Kolkata: On 16 January 2025, Rekha Sau’s world fell apart when her newborn son died seven days after birth.
“Amar kol khali hoye gyalo (my lap has been emptied),” said Rekha, 25, breaking down, as she spoke to Article 14. Frail and exhausted, she sat hunched in a plastic chair on the verandah of her asbestos-roofed home in the small town of Khakurda Bazar, more than 140 km west of here.
Eight days earlier on 8 January, when a pregnant Rekha was admitted to the Midnapore Matri Maa (Mother & Child) Hospital, 60 km from her home, to have her baby delivered, she was given what is called Lactated Ringer’s or Ringer’s Lactate, an intravenous saline commonly used during surgeries and labour to replace lost fluids and electrolytes.
The Matri Maa unit is a part of the State-run Midnapore Medical College and Hospital.
On 13 January, the news magazine India Today reported that a 13-member inquiry committee appointed by the West Bengal government initially found that the solution administered to Rekha had expired. That meant there was no guarantee of its sterility and stability, leaving it vulnerable to contamination.
Within three hours of being administered the saline, Rekha started shivering, her blood pressure dropped, she had difficulty breathing, and then lost consciousness.
At least four other women who underwent cesarean sections at the same hospital that day were given the same saline drip. Rekha survived after losing her son. Another woman died, and three others whose condition turned critical were taken to Kolkata.
They were placed on ventilator support after undergoing dialysis for several weeks because their kidneys, severely damaged, failed. Some were dogged by respiratory and heart failures and infections that led to multiple organ dysfunctions.
The Midnapore incident was not an isolated instance of public healthcare failing mothers and infants in West Bengal. In March 2025, several postpartum women in the Burdwan Medical College and Hospital fell sick after allegedly being administered the wrong injection.
We counted at least six such instances over one year in district hospitals and primary healthcare centres (here, here, here, and here).
That Sinking Feeling
Of 1,162 maternal deaths recorded in West Bengal between April 2023 and March 2024, the majority occurred in government medical colleges and hospitals, and of those the highest number, 204, were in Kolkata, according to the latest available government data quoted in the Bengali daily Anandabazar Patrika, on 29 July 2024.
These failures, said doctors, pointed to a broader failure in the state’s public healthcare system—overburdened hospitals, staff shortages, a faltering drug-inspection system, and a faulty medicine procurement system.
The state’s maternal mortality rate is above the national average and has worsened: from 101 mothers per 100,000 dying in 2014-16 to 103 in 2018-20, according to the latest available data.
These failures played out against a maternal healthcare crisis, said experts. Anemia is rising, as is inequality, as job opportunities recede and make more women anemic and vulnerable.
That means more women are at risk of falling ill and seeking healthcare.
“If you visit the obstetric ward of a medical college, you’ll see two or three pregnant women sharing a single bed,” said Dr Subarna Goswami, a senior doctor in West Bengal government’s health services and joint secretary of the Association of Health Services Doctors, an advocacy group of government doctors pushing for public health reform.
“One doctor is expected to care for dozens of patients at a time,” said Goswami. “This affects the quality of treatment they receive.”
A 2024 report by the Niti Aayog, the union government think tank, classified West Bengal among “least improved” states in an evaluation of healthcare in India’s 21 “larger states”.
A Collapsing System
Public health expert Saswata Ghosh from Kolkata’s Institute of Development Studies, a research and teaching institution, explained why maternal and infant mortality rates in West Bengal were stagnant.
“Most maternal deaths are preventable, but interventions like doctors and nurses recruitment and quality care are lacking,” said Ghosh.
While primary health care facilities have been built under the National Health Mission (NHM), funded in a 60:40 ratio by the union and state governments, there has been very little improvement in staffing, quality of care, or referral systems, especially in rural areas, said Ghosh.
