Child deaths at Gorakhpur hospital highlight grim reality behind “rising India” hype
7 September 2017
The death of 30 children in 48 hours last month due to the disconnection of the liquid oxygen supply at the state-run Baba Raghav Das (BRD) Medical College Hospital in Gorakphur, Uttar Pradesh has rightly shocked and angered people across India and around the world.
But the conditions that gave rise to this tragedy—a dilapidated public health care system, official indifference and neglect, and the subordination of the most basic human needs to the pursuit of profit—are found throughout India and each day take a grim toll in patients’ lives.
For two days starting on the night of August 10, the oxygen supply was disconnected from patients on ventilators in BRD’s children’s wards. Pushpa Sales, a private company, cut off the supply, citing arrears in payments amounting to 6.3 million Indian rupees or US$89,750. Most of the victims were suffering from Japanese encephalitis, a mosquito-borne brain disease that is potentially fatal, but readily preventable through vaccination. Japanese encephalitis is rampant in much of India, especially in rural parts of Uttar Pradesh, the country’s most populous state, with 220 million people.
BRD epitomizes the gutting of India’s public health system. It suffers from chronic shortages of equipment, medicine and staff, including doctors, nurses, trained technicians, orderlies and cleaners. Annually, 400,000 patients seek treatment in the hospital, but it has just 950 beds. Even in the intensive care unit meant for children, two to three patients are cramped into one bed.
According to the Hindustan Times, the government expenditure per bed per year is 152 rupees, or less than US$2.50. A patient is charged 1000 rupees daily for a bed, while 5000 to 8000 rupees is charged to anyone who needs a ventilator (a considerable sum for poor families). Most medication has to be purchased by the patients and their families and from outside the hospital.
With the BRD tragedy provoking a torrent of criticism of the Bharatiya Janata Party (BJP)-led state government, Amit Shah, the BJP party president and right-hand man of Indian Prime Minister Narendra Modi, proclaimed the deaths an “accident,” adding that “many such big tragedies have occurred in this big country.”
For his part, Modi included a reference to the BRD deaths in his August 15 Independence Day address and, like Shah, tried to associate them with earthquakes and floods—although even the impact of these could be massively reduced through planning, the development of emergency services, and investment in public infrastructure.
“Several parts of the country,” said Modi, “faced natural calamities recently. Besides, our innocent children lost their lives in a hospital.” Modi, who as India’s prime minister has slashed social spending and accelerated pro-investor “reform,” then cynically promised that in “this hour of crisis we shall leave no stone unturned to ensure the well-being of all.”
Modi’s and Shah’s insistence that entirely-preventable hospital deaths are a fate people should accept as their lot without a murmur of protest underscores the callous disregard of the BJP regime and India’s elite for the lives of the country’s workers and toilers.
Seeking to gain political mileage from the BRD tragedy, opposition Congress Party leader Rahul Gandhi demanded the resignation of UP’s Chief Minister Yogi Adityanath. However, Congress, which ruled the country for many decades, is no less responsible than the BJP for this tragedy and numerous like disasters.
India’s public health system was always an after-thought for the ruling elite. But since 1991, when the bourgeoisie abandoned its state-led capitalist development program—what it cynically called “socialism”—and embraced neo-liberal policies aimed at making Indian a cheap-labour haven for world capital, public health care has been allowed to collapse.
State health spending is among the lowest in the world. In 2014, Indian governments spent just 1.4 percent of GDP on health care. Meanwhile private hospitals and pharmaceutical companies are reaping huge profits. Indeed, India has become an important center of “health tourism,” where westerners seeking to escape exorbitant private health-care costs seek treatment abroad.
The dismantling of the public health care system compounds the problems caused by chronic poverty. Close to 40 percent of India’s children (those under 15) suffer from stunting, a condition associated with malnutrition that has irreversible impacts on physical and cognitive development and is associated with various illnesses in later life, including diabetes.
Social disasters like the BRD child deaths are regular occurrences. After distraught parents complained of medicine, oxygen and staff shortages, the District Magistrate of Farrukabad, another Uttar Pradesh city, investigated conditions at the government-run Dr. Ram Manohar Lohia hospital late last month and found that 49 newborn children died between July 21 and August 20.
In June, at least 11 patients, including two children, died at a state-run hospital in Indore, after oxygen supplies ran out.
