Deaths of people in Karuna trust run PHC – negligence, denial of care and fraud

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Image courtesy: Karuna trust

Doc signed death certificate indiscriminately: Report
Nandini Chandrashekar, Bangalore, Oct 15, DH News Service:
Deaths at Colony happened with generous help from medical staff
The death of the inmates at the Beggars’ Colony happened with generous help from their supposed saviours – the medical staff.

A Primary Health Centre (PHC) at Beggars Colony is being run by Karuna Trust under a PPP model with the Government. The doctor here, Dr Harimurthy has been in charge since August 2009.

During the inquiry, he escaped all scrutiny about his role in the deaths at the Colony and his explanation about the inmates’ problems not being bought to his notice was readily accepted.

The Health Centre is housed in one of the dormitories situated right in the midst of the other buildings housing the inmates. How did the authorities accept that explanation, when the overpowering stench of the place was enough to alarm anyone?

The doctor’s habit of readily signing death certificates attributing the cause to ‘natural causes’ in every case, also did not worry the authorities.

Now the inquiry report reveals that the doctor aged 50, completed his medical degree only at the age of 48 from Ambedkar Medical College and he has not furnished any certificate of his qualification.

During the time of the deaths, both Social Welfare Department and Health Department were silent about the role of the medical staff, although there was ample evidence at that juncture that the medicines stocks had expired and no register was maintained about any of the patients.

In short no medical attention was ever provided to any patient unless they were bought in by the warders, dead or otherwise. If dead, the staff were kind enough to issue a cursory death certificate.

Gross negligence

Now, the inquiry report speaks of gross negligence by the medical staff. Death certificates were signed by nurses and the pharmacist, no correlation could be found in the death records maintained by the PHC and the records maintained by the administration.

“The death report written by the doctor says that many have died due to anaemia and general weakness. Had the inmates been subjected to preliminary medical screening the doctor could have suggested proper medical care to the inmates and saved that many lives,” the report states.

Even when deaths were reported due to diarrhoea, there was no effort to send the food or water samples for testing.

According to Health Department officials, once a PPP is signed, the responsibility of hiring the staff and day to day running is the responsibility of the private partner and the Department does not involve itself, unless they receive complaints.

As of now, Karuna Trust runs 27 PHCs across the state and a total of 52 PHCs have been given over to private partners.

Report Card

Date of submission of report to the Chief Secretary:
September 23, 2010.

Reaction of the Social Welfare Department: “The Report is under consideration.”

Some recommendations of the report:

*Criminal and disciplinary action on all those responsible for illegal and wrongful confinement of beggars

*Segregation of sick and mentally ill inmates

*Bodies without identification to be disposed by burial and not through cremation.

*Detailed inquiry regarding unaccounted dead bodies to ascertain whether organs have been traded or dead bodies have been sold.

*Probe into cases where death certificates are issued but not recorded in the death register, with focus on identity of the deceased inmate. Set up Local Relief Committees for overseeing the centre

*Restrict the role of the Central Relief Committee to state level financial administration and acting as link to govt.

*Demarcate and fence lands to prevent encroachment.

*Fill all the vacancies of posts of warders and helpers and increase the number of sweepers and cleaners to maintain hygiene.

*Digital cameras to be placed in vans to prevent wrongful arrests. Establishment of grievance redressal mechanism at the Centre
Beggars’ death probe yet to reach CID
• Bageshree S.
• Afshan Yasmeen

The Hindu
Inmates of Nirashithara Parihara Kendra (Beggars’ Home) on Magadi Road, being taken to Isolation Hospital on Old Madras road for treatment, in Bangalore on August 19, 2010. Photo : K Murali Kumar

The death of 286 inmates of the Beggars’ Rehabilitation Centre over a period of eight months under mysterious circumstances, which came to light in August this year, may have shook the conscience of the city and compelled the Social Welfare Department to improve the physical conditions at the home.
But what is happening with the criminal investigation into the case is an altogether different story.
Though Social Welfare Minister A. Narayanaswamy had announced in October that the case will be handed over to Criminal Investigation Department (CID), the case is yet to reach them.
Director-General of Police (CID), D.V. Guruprasad, told The Hindu on Monday the case has not been handed over to them.
File with CM
According to sources, the file is still lying with the Chief Minister’s office. Political uncertainty since then seems to have pushed this important issue into insignificance.
Surprisingly, Mr. Narayanaswamy seemed unaware of this when contacted by The Hindu. He said the inquiry had been handed over but when told it was pending clearance, he said: “The decision was taken in the presence of all high authorities, including the Chief Minister. I will trace the file right away.”
Gross violations
The announcement of the CID inquiry was made following the report by S. Selvakumar, Project Administrator of Karnataka Health System Development and Reforms Project, in October. It revealed gross violations ranging from financial irregularities, inefficient administration, medical negligence and inhuman attitude of the staff.
This further corroborated what was revealed in newspaper reports in August: the heartless conditions in which the inmates lived, woeful lack of medical help with no more than one doctor available during day, and the flagrant manner in which all mandatory legal procedures and rules were thrown to the wind every step of the way.
No trace of bodies
The most shocking part of Mr. Selvakumar’s report was this: Not only did several deaths occur under unexplained circumstances, but several bodies simply disappeared. In this context, Mr. Selvakumar’s report points to the suspicion that, as part of a large racket, vital organs could have been extracted and sold illegally.
Mr. Selvakumar, who is also the Mission Director of National Rural Health Mission (NRHM), has recommended a detailed investigation into reports of illegal extraction and sale of organs from the dead beggars’ bodies.
The aftermath
Many heads rolled following the deaths, including that of the then Social Welfare Minister D. Sudhakar. Four officials directly involved with the maintenance of the home were suspended and the entire staff changed.
Cooking food at the centre was stopped and outsourced to ISKCON. More doctors were deputed to take care of the inmates. The number of inmates at the home today stands at 300, as against 1,000 in August.
Keywords: Beggars’ rehabilitation centre, Sudden deaths, Enquiry, CID probe

