Amravati, India – Anjali Thakur’s first child was born prematurely. The baby spent seven days struggling to survive in an intensive care unit. Anjali prayed while her newborn was pumped with antibiotics. None of them worked.
“The doctors gave her various medicines but she didn’t respond to any of them. She had a high fever and was given medicine, an oxygen mask and a drip,” Thakur says from her home in Amravati, central India.
Thakur had wanted to call her daughter Arya, but she died before she could be named.
Her daughter was one of tens of thousands of newborns in India who succumb to common ailments that could once be easily treated.
Nearly a third of the world’s newborn deaths occur in India and the rise of antibiotic-resistant bacteria – so-called superbugs – is threatening to wipe out recent successes in reducing the country’s infant mortality rate.
A recent study of newborns by one of the world’s leading microbiology researchers, Professor Ramanan Laxminarayan, estimates that 58,000 babies die in India, each year, from superbugs.
“India is absolutely in the frontline for the problem of antibiotic resistance globally,” Ramanan says.
“India has the highest number of newborns that die of drug resistant infections, which means an infection which could not be treated by the typical first-line antibiotics.”
“Now this is a number which is bound to increase over time,” says Ramanan, the director of the Centre for Disease Dynamics, Economics and Policy, which is based in New Delhi and Washington DC.
‘She did not respond to any antibiotic’
The potential ramifications of allowing superbugs to flourish extend far beyond India’s borders.
Researchers have found that at least one antibiotic-resistant bacteria first identified in India has now spread to more than 70 countries.
Some of the strongest antibiotics on the market are now proving ineffective, threatening to turn common diseases like urinary tract infections and pneumonia into untreatable ailments, undoing the medical progress of the last 50 years.
A study by the New Delhi All India Institute of Medical Sciences is tracking 90,000 newborns to monitor drug-resistant infections.
Dr Vinod Paul, a leading paediatrician, says researchers isolated 15,000 high-risk newborns for the study. The results are alarming.
“We found that 60 to 80 percent of organisms that cause infections in newborns in our country are resistant to the kind of antibiotics that we normally use,” he says.
“We are dealing with pathogens which are unusually tough, and a fair proportion of them are now smarter than the antibiotics that we use on them.”
The study is due to be published in the medical journal The Lancet later this year.
The rise of antibiotic-resistant bacteria in India is blamed on poor hygiene, overcrowding but most importantly, the uncontrolled use of antibiotics.
Antibiotics are regularly sold without a prescription; some doctors in private clinics are pressured to oversubscribe; others misdiagnose and prescribe the wrong medication.
In Maharashtra, one of India’s most impoverished provinces, a paediatrician is trying to ensure antibiotics are only used when necessary by training local women to work as community health workers.
Dr Abhay Bang teaches the women to treat their fellow villagers by using modern and traditional medicines. Antibiotics are only used as a last resort.
“So far there are no signs of any antibiotic resistance emerging here. If antibiotic resistance would have emerged, the death rate would have shot up,” he says.
Bang credits the good outcomes in this region to effective training and the fact that he provides the antibiotics for free.
He says that doctors often have “financial incentives” to prescribe antibiotics and want to “impress” patients “with quick results”, which can lead to the overuse of antibiotics.
“Community health workers have no such attraction and so they use antibiotics in a limited way, in the cases where it is indicated,” Bang explains.
Back in Amravati, Anjali Thakur says she knows little about the scourge of antibiotic resistance.
She believes that if she and her husband had more money, their baby might have survived.
“I don’t know if the doctors gave her good treatment. We are poor people and do not have money,” she says.
But the paediatrician who treated Thakur’s newborn says nothing could have saved the little girl.
“She did not respond to any line of treatment,” says Dr Swapnil Talvekar. “She did not respond to any antibiotic. The baby died of neonatal sepsis.”
Talvekar says deaths like Anjali’s daughter’s are becoming more common in India.
“This is a big problem for each and every physician in India, which is a developing country, where such problems are emerging, and emerging with a great velocity,” he says.
Thakur has since had another child – a little girl who is now a thriving two-year-old.
“My second daughter’s name is Khushi, which means happiness,” she says. “When my second daughter was born I was really happy and so I named her Khushi.”
But she still mourns for the daughter she lost.
“What happened to me should not happen to anyone else. It should never happen to anyone,” she says.
From the 101 East documentary “The Rise of India’s Superbugs.” Watch the full film here.
Follow Yaara Bou Melhem on Twitter: @yaaraboutv