India Lags Sub-Saharan Africa in Public Hygiene

[Riaz Haq]

India's rivers have been turned into open sewers by 638 million Indians without access to toilets, according to rural development minister Jairam Ramesh. He was reacting a UNICEF report that says Indians make up 58% of the world population which still practices open defection, and the sense of public hygiene in India is the worst in South Asia and the world.



India(638m) is followed by Indonesia (58m), China (50m), Ethiopia (49m), Pakistan (48m), Nigeria (33m) and Sudan (17m). In terms of percentage of each country's population resorting to the unhygienic practice, Ethiopia tops the list with 60%, followed by India 54%, Nepal 50%, Pakistan 28%, Indonesia 26%, and China 4%.

18 percent of urban India still defecates in open while the percentage of rural India is as high as 69 percent of the population. It is the key reason why India carries among the highest infectious disease burdens in the world.

The number of open defecators in rural India alone is more than twice those in the whole of sub-Saharan Africa, according to a report by DFID, the UK's Department for International Development.

The World Bank has estimated that open defecation costs India $54 billion per year or $48 per head. This is more than the Government of India’s entire budget for health.

The UNICEF report says that with only four more years to go until 2015, a major leap in efforts and investments in sanitation is needed to reach the targets of Millennium Development Goals.

After the embarrassing headlines, it appears that Minister Ramesh is ready to step up the efforts to improve sanitation. He is quoted by Times of India as saying that "we are going to focus now on `nirmal gram abhiyan' -- today 25,000 nirmal grams are a tiny fraction of 6 lakh villages. These nirmal grams are in Maharashtra and Haryana. Maharashtra is a success of social movements while Haryana an example of determined state government action."

Here's a video clip of Indian environment minister Jairam Ramesh saying "if there was a Nobel Prize for dirt and filth, India would win it hands down":



Related Links:

Haq's Musings

Fixing Sanitation Crisis in India

Food, Clothing and Shelter in India and Pakistan

Heavy Disease Burdens in South Asia

Peepli Live Destroys Indian Myths

India After 63 Years of Independence

Poverty Across India 2011

India and Pakistan Contrasted

[Riaz Haq]

#India's Sun Pharmaceutical’s factory in #Gujarat gets #FDA warning for quality issues. #Pharma http://on.wsj.com/1OevB6S via @WSJ

Sun Pharmaceutical Industries Ltd., India’s largest drugmaker by sales, said Saturday that one of its factories is under increased scrutiny from U.S. regulators.

The generic-drug maker’s factory in Halol, in the western Indian state of Gujarat, received a warning letter from the U.S. Food and Drug Administration. Warning letters are issued when the FDA isn't satisfied with a drugmaker’s plan to fix quality issues spotted by the regulator.

This is the latest setback for India’s pharmaceutical companies, which have struggled with quality issues under the increased scrutiny from the FDA. Indian companies account for around 40% of generic drug sales in the U.S.

U.S. inspectors in September last year said they were concerned with how Sun Pharma workers at its plant handled quality-test data and the plant’s “sterile environment,” said Dilip Shanghvi, Sun Pharma’s managing director.

If Sun Pharma is unable to assure the FDA that it can fix the problems, the regulator will issue an import alert, barring that factory from producing medicines for the U.S.

Sun Pharma makes some of its most profitable products at the Halol factory, including pre-filled syringes that need to manufactured in a sterile environment.

The Halol factory is continuing to produce drugs as it tries to fix quality issues, better train its staff and automate more of the manufacturing process, Mr. Shanghvi said.

The company has already moved production of some of the drugs produced at Halol to mitigate any impact on sales should the Halol plant be unable to export to the U.S., he said.

[Riaz Haq]

V.S. Naipaul understood the culture of open defecation when he said #Indians defecate everywhere http://go.shr.lc/24F1XDl via @riceinstitute

