#India -11 babies die in 2 hours at Bengal hospital, death toll now 13 #WTFnews


HT Correspondent , Hindustan Times  Purulia, June 09, 2013

A hospital in West Bengal’s Purulia district, 296 km from Kolkata, reported 11 infant deaths between Friday and Saturday.

“The children who died were brought to the hospital in a very critical condition. The doctors did their best,” said Nilanjana Sen, the hospital super.

“The extension work of the Special Newborn Care Unit (SNCU) is on and when it is completed children will get better treatment, the mortality rate will also come down,” she added.

 

Locals and relatives of the dead children, however, blamed the deaths on the poor infrastructure and lack of doctors at the Special Newborn Care Unit.

A senior doctor with the hospital, who did not want to be named, admitted there was a shortage of doctors in the paediatric unit.

 UPDATE, JUNE 10, 2013

Thirteen infants have died at the Purulia Sadar Deben Mahato Hospital in Purulia since last Friday, the hospital said on Monday.

Most of the infants were in the age group of 0-11 months, hospital superintendent Nilanjana Sen said. While eight deaths were reported on Friday, three infants died on Saturday and two deaths were reported on Sunday, she added.

The infants, who were brought to the Sadar hospital from the block-level hospitals, were suffering from complications such as low birth weight, malnutrition, dehydration and meningitis, the superintendent said.
Citing the difficulties of the Sadar hospital in treating such patients, Sen said the neo-natal unit has only ten beds, which needs to be increased.

 

On an average, 15-20 infants in serious condition are referred to the Sadar hospital from the block-level hospitals daily, she said.

 

#India – One woman doctor for entire district of Mewat #Believeitornot


Aditya Dev, TNN May 16, 2013,
GURGAON: There is an acute shortage of doctors in government hospitals of Mewat. Surprisingly, the district with the worst maternal mortality rate and infant mortality rate, there is only one woman doctor available for the whole of Mewat. However, the apathy could be judged by the fact that the gynecologist has joined the health department only about 10 days ago.

The institutional delivery rate in Mewat is 42% implying only 42 out of 100 deliveries take place at hospital. A health official said these deliveries are done by staff nurses in absence of doctors. Sources said the health institutions are in a bad shape with two of the three community health centres (CHCs) at Punhana and Ferozepur Jhirka in the districts are without senior medical officers (SMOs) for a long time. In their absence, medical officers (MOs) have been made incharge of these CHCs.

Moreover, instead of two medical officers at each of 10 primary health centres (PHCs), there is only one medical officer appointed at present, said sources.

At CHC, Nuh, against the staff postings of 12 medical officers (MOs) and one SMO, there are only 3 MOs and one SMO are deputed.

The population of Mewat is 11 lakh and out of that 5.5 lakh alone lives in Nuh. In such a scenario, the medical facilities are too little to provide any kind of service to residents. A health official said the burden could be gauged that there should be one CHC over a population of 1.2 lakh. There is also a shortage of ASHAs (Accredited Social Health Activists) in the district. ASHA, a trained female community health activist from the village itself who work as an interface between the community and the public health system, plays an important role in providing key services to mother and child and spread awareness. A health official informed that out of 1,200, only 500 are available in Mewat.

This is when the criteria of appointing an ASHA was relaxed from class VIII literate to just any woman who can carry basic duties. Even after that we have not been able to fill the postings, the official added.

When contacted, BK Rajora, chief medical officer, Mewat, said, “There is a shortage of doctors, but the government gives priority to their appointment in the district. The problem is that many of them do not join here even after appointment. What can one do in such a scenario? Doctors do not want to come because of basic living facilities in Mewat.”

The government is also providing difficult area allowance to doctors posted in Mewat, Rs 25,000 per month for specialist and Rs 10,000 per month for other doctors.

Rajora added that besides one gynaecologist joining the office, four doctors have been given training in this field and providing emergency services. There are 53 MOs available out of 79. Almost 50% of positions are filled.

 

Maternal Health Activist Madhuri of JADS arrested #Vaw #Tribalrights


 

English: National Rural Health Mission of India

English: National Rural Health Mission of India (Photo credit: Wikipedia)

 

