At least six stand to lose their sight from free eye surgery camp in Kanpur

The patients are now under the care of doctors at a government hospital but will not let them operate again.

Sher Singh, one of the six patients from Kanpur’s Sughardeva village, who lost his vision after a cataract surgery at a private medical camp: “We were shocked when we were asked for money.” | Photo Credit:  Ismat Ara

Ward nine, Ganesh Shankar Vidyarthi Memorial Medical College (GSVMMC), Kanpur, Uttar Pradesh. Patients from around the district are crammed into the dimly lit ward of the public hospital’s Eye Disease department on December 1, the day this correspondent visited the hospital. In one corner, six patients wearing black goggles are sitting together.

Their shared experience of losing vision in one eye a month ago following complications from cataract surgery at a free medical camp run by a private hospital binds them together.

The patients—Raja Ram (66), Ramesh Kashyap (62), Nanhi Devi (65), Sultana (78), Sher Singh (72), and Rama Devi (55)—are residents of Kanpur’s Sughardeva village.

Still in excruciating pain, the six requested the doctors to give them more painkillers. “My head will burst from the pain. I feel like I will die. I don’t know if it is day or night, I can’t eat properly,” said Sher Singh. Another victim, Sultana, said, “Look at my eye. The eyesight is totally gone.”

This is not an isolated incident. In neighbouring Bihar’s Muzaffarpur, in February this year, a group of patients took part in a protest outside the Shri Krishna Medical College Hospital, the largest public hospital in the city of Muzaffarpur. They too had a similar story.

A pamphlet of Aradhya Eye Hospital advertising the camp | Photo Credit:  Ismat Ara

As many as 36 patients, aged between 40 and 85, had lost their eyesight after attending a cataract surgery camp at Muzaffarpur Eye Hospital, a charitable private hospital. Seventeen of them had to get their eyeballs removed to arrest the spread of infection.

In Kanpur, the hapless patients are still contemplating whether or not to accede to having their eyes removed. It is a big decision. The pain is bad but removing the eye is frightening. “What if something worse happens? We can’t trust doctors anymore,” said Sher Singh. A nurse sitting on the other side of the ward spoke up. She said that they would have to remove the afflicted eye “or else the infection would reach the brain”.

According to Parvez Khan, head of the Eye Department at GSVMMC hospital, the damage caused to the eyes of the victims is irreversible. “Eyes of four patients will have to be completely removed as the infection has spread far,” he said. Khan acknowledged that the patients were hesitant and emphasised, “We cannot operate without their consent.” In the case of two patients, the infection had not spread as much and their condition was being monitored. Also under observation were 11 others from the same village who too had attended the camp.

The Eye Department of Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur. | Photo Credit:  Ismat Ara

With the infection, pseudomonas, being easily transmissible, the government hospitalopted to quickly discharge all the patients on December 2.

One woman, Gyanvati (65), whose eye was also infected during the operation, refused to even be admitted to the public hospital.

At least eight of the 18 patients have complained of severe pain in the eyes and head from the time the surgery was done on November 2. “We have been cheated in the name of the surgery,” said Ramesh Kashyap, speaking in Hindi. The patients were there alone, without attendants. Their children work as daily wage labourers and cannot afford to lose a day’s wages by accompanying their parents for treatment.

Ramesh Kashyap: “Without eyesight, we have become a burden on our families.” | Photo Credit:  Ismat Ara

Kashyap said, “Even in our old age, we work. We earn and spend money on a daily basis. On some days, there is not even salt at home. When there is salt, there is no oil. When there is oil, then there is no soap. Now, without eyesight, we have become a burden on our families.”

Case against doctor

On November 23, an FIR was registered against Dr Neeraj Gupta, who performed the surgery, and his associate Durgesh Shukla at Barra Police Station, and the hospital’s licence was suspended.

The two have been charged under Sections 338 (Causing grievous hurt by act endangering life or personal safety of others) and 419 (Punishment for cheating by personation) of the Indian Penal Code (IPC). After the FIR was filed, the victims were admitted to the public hospital.

Anand Pandey, the police officer investigating the case, said that the doctor and his associate were absconding. “We are in the process of collecting evidence,” he told Frontline.

How it began

The FIR states that Durgesh Shukla lured the patients in the name of a “free government eye camp”, even though permission had not been granted for it. The FIR also states that when they reached the hospital the patients were asked to pay Rs.1,500 each by Shukla.

The incident came to light after the Chief Medical Officer (CMO) of Kanpur, Alok Ranjan, was informed about the camp, and enquiries showed that it had been promoted falsely as a government camp.

Swift action followed. Said Alok Ranjan: “When the government holds such camps in partnership with private hospitals, it deputes representatives who are there to regulate the entire process. In this case, we were not informed.”

Since the incident, all eye camps in the district have been suspended. No arrests have been made so far. The CMO has formed a committee to investigate the matter. He said the doctor’s response submitted to the committee was unsatisfactory.

