In which other half-decent country are medicines, as has been claimed, laced with rat poison? In which other country does the state allow the manufacture of tainted medicines and also buy them for mass distribution?
A grievous tragedy is unfolding in Chhattisgarh, a tragedy that could have been avoided if officials in the State administration had been more honest than they have been found to be. But first, the facts as they are known, and have been widely reported by media, till now.
On November 8 and 11 sterilisation camps were organised by the State Government’s Department of Health for women from impoverished families, nearly all tribals, in Bilaspur district. The purpose was two-fold: To ensure better maternal health for women who tend to be used as brood mares by men loath to use contraceptives; and, to encourage the concept of small, sustainable families among the less affluent in a State that suffers from endemic poverty for a variety of social, political and economic reasons.
The intention behind the camps, therefore, was neither evil nor remotely comparable to what happened during Indira Gandhi’s Emergency when men, including teenaged boys, were forcibly sterilised. Public memory is short and Emergency excesses are rarely recalled; they have disappeared from India’s collective memory. That does not mean they did not happen and Congress vice president Rahul Gandhi, grandson of Indira Gandhi, would be well advised not to shed crocodile tears over the misfortune that has visited Chhattisgarh. If he has sailed forth to fish in troubled waters at the behest of charlatans like Ajit Jogi and Digvijaya Singh, it was extremely foolish of him.
Let’s revert to the facts as they have emerged over the past week. Many of the 83 women who underwent laparoscopy (minimally invasive surgery) for tubal ligation (sterilisation) on November 8 began complaining of sever stomach cramps within 24 hours; at least 12 of them died. Dr RK Gupta, who conducted the operations in an assembly line manner in five hours, was blamed for not following full procedure.
It was also pointed out that sanitary conditions at the health centre where the camp was held were way less than hygienic. Apparently, the health centre at Pendari village had remained unused for a long time (which by itself is a scandal in a country starved of primary health care). Dr Gupta, who was felicitated by Chief Minister Raman Singh on Republic Day this year for conducting a record number of tubal ligation operations, has been arrested: an FIR has been filed and he has been suspended from service.
The story would have ended there had more shocking facts not emerged over the following days in this unrelenting tragedy. Women who underwent tubal ligation surgery at a sterilisation camp on November 10, conducted by another doctor, began complaining of stomach crams and showed symptoms similar to those exhibited by women who fell ill at Pendari. One of them died.
Then there were reports that people treated for flu were complaining of stomach cramps and showing similar symptoms — nausea, swelling and dizziness. Two men treated for flu died on Thursday. That triggered the hunt for a common factor and it was found to be the antibiotic tablet ciprofloxacin or Ciprocin that had been prescribed to both men and women who had fallen ill, and those who died.
Quick lab tests on the tablets showed they contained zinc phosphide, a chemical compound that is used for making ‘rat poison’. Rodents when they consume zinc phosphide, die a rather painful death.
The contaminated antibiotic tablets were handed out to the women as part of post-surgery medication at the sterilisation camps. They were also prescribed to those who went to clinics with flu or flu-like symptoms. Where did these killer pills come from? They had been manufactured and supplied to the administration by Mahawar Pharmaceuticals. They were also supplied to local drugstores from where they were sold to and consumed by unsuspecting victims.
Reports say a search of the premises where Mahawar manufactures Ciprocin led to the horrifying discovery of zinc phosphide stocks. Samples of Ciprocin 500, the suspected killer drug, have been sent for further lab tests. The owner of the firm, Ramesh Mahawar, and his son have been arrested. It now transpires this that Mahawar was found to be producing sub-standard medicines in 2012 and it was shut down for three months. Strangely, its licence was not cancelled.
It is equally inexplicable as to why the Health Department had to source ciprofloxacin from a tainted firm. The question gains further relevance in view of the administration’s statement that there was sufficient ciprofloxacin, sourced from elsewhere, in stock and there was no need to use Ciprocin manufactured by Mahawar. Who, then, took the decision to procure Ciprocin from Mahawar, ignoring the ciprofloxacin tablets that were in stock?
Hopefully, these and other questions will be answered in the coming days — either Chief Minister Singh can instruct his officials for a full inquiry and disclosure or he can await embarrassing details, which may not be entirely factual, in the media. Glossing over severe lapses, irrespective of whether they were motivated or not, will not do, nor shall sweeping the inconvenient truth under the carpet will help. People across the country hold Singh to higher standards than those of run-of-the-mill cynical politicians, and for good reason too: His excellent governance track record is there for all to see.
However, no matter how praiseworthy his Government’s record, Singh cannot escape from the simple fact that but for huge gaps in the administration he heads, gaps that are more to do with probity and honesty than bureaucratic lethargy and callous negligence, such a tragedy would not have visited Chhattigarh. The loss of human lives is one dimension of the tragedy; the other two are no less consequential.
First, popular faith in Government run healthcare camps is bound to be shaken: In tradition-steeped tribal communities, there will be greater distrust of doctors and medicines and the surgeon’s scalpel will evoke fear, not faith. Worse, those opposed to sterilisation, and they are legion, ranging from Left-liberal jholawallahs to Right-wing nuts, will have a field day. As will a TRP-hungry media for which fiction is more important than fact. That would be most unfortunate, not in the least because women from indigent families will suffer the most.
Second, last week’s horror has served to underscore some ugly realities of India, realities which we turn our faces away from rather than work to change them for the better. Fake and contaminated drugs and healthcare essentials are not a problem limited to backward areas and under-developed States; surveys and tests have shown they are sold in Delhi too, right under the nose of the Union Government.
The criminally inadequate infrastructure required to test drugs and ensure manufacturers are not cutting corners should have engaged the attention of successive Governments at the Centre and in the States but has not been thought of as something either urgent or necessary. Our politicians and babus know they will not be exposed to the dangers posed by fake or contaminated drugs. So they don’t care. Convoluted laws, and laws that have more loopholes than plugs, facilitate fly-by-night operators to become manufacturers of life-saving drugs. Drugstores that follow rules and procedures in sourcing and dispensing medicines make the situation terrifying.
Last, it is a measure of the depth to which corruption has eaten into the system of governance in this country that bureaucrats and their flunkies in babudom think nothing of sourcing medicines for the masses from suspect and tainted manufacturers. They know nothing shall ever happen to them even if they are caught red-handed: For evidence, look at how those behind the fake medicine scam in Madhya Pradesh have gone unpunished. Owners of the firm supplying contaminated intravenous fluids to hospitals in Kolkata have successfully thumbed their nose at complicit and compromised law-enforcing agencies. Such stories abound.
The solution to all these problems does not lie in asking for Singh’s resignation. His exit from the Chief Minister’s office is not going to change the ugly reality of Chhattisgarh or, for that matter, rest of India. Nor will it in any manner diminish the fact that India’s image has suffered a huge blow: In which other half-decent country are medicines (as has been claimed) laced with rat poison?
(The writer is a current affairs analyst based in NCR)