By: Ravi Nair
No one knows better than the current ruling party, the BJP, that public memory is very short. And if the media – who ought to consistently highlight the failures of the regime – bats for the government, public memory becomes even shorter. The best example in recent times is the Gorakhpur tragedy that killed hundreds of children because of the system’s apathy and criminal negligence.
Apart from being the Lok Sabha constituency of the current Uttar Pradesh Chief Minister Yogi Adityanath, Gorakhpur has been in the news for all sorts of wrong reasons for over a year now. The state of Uttar Pradesh earned global notoriety last year when scores of infants and children died in the government-run BRD Medical College Hospital due to lack of basic medical facilities. The notoriety reached its peak when 61 children died in a span of just three days due to lack of oxygen supply to critical patients in the hospital.
That was not the first time children had died in this hospital. It pretty much has been a regular occurrence for many years. In 2017, the month wise toll of children’s deaths was: 152 in January, 122 in February, 159 in March, 123 in April, 139 in May, 137 in June, 128 in July and 213 in August. Most of these deaths happened in the hospital’s Neonatal ICU and the rest in the encephalitis ward. Deaths due to other medical reasons and of adults are not counted here and that shows the state of affairs.
Live Mint reported on 15 August 2017: “In 2017 (till July), the total number of admissions to the paediatrics department was 3,878, of which 596 patients died. The figures for the neonatal intensive care unit (newborns) arouse even more concern—of the total 2,386 admissions, 931 died.” That is 15.37% and 39% of death of admitted children respectively!
When the news of the death of scores of children became a topic of intense media conversation last August, many theories started to float on different platforms. The main reason pointed out was the apathy of the hospital administration in clearing the accumulated dues owed to the liquid oxygen supplier, Pushpa Sales Pvt Ltd. When we attempted to dig deeper, we stumbled upon some vital documents that suggest a massive cover up exercise to suppress key facts and the use of diversionary tactics to take the public attention away.
Unfortunately, the topic has already fallen off the news agenda for most so-called news channels and reputed newspapers. The reason could be perhaps the fear of reprisal by the BJP government of Uttar Pradesh or losing out on lucrative government ad revenue or both. However, an emboldened state government has managed to find a few scapegoats in the process. They included the then principal of the institution Dr. RK Misra, his wife Dr. Purnima Shukla, Dr. Satish (Head of Dpt – Anaesthesia), Gajanand Jaiswal (Chief Pharmacist) and three clerks – Sanjay Tripathi, Sudhir Pandey and Uday Pratap. And a separate charge-sheet was filed against Manish Bhandari – the owner of the oxygen supply company Pushpa Sales.
Nodal officer the National Health Mission, Dr. Kafeel Khan was a prize catch of the Adityanath government to divert media and public attention. Right-wing social media and obscure websites came up with such stories that was taken over by the mainstream Hindi media and couple of English news channels; the gory death of scores of children due to lack of oxygen became a non-news item. They made Dr. Khan the main villain just days after he was hailed as a hero and Dr Purnima Shukla the kingpin. In less than a week, the death of children was forgotten!
Just take a look at the year wise number of deaths of children in this hospital’s Neonatal ICU and Pediatric ICU.
Let us go back a bit to understand the problem. In October 2016, Union Health Minister JP Nadda visited the BRD Medical College and said that the institution will not face any difficulty due to lack of funds. But, by then, for more than 500 employees of the various departments of the Medical College, salaries were due for upto three to seven months! This shows that the fund allocation to the Medical College was always patchy.
Fast forward to 31 March, 2017. Available documents in the possession of Janta Ka Reporter show that the government released funds to BRD Medical College for the medicines and pathology department. And the notification clearly warns that the released funds should be used only for the mentioned purpose.
Meanwhile, the oxygen supplier Pushpa Sales Pvt Ltd started to send reminders to BRD Medical College administration from 17 April, 2017 and by 31 July, 2017 they had sent 8 letters asking the hospital to release the pending payment. Over the period of those three and half months, the company wrote to the principal, Dr. Rajeev Misra, Gorakhpur DM Rajeev Rautela, KK Gupta – DG Medical Education – and Anita Jain Bhatnagar – Principal Secretary Of Medical Education.
In these letters the company pointed out that for the last six months, the payment was not released, whereas the contract was to release the payment within 15 days of submitting the invoice. Citing the same breach of contract, Pushpa Sales sent a legal notice to the hospital which also went unanswered. On 1 August, they again wrote stating that despite the huge outstanding of Rs 63.65 lakh, 4-5 days’ supply has been ensured on humanitarian grounds. In the initial letters, Pushpa sales mentioned, the manufacturer – Inox Air Products Ltd, a Mumbai based company – had asked them to deposit Rs 40 lakh immediately as the overdue was a breach of contract. On 8 August they wrote again to the government authorities and the minister requesting for the release of the payment.