I recently picked up V.S. Naipaul’s book An Area of Darkness, a chronicle of his first trip to India published in 1964. Although some view the book as overly pessimistic and scathing, his portrayal of India’s culture of open defecation is uncannily accurate.
Shankaracharya Hill, overlooking the Dal Lake, is one of the beauty spots of Srinagar. It has to be climbed with care, for large areas of its lower slopes are used as latrines by Indian tourists. If you surprise a group of three women, companionably defecating, they will giggle: the shame is yours, for exposing yourself to such a scene.
In Madras the bus station near the High Court is one of the more popular latrines. The traveller arrives; to pass the time he raises his dhoti, defecates in the gutter. The bus arrives; he boards it; the woman sweeper cleans up after him.
—
In Goa, you might think of taking an early morning walk along the balustrade avenue that runs beside the Mandovi River. Six feet below, on the water’s edge, and as far as you can see, there is a line, like a wavering tidewrack, of squatters. For the people of Goa, as for those of Imperial Rome, defecating is a social activity; they squat close to one another; they chatter. When they are done they advance, trousers still down, backsides bare, into the water to wash themselves.
—
Indians defecate everywhere. They defecate, mostly, beside the railway tracks. But they also defecate on the beaches; they defecate on the hills; they defecate on the river banks; they defecate on the streets; they never look for cover.
—
A handsome young Muslim boy, a student at a laughable institute of education in an Uttar Pradesh weaving town, elegantly dressed in the style of Mr. Nehru, even down to the buttonhole, had another explanation. Indians were a poetic people, he said. He himself always sought the open because he was a poet, a lover of Nature, which was the matter of his Urdu verses; and nothing was as poetic as squatting on a river bank at dawn.
He eloquently describes in these vignettes what we have found 50 years later in the SQUAT and Switching Studies: that defecating in the open is the social norm. It is considered to be a part of the wholesome, rural life, in which one takes a walk outside in nature, socializes with friends, and avoids polluting oneself and one’s home.

[Riaz Haq]

A deadly epidemic that could have global implications is quietly sweeping India, and among its many victims are tens of thousands of newborns dying because once-miraculous cures no longer work.

These infants are born with bacterial infections that are resistant to most known antibiotics, and more than 58,000 died last year as a result, a recent study found. While that is still a fraction of the nearly 800,000 newborns who die annually in India, Indian pediatricians say that the rising toll of resistant infections could soon swamp efforts to improve India’s abysmal infant death rate. Nearly a third of the world’s newborn deaths occur in India.

“Reducing newborn deaths in India is one of the most important public health priorities in the world, and this will require treating an increasing number of neonates who have sepsis and pneumonia,” said Dr. Vinod Paul, chief of pediatrics at the All India Institute of Medical Sciences and the leader of the study. “But if resistant infections keep growing, that progress could slow, stop or even reverse itself. And that would be a disaster for not only India but the entire world.”

In visits to neonatal intensive care wards in five Indian states, doctors reported being overwhelmed by such cases.

“Five years ago, we almost never saw these kinds of infections,” said Dr. Neelam Kler, chairwoman of the department of neonatology at New Delhi’s Sir Ganga Ram Hospital, one of India’s most prestigious private hospitals. “Now, close to 100 percent of the babies referred to us have multidrug resistant infections. It’s scary.”

These babies are part of a disquieting outbreak. A growing chorus of researchers say the evidence is now overwhelming that a significant share of the bacteria present in India — in its water, sewage, animals, soil and even its mothers — are immune to nearly all antibiotics.

Newborns are particularly vulnerable because their immune systems are fragile, leaving little time for doctors to find a drug that works. But everyone is at risk. Uppalapu Shrinivas, one of India’s most famous musicians, died Sept. 19 at age 45 because of an infection that doctors could not cure.

While far from alone in creating antibiotic resistance, India’s resistant infections have already begun to migrate elsewhere.

“India’s dreadful sanitation, uncontrolled use of antibiotics and overcrowding coupled with a complete lack of monitoring the problem has created a tsunami of antibiotic resistance that is reaching just about every country in the world,” said Dr. Timothy R. Walsh, a professor of microbiology at Cardiff University.

Indeed, researchers have already found “superbugs” carrying a genetic code first identified in India — NDM1 (or New Delhi metallo-beta lactamase 1) —around the world, including in France, Japan, Oman and the United States.

Anju Thakur’s daughter, born prematurely a year ago, was one of the epidemic’s victims in Amravati, a city in central India. Doctors assured Ms. Thakur that her daughter, despite weighing just four pounds, would be fine. Her husband gave sweets to neighbors in celebration.

Three days later, Ms. Thakur knew something was wrong. Her daughter’s stomach swelled, her limbs stiffened and her skin thickened — classic signs of a blood infection. As a precaution, doctors had given the baby two powerful antibiotics soon after birth. Doctors switched to other antibiotics and switched again. Nothing worked. Ms. Thakur gave a puja, or prayer, to the goddess Durga, but the baby’s condition worsened. She died, just seven days old.

