Sonia Khandelwal Indore, January 23, 2007
THE LOFTY schemes of Madhya Pradesh government for promoting institutional deliveries — for bringing down Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) — need a reality check at ground level as was highlighted by an incident in a village in Barwani district raising several questions about awareness and implementation of these schemes.s.
Twentyone-year-old Santoshi Raju from Rajpur was referred to the District Hospital at Barwani for delivery, from where she was referred to M Y Hospital here as her blood pressure had increased to a dangerous level. Then started her traumatic journey of running from pillar to post.
“At Barwani, they (the doctors) asked us either to fill a consent form for taking responsibility of complicated delivery (which could mean threat to the lives of either the mother or the child or both) at Barwani or take her to Indore,” Santoshi’s husband Raju, a labourer, told Hindustan Times at the post natal ward.
Not ready to take risk at Barwani, Raju asked Barwani Civil Surgeon Dr B K Sawner to provide him ambulance to take Santoshi to Indore. “But as we did not have Deendayal Antyoday Yojana card, the doctor did not agree for the ambulance,” Raju added.
However, Deendayal Yojana card is not required for ambulance service. Despite repeated requests when the hospital authorities did not agree, an Accredited Social Health Activist (ASHA) from Rajpur Sarika Gopal Mukesh, who had accompanied them to Barwani, suggested taking Santoshi back to Rajpur. By this time, Raju, whose family comes under BPL, was penniless and collected funds from donors to take Santoshi back to Rajpur.
Fortunately, the PHC there provided an ambulance and Santoshi was brought to MY Hospital here on time, where she delivered a girl late Thursday night.The incident has exposed the cracks in the system and brings out the true picture painted by the actual implementation of the various welfare schemes of the state government.
To start with, Sarika, an ASHA, did not have proper information about Janani Suraksha Yojana, wherein she is supposed to get Rs 600 for bringing any expectant mother to a health facility. Not just this one scheme, she was not aware of many other schemes.“I have not heard about Janani Suraksha Yojana but during our training, we were told only about our incentives and basic work. They (trainers) never told us about how to tackle serious situations and also about facilities available like ambulance service for taking expecting women to a health facility,” Sarika told Hindustan Times at MY Hospital here.
When asked why the family had no Deendayal Antyodaya Yojana card, Sarika further said, “Almost 50 per cent of the people in our village (Rajpur) do not have this card as on today. The cards are being prepared for a long time and hence not distributed.”
Higher medical officials do not want to take any responsibility and have been passing the buck when it came to pinning down the person responsible for such an incident. Barwani Chief Medical and Health Officer (CMHO) Dr Lakshmi Baghel, when contacted on telephone about the incident, said, “As far as I am concerned, we had organised fairs and programmes to create awareness about Janani Suraksha Yojana at all the villages under our jurisdiction. If the volunteers are still unaware about it, we will try to create more awareness about it.”
Dr Sawner when contacted over telephone first said “I had given permission for providing ambulance to Santoshi”, only to retract later saying “Santoshi was referred to Indore by Barwani District Hospital gynaecologist Dr Sushila Kumrawat. Santoshi’s relatives did not approach me for ambulance.”
The above incident raises several questions. Like inadequate training of ASHAs, no proper publicity about various schemes of the government amid the target group; officials not bothered about proper implementation of schemes and last but not the least lack of awareness on part of the individual (here both Santoshi and Raju are illiterate) about their rights and the facilities available for them.
Published in HT, Indore Jan 23, 2007