On 30 July, 2017, Pushpa Sales Pvt Ltd sent a legal notice asking the college to release the payment within 15 days, but before this deadline expired, they stopped the supply.
nterestingly, this legal notice shed more light on the follow-up done by the company. They started to send the letters for the release of the payments from as early as 26 February, 2017 and it shows that the payments were pending for the bills submitted in October 2016. As per the legal notice, Pushpa sales has sent 14 reminders to the medical college administration!
But these reminders doesn’t mean that the Medical College never released any payments to the supplier. They certainly did do part payments – at least that is what the hospital documents accessed by Janta Ka Reporter shows. It shows that on 8 May, 2017, the medical college released Rs 20,27,024 against eight bills and almost a month later on 5 June, another Rs 13,26,182 was released against five bills. All these 13 bills for which the payments were released were raised between 23 November 2016 and 24 April 2017. In view of this, it will be absolutely incorrect to say that the medical college didn’t release any payment for 6 months. (See below)
The college principal RK Misra, for his part, kept reminding the UP government authorities – especially to the Director General of Medical Education about the lack of funds and the letters from Pushpa Sales. It also kept asking them to release the payment immediately. Copies of at least four such letters, sent on different dates, are in Janta Ka Reporter’s possession. The one sent on 4 August, 2017 is here and this letter says that Oxygen supply had been stopped by Pushpa sales. So, gas supply was stopped by Pushpa Sales at least a week before the reports of large-scale deaths began to emerge. Misra brought this to the Adityanath government’s attention on 4 August and yet they arrested the principal and not the DGME or the Principal Secretary of Medical Education.
The Adityanath government says that they released the payment to the hospital on 5 August and hospital authorities failed to clear the dues till 11 August. Therefore, the apathy from the hospital authorities was the reason for the mishap on 10 and 11 August. But the letter above proves that not only is the argument farcical to mislead the public but also appears to be designed to cover-up the Adityanath government’s culpability. We have more details to prove it.
The budget allocation letter and the details attached with it shows that the funds allocated in April and May 2017 came with a strict rider that these funds should not be used to clear any pending bills to any vendor or to clear the pending remuneration. The next allocation was on 3 August from Lucknow and received by the hospital authorities only on 8 August.
As per the provisions, once the government releases the funds, the receiving authority should submit the hard copy of the release order to the treasury and obtain tokens to transfer the funds to the bank account of the hospital. Hospital sources, on condition of anonymity, confirmed to Janta Ka Reporter that the hard copy of the release order was received by them through speed-post only on 8 August.
On 9 August, Chief Minister Adityanath visited the hospital and employees were busy preparing for his arrival. They obtained the tokens on 10 August and the payment to the oxygen supplier was released on 11 August. By the time, hospital ran out of oxygen and dozens of lives were lost. What the Delhi-based media didn’t highlight was the death of 18 adults on the same day due to the shortage of oxygen.
The state government and the BJP leadership went into an overdrive to cover up their failures and the deaths of scores of children and adults. State ministers including Adityanath first denied the role of lack of oxygen supply for the deaths and blamed the dereliction of duty and mismanagement by the hospital authorities for the unfolding catastrophe. They moved in with lightening speed to suspend the principal. But the pertinent question remained unanswered – why didn’t the UP government release the budget to the hospital till 5 August? Why didn’t the government act when the gas supplier and hospital authorities kept reminding them of the impending lack of funds to run the facility which is the one and only available option in one of the most backward districts of India itself – Gorakhpur?
Why did the Adityanath government not fix the responsibilities of the Director General of Medical Education and the Principal Secretary of Medical Education? Why didn’t the DM act when he began to receive repeated letters from Pushpa Sales?
Fraudulent contract with oxygen suppliers and role of Dr Kushwaha
The contract for the oxygen supply was between a Mumbai based company – Inox Air Products Ltd – the manufacturer of liquid oxygen and the BRD Medical College. The contract document, which was signed by both the parties after Inox won the tender raises some serious questions. The tenure of this contract was meant for eight years with two years extension. In other words, a ten year contract was awarded to Inox in 2014, whereas the UP govt procurement manual mandates a maximum period of three years.
The agreement is so one-sided that a simple reading will prompt the reader to think that the medical college was forcing the manufacturer and supplier into a tripartite agreement where the manufacturer dictated their terms and conditions. This agreement was signed by the then principal of the Medical college Dr PK Kushwaha. The tender documents and other available papers accessed by Janta Ka Reporter clearly state that this particular oxygen plant was meant only for the paediatric and encephalitis department. But at Dr. Kushwaha’s behest, the entire medical oxygen supply to the hospital got connected to this particular facility, thereby increasing the business volume of Inox Air Products Ltd.
