The death of a two-day-old began an investigation into the state of affairs in Agra’s hospital hub.

Exclusive: Greedy Doctors of Death and an Urban ‘Hospital Bazaar’

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At 4:35 am on 16 August, in a small private hospital in Agra, Chanchal Singh became a mother for the first time. Two days later, and before she ever saw her baby boy, the newborn was declared dead.

The events that transpired during the infant’s life paint a harsh picture of Agra’s private healthcare industry, and raise tough questions against the hospitals and the authorities allowing them to function.

Devendra Singh, the baby’s father, alleges that despite his complaints the hospital staff did not tend to the newborn even as his health worsened.

In Agra’s ‘hospital bazaar’, Devendra’s case is one among many. On a 1.8 km stretch, more than 46 private hospitals put the lives of their patients at risk by compromising on qualification and flouting norms.

Greedy hospital authorities refusing to refer patients even when they turn critical. A BSc graduate who treats patients and signs prescriptions. A hospital functioning out of a building still under construction.

In short, human lives at risk. All while the authorities look away.

The Quint travelled to Agra’s Trans Yamuna Colony, where these hospitals are located, to find out more.

The Death of a Two-Day-Old

Chanchal Singh’s son died before she could ever see him.
Chanchal Singh’s son died before she could ever see him.

When Devendra and his wife reached Saraswati Hospital in the wee hours of 16 August, the gynaecologist suspected a complication with the baby and decided to perform a caesarean delivery. Right after the delivery, the newborn seemed to be facing breathing problems.

Saraswati Hospital does not have a neonatal ICU (known colloquially as an ICU for infants). That morning, neither did it have an ambulance.

So, the hospital took a step they considered normal. They transferred a 20-minute-old baby to a child specialty hospital a few hundred metres away, on a bike!

The baby was transferred to Dr Manoj Jain’s Chahak Child Care. His health improved over the next two days. But at the crack of dawn on 18th morning, the baby breathed his last.

Devendra’s son, lying still in bed on the morning of his death.
Devendra’s son, lying still in bed on the morning of his death.
Devendra alleged that the preceding night when his child was crying and had unusual red and white spots on his torso, he asked the compounders on duty to check, but none of them came to see the baby.

He shot a video where a seemingly still baby lay on his bed, but none of the hospital staff attended to him.

On speaking to the doctor-in-charge, we were left with more questions than answers.

We cannot determine the cause of death. The baby died of the Sudden Infant Death Syndrome (SIDS), which is common among newborns. There’s nothing we could have done.
Dr Manoj Jain

Yet, other doctors that The Quint spoke to say that SIDS is when an infant who has been perfectly healthy suddenly dies. This baby, however, had some complications right after his birth.

Next, Dr Jain admitted that when the baby reached his hospital he was facing breathing problems. Yet, in the two days that he was under Dr Jain’s care, not a single test was conducted to enquire into what the problem was.

The baby’s breathing problem could have been because of meconium aspiration, pneumonia, or any other infection, no one can be 100% sure about the cause. We gave him antibiotic injections and he was fine.
Dr Manoj Jain
The details of this case throw up not one but several worrisome questions.

Why were no tests conducted? If it was for a lack of facilities, why was the baby not transferred to a bigger hospital?

The Hospital Hub of Agra - 46 Hospitals in 1.8 Km

The case of Devendra’s son prompted us to explore other hospitals on the Trans Yamuna Colony. And yes, there were many. Way too many.

A slew of hospitals lined both sides of the road. On closer inspection, we counted 46 hospitals within 1.8 km in Agra’s hospital hub. And that’s just on the main road. Do the math and it’s one hospital for every 40 metres. Several of these establishments do not have more than two rooms.

Dr Mukesh Goyal, former secretary of the Indian Medical Association’s (IMA) Agra Branch, owns one of the larger hospitals on the Trans Yamuna Colony. Goyal explains, “For 150-200 kilometres beyond Agra, there is a dearth of hospitals and qualified doctors, which has resulted in the abundance of hospitals on this road.”