Five Years of NRHM-JSY and more than a decade of RCH: continuing maternal deaths in Barwani and MP
Background
Janani Suraksha Yojana (JSY) was launched under the National Rural Health Mission (NRHM) in
April 2005 as a safe motherhood intervention, with the specific objective of reducing maternal and
neo-natal mortality by relying on institutional delivery as the primary strategy for making available
medical care during pregnancy, delivery and post delivery period, and thus promoting safe
motherhood. All women are encouraged to avail institutional care during pregnancy and delivery,
and through ASHAs recruited specifically for this purpose institutional delivery is being promoted
among poor pregnant women. JSY is a 100 % centrally sponsored scheme, and it links cash
incentives to pregnant women with hospital delivery and post-delivery care. Reproductive and
Child Health (RCH-I) has been operational since 1997 as a project to provide a variety of
reproductive and child health services in rural areas to bring down maternal and infant mortality, in
order to reduce fertility rates and achieve population control. The second phase of the program
(RCH-II) also commenced in 2005. NRHM itself was launched with the promise to improve
availability and accessibility to health care services to the rural population, especially the
disadvantaged groups including women and children, by strengthening public health systems for
efficient service delivery, improving access, enabling community ownership and demand for
services, enhancing accountability and promoting decentralization.
It is against this context of programmes and interventions and associated fund flows from
the central government and several international agencies that one needs to view the status of
public health services, of maternal and child health in the country in general and specifically in the
high-focus states like MP, and the developments in Badwani that is the focus of this report.
Mass protest against maternal deaths in District Hospital, Barwani
On 28th December 2010 a rally was held in Barwani town, the headquarters of a predominantly
adivasi district in south-western MP. Nearly a thousand people gathered under the banner of
Jagrit Adivasi Dalit Sangathan (JADS), a mass organisation, to protest against extremely
negligent treatment of women in pregnancy and labour, particularly the death on 29th November
2010 of Vypari bai, an 8-months’ pregnant woman admitted in the District Hospital.
The people had come for this rally
from far-flung adivasi villages of the
district, and sought to draw attention to and
to protest against extreme callousness and
ill-treatment regularly meted out to women
in pregnancy and labour by the public
health system, particularly the District
Hospital (DH). A quick perusal of the DH
records indicated that between April-
November 2010 there had been 25 maternal
deaths, and 9 maternal deaths had been
recorded in this hospital in the month of
November 2010 alone. In addition, deaths
of 21 neonates (within 24 hours of birth) had been recorded, related to 511 deliveries conducted
in the hospital during November 2010. People complained that women with problems during
pregnancy and labour were frequently referred to Indore Medical College Hospital, located 150
kms away, despite the DH being supposed to deal with such cases.
The tragic story of Vypari bai – ‘institutional death’ instead of ‘institutional delivery’
Vypari bai, a 22 year old woman had travelled over 55 kms from her village Ban since the
morning of 27th November 2010 to reach the District Hospital, having been referred from the
PHC at Bokrata, and then from the CHC at Pati. She had been carried in a `jhuli’ (cloth sling)
over the first 10 kms from her village to Bokrata, from where the family managed to get the
Janani Express ambulance. She had experienced a convulsion that morning, and had high blood
pressure (BP) and eclampsia at the time of admission in the DH around 1.30 pm on 27th
November.
Following her examination by a gynaecologist at the time of admission in the DH on 27th
Nov., she was visited only once by another doctor during the entire day on 28th Nov. She had been
prescribed medicines after admission to control her BP, but her treatment sheets show only two
measurements of BP during the entire stay from 27th to 29th Nov. No attempt seems to have been
made to deliver the baby, by either induction or cesarean, as is the standard procedure in such
cases. An ultrasound scan on 28th November (for which the woman was taken by auto-rickshaw to
a private centre even though the hospital has this facility) showed the presence of live foetus.
Both the mother and mother-in-law of Vyparibai are trained health workers, presently
working as ASHAs in the NRHM. The mother-in-law Dunabai in desperation attempted to contact
the gynaecologist, who never turned up to see the patient in spite of repeated pleas from the
patient’s family. Moreover the doctor on duty, after checking the patient only once on 28th, was
also absent from the hospital premises. After repeated efforts to contact her, at late night at around
11 pm on 28th November, she instructed the nurse on duty that the relatives could take the patient to
Indore, but did not bother to examine the patient or modify the treatment. When the family went to
the doctor’s residence (which is within the hospital premise at a stone’s throw from the ward) on
28th night to ask her to attend to the woman as she was in great pain, the doctor refused to go,
saying she would phone the instructions to the nurse. The young woman finally breathed her last at
5 am on 29th November 2010, without medical attention despite being admitted in the District
Hospital.
Both the block CHC and Barwani DH are CEMONC (Comprehensive Emergency Obstetric
Neonatal Care) centres, and the DH is equipped with a Blood Bank. Such centres are supposed
to provide emergency services related to pregnancy/ delivery round the clock and 365 days a year.
In any case, a hospital at the level of district hospital is supposed to provide emergency services at
all times, whether or not it is a CEMONC. Further, there is provision that in case of complications,
CEMONC centers can contract-in services of private medical practitioners. So she could have been
referred under the ‘Janani Sahayogi Yojana’ to one of the two local private hospitals. The DH has
four gynaecologists and two anaesthetists, who could have ensured Vypari bai’s delivery. However,
the case paper shows that nearly 35 hours after admission, the patient had been referred to the
medical college hospital in Indore at around 11 PM on 28th. Further, the family was asked to sign
an undertaking, stating that they were refusing to take her to Indore and they took responsibility for
the consequences. It has been repeatedly experienced that, rather than using the institutional
provisions, patients are generally referred to Indore. And are also made to sign such undertakings.
Several other cases of denial of services leading to complications and ill-treatment at all
levels of health services have been documented by JADS. Few illustrative ones are described
below.
District Hospital, Barwani – Baltabai, 20 years, Village- Ubadagad, Pati Block,
On 6th June 2010, 9-months’ pregnant Baltabai was taken to Pati CHC with labour pains, by bus at around 12
o’clock in the afternoon. There was no doctor in the CHC. When the family contacted the BMO and
requested him to see Baltabai, the BMO did not do so, but simply arranged for the Janani Express
Ambulance and referred the patient to the District Hospital. Around 3 PM Baltabai was admitted in the
female ward of the DH. Not a single doctor was present in the female ward, ostensibly because `it was
Sunday’. The nurse on duty informed the doctor who was supposed to be on duty, but was not physically
present in the hospital premises, about the serious condition of Baltabai. She was advised some blood test,
and after the blood report was available, referred by the doctor to M.Y. Hospital, Indore. During this period
the relatives were not adequately informed about the condition of the patient and need for referral. What is
more serious is that the family was not informed about intrauterine foetal death. Following the nurse’s
advice to go to the local hospital instead of Indore, the family took Baltabai to the private trust hospital in
the Barwani town, where the doctor examined Baltabai and informed them that the foetus was dead. She
recommended an emergency operation to remove the dead foetus and save the mother. The family had no
option but to go ahead with this surgery. They incurred a cost of around Rs 10,000/- and an additional Rs.
7000/- were spent on medicine. The family, dependent on daily-wages, had to borrow money from local
money lenders at very high interest rate.
On 14th June Baltabai was discharged from the trust hospital. However, her agony was not
over yet. On reaching home that evening she complained of abdominal distension and pain. On 15th
June, at 4 am she was taken to a private practitioner, where she was cathetarised, and again referred
to the DH, where she was treated till 21st June. On 21st June Baltabai was referred to M. Y. Hospital
Indore for treatment of paraplegia. What exactly happened to Baltabai from15th – 21st June is not
very clear, largely because there are no trustworthy clinical records. Why and how Baltabai
developed paraplegia was never explained to the family members and other concerned people.
Fortunately Baltabai’s condition improved in the M.Y. Hospital and she was subsequently
discharged on 1st July. The ordeal of Baltabai lasted for 24 days (6th June to 30th June), and has left
the family severely indebted.
In September 2008 a woman in labour at the District Hospital was referred by the attending
doctor to Indore as a case of obstructed labour. The family took her to the local Trust hospital,
where a caesarean operation was performed and the child delivered safely. However, due to the
delay the child developed complications and had to be admitted in the neo-natal intensive care unit
(NICU) in the DH.
CHC-Pati block – Meera, Patel phaliya , Pati
Meera had symptoms of threatened abortion since the second month of pregnancy; and was treated
at CHC, Pati. However, the doctor advised her that she should not rely on the medicines available
in the hospital, and made the family purchase injections and medicines from outside the hospital,
worth about Rs 1000-1200. Meera followed all the instructions given by the doctor, as she was told
that she would have a difficult labour. Despite this treatment Meera had intrauterine bleeding one
morning. When she called up the CHC for the Janani Express ambulance she was told that since
she was from Pati itself, she should go to the hospital by herself, and would not be provided the
ambulance. The lady walked over 5-8 km, for almost 2 hours, bleeding and in terrible pain, to reach
the CHC. At the CHC, she was informed that the baby had died in the womb. The family was
forced to purchase few special medicines from outside for the operation to remove the dead foetus.