On October 31, an announcement was made in Sughardeva village in Kanpur about a free eye camp. It persuaded people with eye problems to attend the camp and avail the free surgery that was on offer.

“We don’t have any savings, so we have never been able to afford a private hospital for eye surgery. We had been trying to get treatment in the government hospital for years, but to no avail. So, when this free camp was announced, we thought it would put an end to the years of blurriness in our eyes,” said Munni Devi.

Munni Devi: “When this free camp was announced, we thought it would put an end to the years of blurriness.” | Photo Credit:  Ismat Ara

On November 2, the group from the village was taken to Aradhya Eye Hospital in a vehicle. On reaching there, they were asked to pay Rs.1,500 even though they had been told it was a free procedure.

Sher Singh told Frontline, “We were shocked when we were asked for money. But we thought that the operation is expensive, so we arranged for Rs.1,500 each and paid it.” The operation was performed and that same night, the patients were sent back to their village.

“Before the surgery, they did not even check our blood pressure or sugar levels. They completed the surgery in haste and sent us back immediately without any monitoring. Later, when we removed the bandage, we felt excruciating pain,” said Raja Ram. The patients started experiencing pain shortly after the procedure, and a day or two later when the pain did not subside they went back to the hospital.They were given some medicines and sent back. After this, Durgesh Shukla stopped taking phone calls from the villagers and they were left on their own.

‘Is it a crime to be poor?’

Back in the village, which is about an hour’s drive from the city, Gyanvati was sitting outside her house on a cot when Frontline visited her.

Her 17-year-old daughter, Preeti, was seated nearby. Gyanvati has four daughters and a 12-year-old son. Preeti does daily wage work along with her mother. Gyanvati said she might not be able to work anymore due to her eye infection, high fever, and severe pain. She said she refused to be admitted in any hospital because she was afraid of hospitals now. The burden of running the household will now fall on Preeti.

Gyanvati, whose eye was also infected after the operation, refuses to go back to any hospital now. | Photo Credit:  Ismat Ara

Ram Dulare, Sher Singh’s son, works as a labourer in the village. “I am unable to take care of my father because if I miss even a day’s work, everything will come to a halt. Is it a crime to be poor?” he asked.

Haripal Singh Chandel, the village head, points to a deeper problem. “It was a difficult task to raise this issue. It was only after I requested the local MP (Satyadev Pachauri of the BJP) to intervene that this case was taken seriously,” he said. According to Chandel, the patients were forced to opt for free surgery at a private hospital due to a lack of access to government facilities.

Ashok Mishra, former CMO of the Uttar Pradesh government, said that the government often had tie-ups with private hospitals under their “Blindness control programme” to encourage the private sector to participate in the initiatives. “When such an agreement is signed, the government pays the hospital a certain sum per case treated,” he said. In the country’s rural areas, most of the poorest citizens choose free procedures in mass eye camps. These initiatives are initiated and supported by a government initiative that was specifically created to lower India’s blindness rate.

Raja Ram: “Before the surgery, they did not even check our blood pressure or sugar levels.” | Photo Credit:  Ismat Ara

Under the circumstances, things can and do go horribly wrong and almost no one is held accountable. Said Mishra: “When such a camp is announced, people from rural areas are lured to participate in large numbers. They are offered free treatment and free food. Sometimes, even people who do not have any illness are admitted under the generalised weakness category.”

As far as UP is concerned, Mishra said the State had all the necessary assets and tools required to achieve its blindness control programme targets, from technicians and machines to surgeons, unlike several other similar programmes. However, Vikas Bajpai, author and professor at the Centre of Social Medicine and Community Health, JNU, pointed out that there was huge disparity in access to healthcare services between rural and urban areas in large States like UP.

“The poor need physically and economically accessible healthcare. Most times, in rural areas, the poor don’t see health as their first priority. Most of them work as daily wage workers, farmers, or labourers. They don’t recognise their conditions and delay treatment for years. In such a scenario, there needs to be a focus on awareness,” he said.

Bajpai believes that there are not enough regulations against exploitation by private hospitals in India. “The poor are often left at the mercy of private hospitals. And the motive of the private hospitals is only to earn profits,” he said.

While there are several sections in the IPC that deal with medical negligence, including Section 304A (Causing death by negligence), a vast majority of cases in India typically go unreported. For want of awareness and for want of resources.

The Crux

• At least eight of the 18 patients who underwent cataract surgery at a private medical camp in Kanpur have complained of severe pain in the eyes and head, while at least six stand to lose eyesight.
• On November 2, the group from the village was taken to Aradhya Eye Hospital in a vehicle.
• The patients were forced to opt for free surgery at a private hospital due to a lack of access to government facilities.
• On November 23, an FIR was registered against Dr Neeraj Gupta, who performed the surgery, and his associate Durgesh Shukla at Barra Police Station, and the hospital’s licence was suspended. 
• With the infection, pseudomonas, being easily transmissible, the government hospital opted to quickly discharge all the patients on December 2. 
• The patients are now under the care of doctors at a government hospital but will not let them operate again.