If you are a tribal woman in Shahpur, and pregnant at that, the chances of getting a sonography done are only on the third Wednesday of every month at the sub-district hospital. There is no radiologist here. In the whole of Thane district (with 15 talukas) there are only two government radiologists who work almost 24 hours to cover all hospitals in turn. Most tribal women shell out Rs. 700 to 800, money they can ill afford, to pay private practitioners rather than wait for weeks.
Since four or five months, the government has not distributed folic acid tablets and essential drugs are always in short supply in this tribal dominated taluka of Thane district, which is barely 100 km from Mumbai.
If a tribal woman manages to reach her full term of pregnancy and goes to the same sub-district hospital for delivery, it can be a great misfortune if she has to use the toilet as Savita Mukne from Vashind discovered last month.
Ms. Mukne escorted by Accredited Social Health Activist (ASHA) Anju Dongre went outside the labour room to find the two toilets shut and used as storerooms. Ms. Dongre recalls, “It was on February 25, I took Savita out of the labour room to find the nearest toilet which was a little further down and to my horror the baby’s head popped out. I was in a dilemma and had to keep holding the head while a vehicle was procured to get Savita back into the labour room. ” The child suffocated in the meantime and Ms. Mukne in a critical condition, had to be rushed to Thane civil hospital that night, a good three-and-a-half hour drive. It took her six days to recover. “See what problems this lack of toilet has caused,” Ms. Dongre said.
While Mumbai has an obscene array of five star care, neighbouring Thane district is a picture of neglect. At the Jansunwai or public hearing in Shahpur on Thursday under the community based monitoring programme of the National Rural Health Mission (NRHM), government doctors and officials tried to save face while a litany of complaints was read out against corruption, the condition of PHCs and lack of anganwadis (in 25 villages), the improper supply of medicines including folic acid tablets for months and non availability of rations for mid-day meal schemes.
Dr. Bharat Masal, medical superintendent, Shahpur sub-district hospital, said that every month only 30 to 35 cases were taken up for sonography since the radiologist who comes from Thane could only work between 9 am to 1 pm. Due to rampant misuse of sonography for pre-natal sex determination, the law was strict about uploading information on each case on the internet on the same day, said Dr. Mahesh Renge, resident medical doctor of the Thane civil hospital. The government offers a radiologist a salary of Rs. 50,000 a month at the Shahpur hospital but there are no takers. Of the 95 total sanctioned posts at the hospital, 18 are vacant. There are 2000 women in the high-risk category registered with the hospital who are given preference for sonography, said Dr. Masal.
One other issue was the non-supply of food grains last year from June to September to women running self help groups (SHGs) who cook mid-day meals. The public distribution system (PDS) centres refuse to stock the grains since it is not profitable, said an official. The SHGs had to put in their own money to buy grains or get it from the PDS shops they ran. A grave issue was the lack of supply of folic acid tablets, crucial during pregnancy since most of the tribal women suffered from anemia. Ms Indavi Tulpule of the Shramik Mukti Sanghatana said that for four months there was no supply of folic acid tablets. Dr. Pooja Singh, additional district health officer, admitted there was a shortage but she said the government had launched a new Weekly Iron Folic Acid Supplementation (WIFS) scheme under which four lakh tablets were given to Shahpur taluka alone on January 28. However, these tablets were sent for testing last December and the report had not come. While Dr. Singh said the tablets were released, the taluka medical officer said these tablets were not available.
Lack of supply of medicines at the nine PHCs and 60 sub-centres in Shahpur came in for much criticism. At Vashind PHC the medical officer Dr. Vinay Devlalkar almost got beaten up because he could not provide the drugs required and he rarely gets what he indents for. He had to buy extra medicines to fulfil demands. The State rarely gives what the PHCs require and even Dr. M S Dhere from Dolkhamb PHC admitted to being low on essential medicines.
At the PHC at Tanki Pathar, the contractor vanished without fitting a water tank. Now bullock carts ferry water to the PHC. The two doctors and staff cannot live there. The condition of other PHCs too is pathetic with leakages during monsoon and poor construction. Access is also an issue for many people. There is one PHC located near a poultry farm and people want it to be relocated due to the high risk of infection.
Dr Nitin Jadhav, state coordinator of the NGO SAATHI for community based monitoring, said that these issues were raised at other public hearings in the area but they have not been resolved. “There has to be a process to resolve them at local levels,” he said.
- Violation of law in land allotted to tribal people, claims study on Forest Rights Act (kractivist.wordpress.com)