PHC Menimata – Baniya Bai
On the night of 11th November 2008 Baniya bai went to the PHC Menimata for delivery. The
compounder and nurse asked her family for Rs 100, which the family did not give. The next
morning she was forced to leave the hospital on grounds of being anaemic. Baniya Bai, in
labour pain, managed to crawl out to the road outside the PHC, where she delivered with the help
on the local dai. She was then sent by members of JADS to CHC Silawad by the Janani
ambulance.
These are not isolated cases; there are reports of similar incidents of maternal deaths and
denial of treatment at the health centres, including the DH in Barwani.
Demanding Accountability for Negligence
We were visiting Barwani to get a firsthand
account of the situation there
concerning health services, particularly
in the District hospital. On the morning
of 28th December when we tried to meet
the CMHO and the concerned lady duty
doctor (who happens to be the CMHO’s
daughter) we were told that they were
out of town. The gynaecologist who had
admitted Vypari bai on 27th November
said she had anemia and eclampsia and
was not in a condition to be operated
upon; and that they did not have a
ventilator in the hospital. This
gynaecologist was not around the day
after admission (28th November) to monitor the progress; she is usually out of the hospital four
days of the week performing sterilization operations in family planning camps.
We observed the rally taking place outside the DH on 28th December. About 500 people
(nearly half of them women) had gathered at the entrance of the DH at around 12 noon, by which
time the OPD was almost over. The 2-3 doctors present there left when they heard the rally
approaching. The police tried to snatch away from the rallyists their microphone and the cart on
which it was placed; however the rallyists managed to convince them that they would leave very
soon. About fifteen minutes later the people moved away from the hospital premises and
continued their dharna on the road in front of the Collectorate office, well away from the DH.
Several activists and ordinary village women, including the mother-in-law of the deceased
Vyaparibai spoke of their travails at the DH. A set of 22 issues concerning the District hospital,
which were mentioned in the memorandum of demands, were read out to the assembled people.
The Civil Surgeon was asked for, but he refused to come out to receive the petition; finally the
ADM came and just gave a brief assurance that the issues would be responded to in writing in 15
days time. By around 4 PM the rally had dispersed.
Response by the administration – ‘the message is secondary, crack down on the messenger’
We met the Collector on 28th December evening after the rally and apprised him of the state of
affairs in the DH. It emerged that the process of carrying out maternal death reviews had not
been carried out in case of any of the 25 maternal deaths. During our meeting with the Collector,
the CMHO and CS came when they were summoned. According to the CMHO such maternal
deaths keep occurring, that women here were very anaemic, and it was ‘not possible to bring
them down to zero’. When pointed out that the DH was a CEMONC centre, that there were 4
serving gynaecologists and 2 anaesthetists, and it was enquired why such institutional deaths
were still taking place, there was no satisfactory response. The Collector appreciated our
bringing things to his notice, and said he would initiate
the task of Maternal Death Reviews. At the same time,
he also hinted at linkages of the mass organisation with
‘Bastar’ and ‘Andhra Pradesh’, thereby seeking to
discredit the people’s organisation as being associated
with the ‘Naxalites’, who have been outlawed by the
central government.
We are now extremely shocked and dismayed
that two days after this rally (on 30th Dec.) as per local
press reports, the police has foisted several charges on
the leaders of JADS and 200 people who participated
in the protest. They have been charged with Sec 146 of
IPC (unlawful assembly, rioting, armed with deadly weapon which when used is likely to cause
death), Sec 186 IPC (obstructing public servant in discharge of public functions), and Sec 16(3)
of MP Kolahal Rules. On 31st December one of the activists of the organisation, Bachhiya bhai,
was arrested and sent to jail on charges that were slapped on him and others in 2008, when they
had protested against the denial of services in PHC Menimata (described above).
It needs to be mentioned that the pilot phase of community-based monitoring of rural
health services in MP under NRHM had been implemented in Barwani during 2007-08. Even
prior to this the mass organisation JADS had been actively addressing the health problems in the
area in several ways. In May 2008 a three-day programme of monitoring of services at the CHC
Pati and dialogue with health officials (with the intention to improve them), was followed up
with a rally at Barwani town on the dismal state of health services in the DH. So the area has a
history of peaceful rallying for improvement of rural health services. However, there seems to
have been hardly any concerted response from the administration to address the genuine
problems faced by and raised by the people.
Is the situation restricted to Badwani?
The situation regarding maternal deaths seems to be similar in many other districts of MP. The
audit report of NRHM in MP by the CAG gives an idea of the serious situation in the state.
According to the CAG audit report for the period 2005-06 to 2008-09 incidences of maternal and
infant deaths in MP remained high. In the 12 districts surveyed for the audit there had been 1377
maternal deaths in all in the four-year period – Betul recorded 152, Bhopal 269, Indore 162,
Shahdol recorded 393, Dhar recorded 125, Ujjain 124, and so on. Shahdol district reported 55
maternal deaths in 2008-09. The audit report also points out that despite increase in number of
institutional deliveries, post-delivery mortality remained alarmingly high. The Maternal Mortality
Rate remained high at 379 per lakh live births. Interestingly, the state government has fixed a
lower target than that of the central government for reduction of MMR and IMR. While NRHM
envisages MMR of less than 100 per lakh live births and IMR of 30 per 1000 live births by 2012,
the MP government has set these at less than 220 and 60 respectively. It has said that due to
shortage of manpower it was not possible to achieve the NRHM targets! The audit also found that
Maternal Death Review Committees were to be constituted at each district, but had not been done.
A large number of neo-natal deaths also seem to be occuring: according to figures (collected by
RCH – NRHM for monitoring and evaluation) between April-November 2010, there were 154 neonatal
deaths in the entire district of Badwani, of which 133 have been recorded at the District
Hospital (3879 deliveries recorded at the DH in the same period).
Some other findings of the CAG audit indicate that even after four years of NRHM the
state government was not taking adequate measures to address the long-standing problems of
lack of basic medical facilities, lack of physical infrastructure, and of doctors and other staff.
For instance: the number of health centres fell short of the prescribed norms; several centres,
particularly sub-centres were functioning without buildings; none of the institutions had been
upgraded to Indian Public Health Standards (IPHS); of the 82 CHCs designated as first referral
units (FRUs) 80 percent were non-functional and the rest were only partially functional. The
state government itself acknowledged that the health centres are non-functional due to shortage
of man-power. 101 out of 297 PHCs in the 12 districts studied were running without doctors,
despite the provision for hiring contractual staff under NRHM. Monitoring Committees too at
state and at lower levels to review the activities under NRHM had not been formed till 2009.
One also finds that several hundreds of crores of rupees have been spent over the past few
years under RCH-JSY. Government reports show that the allocations for RCH-JSY had increased
since 2005, and expenditure too had increased from Rs 26.29 crores in 2005-06 to Rs 344.87
crores in 2008-09. By 2009-10 Rs 797.65 crores from NRHM funds had been spent on activities
to improve maternal and child health.
Issues and Concerns
We wish to draw attention to the grave situation that seems to be building up in places like
Barwani. It is now more than a decade of RCH and five years since NRHM, RCH-II, JSY etc,
were launched as flagship programmes. On one hand, the government is spending several
hundreds of crores of rupees annually, is vigorously promoting institutional deliveries as a
panacea for high maternal and infant mortality, and talks of safe and guaranteed health services;
through processes such as community monitoring it is promoting the idea of demanding
accountability from the public health machinery. On the other hand, the ground reality in places
like Barwani shows little change. And when people get organized to demand accountability
through peaceful actions, attempts are made to discredit and ‘brand’ their leaders, to intimidate
and repress them, and to shield the responsible officials who seem to be to completely indifferent
to the plight of the patients.
One finds that in spite of several interventions and expenses of crores of rupees, women
continue to die in large numbers. Majority of these deaths are avoidable and completely
unacceptable. It is precisely these preventable deaths that JSY claims to address, right from
ante-natal care (ANC) to post-delivery care of mother and new-born, by getting the pregnant
women to register soon after pregnancy and `motivating’ them to go to a hospital for delivery.
However, the ground reality indicates that the government is not improving the `health’ of the
health facilities in order that they treat satisfactorily women in labour, especially those with
complications. This is corroborated by the findings of the audit of the performance of NRHM in
MP. The experiences of ill-treatment narrated by the rural women also point to the apathy of the
doctors and the poor quality of care they receive when they come in pain and suffering.
How many more such `institutional deaths’, complications and denial of services, are to
occur before the hospital doctors become responsible and accountable; before the state health
department, the health ministry, the rogi kalyan samitis, the district health societies, the
numerous managers, planners, consultants, and international agencies look beyond their
ritualistic exercises of working on technical assistance, planning, evaluating, re-evaluating, replanning,
merely recording numbers of pregnant women registered, of institutional deliveries and
of beneficiaries etc., in the name of safe motherhood and child health, and seriously take note of
the reality of the deaths of women and infants?
Dr Abhay Shukla – National Joint Convenor, Jan Swasthya Abhiyan
Dr Indira Chakravarthi – Public Health Researcher, Delhi
Rinchin – Bhopal
8.1.2011

