wingmates who first discoverd the coach in that state

    Rahul Mehrotra BT/EE/1996

  13. Blue said...

    This issue is also addressed in Michael Moore's Sicko. It's only about the U.S. health care system, but it has a few stories of people being turned away at hospitals because the hospital was not part of their HMO network, including one harrowing story about a child having seizures who died in the ambulance ride to a "more appropriate" hospital.

  14. N said...

    Well, lets see what my short individual memory turns up on emergency medical care in IISc.

    Sometime over the last two years a security guard was hit by a speeding student while on duty. He broke his leg.

    IISc refused him medical help and refused to bring the student to book. The guard unable to afford medical treatment stayed in his quarters for a few days with a broken leg. This went on until a collection in the messes managed enough money to send him to a doctor and then to his home. the students who organised the collection also confronted the speeding student who refused all responsibility. what were they going to do without any backing, so they named and shamed and everyone soon forgot.

    Its very convenient for IISc and institutes like that to have contract workers like our guards, cleaners, attenders and mess workers. Because it means we can disavow all responsibility towards them. One wonders if they receive minimum wages? (When they receive wages, re the current situation with our mess labour.)

    I agree that the issue is largely about emergency medical care, but really isn't the denial of simpler smaller things, (esp. when themselves required by law, such as minimum and regular wages), symptomatic of the larger malaise?

  15. Rahul said...

    I guess the issue is about basic human feeling, whether it's emergency medical care or something else.

    Most affluent Indians think the less well-off don't count. And I really mean most affluent Indians. Reactions like ours are very much a minority.

    Here's a posting by Dilip D'Souza some time ago. Not about emergency medical care, but about wanton cruelty, by an educated person -- a college principal! -- to a ten-year-old girl, that went unchallenged.

  16. Anonymous said...

    Its very convenient for IISc and institutes like that to have contract workers like our guards, cleaners, attenders and mess workers. Because it means we can disavow all responsibility towards them. One wonders if they receive minimum wages? (When they receive wages, re the current situation with our mess labour.)

    If you are talking about "legal" responsibility, then that is defined by the terms of the contract. I guess though you are talking of some "higher" moral responsibility. While I do believe in a notion of moral responsibility, the point is that it is voluntary, being defined by one's moral outlook. This can and does differ across individuals and organisations. Part of the conflict between, say, students at JNU and the administration is that the former talk about moral responsibility while the latter talk about their legal responsibility.

    You are free to target IISc or whatever for failure to live up to your moral ideals. Fine. But, presumably, there is presumably a law and a law enforcement authority also to deal with such issues as failure to pay minimum wages. Basically, you seem to be saying that since the law enforcement authority is hopeless at enforcing the law, it is upto IISc or IIT-K or whatever to do the needful. This is problematic. I do agree that IISc or IIT-K cannot totally close their eyes to what is going on around them; however, I also think it is not their job to do what the law enforcement authority is supposed to do.

    It is curious that in the JNU affair, for instance, it is JNU which has been targeted for the failure to ensure that the contract workers get minimum wages both by the students and the other organisations like PUDR etc. I suppose this says something about the high regard in which the police and judiciary are held. While the policy of targetting JNU or IIT-K for someone else's failure [on the grounds that it is their "moral responsibility"] may work in the short run, it cannot be a permanent solution. I am sure this has been recognised but I don't think this has been emphasised enough. Our social organisations have - in my opinion - concentrated more on introducing more and more new laws when the ability to enforce even the existing ones is very limited. Case in point: We "officially" got rid of untouchability in 1950. Indeed, this hypocritical position is India's official stance whenever we are targeted by international organisations. The point is not that untouchability survives but that it is so prevalent. You do not have travel very far from the metropolises where most reading this blog live to encounter it. Now, That is inexcusable.

    Suresh.

  17. vaiby said...

    @suresh
    You might be surprised to know that the "legal responsibility" (no, not moral) of ensuring minimum wages is actually vested with, what is legally known as "principal employer", in the respective case that would be JNU.
    One is usually in these cases (as I know from IITK experience) trying to go to "enforcement authorities" (law) to see that these laws are actually implemented. Its just that experience suggests that it is better to talk to IITs and IIMs and institutes like these directly and use court actions etc. as last resorts.

    Of-course, the opinions on what should be the strategy by social organizations(?) would vary and depend on personal experience, and I outrightly disagree with the "by the law-book" approach as you suggest.

