Chattisgarh High Court
In Reference Court On Its Own Motion ... vs State Of Chhattisgarh on 23 March, 2017
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AFR
HIGH COURT OF CHHATTISGARH, BILASPUR
Order Sheet
WPPIL No. 24 of 2017
In Reference Court on Its own motion
(regarding death of Ku. Divya Verma, D/o Shri Ashok Verma due to Rabies) Shri Ashok Verma
Versus
State of Chhattisgarh
23.03.2017 Shri Abhishek Sinha, Advocate as Amicus Curiae.
Shri J.K. Gilda, Advocate General along with Shri A.S.
Kachhawaha, Additional Advocate General for the State.
Ms. Rajni Soren, Advocate for Intervenor.
1.This writ petition is triggered by the unconsolable tears of the parents of an eight years old girl child, Ku. Divya, who not only suffered the pain and aftermath of a confrontation with a dog, which mercilessly bit her on the face, but ultimately succumbed to rabies.
2. Keeping aside the emotional issues of the parents, certain larger requirements of the State's governance of public health require to be addressed in this matter. It is therefore that this Court had registered this matter as a Public Interest Litigation fundamentally on the issue of non-availability or improper management of anti-rabies vaccination and the facilities available through the three-tier system of medical institutions under the State Government.
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3. We have the benefit of hearing the learned Amicus Curiae Shri Abhishek Sinha and the learned Advocate General Shri J. K.Gilda.
4. The submissions of the learned Advocate General in the presence of the Secretary to Government of Chhattisgarh in the Department of Health and the Director of Health Services show that certain efforts have been taken by the State Government, though there is considerable managerial confusion and lack of cohesion between the different departments of governance in streamlining the efforts to handle the problem.
5. Taking an over all look at the different statutory provisions which govern animal-human conflicts and the public health scenario, we think that, while sterilization or neutralization of stray dogs may not by itself be an end all of the problems, the focal requirement in the present proceedings is to ensure that adequate support to the victims of bog bites by providing medical health at the earliest point of time including through the provisions for administration of anti-rabies vaccine ought to be in place, that too in a systematic manner, with full knowledge of such facility in the local public domain so that any user of such facility can access the public health system to reach for medical help at the earliest.
6. From the submissions by the learned Advocate General and the learned Amicus Curiae and also going by the statements made before us by the Secretary, Health Department of the Government, we notice that the problems of 3 the management of rabies infection is divided into different stages. The immediate relief that could be extended is to provide anti-rabies vaccination and treatment at the earliest point of time which is reckoned as the primary level treatment. A little more grown up stage could be called as secondary situation which would be dealt with only in hospitals other than those at the primary level. The third, which is the tertiary or the end stage, is the extremely unfortunate regime where the patient undergoes an extreme situation of hydrophobia, photo- phobia and other incidental physical, psychosomatic and attendant problems, generating agony not only to that person, but also to the kith and kin, as well as those who are put in- charge of the care of that unfortunate person.
7. We are told that there are different modes and types of vaccines which are being administered as management of this challenge in the part of medical and health scenario. It is also mentioned that there are certain systems of vaccination which require expertise of the highest order, at least at the level of post graduate doctors with facilities of either a medical college hospital or hospital which can extend such support. The other hospitals would work as primary heath support providers or transit providers under medical assistance.
8. An issue of critical importance which we have noticed is the non-availability of dependable anti-rabies vaccines with clear identity as to their source of manufacture, source of transit and identifiable with requisite identity marks as to batch 4 number, date of manufacture etc. We pointedly see that in the case in hand, the facts apparently tend to indicate that the private medical facility center to which the unfortunate child Ku. Divya was initially taken is stated to have administered anti- rabies vaccine which did not have any identity in the form of batch and serial number or the date of manufacture, as ought to be discernible from the papers issued from the facility provider. She was thereafter taken to yet another hospital where she was identified as having crossed the limits of possible management, leading to her being again moved on to Medical College Hospital at Raipur from where she breathed her last.
