Eight infants die of pneumonia for want of ventilators

Children’s Hospital Lahore

EPI director says deaths due to infants’ late arrival

LAHORE: As if child mortalities due to diphtheria were not enough, at least eight infants have expired due to another vaccine-preventable disease — pneumonia — for lack of sufficient ventilators in the Children’s Hospital, Lahore, during the past 48 hours.

The negligence also remains the common factor in children’s deaths due to vaccine-preventable diseases of diphtheria and pneumonia as several children, suffering from diphtheria, lost their lives due to non-availability of Anti-Diphtheria Serum (ADS), while eight children, suffering from pneumonia, could not survive for inability to restore their breath owing to a shortage of ventilators in the hospital.

Eight child patients of pneumonia lost their lives due to shortage of ventilators in Room No214 of Medical Unit-II of Children’s Hospital, whereas three more child patients died of diphtheria, which raised the casualties to 11 in two days.

The deaths of young patients due to diphtheria alone have risen to 32 in two-and-a-half months in the biggest paediatric health facility in the province. Three child patients, who died due to diphtheria, included a nine-year-old, Furqan, from Lahore, eight-year-old Nimra, and 12-year-old Asia. There are 8 to 10 patients of diphtheria still admitted to the hospital.

Meanwhile, the children’s health facility has witnessed a sudden rise in cases of pneumonia due to the ongoing dry cold spell, which not only increased the load but also caused a shortage of facilities i.e. ventilators that led to death of at least eight child patients in two days.

It was learnt that there are 46 ventilators including 12 ventilators in cardiology ward and cardiac surgery operation theatres (six each), six in surgery ward, eight in miscellaneous wards and 15 ventilators are spared for pneumonia patients out of which seven ventilators were given to patients of paralysis, while the remaining five ventilators were installed in ICU ward. However, sources claimed, not more than 40 ventilators were in working condition, while the remaining were out of order.

According to official sources, more than 20 patients of pneumonia were being admitted to hospital, which also raised questions about coverage and efficacy of pneumococcal vaccine included in the routine immunization.

The gaps in the coverage of diphtheria vaccine has already taken its toll on child patients with 32 deaths in less than three months, which were identified as complete absence or missing of injectable-vaccine doses at specified time of 6th, 10th and 14th week of their birth to prevent against this disease. Similarly, although pneumococcal vaccine has been included in the Expanded Programme of Immunization (EPI) to fight against pneumococcal disease (including Pneumonia, Meningitis and Bacteria), there are gaps in the vaccination against the disease, which not only raised the number of patients but also led to casualties among the children with weak immunity against pneumonia. The pneumococcal vaccine is also given along diphtheria vaccine at 6th, 10th and 14th week of child’s birth.

The Medical Director of Children’s Hospital, Lahore, Prof Dr Ahsan Waheed Rathore, has, however, rejected exaggerated number of child mortalities due to pneumonia, claiming that only four deaths of child patients had occurred in the Medical Unit-II in the last 48 hours and two of them died just within the first hour of their arrival as they were critically sick patients. He said that a total of 54 ventilators were available in excellent working condition in the hospital, adding majority of patients needed assisted ventilation at the time of resuscitation and it is done by Ambu Bagging. “We have more than 150 Ambu bags,” he added.

He said the patients were coming from all over Punjab as in the last 24 hours alone, as many as 753 patients were brought in emergency ward out of which at least 370 patients were admitted to the hospital. He informed that Children’s Hospital had 23 specialties for children, saying that Children’s Hospital has scored 100 per cent in all 91 parameters during the recent inspection by the Punjab Healthcare Commission.

Punjab’s Director Expanded Program on Immunization (EPI) Dr. Munir Ahmad said that the deaths due to vaccine-preventable diseases can be controlled but not eliminated, adding the reason behind this unfortunate assertion was a lack of awareness among the people to bring their children to health facilities for treatment at the early stage of any signs or symptoms of different diseases. “Most of deaths among children occur because of arrival of patients in hospitals at terminal stage,” he added while giving an example that another 11 deaths of children had occurred due to diphtheria in Children’s Hospital despite provision of Anti-Diphtheria Serum since December 4, 2015.

He said all vaccines developed immunity among 85 per cent of all children even in developed world and 15 per cent children remain susceptible to succumbing to vaccine-preventable diseases. While in Pakistan, he said, more than 35 per cent children were malnourished, which further lowered chances of developing immunity despite vaccination against diseases. “On top of it, we are having a population explosion,” he said.

He, however, showed no intention to start an aggressive vaccination campaign against diphtheria in hospitals and health centres in affected districts, saying vaccination against diphtheria was already continuing in hospitals. Therefore, he advised parents of newborns to get their children three mandatory vaccinations against diphtheria in 6th, 10th and 14th week of their birth to prevent against this disease.