Hospital sources confirmed on the condition of anonymity that this call was taken unilaterally by Dr Kushwaha. Interestingly, neither did Adityanath government revoke the contract nor question the person, who signed such a contract and took other critical decisions related to the plant.
The contract agreement makes it clear that the payments must be released within 15 days of receiving the invoices / bills. If failed, the manufacturer holds the right to cancel the supply and they exactly did that. Repeated calls to Pushpa Sales went unanswered except on one occasion a female voice told us that the concerned person was out of the country.
When Pushpa sales started to send regular letters to the hospital threatening the discontinuation of the liquid oxygen supply in 2016, the hospital administration had lodged a complaint, signed by Principal Dr. RK Misra, to the National Human Right Commission on 21 December 2016, a copy of which is in possession of Janta Ka Reporter. The letter states that the BRD Medical College had paid Rs 10,060,342 to Pushpa Sales from April 2016 to November 2016 and yet Pushpa Sales was threatening do disrupt the supply of a critical life saving facility such as oxygen gas. Based on the complaint,the NHRC forwarded their report to the Principal Secretary, Department of Health and Family Welfare, Government of UP on 9 February 2017. The letter said, “The complaint be transmitted to the concerned authority for such action as deemed appropriate. The authority concerned is directed to take appropriate action within eight weeks and to inform the complainant of the action taken in the matter”.
While complaining to the NHRC, college principal wrote a letter to Pushpa Sales on 21 December, 2016 clarifying that only Rs 5 lakh was pending and the rest had been cleared while asking Pushpa Sales to desist from writing such threatening letters in future.
That was the assembly election time in UP and within that stipulated 8 weeks deadline set by the NHRC, Adityanath assumed office. With the available documents and the subsequent developments, it can be safely concluded that no action was taken by the new BJP government. It is unclear whether the hospital authorities pursued this matter further with the NHRC.
Another question that was rightly raised amidst the alarming increase in children’s deaths was that how could a hospital as big as BRD Medical College not have adequate oxygen cylinders? The BRD staff, on condition of anonymity, shared some shocking details.
A company – Modi Chemicals Pvt Ltd – used to supply oxygen cylinders to the medical college. It has been alleged that this company used to manipulate the bills in connivance with a certain clerk, who is already in jail. Within a month of Adityanath government coming in to power, BRD Medical College floated a tender for the supply of oxygen cylinders and Imperial Gases Ltd, a company based in Allahabad won the contract. The Director of the company Gulshan Kumar Luthra is said to be very close to new health minister of Uttar Pradesh Siddharth Nath Singh. On the fateful days of 10 and 11 August, if hospital had adequate supply of oxygen cylinders, such a tragedy could have been averted.
Few other interesting things popped up during the course of our investigation. It was widely reported in the media that the principal, Dr. RK Misra went on leave while the tragedy was unfolding. The report was correct in one part – that he was on leave on 10 August. But, what media did not report was that he submitted his leave application a day before and travelled to Rishikesh to attend a conference as a special invitee. He marked his leave application to all relevant government departments and handed over his responsibilities to the head of another department Dr. Ram Kumar Jaiswal. At the same time, what media did not highlight was the absence of Dr. Mahima Mittal, head of paediatric department, where this tragedy happened. The hospital attendance register shows that Dr Mahima Mittal went on casual leave on 11 and 12 August (See below). Dr Mittal’s absence from the duty taking casual leave is not even a part of the investigation.
The most cruel causality in this entire episode of the cover up of the mistakes made by the UP government and administration is Dr Kafeel Khan. Adityanath government played the cunning game of vilifying a Muslim doctor to divert the attention from its failures and RW supporting media houses came out with stories like this. Inept and biased reporting in the name of journalism changed the course of the narrative and the entire blame shifted to the hospital administration alone and Dr Misra and Dr Khan were portrayed as the masterminds of a planned massacre.
A special programme broadcast by ABP News on 31 July, 10 days before the massacres began to surface, showed just how ill-equipped the BRD Medical College and Nehru Hospital were to deal with any potential outbreak of encephalitis. ABP journalist also interviewed Dr Kafeel Khan, who is seen here (watch below) expressing the difficulties the doctors grapple with day in and day out. Khan, it seems, was punished for speaking to media and subsequently being portrayed as a hero.
The story of Dr Khan started with the accusation of him stealing oxygen cylinders from BRD to his nursing home. But, what was not disclosed was that Dr Khan’s wife is also a doctor and the nursing home is run by her along with few other doctors. Available documents coupled with our off-the-record conversations with the hospital staff prove that without Dr Kafeel’s efforts, the toll would have been significantly higher. The Indian media, which chose to ignore the absence of Dr Mahima Mittal, highlighted the absence of Dr Khan and Dr Misra. Just like Dr Misra, Dr Khan had also applied for a day’s leave a day in advance and the leave application was accepted by the department head – Dr Mahima Mittal. In the attendance register, he was still marked absent and not ‘on leave.’ And contrary to most of the media reporting, Dr Khan was not the head or senior doctor in the department, but he was only 7th in line of seniority.
