'I would do the same today to save children'

IN August last year, Gorakhpur in eastern Uttar Pradesh, considered the pocket borough of Chief Minister Yogi Adityanath, was in the news for the death of over 30 children within 48 hours between August 10 and 12 at the Baba Raghav Das Medical College there, allegedly because of acute shortage of oxygen cylinders for patients at the hospital. They had been admitted to the hospital with Japanese encephalitis. Incidentally, the hospital is the sole medical college in the region and serves around two crore people from eastern Uttar Pradesh, Bihar, West Bengal and Assam.

Dr Kafeel Khan, the nodal officer for the Department of Paediatrics at the hospital, was on leave when the incident occurred. He cancelled his leave so that he could help the children in distress. When the hospital ran out of oxygen cylinders, Dr Khan, along with junior doctors and nurses, called the Border Security Force for a truck and arranged for refill cylinders from a private vendor. His quick response helped limit the casualties, and he was hailed by a section of the media as a hero whose dedication saved many a life. “For 48 hours we worked with the available staff without break to save precious lives, and give comfort to grieving parents,” Dr Khan recalled.

All this changed after the Chief Minister visited the hospital and set up a committee to fix accountability for the tragedy. From being a hero, Dr Khan suddenly became an accused. An initial inquiry pronounced him guilty even as the State Health Minister, Siddharth Nath Singh, said: “After the first level of investigation, we can say deaths did not take place due to disruption in oxygen supply.”

Recalling the incident, Dr Khan, who spent eight months in jail before being released on bail on April 25, said: “Children were dying almost every hour. The parents knew that oxygen supply to the hospital was disrupted. We could not hide the facts. There were over 1,000 angry parents ready to attack us.”

Just as his fate had turned for the worse on September 2 when he was arrested in Lucknow, it took a dramatic turn again on his release from jail: hundreds of parents turned up to receive him and thank him for saving their children's lives.

Though eight months in prison had been a tough time for him, Dr Khan is not ready to throw in the towel and has pledged to work in the same college and in the encephalitis wing, if given an opportunity.

If a similar situation arose today, he said, he would not take a step backwards. “I am willing to step up if a similar situation arises. I am willing to stay back and help. Just as I did last year,” he told Frontline on a visit to New Delhi. Excerpts from the interview:

When you were released from jail recently, you got a hero’s welcome. There have been reports of hundreds of people, including your patients, coming over to receive you. How did it all happen considering that just a few days earlier you were an accused?

When I was in jail, no one came to see me except my family members and a few friends. When I was released, hundreds of people came with placards carrying my name. Some expressed joy at my release. Some came to say thanks. It was a stampede-like situation. I did not know that so many people were waiting for me. Everybody wanted to shake hands, hug and embrace me. When I came out, I realised there was a social media campaign going on too for my release.

After my release, people have been calling me from all places, from the United States, the United Kingdom, the United Arab Emirates, etc. People have invited me from Kerala and Bangalore to settle down there. It has been overwhelming. Also, so many doctors called me from Lucknow. They identify themselves with me. They realise it can happen to anybody. Whatever I was doing was in the line of my oath as a doctor.

But life inside jail must have been difficult. How did you cope?

It was difficult for me. I was with some hardcore criminals. It was really difficult to be away from my family. My daughter was only nine months old when I was arrested. When I came out, she failed to recognise me. My wife suffered; she had to run the family and the hospital. My brother had to stop his business as he had to run from Lucknow to Allahabad, to Gorakhpur to Delhi, to meet people for my release. He was meeting lawyers and others almost every day. So, it was not about me alone. The family suffered more.

As for me, I had to share a bathroom with 150 others. The conditions in the jail were dirty, unhygienic, inhuman. We had to sleep on the floor. There were days when I could not meet my family. They used to threaten me. There came a time when I thought I won’t be released for a long time, maybe years. That is when I read the Quran and some self-help books.

Did some NGOs come to your rescue? Or did Muslim bodies like Jamiat Ulema-e-Hind or Jamaat-e-Islami approach you?

No, they never came to the jail. No one came. They may have contacted my brother, though I do not think they did. At times, it felt like it was my own battle though obviously it was not just mine. There were other doctors too.