9. Even if private practitioners and private medical services providers utilize such vaccines or drugs, they ought to be accountable, when the question about the identity of a particular material which was infused into the system of a human being becomes relevant. Such identity should be discernible on the basis of batch number, the date of manufacture, the manufacturer's identity etc. as is prescribed under the relevant laws. Bereft of this, there is no assurance to the consumers who happen to be hapless victims, who would repose complete confidence in the decision of the institution of medical health to which a patient is taken. The Drugs Control Authorities, the Health Department are those who involve in regulating the stores and supplies of essential drugs. They have to necessarily to take a call on this issue.
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10. Fundamental right to life in terms of Article 21 of the Constitution of India includes the right to health; which in turn, makes that person eligible to the protective cover by administration of preventive medicine and also by provision of appropriate curative medicines at the earliest, as and when required. In a welfare State, this right is eligible to be enforced to the extent of the States resources to provide. Timely administration of certain curative or preventive medicine like anti-rabies vaccine is a life saving medication regime and to access such right is also a human right. It has also an inbuilt quotient of dignity of the individual which is a seminal constitutional value and human value. Hence, right to access anti-rabies vaccine with identifiable shelf life and its prompt administration is part of the fundamental right to life guaranteed by the Constitution of India.
11. Having regard to what is aforesaid, the State Government is directed to place on record a detailed affidavit through an officer not below the rank of the Secretary to the Government detailing the structured procedure that is in place and that which would be appropriately put in place to streamline and thereby get over the deficit noted above.
12. When there is an alarming increase in the rate of stray dog bites, it cannot but be presumed, logically and in the common course of human conduct, that those who are visited by those animals and get injured, would necessarily go to the hospitals for medical help. Deficit of help in the public sector will 6 be one attraction for the victim to take private medical aid. Though we are not critical of the private sector, it is necessary to sound a word of caution that in management of situations like dog bite and requirement to administer anti-rabies vaccine, the larger thrust should be with the governmental machinery. It is not as if the people, by and large, can afford to spend and obtain medical assistance in the critical hour of need in such situations. We underscore this more importantly because the calamitous situation to which a patient may fall if help is not extended in time is something unbearable and shocking comprehended.
13. We understand from the submissions made on behalf of the State and also the statements of the Health Secretary to the Government that different protocols are being followed in relation to the Primary Health Centers, Community Health Centers, District Hospitals and the Medical College Hospitals. We need to be told as to whether the public are aware, at the instance of the Government, of any particular protocol of such management, because a patient in such a situation has to be rushed to the immediately available point, in time. Therefore, we direct that the State Government will describe in its affidavit, the protocol for systematic management of the issue. It will also state as to what action has been taken for dissemination of information to the public at large about such facility, having regard to the enormous rate of dog bites, including by stray dogs.
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14. There is a scheme in force to support the victims of crimes by humans. The victim compensation scheme in terms of provisions of Code of Criminal Procedure is aimed to reach out to the unfortunate victims of crimes. In the ultimate analysis, the victims of animal attack suffer virtually the same situation as an attack by a human being. In the absence of any specific scheme or guidelines or statute law, it would be well within the domain of the State to consider as to why it shall not extend a hand of support to the kith and kin of a person who dies in such unfortunate event. In the case in hand, we see from the facts that the girl child appears to have been the greatest expectation of a poor family which was bringing her up. Solace is not merely something that should remain in the heart. It should come out through the Administration by providing such amount which the Government may feel appropriate, even as ex-gratia to be given to the parents; for which culmination of these proceedings need not to be awaited. We therefore direct the Government to consider this aspect of the matter and make submission by the next date as to what action has been taken in that regard in the meanwhile, following this direction to consider.
15. Let affidavit in terms of the aforesaid be filed within one month without fail. Learned Advocate General will also obtain instructions from the jurisdictional Police Station as to why no case has been registered on the basis of the occurrence which apparently has been brought to its notice, at least as a case of unnatural death. If the jurisdictional police is in cognizance of 8 any particular report, let the action taken in that regard be brought to the notice of this Court.
16. The application filed by the Intervenor is deferred for consideration.
17. Post after one month.
Sd/- Sd/-
(Thottathil B. Radhakrishnan) (Pritinker Diwaker)
Chief Justice Judge
Chandra