On the intervening night of 10 and 11 August, at 12:48 AM in a WhatsApp group of doctors and senior employees of BRD Medical College and Nehru Hospital in which Dr Khan was also a member, received a message from Dr Satish Caubey which read “ There is no oxygen supply in nicu, cylinders out of stock.”
The call records below has the list of people Dr. Khan called in the next 24 hours. Janta Ka Reporter accessed the complete call detail list of two phone numbers. As we respect the privacy of these individuals, we are not publishing their phone numbers. Many people received multiple calls from Dr Khan and few of them confirmed that they certainly received calls from him seeking help to procure oxygen cylinders from all possible sources including private hospitals. Even the Seema Surakha Bal confirmed that Dr Khan had sought their help and they deputed few jawans and a truck to assist him to procure oxygen cylinders from all available sources.
In less than 72 hours, a smear campaign by the ruling dispensation and the media, which blindly follows only government versions on everything, changed the course of news from the pathetic conditions prevailing in the hospital due to the apathy of successive governments to a smear campaign against one individual, who was essentially a hero. The propaganda ran by the entire Hindi media helped the government successfully divert the attention from the ground reality. In the end, a doctor who had put his best efforts to save countless lives was arrested and he continues to languish in jail ever since.
Accused becomes inquiry commission chief
Hospital sources told us that the liquid oxygen plant was set up in the hospital under National Health Mission scheme in 2014 and it was meant only for the Paediatrics and Encephalitis wards. The then Pricipal Dr. KP Kushwaha – the same person who signed the contract with Inox and Pushpa Sales – changed that and now most of the hospital wards uses liquid oxygen supplied by Inox through Pushpa Sales.
The state government, the central government and the Indian Medical Association constituted different enquiry committees – seven in total (Janta Ka Reporter has the copies of 6 commission reports). All the commissions formed by the state’s BJP government blamed the alleged casual approach of the interim principal Dr Misra and other hospital employees. Interestingly one commission was headed by DGME KK Gupta to whom Dr Misra kept writing numerous letters highlighting the hospital’s woes for the release of funds.
This same KK Gupta was removed from the position in 2015 by the then UP government after complaints were filed against him in Lokayukta. It was an interesting move when Yogi government appointed him as an inquiry commission chief keeping him clear of the culpability without any probe . What’s worse? KK Gupta was the person, who filed the FIR against the hospital staff! Unbelievable, but true.
The commission constituted by IMA cited poor infrastructure, lack of facilities, over crowding and untrained staff as the main reason. In the interview to ABP news’, now deleted video clip, Dr Kafeel Khan highlighted the same point. All the state government constituted commissions explain the budgetary constraints and disbursal of 2017 ( March to August) to pinpoint the blame to hospital administration while conveniently hiding the accompanied circular, which clearly instructs not to release the pending payments to vendors.
The members of the Chelani committee visited the hospital along with Union Health Ministet JP Nadda and state ministers itself shows the seriousness and neutrality of the committee. Within few hours they have completed their enquiry. They refused to interact with media while cameras are on and insisted the media team present to keep keep their mobile phones away!
And none of them have taken the repeated letters of the acting principal Dr RK Misra to the DGME, Principal Secretery, DM and other senior officials into consideration. They’ve also chosen to ignore the lack of action taken by the state government on NHRC’s forwarded recommendation. If Dr Kafeel khan was arrested for violating the service rules by purchasing oxygen cylinders from outside – even by spending his own money – the paediatric department head Dr. Mahima Mittal was not even questioned.
The most atrocious of the report is of DGME KK Gupta which says that Dr. Purnima Shukla, W/o Dr RK Misra was the kingpin of corruption in BRD Medical College & Nehru Hospital. It goes on to add that the grave mistake of Dr Khan was that he was doing private practice while being in govt service. But this Supreme Court order clearly states that it is not a crime for a doctor in Govt service to do private practice as long as it is not affecting his / her official commitments.
It’s a real travesty of justice that a few individuals were severely punished for doing their job with utmost sincerity while the corrupt and incompetent continue to enjoy the immunity because of their proximity to the ruling dispensation. Their relatives allege that the judiciary too has come under pressure from the Adityanath government, thereby denying them the bail for more than six months.
In nutshell, just to hide their failures, Adityanath government simply made few scapegoats. The people in power – the health minister, DGME, Principal Secretary of Medical Education, DM, CMO and others were not even questioned on their failures. Though a director of Pushpa Sales was arrested, the government didn’t touch anyone from Inox Air Products.