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Delivery on roadside, peon gives injections

Meena Menon

Another shocking reality in an Adivasi-dominated taluk in Thane district: PHC doctor collects donations from patients

— Photo : Meena Menon

A public hearing under the National Rural Health Mission at Dhasai on July 3.

Dhasai village (Maharashtra): Lack of basic health care and apathy plague the Adivasi-dominated Murbad taluk of Thane district, which is less than 150 km from Mumbai. These are the shocking realities in the area: women are delivered of babies on the road, peons give injections in the primary health centre and the doctor collects donations in a neat little metal box kept on his consulting table.The ambitious National Rural Health Mission (NRHM) launched in 2005 seems to have made little difference to the lives of these people.

Complaints galore

At a well-attended public hearing, held as part of a community-based monitoring programme under the NRHM on Thursday, there were complaints galore about the goings-on in the PHCs at Dhasai and Tokawade.

Hirabai Sawla of Madh village brought a pregnant woman to the Tokawade PHC at night, but the duty nurse said the infant had problems and she would need to go to the Murbad hospital. “We were on way there, when the woman was delivered of a baby on the road,” said an angry Hirabai. There was nothing wrong with the baby.

Running from pillar to post

Shankar Nirguda from Kewarwadi says it could have been better had his daughter-in-law Hirabai not stepped out of her house. She was six months pregnant and was bleeding.

“When we went to the Tokawade PHC, Hirabai was not treated there. They told us to go to Shahpur and from there to the sub-district hospital at Murbad. I waited there from 10 a.m. to 4 p.m., but no one looked at her.” On top of it, Shankar alleged, he was charged Rs. 80, for which no receipt was given at the hospital.

Finally, Hirabai was delivered of a baby — a stillborn child — in a stranger’s hut on way back home. Shankar spent a total of Rs. 1,350 taking the woman to various hospitals.

A number of complaints of neglect of pregnant women at the Murbad hospital were made at the meeting.

This in spite of the existence of the Janani Suraksha Yojana, a safe motherhood intervention programme under the NRHM to encourage institutional deliveries. Each woman gets Rs. 700 for giving birth in a hospital or PHC and Rs. 500 if the delivery takes place at home.

Bhimabai alleged that Adivasis were treated badly in the Tokawade PHC; often women in the family had to clean up after a delivery and dispose of the placenta and the umbilical cord. For, PHCs do not have disposal facilities.

Last month Kusum Ugda from Shirwadi accompanied her pregnant daughters to the Dhasai PHC and on both occasions she was told to clean up the room after the delivery. She also had to dispose of the waste. “Why should I do this work? There is a sweeper who never does anything,” she said.

Peon mans PHC

In the Dhasai PHC, it is alleged, peon Pandu Gholap gave injections to people and charged them Rs. 20. People said the two doctors at the PHC often went out, instructing the peon to administer injections. Gholap admitted to his doing so and promised to mend his ways.

However, Dr. Y.S. Gedam, who is holding charge as taluk health officer, said the peon continued with his practice even after he was threatened with suspension in the past.

For this year, under the NRHM, Thane district has a budget of Rs. 90 crore. The Dhasai PHC has a high patient load of 1,000 people a month, with nearly 35 deliveries. Yet a lone medical officer, S.B. Bansode, has been holding fort for the past four years. He is on contract and gets his salary every four months.

A second doctor, P.G. Kharde was appointed last year, but there is a litany of complaints against him, mostly of asking patients to drop money into the donation box.

An examination of the Dhasai PHC records by Dr. Dhananjay Kakde of Sathi, an NGO which is coordinating community-based monitoring, revealed that the Out-Patients Department remained closed for 10 or even 15 days at a time last year.

The PHC is dirty, it is hard to find a single clean bedsheet and often patients have to do without it.

Indavi Tulpule of Van Niketan, a voluntary organisation, said the untied funds for each PHC or sub-centre were used to hold meetings or buying weighing scales in anganwadis, instead of for health care.

Shortage of medicines and materials at the PHC is common.

Bansu Burbuda from Bangarwadi said he took his wife to the Tokawade PHC two months ago for delivery and he was asked to buy gloves and suturing materials from a medical shop.

Also there is shortage of cough syrup in the PHC, admitted Dr. T.V. Mahirrao, medical officer.

Shocking conditions prevail also in the anganwadi at Bangarwadi. Ramesh Burbuda said there had been no weighing scale there for the past six months.

Despite this, children’s weight is written down every month. Many complained that pregnant women and mothers were not getting their allowances under the Matrutva Anudan and the Janani Suraksha Yojana.

A report of the several public hearings held in the district, this being the last, will be submitted to health authorities.

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