Over the last decade though, too many establishments have cropped up. Not all of them function properly. Many of them flout norms and risk patients’ safety in the search for a quick buck.
Dr Mukesh Goyal, former secretary, IMA, Agra

We question locals about the condition of these hospitals. An auto driver stationed outside one of them scoffs,

There are at least a hundred hospitals here if you go into the lanes. Sab farzi hain yeh (Most of these aren’t genuine). Think for yourself, if there are so many of them, how can they be proper? Only a handful are known to provide decent healthcare.
A local

What is certain is the abundance of hospitals. What is not is whether the patients admitted there are really in safe hands.

Building Under Construction, Hospital up and Running

An external view of Chaitanya Hospital.
An external view of Chaitanya Hospital.

Walking down the Trans Yamuna Colony, an under-construction building catches our attention. The board outside reads ‘Chaitanya Hospital’. A pile of rubble greets us once we enter the building. We’re yet to find the hospital in the hospital building.

A woman from Manikpur was waiting outside with her husband. Pointing to a man in a white shirt, she told us she’s come here through his reference to get her treatment done. He’s one of the owners of the hospital. After tending to the patient, he speaks to us.

The hospital has been running since two months now. We have two doctors registered with us. But I handle a lot of the cases myself. 
Brijesh Kumar Yadav, owner of Chaitanya Hospital

Since he was treating patients, we assumed that 34-year-old Brijesh Kumar Yadav is a doctor. But we were in for a rude surprise.

Playing 'Doctor Doctor'

On asking Yadav about his credentials, he revealed that he was just a BSc graduate in Biology.

The Quint: “Not an MBBS?”
Yadav: “No, no. Not an MBBS.”

The Quint: “But you treat patients?”
Yadav: “Yes, I do.”

The Quint: “And sign prescriptions too?”
Yadav: “Ya of course, I sign prescriptions for the patients I’m treating.”

Chaitanya Hospital’s prescriptions carry the names of two registered doctors. However, they were being signed and handed out by someone who hadn’t even registered for an MBBS.

Yadav’s only experience with healthcare came as a doctor’s assistant in Agra’s Synergy Plus Hospital. Clearly, he thought that was enough to enable him to charge patients and begin his own practice.

Showing us a prescription, Yadav points to a number at the top right of the paper saying that’s the registration number of the hospital. It reads “UP/AGR/AL/2016-2550”.

Look, this says our hospital’s registration is valid from 2016 to 2550.
Brijesh Kumar Yadav

We waited for Yadav to laugh and tell us he was joking. He didn’t. He was dead serious.

Chaitanya Hospital’s prescription pad.
Chaitanya Hospital’s prescription pad.

The bottom of the prescription paper also says that the hospital is not to be held responsible in case of any eventuality – “Not valid for medico legal purpose.”

At the back of the building are stairs leading to the basement where a general ward with 7 beds has been set up. This, even when the building is still under construction.

Reputed doctors we spoke to admitted that having patients live in an under-construction site greatly increases the risk of them contracting infections and respiratory problems.

Urmila, one of the patients admitted at Chaitanya Hospital, is suffering from a liver problem. The 35-year-old labourer works in Delhi, but hails from Jalesar Gaon, a village around 50 km outside of Agra. After doing the rounds of several government hospitals in Delhi, she came to Agra’s Trans Yamuna Colony for treatment.

We’re poor people and can’t afford to go to private hospitals in Delhi, so we came here since our relatives told us it’s reliable. But now, it’s been six days, we’ve spent around Rs 60,000 here, but to no avail. We’re trapped. Am I supposed to leave her to die?
Urmila’s husband

Her husband alleges that when they initially asked what the problem was and how much the treatment will cost, the hospital didn’t answer them. “And now, we have no way of getting out of it. This hospital has tricked us.”

When the Doctor Is Away...

For most of the day, the small hospitals have no doctors and no nurses either. Doctors are only on-call. When the doctor is away, patients are tended to by the hospital compounders, none of whom have qualifications in medicinal science.

