We have read with alarm the unfolding events at the Baba Raghav Das Medical College (BRD) in Gorakhpur, Uttar Pradesh, India, where the media has reported more than 70 children have died since August 7th, with lack of oxygen a contributing factor in many of the deaths.
While we await the findings of the various investigations that are underway, this tragedy underscores the vital role that access to oxygen plays in health facilities, especially those serving the needs of sick and vulnerable children.
Unfortunately, access to oxygen has been a neglected health issue for decades and many low and middle income countries are struggling to provide a safe, reliable source of oxygen in health facilities, especially those serving the poor. This is one of the factors sustaining the high death rates, especially in NICUs, pediatric, and maternity wards, in so many low and middle income countries.
Now that the World Health Organisation* has listed oxygen as an essential medicine for children, we expect member states to identify oxygen access gaps in their health facilities and introduce plans to close them.
This is exactly what the Government of Ethiopia is doing with its landmark, National Medical Oxygen and Pulse Oximetry Scale-Up Road Map, which aims to increase the availability of pulse oximetry screening and oxygen therapy in health facilities across the country; to train local staff in the use of new technologies; to establish sustainable financing solutions for the procurement, installation, and maintenance of new equipment; and to ensure that pulse oximetry and oxygen access is prioritized in the policies and guidelines at all levels of government and in government health facilities.
The United4Oxygen Alliance** — a coalition of companies, nonprofit organizations, foundations, UN and government agencies —is proud to be supporting the implementation of Ethiopia’s Road Map.
We encourage the Government of India and the Government of Uttar Pradesh to consider adopting the Ethiopian model to identify and close oxygen access gaps in major public health facilities like the BRD Hospital, and to prioritize oxygen access as part of national health plans, especially India’s Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCH+A) Strategy and the Newborn Action Plan. Our United4Oxygen partners stand ready to support these efforts.
By closing oxygen access gaps, India can make progress not only on reducing maternal, newborn and child deaths, but also deaths from communicable and non-communicable diseases and road traffic accidents, all required by the Sustainable Development Goals.
We look forward to the public release of the results of the government investigations so that we can learn lessons, especially the role that lack of oxygen played in the deaths of the children and how to prevent such a tragedy from occurring again – in India and in other countries.
Above all, we extend our heartfelt condolences to the parents, siblings and extended families of the 70 children who have died. We read with alarm the comments of parents who were asked to manually operate oxygen bags in a desperate attempt to keep their children alive. No parent should ever be put in this situation and no child anywhere in the world today should die for lack of oxygen.
*In June 2017, the World Health Organization (WHO) listed oxygen as an essential medicine for the management of hypoxemia, or dangerously low levels of oxygen in the blood, on the Model List of Essential Medicines (EML) and List of Essential Medicines for Children (EMLc).
**The United4Oxygen Alliance is a 2016 Clinton Global Initiative commitment.