KH.NOBIN SINGH,J. -
(1.) The prayers in this PIL are as follows:-
"ii) to issue a writ in the nature of Mandamus directing the Respondents to ensure adequate supply of blood/availability of blood in all the District Hospitals by setting up Blood Banks at all the District Hospitals in the State of Manipur within a specific period of time;
(iii) to issue a writ in the nature of Mandamus directing the Respondents to set up Blood Storage units at all the Community Health Centres (CHCs), Primary Health Centres (PHCs) and Primary Health Sub-Centers (PHSCs) and ensure that all the Blood Storage units are functioning at the earliest;
(iv) in the interim to issue an appropriate order for constituting a high powered committee for investigating and preparing a report
(a) on the demand for blood or its components for clinical use at various hospitals In the State, (b) the supply of blood or Its components to the various hospitals in the State, the quantum of collection of blood by various blood banks, (c) the end use of blood/its components collected by the blood banks, (d) the prices at which blood or its components are made available by the blood banks and for all matters connected with distribution of the blood collected by blood banks;"?
1. In this PIL, notice was issued on 22.3.2018. On 12.7.2018, the following advocates were appointed as Advocate Commissioners:-
"1. Ms. Ksh. Harichhaya, Advt. Commissioner
2. Ms.Laisom Sillori, Advt. Commissioner
3. Ms. N.Savitri Devi, Advt. Commissioner,
4. Mr. Henba Thokchom, Advt. Commissioner
5. Mr. Th.Rohitkumar, Advt. Commissioner"?
And the Advocate Commissioner filed a report on 29.11.2018. The said report has been taken on record and on the basis of the defects pointed out by the Advocate Commissioners, subsequent orders have been passed and the Director of Health Services filed a preliminary report dated 10.12.2018 which reads as below:-
"REPORT SUBMITTED BY THE DIRECTOR OF HEALTH SERVICES, MANIPUR IN COMPLIANCE WITH THE ORDER OF THE HON'BLE HIGH COURT PASSED ON 29- 11-2018
(2.) Upon perusal and examination of the Report submitted by the Advocate Commissioners as constituted by the Hon'ble High Court, the certain shortfalls can be seen in respect of the Blood Banks in Regional Institute of Medical Sciences (RIMS), Imphal and Jawaharlal Nehru Institute of Medical Sciences (UNIMS), Porompat.
The shortfalls in respect of RIMS are shown as below:
1. Phlebotom Room : Lack of cleanliness.
2. Component and walk in cold room : The area/place and entrance to this room is in a very pathetic and unhygienic condition which is against the guidelines.
3. Component separation room:2 (two) segregation machines are there, but 1 (one) is working and it has very bad smell. AC installed in the room has water dripping/flowing inside the room which is quite dangerous which may cause infections leading to contamination of blood segregation process and quite unhygienic,
4. Rest cum refreshment room : Particular room for rest and refreshment of the donor are not available
5. Wash room : The wash room was room wherein test tubes are washed for reuse is in a very worst condition. Male wash room is inside this room and slides are very dirty and kept in a very dirty place The shortfalls in respect of JNIMS are shown below:
1. Location& surrounding: Premises around the blood bank is not properly maintained and unhygienic and next to the gynaecology ward and also near the site for dumping bio-medical waste which is against the guidelines
2. Cold room : The distillation machine is installed in a very unhygienic place which is very much prone to infections.
3. Component room : 2 (two) Refrigerated Centrifuge machines are there, but 1 (one) is not well functional.
Taking in to consideration of the importance of blood, the Director of Health Services, Manipur/State Licensing Authority vide its Letter dated 7h December, 2018 requested the authorities of RIMS, Imphal and JNIMS, Porompat to take up necessary to make up the shortfalls within a stipulated period (Copies enclosed).
State Blood Transfusion Council, Manipur has vide its Order dated 10th October, 20108 fixed the service charges to be recovered from the patients. The amount incurred in the processing of blood and blood components including blood bags, reagents, test kits etc. is regulated by the State Blood Transfusion Council, Manipur and as such, the authority has proposed the State Blood Transfusion Council to look into the matter and decide its decision/resolution. Once the State Council has accepted the proposal, the authorities will take necessary steps in this regard. Now, the report from the State Blood Transfusion Council is awaiting.
The 10th December, 2018
Director of Health Services, Manipur"?.
(3.) Thereafter, another order was passed on 18.3.2019 which is extracted as below:-
In the report given by the Advocate Commissioners at page 100, general observations are given as follows:-
"Pursuant to the inspection conducted on the above mentioned Blood Banks, we have gathered from the concerned Medical Officers that even though there are only 4 Blood Banks opened in the Government Hospitals, there is no shortage of blood supply in the State whenever it is demanded. It is also informed by the Medical Officers of these Blood Banks that the ratio of unused discarded blood due to expiry is higher than the blood supplied/ used in the hospital and the same can verified from chart appended in the report of Blood Bank, JNIMS, District Hospital Thoubal. Likewise, in other Blood Banks the same remain as it is. The reason for discarding the blood stored in the Blood Banks is because of the low demands. As such, despite spending huge amount in the storage and maintenance of blood, the same cannot be used for true purposes. Therefore, instead of opening of new blood banks, proper maintenance of the already existed blood banks/ Blood Storage Centre and supply of blood whenever required by means of proper transportation would be much more beneficial and efficient. The same view is expressed by all the concerned Medical Officers of all the Blood Banks.
Apart from this, it is also come to our knowledge this Court is of the view that the equipments which are installed in these Blood Banks are mainly sponsored and initiated by NACO initially and now it had been under the control of National Health Mission. Thus, we have gathered information from the concerned staffs that expenses incurred in installing these equipments are wholly sanctioned by the NACO and NHM and not from the exchequer of the State Government.
Regarding maintenance of equipments installed in these Blood Banks, it is probably difficult to maintain by the State Government especially machines installed in the State-run Blood Banks cannot carry out routine servicing/ calibration in time because of financial constraint as expressed by the concerned Medical Officers.
We have also mainly focused on the fees charged from the patient at the time of supplying the blood and in this regard, we are informed that the present rate of fees charged from the patient is going to be dropped since there is a proposal for providing blood free of cost."?
We request the State Mission Director, State Health Society, National Health Mission, Manipur, Lamphelpat, respondent No.2 and Director of Health Services, Govt. of Manipur, respondent No.6 to respond to these General Observations with material particulars and compliance report on the next hearing date.
In so far as the Jawaharlal Nehru Institute of Medical Sciences (JNIMS), at page 32 of the report of the Advocate Commissioners, details of the errors of bad management and non-maintenance has been highlighted. The Director of JNIMS Hospital, is called upon to ensure that the defects pointed out by the Advocate Commissioners are rectified and compliance also be filed on the next hearing date.
For compliance, list on 15.5.2019. A copy of this order be served to Ms. Momota Oinam, learned Addl.AG, Director, RIMS and JNIMS."? ;