 

 

Madhuri of JADS has been arrested for fighting against contnuing Maternal Deaths In Barwani #Vaw #Tribalrights


 

 

English: National Rural Health Mission of India

 

Five Years of NRHM-JSY and more than a decade of RCH: continuing maternal deaths in Barwani and MP

 
Background
Janani Suraksha Yojana (JSY) was launched under the National Rural Health Mission (NRHM) in
April 2005 as a safe motherhood intervention, with the specific objective of reducing maternal and
neo-natal mortality by relying on institutional delivery as the primary strategy for making available
medical care during pregnancy, delivery and post delivery period, and thus promoting safe
motherhood. All women are encouraged to avail institutional care during pregnancy and delivery,
and through ASHAs recruited specifically for this purpose institutional delivery is being promoted
among poor pregnant women. JSY is a 100 % centrally sponsored scheme, and it links cash
incentives to pregnant women with hospital delivery and post-delivery care. Reproductive and
Child Health (RCH-I) has been operational since 1997 as a project to provide a variety of
reproductive and child health services in rural areas to bring down maternal and infant mortality, in
order to reduce fertility rates and achieve population control. The second phase of the program
(RCH-II) also commenced in 2005. NRHM itself was launched with the promise to improve
availability and accessibility to health care services to the rural population, especially the
disadvantaged groups including women and children, by strengthening public health systems for
efficient service delivery, improving access, enabling community ownership and demand for
services, enhancing accountability and promoting decentralization.
It is against this context of programmes and interventions and associated fund flows from
the central government and several international agencies that one needs to view the status of
public health services, of maternal and child health in the country in general and specifically in the
high-focus states like MP, and the developments in Badwani that is the focus of this report.
Mass protest against maternal deaths in District Hospital, Barwani
On 28th December 2010 a rally was held in Barwani town, the headquarters of a predominantly
adivasi district in south-western MP. Nearly a thousand people gathered under the banner of
Jagrit Adivasi Dalit Sangathan (JADS), a mass organisation, to protest against extremely
negligent treatment of women in pregnancy and labour, particularly the death on 29th November
2010 of Vypari bai, an 8-months’ pregnant woman admitted in the District Hospital.
The people had come for this rally
from far-flung adivasi villages of the
district, and sought to draw attention to and
to protest against extreme callousness and
ill-treatment regularly meted out to women
in pregnancy and labour by the public
health system, particularly the District
Hospital (DH). A quick perusal of the DH
records indicated that between April-
November 2010 there had been 25 maternal
deaths, and 9 maternal deaths had been
recorded in this hospital in the month of
November 2010 alone. In addition, deaths
of 21 neonates (within 24 hours of birth) had been recorded, related to 511 deliveries conducted
in the hospital during November 2010. People complained that women with problems during
pregnancy and labour were frequently referred to Indore Medical College Hospital, located 150
kms away, despite the DH being supposed to deal with such cases.
The tragic story of Vypari bai – ‘institutional death’ instead of ‘institutional delivery’
Vypari bai, a 22 year old woman had travelled over 55 kms from her village Ban since the
morning of 27th November 2010 to reach the District Hospital, having been referred from the
PHC at Bokrata, and then from the CHC at Pati. She had been carried in a `jhuli’ (cloth sling)
over the first 10 kms from her village to Bokrata, from where the family managed to get the
Janani Express ambulance. She had experienced a convulsion that morning, and had high blood
pressure (BP) and eclampsia at the time of admission in the DH around 1.30 pm on 27th
November.
Following her examination by a gynaecologist at the time of admission in the DH on 27th
Nov., she was visited only once by another doctor during the entire day on 28th Nov. She had been
prescribed medicines after admission to control her BP, but her treatment sheets show only two
measurements of BP during the entire stay from 27th to 29th Nov. No attempt seems to have been
made to deliver the baby, by either induction or cesarean, as is the standard procedure in such
cases. An ultrasound scan on 28th November (for which the woman was taken by auto-rickshaw to
a private centre even though the hospital has this facility) showed the presence of live foetus.
Both the mother and mother-in-law of Vyparibai are trained health workers, presently
working as ASHAs in the NRHM. The mother-in-law Dunabai in desperation attempted to contact
the gynaecologist, who never turned up to see the patient in spite of repeated pleas from the
patient’s family. Moreover the doctor on duty, after checking the patient only once on 28th, was
also absent from the hospital premises. After repeated efforts to contact her, at late night at around
11 pm on 28th November, she instructed the nurse on duty that the relatives could take the patient to
Indore, but did not bother to examine the patient or modify the treatment. When the family went to
the doctor’s residence (which is within the hospital premise at a stone’s throw from the ward) on
28th night to ask her to attend to the woman as she was in great pain, the doctor refused to go,
saying she would phone the instructions to the nurse. The young woman finally breathed her last at
5 am on 29th November 2010, without medical attention despite being admitted in the District
Hospital.
Both the block CHC and Barwani DH are CEMONC (Comprehensive Emergency Obstetric
& Neonatal Care) centres, and the DH is equipped with a Blood Bank. Such centres are supposed
to provide emergency services related to pregnancy/ delivery round the clock and 365 days a year.
In any case, a hospital at the level of district hospital is supposed to provide emergency services at
all times, whether or not it is a CEMONC. Further, there is provision that in case of complications,
CEMONC centers can contract-in services of private medical practitioners. So she could have been
referred under the ‘Janani Sahayogi Yojana’ to one of the two local private hospitals. The DH has
four gynaecologists and two anaesthetists, who could have ensured Vypari bai’s delivery. However,
the case paper shows that nearly 35 hours after admission, the patient had been referred to the
medical college hospital in Indore at around 11 PM on 28th. Further, the family was asked to sign
an undertaking, stating that they were refusing to take her to Indore and they took responsibility for
the consequences. It has been repeatedly experienced that, rather than using the institutional
provisions, patients are generally referred to Indore. And are also made to sign such undertakings.
Several other cases of denial of services leading to complications and ill-treatment at all
levels of health services have been documented by JADS. Few illustrative ones are described
below.
District Hospital, Barwani – Baltabai, 20 years, Village- Ubadagad, Pati Block,
On 6th June 2010, 9-months’ pregnant Baltabai was taken to Pati CHC with labour pains, by bus at around 12