Between 2004 and 2021, vacancies for government doctors in rural Bengal rose from 441 to 578, as sanctioned positions marginally decreased from 1,560 in 2005 to 1,533 posts in 2021, a trend not seen in most other states, the website NewsClick reported in January 2023.
The number of vacant nursing posts quadrupled over 16 years, from 422 in 2005 to 1,688 in 2021.
About 93% of specialist doctor positions at community health centres and 36.6% of sanctioned doctor posts at PHCs in the state were vacant, according to the rural health statistics of 2021-22, the latest data available. Nearly two-thirds of PHCs function with just one doctor, and 85 have none. There are more patients than beds in district and medical college hospitals, The Wire reported in October 2024.
“The state-run health system is collapsing,” said Goswami.
As waiting times increase and quality of care at public-health facilities decreases, West Bengal—in line with the union government thinking—has increasingly outsourced secondary and tertiary care, diagnostics, dialysis, ambulance, catering and laundry services to the private sector, wrote policy analyst Mampi Bose in The Wire in 2019.
‘Wife, Baby Were Fine’
Rekha’s husband, Santosh Sau, a teacher at a coaching center in Khakurda Bazar, said there were no complications during her pregnancy.
“She was fine. The baby was fine. All her reports throughout her pregnancy were normal,” he said. “Then they gave her that saline before her cesarean section. That’s when she fell sick.”
Two months later, when we met her, Rekha still struggled with pain, memory loss, sleepless nights, and other complications. She has been diagnosed with postpartum psychosis.
“I still feel weak, cannot sit or get up without pain. I have difficulty breathing. I forget things. I can’t do any work,” said Rekha. “I have not been able to sleep most nights. I just keep crying, thinking about my baby.”
The contaminated-saline incident at the Midnapore Medical College quickly sparked allegations of corruption and malpractice in West Bengal’s public healthcare system, already under scrutiny after the rape and murder of a postgraduate medical student at Kolkata’s R G Kar Medical College in August 2024.
For over two years, doctors at the Midnapore Medical College had expressed concerns about a particular batch of Ringer’s Lactate supplied by an 11-year company called Paschim Banga Pharmaceuticals Ltd.
On 16 January 2025, the Calcutta High Court ordered the company to stop production. The court ordered stocks bought by the West Bengal government to be withdrawn, whether expired or not.
Hospital Was Warned
Patients who received the saline drip in question frequently experienced shivering, breathlessness, and kidney complications, even before the Midnapore tragedy (here and here).
“We informed the medical superintendent that patients were having reactions to the saline,” said Dr Sudhanil Sarkar, a post graduate trainee at N R S Medical College and Hospital and former medical intern at the Midnapore Medical College.
“We were assured the health department had been notified,” said Sarkar. “But nothing happened.”
On 11 April and 14 April, Article 14 sought comment over phone and email from Dr Mausumi Nandy, principal, and Dr Jayanta Kumar Routh, medical superintendent, of Midnapore Medical College and Hospital, about allegations that hospital staff had reported adverse reactions in patients due to the expired saline. They did not respond.
In November 2024, the Karnataka government banned the saline, blacklisted Paschim Banga Pharmaceuticals, and suspended the state’s drug controller, after four women at the district hospital in Ballari died from kidney and multi-organ failure.
The women in Karnataka were all administered the saline during childbirth and died after giving birth.
Even after the Karnataka deaths, the West Bengal government took until December to halt Paschim Banga Pharmaceuticals Ltd’s operations. It ordered hospitals to stop using the saline only on 7 January 2025 via a WhatsApp order.
The expired saline was never flagged by drug inspectors.
That could be because the drug-inspection system is tottering, as Down to Earth reported in July 2019. Up to 77% of drug inspector posts are vacant, and existing laboratories are ill-equipped and underfunded, running with only 23% of approved staffing.
The volume of testing required is not evident. “Instead of 45 [drug inspectors], there are only six,” said Goswami. “So, sometimes qualifying reports are issued without proper testing.”