Amidst all the attention around you, the focus shifted from Japanese encephalitis, the original cause of the tragedy. How big a danger is it in Gorakhpur?

It is a disease that spreads through the mosquito of the culex variety. The mosquito bites more during daytime. [With an infection caused by] the mosquito bites, children, and even adults, lose sense. That is why it is called encephalitis, which means swelling of the brain.

The disease was first reported in Japan in 1971. After more than two decades, it was brought under control there. In our country, today it is prevalent in eastern Uttar Pradesh, Bihar and parts of Bengal and Assam.

State of PHCsThe disease has made periodic headlines, but we are still some distance from controlling it. Is it because of a paucity of resources?

Around 25,000 people have died because of the disease [since 1978]. The official statistics take into count only those who die. But it is worse for those who survive. For them, life becomes a challenge. They become completely dependent. They cannot stand on their own. They cannot even feed themselves. They have to be fed through a drip.

The government is trying. The funds are available. Still the disease continues to take lives. One cannot say it accurately, but maybe the patients are not being given enough dosage of medicine, or they are skipping medicines. A lot of focus is on the treatment of the disease, and not as much on prevention. Not enough is done. With Japanese encephalitis, it is prevention that matters a lot.

With the onset of this disease, the role of our primary health centres becomes critical. Unfortunately, at times, the primary health centres are not able to come up to the mark. They are ill-equipped and understaffed. You will find an entire centre running on one doctor. For seven days a week, he has to work. There will be only one nurse, one pharmacist. Under the circumstances, the primary health centres are not able to play their role. More so in a disease like Japanese encephalitis. It spreads very fast. On the first day the patients report fever, on the third day they have seizures, on the fifth day many die. That is why one has to act fast, and there the role of the primary health centres becomes crucial in saving lives.

Is superstition also at play here?

Most people are ignorant. They often go to quacks first, and by the time they come to qualified practitioners, it is too late. In rural areas, they call this disease noka bimari . Having said that, I must clarify that out of all cases, only 10-15 per cent are of Japanese encephalitis.

It is also said that the disease strikes Dalits more often than other segments of the population.

Well, if the water is contaminated, one can get the disease. Sometime in 2016, a theory was floated that the disease spreads through mice and rat bite. Each monsoon, rodents bite children sleeping in the open.

But still, what does it have to do with Dalits?

It is a disease of the poor. The mosquito won’t differentiate between the rich and poor, Hindu or Muslim. But if you look at the statistics, in 10,000 cases, 9,990 cases are of poor families. And as many Dalits are poor, they often contract the disease more than, say, a person who is well off and is able to maintain a certain level of protection. Again, I repeat, the disease does not strike a caste or a religion. It strikes the poor more often than others. Hygiene, education, awareness, sanitation, everything, play a role.

Any signs of improvement in the encephalitis ward after you were released on bail?

After my release, I have not visited the college. But from media reports, I got to know that the government has given a lot of funds. Once they put me and others behind bars, they gave a lot of money, it seems.

Talking of life behind bars, how did you become a villain? More so, after you were hailed as a hero for weeks on end. Did you face any persecution in jail?

The first part, Yogi ji can answer. All I would say is the culprits who failed to pay for the oxygen cylinders were saved while nine of us were made scapegoats. Having said that, inside the jail things were the same for all of us. There was no communal feeling among prisoners. In the jail, even though there were hardcore criminals staying with me and I took time to open up to them, they supported me. If I skipped dinner on a particular day, they would insist that I must eat a fruit, maybe an apple or a banana. There was a prisoner who was serving 10 years in jail. I told him once that he should lead a simple life, do good deeds, after his release from jail. He shot back: “What is the difference? You did good deeds and ended up in jail. I did bad deeds, and ended up in jail.” That shook me.

What does the future hold for you?

If they revoke my suspension, I am willing to work in that college. Otherwise, I will start my own hospital in Gorakhpur. We plan to have a corporate hospital, funded by big businesses. But it will be for the poor. We will fight the encephalitis menace together. I am not running away. I am not leaving Gorakhpur. And today I can say that whatever I did in August last year, I would do the same to save children. I have no regrets. Humanity is over and above the divisions of caste or religion. My resolve is not shaken.