o’clock in the afternoon. There was no doctor in the CHC. When the family contacted the BMO and
requested him to see Baltabai, the BMO did not do so, but simply arranged for the Janani Express
Ambulance and referred the patient to the District Hospital. Around 3 PM Baltabai was admitted in the
female ward of the DH. Not a single doctor was present in the female ward, ostensibly because `it was
Sunday’. The nurse on duty informed the doctor who was supposed to be on duty, but was not physically
present in the hospital premises, about the serious condition of Baltabai. She was advised some blood test,
and after the blood report was available, referred by the doctor to M.Y. Hospital, Indore. During this period
the relatives were not adequately informed about the condition of the patient and need for referral. What is
more serious is that the family was not informed about intrauterine foetal death. Following the nurse’s
advice to go to the local hospital instead of Indore, the family took Baltabai to the private trust hospital in
the Barwani town, where the doctor examined Baltabai and informed them that the foetus was dead. She
recommended an emergency operation to remove the dead foetus and save the mother. The family had no
option but to go ahead with this surgery. They incurred a cost of around Rs 10,000/- and an additional Rs.
7000/- were spent on medicine. The family, dependent on daily-wages, had to borrow money from local
money lenders at very high interest rate.
On 14th June Baltabai was discharged from the trust hospital. However, her agony was not
over yet. On reaching home that evening she complained of abdominal distension and pain. On 15th
June, at 4 am she was taken to a private practitioner, where she was cathetarised, and again referred
to the DH, where she was treated till 21st June. On 21st June Baltabai was referred to M. Y. Hospital
Indore for treatment of paraplegia. What exactly happened to Baltabai from15th – 21st June is not
very clear, largely because there are no trustworthy clinical records. Why and how Baltabai
developed paraplegia was never explained to the family members and other concerned people.
Fortunately Baltabai’s condition improved in the M.Y. Hospital and she was subsequently
discharged on 1st July. The ordeal of Baltabai lasted for 24 days (6th June to 30th June), and has left
the family severely indebted.
In September 2008 a woman in labour at the District Hospital was referred by the attending
doctor to Indore as a case of obstructed labour. The family took her to the local Trust hospital,
where a caesarean operation was performed and the child delivered safely. However, due to the
delay the child developed complications and had to be admitted in the neo-natal intensive care unit
(NICU) in the DH.
CHC-Pati block – Meera, Patel phaliya , Pati
Meera had symptoms of threatened abortion since the second month of pregnancy; and was treated
at CHC, Pati. However, the doctor advised her that she should not rely on the medicines available
in the hospital, and made the family purchase injections and medicines from outside the hospital,
worth about Rs 1000-1200. Meera followed all the instructions given by the doctor, as she was told
that she would have a difficult labour. Despite this treatment Meera had intrauterine bleeding one
morning. When she called up the CHC for the Janani Express ambulance she was told that since
she was from Pati itself, she should go to the hospital by herself, and would not be provided the
ambulance. The lady walked over 5-8 km, for almost 2 hours, bleeding and in terrible pain, to reach
the CHC. At the CHC, she was informed that the baby had died in the womb. The family was
forced to purchase few special medicines from outside for the operation to remove the dead foetus.
PHC Menimata – Baniya Bai
On the night of 11th November 2008 Baniya bai went to the PHC Menimata for delivery. The
compounder and nurse asked her family for Rs 100, which the family did not give. The next
morning she was forced to leave the hospital on grounds of being anaemic. Baniya Bai, in
labour pain, managed to crawl out to the road outside the PHC, where she delivered with the help
on the local dai. She was then sent by members of JADS to CHC Silawad by the Janani
ambulance.
These are not isolated cases; there are reports of similar incidents of maternal deaths and
denial of treatment at the health centres, including the DH in Barwani.

 
Demanding Accountability for Negligence
We were visiting Barwani to get a firsthand
account of the situation there
concerning health services, particularly
in the District hospital. On the morning
of 28th December when we tried to meet
the CMHO and the concerned lady duty
doctor (who happens to be the CMHO’s
daughter) we were told that they were
out of town. The gynaecologist who had
admitted Vypari bai on 27th November
said she had anemia and eclampsia and
was not in a condition to be operated
upon; and that they did not have a
ventilator in the hospital. This
gynaecologist was not around the day
after admission (28th November) to monitor the progress; she is usually out of the hospital four
days of the week performing sterilization operations in family planning camps.
We observed the rally taking place outside the DH on 28th December. About 500 people
(nearly half of them women) had gathered at the entrance of the DH at around 12 noon, by which
time the OPD was almost over. The 2-3 doctors present there left when they heard the rally
approaching. The police tried to snatch away from the rallyists their microphone and the cart on
which it was placed; however the rallyists managed to convince them that they would leave very
soon. About fifteen minutes later the people moved away from the hospital premises and
continued their dharna on the road in front of the Collectorate office, well away from the DH.
Several activists and ordinary village women, including the mother-in-law of the deceased
Vyaparibai spoke of their travails at the DH. A set of 22 issues concerning the District hospital,
which were mentioned in the memorandum of demands, were read out to the assembled people.
The Civil Surgeon was asked for, but he refused to come out to receive the petition; finally the
ADM came and just gave a brief assurance that the issues would be responded to in writing in 15
days time. By around 4 PM the rally had dispersed.
Response by the administration – ‘the message is secondary, crack down on the messenger’
We met the Collector on 28th December evening after the rally and apprised him of the state of
affairs in the DH. It emerged that the process of carrying out maternal death reviews had not
been carried out in case of any of the 25 maternal deaths. During our meeting with the Collector,
the CMHO and CS came when they were summoned. According to the CMHO such maternal
deaths keep occurring, that women here were very anaemic, and it was ‘not possible to bring
them down to zero’. When pointed out that the DH was a CEMONC centre, that there were 4
serving gynaecologists and 2 anaesthetists, and it was enquired why such institutional deaths
were still taking place, there was no satisfactory response. The Collector appreciated our
bringing things to his notice, and said he would initiate
the task of Maternal Death Reviews. At the same time,
he also hinted at linkages of the mass organisation with
‘Bastar’ and ‘Andhra Pradesh’, thereby seeking to
discredit the people’s organisation as being associated
with the ‘Naxalites’, who have been outlawed by the
central government.