Appallingly inadequate state expenditure on education is yet another measure of the destruction of public services. In 2013-14, the last year of Congress Party-led government, spending on education was at 0.63 percent of GDP. The Modi government has pruned it to 0.47 percent.
Modi and his Hindu supremacist BJP, the western press, and various US military-strategic think-tanks are forever touting “rising” India, pointing to its “high” economic growth rate, burgeoning list of billionaires and transnational corporations, and rapidly expanding military. Such claims, as the social murder at Gorakphur’s BMD hospital and more generally the decrepit state of India’s public health system illustrate, ignore the catastrophic social conditions that face the more than two-thirds of Indians who eke out their existence on $2 US per day or less.
Since 1991, every Indian government, whether led by the Congress, BJP, or a coalition of “third parties” has implemented unabashedly “pro-investor” policies—deregulation; privatization; the elimination or curtailing of price subsidies on energy, basic foods, and agricultural inputs; massive tax cuts for big business and the rich; and the diversion of state resources from public services to big business developments. All with the aim of making India a cheap labour manufacturer, back-office, and research center for global capital.
These policies have provided billions in profits for international investors and nurtured a tiny super-rich layer, while eliminating rudimentary social supports that for hundreds of millions provided a modicum of protection from the vicissitudes of life and the capitalist market.
Today India is one of the most socially unequal societies in an increasingly unequal world.
According to a study co-authored by Thomas Piketty and released this week, India’s richest 1 percent earned 22 percent of all income in 2014, while the poorest 50 percent of Indians earned little more than 15 percent. Wealth inequality is even more stark. According to Credit Suisse, the top 1 per cent of India’s population owns 58.4 per cent of the country’s wealth, a dramatic increase from the 33 percent they owned in 2000. The top ten percent of Indians own 81 percent of the country’s wealth, leaving just 19 percent to the bottom 90 percent.
And the Indian bourgeoisie is determined to continue gorging on the savage exploitation of the working class. Three years ago, big business propelled the notorious communalist and self-styled Hindu strongman Modi to power to accelerate the pace of “market reform.”
Resistance by workers to poverty wages, a brutal work regimen and precarious contract labour jobs has been met with state violence, as exemplified in the frame-up convictions and life-terms given the leaders of the Maruti Suzuki Workers Union, a fledgling independent union.
Last week, one of Indian’s major business publications, the Economic Times, touted as a major plus that wages in India are one-fifth those of China, calling the wage-gap the “Make in India edge.”
While pursuing a more aggressive policy against the working class, the Modi government, with the full-throated support of the corporate media, has integrated India into Washington’s incendiary military-strategic offensive against China. By supplanting Pakistan as US imperialism’s chief ally in South Asia, the Indian ruling class hopes to advance its own great-power ambitions. India’s recent war crises, first with Pakistan, then China, underscore the catastrophic logic of the Indo-US alliance.
Indian capitalism can’t provide basic health care and other vital services. Yet the government squanders more than $55 billion a year on the military and, to applause from the media, recently boasted India’s military has achieved a nuclear triad, i.e., the capacity to deliver nuclear bombs from land, air and underwater.
In response to the Gorakhpur tragedy, the Politburo of the Stalinist Communist Party of India-Marxist, or CPM, issued a statement calling it “impermissible” to cut off the oxygen supply and demanding “a high level judicial enquiry be instituted to establish the culpability” of persons, including the chief minister and state government.
Such enquiries are a tried and true mechanism of capitalist rule in India. They are used to dissipate public anger and cover up the responsibility of the political establishment and Indian capitalism as a whole for the myriad social catastrophes that blight India. Moreover, when such inquiries make recommendations for increased social expenditure, their proposals are almost invariably ignored.
The Stalinists have systematically suppressed the class struggle, supporting a succession of governments, most of them Congress-led between 1991 and 2008, that spearheaded the bourgeoisie’s drive to make India a cheap-labor hub for global capital and implementing what they themselves call pro-investor policies in the states, like West Bengal, where they have formed the government.
Seven decades of Indian independence have conclusively demonstrated that the rule of the Indian bourgeoisie is incompatible with realizing the most elementary democratic and social needs of the workers and rural poor.
A new, revolutionary workers’ party must be built to prosecute the struggle for a workers’ government leaning on the rural toilers. Such a government would radically reorganize socio-economic life on socialist lines so as to make meeting human needs, not the insatiable demands of the super-rich, the animating principle.