Proceedings against beggars’ home staff stayed
The Karnataka High Court on Friday ordered a stay on the criminal proceedings against four staff members of the Nirashritara Parihara Kendra (Beggars’ Home) on Magadi Road here with regard to the death of 286 inmates in 2010.
Hanumantarayappa, the then warden; Lakshminarasimhaiah, the then superintendent; Bhagyalakshmi, a staff worker; and S. Krishne Gowda, then secretary, filed a criminal petition challenging the proceedings against them before the 5t Additional Chief Metropolitan Magistrate by the police.
Vacation judge Anand Byrareddy passed the stay order and ordered issue of notices to the police and the government on the petition. The petitioners contended that they could not be blamed for the centre’s mismanagement and that their higher-ups should be held responsible.
Instead of investigating the management’s role, the police had been harassing the lower-level staff who were just carrying out their seniors’ directives, they said. IAS officer S. Selvakumar, who conducted an inquiry into the mass death of inmates, had found serious irregularities in the home and had recommended a CID probe.
Keywords: Karnataka High Court

Scores flee beggars’ home after 22 deaths in three days
Last updated: 20 August, 2010
Bangalore, Aug 20, (IANS):
A number of inmates of the government-run Destitute Rehabilitation Centre on the city’s outskirts fled the place Friday following the death of 22 inmates in the last three days, an official said.

“A large number of inmates made use of the opportunity provided when the centre’s officials were busy seeing off ministers, who visited the camp Friday. They fled from the camp,” the official said.

It was reported Wednesday that 12 inmates of the centre, also known as Beggars’ Colony on Magadi Road in west Bangalore, had died. Eight more deaths were reported Thursday and two Friday.

The cause of these deaths is yet to be ascertained and a probe has been ordered. Home Minister V.S. Acharya, who visited the place along with three cabinet colleagues Friday, however, told reporters that the 22 had died of ‘natural causes’.

He was accompanied by Minister for Water Resources Basavaraj Bommai, Minister for Law S. Suresh Kumar and Minister for Social Welfare D. Sudhakar.

Acharya, a medical physician, said doctors “have certified all the deaths as natural.

However, I have asked the commissioner of the social welfare department to submit a report by Saturday on the causes that led to these deaths”.

The camp was set up decades back to house and provide skills training to people found begging. It was part of the government’s efforts to end beggary.

Though the place is meant to house about 900 people, it has more than 2,500 people living there, leading to complaints of unhygienic conditions.

Acharya said a panel will be set up to suggest improvements at the centre as majority of the inmates were suffering from chronic diseases. Several terminally-ill patients were also in the centre, he said.

Sudhakar, whose ministry oversees the centre’s running, Friday rejected demands of the opposition Congress and Janata Dal-Secular for his resignation for the large number of deaths in the camp in three days.
Criminal Case Against Beggars’ Home Officials
Criminal case against beggars’ home officials
HM Chaithanya Swamy, DNA | Oct 30, 2010, 05:10AM IST
Bangalore: The Karnataka government has directed the police to register criminal cases against four officials of the Beggars Relief Centre in the city in the wake of a spate of death of inmates due to their alleged negligence, minister for social welfare A Narayanaswamy said on Friday.
Joint director Krishnegowda, Lakshminarasimhaiah (superintendent), Bhagyalakshmi (warden) and Hanumantharayappa (chief warden) would face criminal charges under various sections of the IPC, he said. The officials have been placed under suspension.
The centre officials, however, held the medical officer Dr Hari Murthy  of Karuna trust responsible for the deaths and claimed that they had repeatedly lodged complaints against him with the authorities.
Hanumatharayappa claimed that he had complained against the Karuna Trust-appointed doctor to the authorities several times in writing, but no action was taken. He had also mentioned about deaths missing from the centre’s records.
A report submitted to the government by S Selvakumar, director of the National Rural Health Mission has recommended a detailed enquiry into the deaths. The report said the inmates had died due to the negligence of the medical staff and centre’s administration.
Itt also noted that all deaths were not entered in the centre’s records, raising doubts of the involvement of a human organs racket.
About 20 beggars died within three days in the centre in August.



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