On 6 March 2025, we sought comment over email from the Central Drugs Standard Control Organisation (CDSCO), the national drug regulatory body, about substandard medicines supplied to government hospitals and corrective measures. We will update this story if they respond.
On 11 April, we sought comment from Chandrima Bhattacharya, West Bengal’s minister of state for health & family welfare, on the use of expired saline at Midnapore Medical College and Hospital. There was no response. We will update this story if she does.
“If the drug was banned, why was it still being used?” said Sarkar. “Why wasn’t it pulled from hospitals?”
Saline Fails Tests
When protesting junior doctors met the district magistrate, they said officials failed to provide any document confirming the order of the recall or ban.
“The day this happened, we demanded that those IV fluid bottles be sealed and sent for testing in the presence of the working doctors and nurses. That didn’t happen,” said Dr Punyabrata Goon of the West Bengal Doctors Forum, a collective of medical professionals in the state.
Goon said that a central drug authority report, referred to in this January 2025 story in The Week, found pyrogens—substances that cause fever and other severe reactions; in pregnant women they can cause septic shock or organ failure— in the saline. That meant, it should never have been used.
A November 2024 report from the CDSCO revealed 111 medicines were “Not of Standard Quality (NSQ)”, including several batches of Ringer’s Lactate IV fluid manufactured by Paschim Banga Pharmaceuticals. In a March 2025 report, it said 16 samples of Paschim Banga Pharmaceutical’s saline failed sterility tests in Karnataka.
On 18 February 2025, chief minister Mamata Banerjee told the state assembly that the saline used in the Midnapore Medical College and Hospital was cleared by two laboratories.
Despite widespread evidence of larger regulatory failure, the West Bengal government responded on 16 January by suspending 12 duty doctors from the Midnapore hospital for medical negligence.
Complaints Ignored
“There is a whole racket going on in the supply chain of medicines in West Bengal, which came out during the R G Kar incident,” alleged Goon. “Low-quality, substandard, and contaminated medicines are being used across state-run hospitals.”
Goon said the state health department had received many complaints about Paschim Banga Pharmaceuticals’ saline from hospitals and public health centers (PHC) but did nothing.
“Hospitals were verbally told not to use [the saline drip], but no replacement was supplied,” said Goon. “So the hospitals kept using it.”
Goon explained that contaminated IV fluids often show no visible signs of impurity. “If you could see fungus floating in the bottle, it wouldn’t be administered,” he said. “But most contaminants are microscopic and cannot be seen with naked eyes.”
“They needed scapegoats,” Sarkar said. “If junior doctors are being held responsible, then why not the health minister, the health secretary, or the drug control authorities who failed to enforce the ban?”
We sought a response to that question over email from minister of state for health Bhattacharya and health secretary Narayan Swaroop Nigam, whom we also tried to reach over the phone. Bhattacharya’s secretary said the minister would respond. We will update this story if either of them does.
The long-term health risks of using contaminated saline remain unknown because there hasn’t been enough research. “But we’ve seen the immediate effects—large doses can kill,” said Goon.
‘Everything Went Black’
On 8 January, a vial of the expired Ringer’s Lactate was enough to incite a reaction in Rekha Sau.
“As soon as they gave me the saline, I started shivering,” said Rekha. “My whole body turned cold. I couldn’t breathe. Then everything went black. When I woke up, they were pressing something warm against my chest, asking if I was in pain.”
Her condition worsened, and doctors told the family she needed an emergency C-section, without informing them that she was given contaminated saline.
Santosh, her husband, bought additional saline and injections from outside the hospital.
When Rekha regained consciousness, she saw her son only once before he was moved to another ward to be placed in a ventilator. For two days, the family received no updates.
When they were finally allowed to see the baby, his condition had deteriorated. Doctors said that he had ingested stools in the womb, but Rekha’s family suspected the contaminated saline caused death.