“We tried everything we could,” said Dr. Swapnil Talvekar, the pediatrician who treated her. Ms. Thakur was inconsolable. “I never thought I’d stop crying,” she said.

A test later revealed that the infection was immune to almost every antibiotic. The child’s rapid death meant the bacteria probably came from her mother, doctors said.

http://www.nytimes.com/2014/12/04/world/asia/superbugs-kill-indias-...

[Riaz Haq]

The cultural politics of shit: class, gender and public space in India

Full text HTML
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DOI:10.1080/13688790.2015.1065714
Assa Doron & Ira Raja
pages 189-207

In this article we seek to interrogate the cultural, political and economic conditions that generate the crisis of sanitation in India, with its severe implications for the poor and the marginalized. The key question we ask is how to interpret and explain the spectre of ‘open defecation’ in India's countryside and its booming urban centres. The discussion is divided into three parts. Part one examines the cultural interpretation of ‘shitting’ as symbolic action underpinned by ideas of purity, pollution and ‘the body politic’. Part two takes the political economic approach to gain further insights into contemporary discourse, performance and cultural politics surrounding toilets and open defecation in India. Part three examines civil society activities, state campaigns and media accounts of open defecation to explore the disruptive potency of everyday toilet activities, and how these interplay with issues of class, caste, and gender. Drawing on interviews and a review of ethnographic work, we seek to interrogate the idiom of modern sanitation, with its emphasis on cleanliness, progress and dreams of technology, as a constitutive idea and an explanatory force in Indian modernity.

http://www.tandfonline.com/doi/full/10.1080/13688790.2015.1065714

[Riaz Haq]

How bad are most of #India's medical schools? Very, according to new reports. #highereducation #health #MEDICINE

https://www.washingtonpost.com/news/worldviews/wp/2016/04/21/how-ba...

In a country with the world's heaviest health burden, and highest rates of death from treatable diseases like diarrhea, tuberculosis and pneumonia, corruption at medical schools is an extremely pressing issue. The Indian Medical Association estimates that nearly half of those practicing medicine in the country do not have any formal training, but that many of those who claim to be qualified may actually not be.


a couple of recent studies and reports have cast serious doubts on the quality and ethics of the country's vast medical schooling system. The most recent revealed that more than half of those 579 didn't produce a single peer-reviewed research paper in over a decade (2005-2014), and that almost half of all papers were attributed to just 25 of those institutions.


The 2011 court case against a man, Balwant Arora, was one of the earlier indications of the massive levels of fraud. Arora brazenly admitted to issuing more than 50,000 fake medical degrees at around $100 apiece from his home, saying that each of the recipients had "some medical experience" and that he was doing it in service to a country that desperately needs more doctors. He had served four months in jail in 2010 for similar offences.

Private medical colleges have proliferated rapidly in India. When in 1980 there were around 100 public colleges and 11 private, the latter now outnumber the former by 215 to 183. Most are run by businessmen with no medical experience. Last January, the British Medical Journal found that many private medical colleges charged "capitation" fees, which are essentially compulsory donations required for admission. Jeetha D'Silva, who authored that report, wrote, "Except for a few who get into premier institutions of their choice purely on merit, many students face Hobson's choice — either pay capitation to secure admission at a college or give up on the dream of a medical degree."

The best public medical colleges have acceptance rates that are minuscule, even compared to Ivy League universities. Those colleges also tend to be the ones that produce the most research papers, as well as handle the most patients, which would seem to eliminate the possible excuse that overwhelming patient burdens prevent private colleges from producing valuable research.

The most productive medical college in India is also its largest public health institution, the All India Institute of Medical Sciences, or AIIMS. In the 10-year period that Samiran Nundy and his colleagues examined, AIIMS published 11,300 research papers. For context, that is about a quarter of what Massachusetts General Hospital produced in the same time frame.

[Riaz Haq]

Lack of toilets contributing to rise of #rape in #India – University of Michigan Study. , #opendefecation http://www.rt.com/news/370425-india-toilets-women-rape/#.WFTPBWX7tQ... …

Women in India who don’t have adequate access to sanitation facilities and are forced to openly defecate are more likely to experience sexual violence, according to a new study.
Approva Jadhav, a researcher from the University of Michigan, said that “open defecation places women at uniquely higher risk of type of sexual violence: non-partner” in the co-authored report.

In their findings, researchers said it was twice as likely for women without access to “household toilets” to face sexual violence than women who do have such access, suggesting that improvement of infrastructure and access to toilets would provide a safer environment for women.