At Saraswati Hospital, the operation theatre has families of patients lounging in it.

An operation theatre at Saraswati Hospital.
An operation theatre at Saraswati Hospital.

At Chahak Child Care’s Neonatal Intensive Care Unit (NICU), the compounders are caught napping at 1:30 in the afternoon.

Compounders sleeping inside the neonatal ICU at Chahak Child Care Hospital.
Compounders sleeping inside the neonatal ICU at Chahak Child Care Hospital.

Also, the NICU’s door opens into the general ward and there’s no check for who’s walking into that space, where newborns are lying susceptible to infections.

Almost all these hospitals regularly conduct surgeries. The examples above raise concerns about the level of hygiene in which these surgeries are carried out, especially since operations are supposed to be done in a sterilised environment.

Greed Threatening Lives of Patients?

Dr Mukesh Goyal alleges that small private hospitals are compromising patients’ health.
Dr Mukesh Goyal alleges that small private hospitals are compromising patients’ health.

At Madhuban Hospital, a small establishment with a general ward and an operation theatre, Dr Amit Agarwal agrees that the state of affairs is far from desirable.

Not all five fingers of the hand are the same. There are several unscrupulous people on this road. They’re playing with the patients’ lives. With no one checking them, they’re functioning however they want to.
Dr Amit Agarwal, Madhuban Hospital

Shambhu Dayal, a police constable from Etah, chips in, “Bahut toh fraud bhi hain yahan (There are a lot of frauds around here). The government facilities aren’t great either, and the hospitals on the Trans Yamuna Colony do operations and surgeries for cheaper. So, a lot of people prefer such places.”

More Hospitals: Boon or Bane?

“Faults are there in every field. This is India. When you’re building a house, are you following all the construction rules? No. These clinics shouldn’t be closed, we’re serving the public. Not everyone is a dacoit,” says Dr MK Singhal of Narvada Devi Hospital.

Even if all the facilities aren’t there, we’re still helping the poor who have nowhere else to go. How will a person who’s earning Rs 10,000 pay for a surgery which costs almost a lakh at these fancy private hospitals? We’re helping them out by doing it in Rs 10,000-15,000. You can’t just call it greed for money.
Dr MK Singhal

Madhuban Hospital’s Dr Amit Agarwal turns defensive too, when asked if the price difference is because they are providing below-par facilities. “Whether you take a black t-shirt from a local shop or a branded one, it’s the same, right?”

At the chemist outside Chaitanya, Rinku, who works at a nearby hospital, responds to our curiosity about the large number of private hospitals. “If even one big government hospital like the ones in Delhi opens up here, then you won’t need any of these,” he says, pointing to the line of hospitals.

Where Does the Buck Stop?

The Quint travelled to Agra to find out some of the answers that the case of Devendra’s child threw up. But what we got back from Agra’s ‘hospital bazaar’ were more questions.

Are the state authorities unaware that the lives of these patients are at risk?

There should be checks conducted by the Chief Medical Officer (CMO) and his staff. And they should verify whether these places are suitable to function as hospitals. It’s suspicious that proper checking is not being done by them.
Dr Mukesh Goyal, former secretary, Indian Medical Association, Agra Branch
How do establishments that are flouting norms continue to function with impunity? Are the authorities hand-in-glove with the owners of these small private hospitals?
A lot of these hospitals shut shop in a year or so when some tragedy occurs at their place or after they get into trouble with the authorities. But that’s not it. They open another in a while, at some distance and under another name.  
Dr OP Sharma, Janhit Hospital

But don’t the authorities come by to conduct checks at these places?

When we contacted Mukesh Vats, the Chief Medical Officer of Agra, he said he was still new to the job.

I’ve only joined this office about a month back. We don’t have too many vehicles so we can’t conduct as many checks as we’d like to. But in cases where the hospitals are flouting norms as you are telling me, we will definitely conduct checks and ensure that action is taken against errant hospitals.
Mukesh Vats, Chief Medical Officer, Agra
So where will the buck finally stop?

Video Editor: Vivek Gupta

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