Rekha was hospitalised for 16 days after her delivery. During that time, she also contracted dengue. “There were no mosquito nets, beds (were) crammed together,” she said. “The place was full of infections.”
“I don’t want another mother to go through this,” she said. “They should stop treating us poor women like this. I lost my child because of their negligence.”
Same Hospital, Another Mother Dies
Mamoni Rui Das, 21, from West Midnapore’s Chandrakona Road’s Sarga village, was admitted to the same hospital as Rekha for her second delivery. Like Rekha, the doctors said there were no complications.
On 8 January, Mamoni delivered a baby by C-section. Hours later, she stopped urinating. Her condition deteriorated rapidly.
Debasish, her husband, who used to work as a daily wage earner at a saw mill, suspected that the saline administered after surgery was the problem. Doctors initially told him everything was fine but later admitted there had been mistakes in treatment.
“They gave her expired saline,” he said. “I asked why they didn’t check it before. They just said she would be fine.”
The next day, she was moved to the ICU. By the next morning, she was dead.
The official cause of death, according to the hospital, was multi-organ failure due to septicemia. “She never had any kidney or liver issues before,” said Debasish.
His mother said the hospital never gave them an option for referral.
“If they had told us they couldn’t treat her, we would have taken her somewhere else,” she said.
Mamoni left behind two children—a four-year-old daughter and a newborn son. Neither knew their mother had died.
“My daughter keeps asking when her mother is coming home,” Debasish said. “How long can we keep the truth from them?”
His newborn son was also unwell and required treatment at Midnapore for days. Debasish still takes him there for checkups.
The Crisis Grows
The state’s maternal healthcare crisis is not just about a rising maternal mortality rate and failing hospitals—it is also a reflection of rising poverty, malnutrition, and systemic neglect, said experts.
According to Oxfam India’s 2023 report on wealth inequality, India’s richest 1% now owns an outsized share of nation’s total wealth, while the bottom half of the population together hold 3%. This widening economic disparity has significant repercussions for healthcare access, with approximately 63 million Indians pushed into poverty each year due to out-of-pocket medical costs.
Anemia among women in West Bengal has surged in recent years, rising by 9% from 2015-16 National Family Health Survey or NFHS-4 data, according to 2020 NFHS-5, which recorded 71% of women in the state as anemic.
“You can’t fix this with iron supplements alone,” explained Goswami. “If a woman isn’t getting proper nutrition, medicine won’t compensate for a poor diet.”
As rising inequality and vanishing rural jobs push more families into poverty, access to healthcare becomes more difficult, as we said.
With agricultural work declining and the Mahatma Gandhi National Rural Employment Guarantee Act (MNREGA)—the national make-work programme that guarantees 100 days of work every year—stopped in West Bengal from 2022 because of a tussle with the union government, many men are migrating out of the state for jobs, while women are left with fewer options.
For pregnant women in rural areas, the declining state of primary healthcare facilities also means traveling long distances to government hospitals—only to find overcrowded wards and inadequate care.
Teen Pregnancies & Moonlighting Doctors
West Bengal is one of two states—the other, Bihar—with the highest rates of teenage pregnancies in India. More than 42% of women are married before 18, according to NFHS-5 data: unofficial numbers are likely higher, said experts.
These pregnancies come with greater health risks. In West Bengal, the percentage of girls of 15-19 years who were already mothers or were pregnant, according to the same data, was 19.6 in rural areas.
“If most pregnancies are high risk, how can we provide quality care to everyone?” said Goswami. “We don’t have the infrastructure or the manpower for that.”
Government efforts to reduce child marriages through ASHA (accredited social health activist) workers often fail due to family resistance.
“When ASHA workers try to intervene, families ask them: ‘Will you take responsibility for her?’” said Goswami. The problem worsened after COVID-19 school closures, which increased dropout rates among girls and pushed many into early marriages and pregnancies.
“This crisis can’t be solved by the health department alone,” said Goswami. “It requires broader socio-political change.”