“Women who use open defecation sites such as open fields or the side of a railway track are twice as likely to get raped when compared with women using a home toilet,” the study stated.

“Our findings provide further rationale for NGO’s and the Indian government to expand sanitation programs, and raise new questions about the potentially protective role of sanitation facilities in other contexts beyond India,” the research found.

Almost half of India’s population do not have access to basic sanitation and have to defecate in public and women appear to be affected the most.

“This is an urgent need that cannot be ignored anymore,” Ms Jadhav, lead author of the report, told NDTV. “We need more than anecdotes to bring a policy change.”


By analyzing data from the Indian National Family Health Survey along with an overall representative sample of 75,000 women who answered questions on accessibility to toilets in their homes and experiences of various types of violence, the researchers found that previous sanitation studies did not examine the synonymous link between the two.

The issue of India’s sanitation crisis being linked to sexual violence came to light in 2014 when two teenage girls were raped and hanged in Uttar Pradesh while they were making their way to fields to defecate.

In the slums of Delhi, where communities often have to share public toilets, girls under the age of 10 have been found to be at risk of “being raped while on their way to use a public toilet,” according to a BBC report, which also states that around 300 million women and girls in the country defecate in the open.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100257/

[Riaz Haq]

#American woman US dies from antibiotic resistant superbug after #surgery in #India #MedicalTourism

http://www.mirror.co.uk/news/world-news/woman-who-returned-surgery-...


An American woman who travelled to India died after contracting a superbug resistant to all forms of antibiotic, doctors have said.

The victim, aged in her 70s, died in Nevada after medics in the US were unable to find any drug that could treat her.


A report into the incident says it is believed she contracted the superbug NDM-1.

"The patient developed septic shock and died in early September," it read.

"During the two years preceding this US hospitalization, the patient had multiple hospitalizations in India related to a right femur fracture and subsequent osteomyelitis of the right femur and hip; the most recent hospitalization in India had been in June 2016,"

The lethal bug NDM-1 first came to the attention of doctors in Britain around 2010.

Scientists writing in the journal Lancet Infectious Diseases said there had been 37 cases in the UK of a bug resistant to all antibiotics.

All patients had travelled from Asia after cosmetic surgery, cancer treatment and transplants.

New Delhi-Metallo-1 (NDM-1) also has an "alarming potential to spread and diversify."

Experts said there are currently no drugs in development to counter NDM-1 meaning it was likely to spread.

Randall Todd of the Washoe County, Nevada health department, said: "We have a shrinking world.

"Hospitals should be reminded that they have got to take a travel history and be open to the possibility that an uncommon infection might be responsible."

[Riaz Haq]