 
We are now extremely shocked and dismayed
that two days after this rally (on 30th Dec.) as per local
press reports, the police has foisted several charges on
the leaders of JADS and 200 people who participated
in the protest. They have been charged with Sec 146 of
IPC (unlawful assembly, rioting, armed with deadly weapon which when used is likely to cause
death), Sec 186 IPC (obstructing public servant in discharge of public functions), and Sec 16(3)
of MP Kolahal Rules. On 31st December one of the activists of the organisation, Bachhiya bhai,
was arrested and sent to jail on charges that were slapped on him and others in 2008, when they
had protested against the denial of services in PHC Menimata (described above).
It needs to be mentioned that the pilot phase of community-based monitoring of rural
health services in MP under NRHM had been implemented in Barwani during 2007-08. Even
prior to this the mass organisation JADS had been actively addressing the health problems in the
area in several ways. In May 2008 a three-day programme of monitoring of services at the CHC
Pati and dialogue with health officials (with the intention to improve them), was followed up
with a rally at Barwani town on the dismal state of health services in the DH. So the area has a
history of peaceful rallying for improvement of rural health services. However, there seems to
have been hardly any concerted response from the administration to address the genuine
problems faced by and raised by the people.
Is the situation restricted to Badwani?
The situation regarding maternal deaths seems to be similar in many other districts of MP. The
audit report of NRHM in MP by the CAG gives an idea of the serious situation in the state.
According to the CAG audit report for the period 2005-06 to 2008-09 incidences of maternal and
infant deaths in MP remained high. In the 12 districts surveyed for the audit there had been 1377
maternal deaths in all in the four-year period – Betul recorded 152, Bhopal 269, Indore 162,
Shahdol recorded 393, Dhar recorded 125, Ujjain 124, and so on. Shahdol district reported 55
maternal deaths in 2008-09. The audit report also points out that despite increase in number of
institutional deliveries, post-delivery mortality remained alarmingly high. The Maternal Mortality
Rate remained high at 379 per lakh live births. Interestingly, the state government has fixed a
lower target than that of the central government for reduction of MMR and IMR. While NRHM
envisages MMR of less than 100 per lakh live births and IMR of 30 per 1000 live births by 2012,
the MP government has set these at less than 220 and 60 respectively. It has said that due to
shortage of manpower it was not possible to achieve the NRHM targets! The audit also found that
Maternal Death Review Committees were to be constituted at each district, but had not been done.
A large number of neo-natal deaths also seem to be occuring: according to figures (collected by
RCH – NRHM for monitoring and evaluation) between April-November 2010, there were 154 neonatal
deaths in the entire district of Badwani, of which 133 have been recorded at the District
Hospital (3879 deliveries recorded at the DH in the same period).
Some other findings of the CAG audit indicate that even after four years of NRHM the
state government was not taking adequate measures to address the long-standing problems of
lack of basic medical facilities, lack of physical infrastructure, and of doctors and other staff.
For instance: the number of health centres fell short of the prescribed norms; several centres,
particularly sub-centres were functioning without buildings; none of the institutions had been
upgraded to Indian Public Health Standards (IPHS); of the 82 CHCs designated as first referral
units (FRUs) 80 percent were non-functional and the rest were only partially functional. The
state government itself acknowledged that the health centres are non-functional due to shortage
of man-power. 101 out of 297 PHCs in the 12 districts studied were running without doctors,
despite the provision for hiring contractual staff under NRHM. Monitoring Committees too at
state and at lower levels to review the activities under NRHM had not been formed till 2009.
One also finds that several hundreds of crores of rupees have been spent over the past few
years under RCH-JSY. Government reports show that the allocations for RCH-JSY had increased
since 2005, and expenditure too had increased from Rs 26.29 crores in 2005-06 to Rs 344.87
crores in 2008-09. By 2009-10 Rs 797.65 crores from NRHM funds had been spent on activities
to improve maternal and child health.
Issues and Concerns
We wish to draw attention to the grave situation that seems to be building up in places like
Barwani. It is now more than a decade of RCH and five years since NRHM, RCH-II, JSY etc,
were launched as flagship programmes. On one hand, the government is spending several
hundreds of crores of rupees annually, is vigorously promoting institutional deliveries as a
panacea for high maternal and infant mortality, and talks of safe and guaranteed health services;
through processes such as community monitoring it is promoting the idea of demanding
accountability from the public health machinery. On the other hand, the ground reality in places
like Barwani shows little change. And when people get organized to demand accountability
through peaceful actions, attempts are made to discredit and ‘brand’ their leaders, to intimidate
and repress them, and to shield the responsible officials who seem to be to completely indifferent
to the plight of the patients.
One finds that in spite of several interventions and expenses of crores of rupees, women
continue to die in large numbers. Majority of these deaths are avoidable and completely
unacceptable. It is precisely these preventable deaths that JSY claims to address, right from
ante-natal care (ANC) to post-delivery care of mother and new-born, by getting the pregnant
women to register soon after pregnancy and `motivating’ them to go to a hospital for delivery.
However, the ground reality indicates that the government is not improving the `health’ of the
health facilities in order that they treat satisfactorily women in labour, especially those with
complications. This is corroborated by the findings of the audit of the performance of NRHM in
MP. The experiences of ill-treatment narrated by the rural women also point to the apathy of the
doctors and the poor quality of care they receive when they come in pain and suffering.
How many more such `institutional deaths’, complications and denial of services, are to
occur before the hospital doctors become responsible and accountable; before the state health
department, the health ministry, the rogi kalyan samitis, the district health societies, the
numerous managers, planners, consultants, and international agencies look beyond their
ritualistic exercises of working on technical assistance, planning, evaluating, re-evaluating, replanning,
merely recording numbers of pregnant women registered, of institutional deliveries and
of beneficiaries etc., in the name of safe motherhood and child health, and seriously take note of
the reality of the deaths of women and infants?
Dr Abhay Shukla – National Joint Convenor, Jan Swasthya Abhiyan
Dr Indira Chakravarthi – Public Health Researcher, Delhi
Rinchin – Bhopal
8.1.2011

 

 

 

 

 

When Rape is not Rape #Vaw #Womenrights


 Adrienne Rich`s #Rape- but the hysteria in your voice pleases him best #poem #Vaw

Majlis Team, Mumbai

Sometime around August, 2012* newspapers reported that a 14 year old girl was raped. The girl was 8 months pregnant and had been admitted to hospital. The rapist, a Muslim youth, was arrested. We decided to follow up the case and so approached the concerned hospital but were informed that the girl had been discharged. We then contacted the local police station who directed us to the girl’s  home.