    About the "moral" v/s "legal" grounds, a growing cause of concern is the diminishing legal grounds! The law enforcement authority needs to be pressured into action as you say (and lot of activists attempt to do just that, don't they?) ... but that is increasingly difficult too -- labour laws are being diluted; in those loads of SEZs that are coming up they may be diluted at whim bypassing usual procedures - the whole legal tables are just so turned!
    Probably we must have enough of "moral" ground in future, if we are to hope for any natural justice. And, unlike as you suggest, equally well struggle to get "legal" grounds in place, even as one works with the "enforcement authorities".

    Vaibhav

  18. Anonymous said...

    Vaibhav,

    I am no expert in law, but if what you say is correct, then it means JNU is guilty of not meeting its legal obligations. Surely, then, a case can be filed against JNU; so why has this not been done? (If I am mistaken, please set me right.) If nothing else, it would serve as a warning to other institutions to take minimum wage law enforcement more seriously.

    Regarding the rest:

    1. I believe that if there is a law then the primary responsibility for its enforcement lies with the enforcement authority. Presumably you disagree. Fine. I don't think there is much point debating this any further; let us agree to disagree.

    2. Some labour laws may have been diluted, but so far as I know, minimum wage laws are still very much on the statutes. The fact that there are problems with people receiving even minimum wages (and that too in the capital) suggests a serious problem with enforcement.

    3. Contrary to what you appear to think, I have by no means ruled out actions on the basis of "moral responsibility." I just happen to think that the case for moral responsibility is strongest in instances when an act is legal but arguably not moral. For instance, one can make a strong moral case that even if there is no legal obligation for IISc or any other institution to provide (some) medical care for contract workers, nonetheless they should do so. In the case of minimum wage, where there is a law, one should rely on the law. Otherwise why have it? For decorational purposes - like in using our "anti-untouchability" law to deflect criticism coming from abroad?

    5. If a law cannot be enforced effectively, then I think it makes little sense to have it on the statutes. I concede that in a few cases, like "anti-untouchability," one can argue that the law ought to be there anyway on moral grounds. But such instances should be limited.

    I believe in the US, before a law actually comes into force, the government has to make a convincing case to the judiciary that it is in a position to effectively enforce the law. I think we would profit from such an exercise.

    6. You might want to check the web page of Manushi which documents how laws - ostensibly meant to protect the poor - are often used to harass them. In particular, check the articles under the heading "Laws, Liberty and Livelihood." Manushi's website is at

    http://www.manushi-india.org

    Apologies if you already know this.

    7. I am not a social worker, so you'll have to forgive my "academic" take on the subject.

    Suresh.

  19. Ramjee said...

    What a shame!
    Irrespective of where this incident occurred, it shows out blatant disregard towards human life and humanity.
    It is really saddening that the such incidents keep on occurring no long term action is taken.

  20. vaiby said...

    @suresh

    Oh, yes. If it can be proven that the minimum wages are not being paid, JNU is indeed under liability. To why such cases have not been filed ... it is the "proven" part that makes it a load of hassle, though I am sure there are other reasons too.
    To give you an example, under pressure from community members to pay minimum wages at IITK , now (meaning at least an year hence - haven't been so much in touch off late) contractors make documents very well, even pay the minimum wages since they have to do it in front of volunteer run so called minimum wage monitoring committee. The catch - laborers must return part of the payment if they want to continue in the job. What is supposed to be done? Its not even clear it is non payment of minimum wages any longer, forget getting to prove this in court.

    Any ways opinions can certainly vary, and as you said we can well agree to disagree.

    [ And yes, I don't understand the words social organizations or social workers very much. I would rather see them as concerned individuals - someone like us perhaps, and not to be identified with the so called social service. For otherwise it is like saying, it is they who should be acting and taking stands, not us. Perhaps any concerned individual should.

    In any case, my take would be just as academic as yours. And, thanks for the link. ]

  21. Supriya said...

    I'm surprised by the reaction to this being morchas and protests. I think it is criminal negligance on the part of the doctor on call, and should be dealt with by filing a case against her in a court of law.

  22. Ravi said...

    There is an online letter to Director of IIT-Kanpur that is at http://aidindia.org that people are signing to help get compensation for victims and improve working conditions and health care at IIT-Kanpur.

    Please read and sign letter at:
    http://aidindia.org/main/component/option,com_wrapper/Itemid,201/

    Thanks
    Ravi