Reflections on India  by  Sean Paul Kelley   Sean Paul Kelley is a travel writer, former radio host, and before that, an asset manager for a Wall Street investment bank that is still (barely) alive. He recently left a fantastic job in Singapore working for Solar Winds, a software company based out of Austin, to travelaround the world for a year or two. He founded The Agonist, in 2002, which is still considered the top international affairs, culture and news destination for progressives. He is also the Global Correspondent for The Young Turks, on satellite radio and Air America.     If you are Indian, or of Indian descent, I must preface this post with a clear warning: you are not going to like what I have to say. My criticisms may be very hard to stomach. But consider them as the hard words and loving advice of a good friend. Someone who is being honest with you and wants nothing from you.   These criticisms apply to all of India except Kerala and the places I didn’t visit, except that I have a feeling it applies to all of India.    Lastly, before anyone accuses me of Western Cultural Imperialism, let me say this: if this is what India and Indians want, then, who am I to tell them differently.   Take what you like and leave the rest.   In the end it doesn’t really matter, as I get the sense that Indians, at least many upper class Indians, don’t seem to care and the lower classes just don’t know any better, what with Indian culture being so intense and pervasive on the sub-continent.    But, here goes, nonetheless.   India is a mess. It’s that simple, but it’s also quite complicated.   I’ll start with what I think are Indias’ four major problems – the four most preventing India from becoming a developing nation – and then move to some of the ancillary ones.     First:  Pollution.   In my opinion the filth, squalor and all around pollution, indicates a marked lack of respect for India by Indians.  I don’t know how cultural the filth is, but it’s really beyond anything I have ever   encountered.  At times the smells, trash, refuse and excrement are like a garbage dump.    Right next door to the Taj Mahal was a pile of trash that smelled so bad, was so foul as to almost ruin the entire Taj experience. Delhi, Bangalore and Chennai to a lesser degree, were so very polluted as to make me physically ill.  Sinus infections, ear infection, bowels churning was an all too common experience in India. Dung, be it goat, cow or human fecal matter, was common on the streets.  In major tourist areas filth was everywhere, littering the sidewalks, the roadways, you name it.    Toilets in the middle of the road, men urinating and defecating anywhere, in broad daylight.    Whole villages are plastic bag wastelands.   Roadsides are choked by it.   Air quality that can hardly be called quality.   Far too much coal and far to few unleaded vehicles on the road.    The measure should be how dangerous the air is for ones’ health, not how good it is.    People casually throw trash in the streets, on the roads.   The only two cities that could be considered sanitary, in my journey, were Trivandrum – the capital of Kerala – and Calicut.   I don’t know why this is, but I can assure you that, at some point, this pollution will cut into Indias’ productivity, if it already hasn’t.   The pollution will hobble Indias’ growth path, if that indeed is what the country wants. (Which I personally doubt, as India is far too conservative a country, in the small ‘c’ sense.)   The second issue, infrastructure, can be divided into four subcategories: Roads, Rails, Ports and the Electric Grid.   The Electric Grid is a joke.   Load shedding is all too common, everywhere in India.  Wide swathes of the country spend much of the day without the electricity they actually pay for.    Without regular electricity, productivity, again, falls.    The Ports are a joke. Antiquated, out of date, hardly even appropriate for the mechanized world of container ports, more in line with the days of longshoremen and the like.  Roads are an equal disaster. I only saw one elevated highway that would be considered decent in Thailand, much less Western Europe or America and I covered fully two-thirds of the country during my visit.   There are so few dual carriage-way roads as to be laughable.   There are no traffic laws to speak of and, if there are, they are rarely obeyed, much less enforced (another sideline is police corruption).   A drive that should take an hour takes three.   A drive that should take three takes nine.   The buses are at least thirty years old, if not older and, generally, in poor mechanical repair, belching clouds of poisonous smoke and fumes.                                                                                                                        Everyone in India, or who travels in India, raves about the railway system.   Rubbish!  It’s awful!   When I was there in 2003 and then late 2004 it was decent.    But, in the last five years, the traffic on the rails has grown so quickly that once again, it is threatening productivity. Waiting in line just to ask a question now takes thirty minutes.   Routes are routinely sold out three and four days in advance now, leaving travelers stranded with little option except to take the decrepit and dangerous buses.    At least fifty million people use the trains a day in India. 50 million people! Not surprising that wait lists of 500 or more people are common now.    The rails are affordable and comprehensive, but, they are overcrowded and what with budget airlines popping up in India like sadhus in an ashram in the middle and lowers classes are left to deal with the overutilized rails and quality suffers.     No one seems to give a shit.                                                             Seriously, I just never have the impression that the Indian government really cares.   Too interested in buying weapons from Russia, Israel and the US, I guess.     The last major problem in India is an old problem and can be divided into two parts: that’ve been two sides of the same coin since government was invented: bureaucracy and corruption.    It take triplicates to register into a hotel.   To get a SIM card for ones’ phone is like wading into a jungle of red-tape and photocopies one is not likely to emerge from in a good mood, much less satisfied with customer service.                                                           Getting train tickets is a terrible ordeal, first you have to find the train number, which takes 30 minutes, then you have to fill in the form, which is far from easy, then you have to wait in line to try and make a reservation, which takes 30 minutes at least and if you made a single mistake on the form, back you go to the end of the queue, or what passes for a queue in India.    The government is notoriously uninterested in the problems of the commoners. Too busy fleecing the rich, or trying to get rich themselves in some way, shape or form.   Take the trash, for example, civil rubbish collection authorities are too busy taking kickbacks from the wealthy to keep their areas clean that they don’t have the time, manpower, money or interest in doing their job.    Rural hospitals are perennially understaffed as doctors pocket the fees the government pays them, never show up at the rural hospitals and practice in the cities instead.     I could go on for quite some time about my perception of India and its problems, but in all seriousness, I don’t think anyone in India really cares.   And that, to me, is the biggest problem. India is too conservative a society to want to change in any way.   Mumbai, Indias’ financial capital, is about as filthy, polluted and poor as the worst city imaginable in Vietnam, or Indonesia – and being more polluted than Medan, in Sumatra, is no easy task. The biggest rats I have ever seen were in Medan ! One would expect a certain amount of, yes, I am going to use this word, "backwardness," in a country that hasn’t produced so many Nobel Laureates, nuclear physicists, imminent economists and entrepreneurs.    But, India has all these things and what have they brought back to India with them?   Nothing.    The rich still have their servants, the lower castes are still there to do the dirty work and so the country remains in stasis. It’s a shame. Indians and India have many wonderful things to offer the world, but I’m far from sanguine that India will amount to much in my lifetime.   Now, you have it, call me a cultural imperialist, a spoiled child of the West and all that.    But remember, I’ve been there. I’ve done it and I’ve seen 50 other countries on this planet and none, not even Ethiopia, have as long and gargantuan a laundry list of problems as India does.    And, the bottom line is, I don’t think India really cares. Too complacent and too conservative.

