The large number children among those affected with communicable diseases, including dengue, the spotlight has fallen on lack of paediatric facilities across the State, which, in turn, has led to overcrowding at the few specialty hospitals.
There are only three dedicated paediatric facilities in the State, of which two are in Chennai – the Institute of Child Health (ICH), Chennai; Institute of Child Health, Madurai; and Institute of Social Paediatrics at the Government Stanley Medical College Hospital, Chennai. There are paediatric departments at the medical college hospitals that offer tertiary care.
Of these, the ICH, Chennai, which provides tertiary care for clinical and surgical cases, receives at least 200 admissions every day, and has a capacity of about 800 beds. The one in Madurai, which receives around 150 admissions daily, has a capacity of about 500 beds. The Institute of Social Paediatrics gets about 80-100 children every day, and has a capacity of about 300 beds.
Though there are seven dedicated hospitals for women and children in the district headquarters hospitals, tertiary care is available only in these three institutes.
“There is a need to identify medical hotspots in districts such as Coimbatore, Vellore, Villupuram, Dharmapuri, The Nilgiris and other districts that are often hit by epidemics. Constituting separate institutes for childcare would help reduce the burden at the tertiary care hospitals where the staff are feeling increased workload, which affects the quality of the medical care,” said State Neonatal Intensive Care Unit coordinator Dr S Srinivasan.
Overcrowding in children’s hospitals
“The ICH, Chennai, receives a large number of cases that come as referral from other districts and even other States like Andhra Pradesh, Karnataka, Kerala and Telangana. The numbers almost double between the months of July and November because of seasonal changes and rise in communicable diseases due to the rains,” added Dr Mohan Kumar, paediatrician, ICH, Chennai.
Such a large number of referral cases not only leads to overcrowding but also overburdens the staff, he said. “With limited amount of staff, managing double the number of patients becomes difficult,” added Dr Mohan Kumar.
This year, the hospital authorities at ICH had to ask the Directorate of Medical Education to deploy staff from other hospitals in the city to the institute so as to provide medical services to the patients without burdening the doctors and other medical staff with additional stress.
Insufficient facilities, compromised hygiene
It is common to hear complaints from the attendants of patients at ICH that there were not enough facilities, including even seating. Often, attendants and patients who come from outside the district to the outpatient section are seen taking shelter at space available outside wards and even near parking lots.
R Srividya, attendant of a 3-year-old from Dharmapuri, has been at the hospital for four days with her child for various clinical tests. “I cannot afford to travel from my native every day, I don’t have relatives in Chennai. So I stayed in the hospital itself,” she said.
Srividya is one of the many attendants who has to stay in the hospital premises. “The waiting hall is filled with patients, making it difficult to find place to sleep. So I had to stay outside the new building for two days till my child was admitted to the ward,” said Vinodini from Nellore, Andhra Pradesh.
While those from outside the districts complain about overcrowding and crammed facilities, the real issue is the lack of childcare facilities elsewhere in the State.
According to officials from the Directorate of Medical Education, the hospitals have sufficient staff and facilities to handle the large number of patients being brought there. Also, establishing a standalone institution for childcare is difficult process. “We are upgrading the intensive care units at the government hospitals,” said Dr K Kolandaisamy, Director of Public Health.