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印度公立医院大量患儿集中死亡是天灾还是人祸?
2017-09-05 09:25:44 中国经济网
【环球时报驻印度特约记者 程心】印度北方邦戈勒克布尔县巴巴·拉加夫·达斯医院(以下简称BRD医院)继8月中旬爆出“断氧门”后,8月28日到30日又发生72小时内63名儿童死亡事件。大量患儿在短时间内集中死亡,是天灾还是人祸?在警方尚未得出调查结果之际,印度舆论界已开始进行反思。
据戈勒克布尔县警方透露,8月以来,BRD医院收治约1200名儿童,其中386人死亡,死亡率超过30%。这一比例已超过脑炎儿童平均20%的死亡率,令院方此前的“死亡儿童多系脑炎及新生儿疾病”说法备受质疑。在最新的儿童死亡案中,该院新院长辛格还坚称死亡患儿死于脑炎、早产及其他病症。尽管他一直否认院方存在玩忽职守的过错,但却不得不承认在忙碌的八九月间,医院从人手到设备都已捉襟见肘。据《印度斯坦时报》8月29日报道,虽然BRD医院的新生儿病房和儿童病房是当地公立医院中最好的,但医护与患者的数量比例高达1∶30,很多家长及亲属不得不亲自上阵陪护患儿,这严重违反了传染病救治规程。
BRD医院还能拿“地处穷困地区”作挡箭牌,可事实上,印度大城市的公立医院状况也强不到哪儿去。《环球时报》特约记者曾多次前往位于新德里市中心的全印医学院及其附属医院采访,发现那里的就医环境十分糟糕。在新德里当司机的拉库尔曾对记者说,他的母亲车祸重伤,凑钱也要到私立医院去救命,因为公立医院无论从问诊效率还是医疗水准都没有保障。据了解,目前印度医疗条件较好的私立医院绝大多数集中在大城市,而公立医院和诊所则广泛分布于中小城市及农村。尽管印度每年在公共医疗上投入约5000亿卢比(约合510亿元人民币)的医疗经费,但这还不到印度国民生产总值的2%,远低于国际平均水平的5.4%。这一现实决定着城市及中产以上阶层可享受与国际医疗水平接轨的诊疗服务,而约有9亿印度中下层人士则基本上只能依赖国家财政支撑的公共医疗体系。
在世界卫生组织驻印度办事处工作的哈希娜告诉《环球时报》特约记者,政府投入不足及过分依赖私立医疗机构是印度医疗事故频发的重要原因。印度新德里妇女与儿童保障协会理事贾尔吉也分析称,印度公共医疗支出不足与蓬勃兴起的私立医疗体系间不但未进行有效互补,反而不断出现互相拆台局面。例如,在BRD医院“断氧门”事件中,不排除有医院内部人员长期借助医院外包机构谋私利,最终导致院方债台高筑“被断氧”。据称,这种将相关职能机构外包的做法在印度公立医院相当普遍,这也致使公立医院“免费医疗”的承诺成为一个幌子。在诊疗环境及水准上,贾尔吉认为,在利益驱动下,优势医疗资源已严重流向私立医疗机构。“谁也不愿意每天被上百个患者围着喘不过气,多数医学专科毕业的学生在公立医院待不了两年就会被挖走”,贾尔吉无奈地表示,“很多私立医院的医生都有欧美留学背景,他们在全世界给印度医疗创造品牌与价值,可惜这些与广大印度底层民众没有关系”。
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