[Riaz Haq]

Visa hurdle stops #Pakistani patients, hurts medical tourism in #India http://toi.in/hJPrAb via @TOIDelhi

When countries go to war, even diplomatically, it's always the people who suffer. This is exactly what's been happening to the people as Indo-Pak ties have become frosty. India's imposition of restrictions on the issue of medical visas to Pakistanis has not just affected hundreds of patients from across the border but also dealt a body blow to medical tourism in India.
It's hard to find out precisely how many people travelled to India from Pakistan for treatment, but several laboratories TOI spoke to in Islamabad revealed that before visa restrictions were imposed, over 600 Pakistani patients used to visit India.
Most of them suffering from liver and heart ailments would go to major hospitals in Delhi, Mumbai, Chennai and other cities. But in February, there was a sharp drop in the numbers. And in the last two months, not a single Pakistani was granted a medical visa.
India took this decision after a Pakistani court sentenced Indian national and retired naval officer Kulbhushan Jadhav to death on the charge of espionage. Islamabad has reacted strongly to this, while Pakistani civil society has appealed to human rights organisations to take it up with India and international bodies.

On this side of the border, business has been affected a bit. Even though more people come from Bangladesh, Iraq and Maldives for treatment, Pakistanis spend the most in India. A recent report by ministry of commerce and industry says an average Pakistani spends Rs 1.87 lakh on treatment in India. Those from Bangladesh spend Rs 1.34 lakh on an average, followed by those from Commonwealth countries (Rs 1.25 lakh), Russia (Rs 1.04 lakh) and Iraq (Rs 98,554).
"This is because Pakistani patients mostly come for organ transplants and heart surgeries for children that are costly," said Manish Chandra, co-founder of Vaidam medical travel assistance company.
In 2015-16, he added, nearly 166 Pakistanis received treatment in India every month. Top Delhi hospitals, which are frequented by foreign nationals, confirmed this.
"We have observed a decrease in the number of patients coming from Pakistan. Patients have also informed us that visas have become hard to get. Issuing of visas is in the domain of the two governments and we would not like to comment on the policy of the central government on this," said a spokesperson of Max healthcare.
Dr Subhash Gupta, senior liver transplant surgeon at the hospital, added that there hasn't been a single patient from Pakistan for a month as against up to 30 earlier.
At Fortis, sources said, at least 20 patients who had contacted the hospital for various procedures have failed to come due to visa issues.
Officials at Apollo hospital said they used to get 30 Pakistani patients each month till last year, but not a single one has come in the last month.

[Riaz Haq]

BBC News - Anger as #India doctor mistakenly declares newborn dead. #Health #MedicalTourism

http://www.bbc.com/news/world-asia-india-42194192#

A newborn baby, declared dead by a hospital in the Indian capital Delhi, was found to be alive while they were on their way to his funeral.
Doctors at the privately run Max Hospital had pronounced the baby dead hours after his twin who was stillborn.
The parents said they noticed one of the babies squirming inside the plastic bag that doctors placed the infants in.
The incident has sparked outrage and a debate over the quality of private healthcare which is often costly.

Delhi Chief Minister Arvind Kejriwal tweeted that he had ordered an inquiry into the matter. The state health minister has also described the incident as "shocking criminal negligence".

According to the twins' grandfather, the stunned family rushed the newborn to a nearby hospital where they were told that their baby was still alive, local media reported.

In a statement to reporters, Max hospital said they were "shaken" and "concerned" over the incident, and added that the doctor has been asked to go on leave, pending an inquiry.

According to ANI news agency, Delhi police have begun to investigate the case and have consulted legal experts.
This is the second instance in recent months where a private hospital in India has been called out for negligent care. Last month, a girl died of dengue fever in another hospital and the parents allege they were overcharged for her treatment.