Our first image of Monica was that of a very pregnant, chirpy and vivacious teenager. She was at home chatting with some friends around her own age. Her mother was away at work. Monica lives on the attic of a hutment in the fisherman’s colony, situated in one of the posh areas of South Mumbai. When we enquired about the incident she told us that Iqbal was her boyfriend and that they were to be married. According to her, there was some misunderstanding and Iqbal would be released soon. She seemed quite relaxed and oblivious of the gravity of the situation. Her only request was for us to help her meet Iqbal in the Arthur Road jail where he was lodged.

We introduced our work on socio legal support and as she grew comfortable she revealed her story. Monica’s father had abandoned them and was living with another woman in a slum nearby. Her mother worked a 12 hour shift as a private helper-nurse. Her father continued to visit their place in a drunken state. He would beat up her mother and demand money and sex from her. In her growing up years, Monica had been traumatized by these recurring incidents of violence.

Initially Monica attended a local municipal school but after school hours she had to fend for herself till her mother returned from work. Monica couldn’t cope and so she dropped out of school. She would then spend the entire day with her friends who were also school drop outs.

Soon Monica got into a relationship with Iqbal aged 20. He lived in a nearby slum and worked as a driver earning Rs.15,000 per month. Iqbal would visit Monica at home when her mother was away at work. It was only when Monica visited a public hospital with stomach pains that she realized she was five months pregnant. She had crossed the permissible period for abortion and hence had no choice but to continue with the pregnancy.

Monica’s mother was very upset. She approached Iqbal’s family and proposed marriage. However Iqbal’s family rejected the proposal of marriage of their son to a lowly Christian girl. But Monica was confident of her relationship and convinced her mother that in due course of time Iqbal would surely marry her. Her mother had no choice but to bide time.

As her pregnancy advanced, Monica continued to suffer from acute abdominal pain. It was thus in her eighth month Monica again approached another public hospital. At the registration counter, Monica was asked routine questions about her age and marital status. On realizing that she was 14 and unmarried, the hospital, without her knowledge, contacted the local police and all hell broke loose!

When the police arrived Monica’s mother tried desperately to convince them that they were in a relationship and were to be married soon. But the doctors insisted that it was a case of statutory rape (as Monica was below the age of consent). The police and doctors compelled her to file a criminal complaint.

Iqbal was arrested. The news was splashed in local newspapers and cable networks. Iqbal was immediately sacked from his job. He was the sole earning member of his family, so the family was furious with Monica and her mother and blamed them for his misfortune.

Monica pleaded with us to help her meet Iqbal in jail.  We tried counseling her and placed various options before her. Give the baby up for abortion, pursue her studies.  We suggested her moving to a shelter so that she could distance herself from the situation and reflect and explore her options. Her mother liked the idea, but Monica was not interested. Marriage was the only reality for her. Every time there was a pause in the conversation, she kept asking whether we will help her to meet Iqbal in jail. She had even come with cooked food to take for him.   However the jail authorities informed us that only blood relatives were allowed to meet under trials. The fact that she was carrying his blood in her stomach, did not matter at this juncture!

Then started the legal rigmarole. Iqbal’s family hired an expensive lawyer. Under his advice Monica personally appeared before the judge to plead for the release of Iqbal. They promised to arrange her marriage as soon as he was released. But this strategy did not work and even bail was not granted, so Iqbal remained in judicial custody. Monica attended court on each date to have a brief interaction with Iqbal despite her advanced pregnancy and health issues, but every time the bail application was rejected, his family grew more antagonistic towards Monica.

After several bail applications were rejected, the lawyer advised Monica  to stop contacting us as they feared that being a women’s  rights organisation our only interest would be to secure a conviction. But Monica’s mother kept in touch. Somehow she felt that we could mediate between the police, the court and Iqbal’s family to secure the future of her daughter.

As the charge sheet was getting filed, Monica delivered a baby girl. The trial started four months later.  Monica came to court carrying her tiny daughter in her arms, both fully covered in a Hijab! Perhaps, she thought, this would give her a semblance of respectability within the court environment or that by accepting the cultural norms of Iqbal’s family she would gain acceptability.

The trial concluded within two hearings. There was nothing much to decide. Monica turned hostile and deposed on oath that she does not know Iqbal, that it was a case of mistaken identity by the police. Everyone cooperated – the Investigating Officer, the woman public prosecutor, the court staff, and even the judge herself! Iqbal was acquitted. We have not been able to contact Monica or her mother thereafter. We do not know whether Iqbal actually married her.

This is a case where a young girl with multiple levels of marginalization tries to find a meaningful resolution on her own terms. She is then caught in a web of state laws and its moral codes. Young girls in consensual relationships, who accidentally get caught in this legal web will have no other option but to turn hostile in court.

More recently, the situation of girls like Monica has been rendered even more precarious. The recently enacted Protection of Children from Sexual Offences Act, 2012 prohibits all sexual activity for children below 18, as consent of children is not recognised. It also introduced the provision of mandatory reporting, hence non reporting of sexual activity of children below the age of 18 has been now rendered an offence.

The Act aims to deal with child marriage, rape and trafficking of children and is based on the  underlying premise that a young girl is incapable of giving valid consent. However these same girl are routinely exposed to discrimination, vulnerabilities and a range of exploitations.  Women’s groups appealed to protect the interest of these children and campaigned, not to criminalise normal sexual exploration during growing up years. But in the fight with a conservative and regressive moral brigade, we lost.

When will state and civil society begin to take responsibility and address marginalities of poor young girls rather than sitting on a moral high ground, and criminalizing its consequences? What is the future that awaits these young girls?

*The names of both the survivor and the accused as well as the month in which the newspaper report appeared, have been changed to protect the identity.

 

#India – If you are a tribal woman in Shahpur…, near Mumbai #Vaw


 

SHAHPUR, THANE, MARCH 29, 2013, Meena MENON, THE hINDU

File photo shows women attending a public hearing under the National Rural Health Mission (NHRM) in Sayvan village in Thane district.

Special Arrangement File photo shows women attending a public hearing under the National Rural Health Mission (NHRM) in Sayvan village in Thane district.

While Mumbai has an obscene array of five star health care, neighbouring Thane district is a picture of neglect

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.

 

#India- Don’t wear jeans, Congress MLA tells women’s kabaddi coach #Vaw #WTFnews


HARYANA, Updated Mar 23, 2013 at 03:54pm

Gurgaon: Indian women’s kabaddi team coach Sunil Dabas, who is also a teacher in a Gurgaon school, reportedly fainted after a Congress MLA passed some lewd and insulting comments against her during a function in Gurgaon. The alleged incident took place at DSD college, Gurgaon.