The problem is compounded by overworked and underpaid government doctors often prioritising private practice.
“If doctors were paid fairly, many would stay in public healthcare. Instead, they leave for private practice,” said Goswami. “There’s no incentive for doctors to stay. Many just do quick rounds in the hospital and rush back to their clinics.”
This means more oversights, rushed procedures, and mismanagement, leading to avoidable maternal deaths like those in Midnapore.
The lack of a functional referral system means that when complications arise, hospitals often transfer patients without checking if beds are available, forcing women to travel between facilities in critical condition.
“Even private hospitals, except the large corporate ones, lack proper infrastructure,” said Goswami. “So, when a mother’s condition worsens, they refer her back to a government hospital—where there are no facilities to save her.”
Doctors, fearing violence from angry families, are reluctant to take risks, leading to possibly unnecessary referrals that overburden larger hospitals.
An Indian Problem
West Bengal’s flailing healthcare system is a reflection of a general shortfall in India’s healthcare spending, which was around 2% of the GDP in 2023-24, falling short of the National Health Policy’s target of 2.5% by 2025.
The budget allocated for healthcare in 2025 was 1.94% of GDP—a decline from previous years. Health is a state subject, but New Delhi plays a significant role in healthcare deliveries through NHM to strengthen primary healthcare infrastructure. This is important because 69.6% of households— 73.2% in rural areas and 62.4% in urban areas—depend on State healthcare.
National spending on primary healthcare is 40% of the health budget, far below NHP 2017’s recommendation of two-thirds. Instead, investment has shifted toward tertiary care, such as specialty hospitals, like the All India Institute of Medical Sciences (AIIMS), 16 of which are now running and another six sanctioned.
“No country can improve health index ratios without strengthening primary care,” said Goswami.
“We need well-equipped local health centers with enough beds, doctors, and nurses so that people don’t have to rely solely on overcrowded medical colleges,” he said. “If referrals to bigger hospitals reduce, the patient load will decrease, and the quality of care will improve.”
Solving the problems in buying medicines will be tougher, said experts. Government hospitals in West Bengal buy medicines through a tender-based bidding system, where contracts are awarded to the lowest bidder, often at the cost of quality.
Previously, a base price ensured that essential medicines, such as the commonly used pain and fever relief drug paracetamol, could not be sold below a certain rate to maintain quality.
But that safeguard of maintaining a base price for essential medicines in the state was removed following the adoption of an e-tendering procurement system in 2022.
“Now, if a company offers to supply medicines at three paisa, the government will place the order—regardless of quality,” said Goswami. “But at that price, you cannot produce quality paracetamol.”
No Justice, No Assistance
Both Rekha and Mamoni’s families continue to wait for justice and financial support from the government. When this story was published, they had not received post-mortem reports or official death certificates.
Rekha said she could not afford private healthcare. “Another pregnancy could put my life at risk—this is my last chance,” she said. “I need proper medical care, a good doctor, and thorough check-ups. My treatment should be covered.”
Rekha has been visiting private doctors for check-ups, which she is paying for out of pocket. She has still not received her Swasthya Sathi Card, a state government health insurance scheme she applied for in December 2024. However, the scheme does not cover outpatient consultations, diagnostics, or medicines, which is the bulk of her care currently.
Mamoni’s husband, Debashish, formerly a saw-mill labourer and currently unemployed, said he could not manage medical costs. “I have spent almost Rs 60,000 since we took her to the hospital,” he said.
On 16 January, the West Bengal government announced Rs 500,000 in compensation and a job for Mamoni’s family. A local councillor has helped with food and transport for his child’s health checks, but it is not enough.
“I used to earn Rs 200 a day at the wood mill, but I lost my job when I took my wife to the hospital,” Debashish said. “We cannot survive on aid forever.”
(Arunima Kar is an independent journalist based in Kolkata. She writes on the climate crisis, gender and health.)
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