Congress MLA from Badshahpur Rao Dharmpal was the chief guest at the college’s annual function and Sunil Dabas was also present on the stage. Seeing Dabas dressed in a jeans and shirt, the Congress MLA passed some comments and asked her why she was wearing such clothes. Dabas was shocked on hearing the comments and reportedly fainted.

The students started protesting against the MLA after they came to know about the incident following which Dharmpal had to leave the function under police escort. Dabas’s brother said that the MLA should have been courteous and not made such an insulting comment. He said that Dabas was in a jeans and shirt but the MLA’s comments were very humiliating which shocked her. He also said that he would take appropriate action in the case whereas Dabas has been referred to Medanta Hospital from Shitla Hospital where she had been initially admitted.

Meanhile, Dharmpal defended his comments by claiming that he had congratulated Dabas for brining laurels to the country and then he advised her to dress in a dignified manner as all the female teachers of the school were wearing either a saree or salwar suit whereas she was the only one in a jeans and shirt. He also said that he did not visit Dabas in the hospital as the there were protests against him and alleged that the entire incident was a political conspiracy and appealed to the people not to get their wards admitted to government colleges as they were in a very poor state.

The local administration and college authorities have been keeping quiet. While Haryana Sports Minister came to see Dabas in the hospital, he refused to comment on the incident. College students allege that the local MLA was aware about the incident but had not come to meet Dabas while a senior Congress MLA should not have made such an insulting and irresponsible statement.

 

Kerala: 3 year old gangraped is fighting for her life #Vaw #WTFnews


 

CHILDRAPE

Vidya Iyengar Updated: Thursday, March 7, 2013, 12:31

Thiruvananthapuram, March 7: Even as the government claims to be working on enhancing security for girls and women, a 3 year old girl who was kidnapped and gangraped is battling for life at a local hospital. The girl was found abandoned near the Thrikandiyur following a search launched by the police.

The girl was first admitted to the Tirur District Hospital and later shifted to the Kozhikode Medical College Hospital (KMCH). According to Kozhikode Medical College Hospital (KMCH) deputy superintendent J C Cheriyan, the condition of the girl is improving. According to doctors who have performed two surgeries on her, she will take months together to recover.

The abandoned child was found on Tuesday morning. “She had high fever and was found with ants crawling all over her body,” eye-witnesses said. The girl’s mother who is a rag-picker is in a state of shock. On Monday night, when she went to sleep her daughter was beside her but when she woke up on Tuesday morning the girl was missing.

Although the child was admitted with severe injuries, she is now out of danger. She is currently under observation in the ICU. The medical examination has confirmed it was a rape. The girl has suffered a number of internal injuries. 16 men have been detained for questioning in connection with the rape.

According to district police chief K Sethuraman in the coming day more people will be questioned. “Police will ensure that the culprits behind the incident are nabbed,” additional director general of police N Shanker Reddy said. He visted Tirur and held a meeting with the invetigation team.

The Kerala Women’s Commission Chairperson KC Rosakutty visited the girl and her mother at the hospital and said that that all would be given to the child who would be under their protection. OneIndia News

Read more at: http://news.oneindia.in/2013/03/07/kerela-3-year-old-gangraped-1165832.html

 

#Mumbai- SevenHills wants to treat ‘Bachchans’, not poor: BMC #patientrights


Rosy Sequeira TNN

Mumbai:The BMC on Tuesday told the Bombay high court that SevenHills Healthcare Private Limited (SHHPL) wants to treat “only the Bachchans” and not poor and needy at its super-specialty hospital in Marol. Aishwarya Rai-Bachchan had given birth to a baby girl at the hospital.

BMC advocates Ashutosh Kumbhakoni and Shardul Singh said this while opposing a fresh plea by SHHPL for an NOC to change its bank mortgage. In September 2011, SHHPL had challenged BMC notices to vacate the land allotted to it to run the super-specialty hospital in a public-private partnership.
SHHPL’s counsel Venkatesh Dhond urged the HC for urgent relief in shifting the mortgage to other banks, saying mounting arrears had nearly made the hospital a non-performing asset.
The division bench of Justices Abhay Oka and K K Tated pointed out that following the November 2011 HC order, the BMC has granted an NOC. To which Dhond replied the NOC is more of an objection that has dissuaded bankers from granting funds. The judges said if SHHPL is not happy with the NOC, it should take out appropriate proceedings and not file a fresh plea claiming the same relief.
Dhond urged the HC to direct the BMC to grant an occupation certificate for the hospital. Kumbhakoni said there are conditions in the intimation of disapproval that SHHPL has to first comply with. The matter will be heard after three weeks.

After Mass Sterilization In India, 100 Women Apparently Left In Field To Recuperate #Vaw #WTFnews


More than 100 women in India were apparently left out in a field after a mass sterilization at a hospital in the Malda district of West Bengal, according to multiple reports.

“Helpers” were said to have moved the women — many of them unconscious from anesthesia administered during the invasive medical procedure — from the hospital and laid them out in an open field nearby. Medical officials told Agence France-Presse that there was not enough space at the hospital for them to recover indoors.

“Over 100 women, mostly poor, came to the camp for the surgery. Immediately after the procedure, the doctors asked the helpers to move each of them to the adjacent field,” the state’s director of health services, Dr. Biswaranjan Satpathi, told AFP.

According to the Press Trust of India, the mass sterilization was carried out on Tuesday at the Manikchak Rural Health Center.

Indian TV network NDTV captured footage of the women being carried from the hospital and placed on tarps outside. According to the broadcaster, doctors at the government-run hospital broke several medical rules, such as greatly exceeding the number of procedures that can be performed in one day — said to be set at 25 per doctor. Reports differ on how many doctors carried out the procedures. NDTV, for example, claims only two doctors were responsible for the sterilizations; Tamil News Network says four doctors were involved.

Dr. Bidhan Mishra, the district’s chief medical officer of health, has launched an investigation into the doctors involved, noting that proper post-operation procedures were not followed, the Tamil News Network reports. The National Human Rights Commission is also looking into the incident.

An NDTV reporter at the hospital in Kolkata described the scene, remarking that women were brought out on stretchers and dumped on the ground outside the hospital.

“Their relatives are massaging their feet, and that’s about all the after-care they seem to be getting after the sterilization operation,” she says during the video clip.

Sterilization is performed to prevent women from becoming pregnant. In India, government policies encourage women to have the tubal ligation procedure as a means of birth control, according to the Earth Policy Institute.

Adequate after-care and hygiene following the routine operation has been an ongoing issue in the country for years. While the U.K. pledged £166 million (about $260 million) to fund sterilization programs, the aid has been used to cover the costs of forced sterilizations of the poor, the Guardian reports.

Click over to NDTV to watch video footage of the women being carted away from the hospital in Kolkata, or watch the clip above.