KASARAGOD: The Supreme Court on Thursday directed the Kasaragod District Legal Services Authority (DLSA) to submit a report on the healthcare facilities, including palliative care and physiotherapy, available for endosulfan victims in the district.
The apex court sought the "objective assessment" of the DLSA after the state government and an NGO submitted differing reports on the healthcare facilities for endosulfan victims in the district.
The two-judge bench of justices D Y Chandrachud and A S Bopanna directed the secretary of Kasaragod DLSA (sub-judge Karunakaran B) to visit the healthcare facilities and submit the report within six weeks.
The court should have an "objective assessment of the medical and healthcare facilities available for the endosulfan affected areas of Kasaragod at various levels, including the District Hospital, General Hospital, community health centres, and primary health centres", the order said.
The bench was hearing a contempt of court petition filed by eight endosulfan victims against the state government for not releasing the compensation of Rs 5 lakh each as directed by the apex court in January 2017.
After the petition was filed, the Supreme Court censured the state government, following which the government gave Rs 5 lakh each to almost all the endosulfan victims in three months.
But the Supreme Court did not close the contempt case and sought to know from the state government about the healthcare facilities and palliative care provided to the endosulfan survivors because they suffer from life-long conditions.
Chief secretary V P Joy submitted two affidavits listing out the government initiatives for endosulfan victims in Kasaragod. TNIE had filed detailed reports exposing the half-truths in the two affidavits.
On Thursday, the Confederation of Endosulfan Victims Rights Collectives (CERV), which is giving legal support to endosulfan victims, submitted a 'situational analysis of healthcare facilities in Kasaragod' puncturing holes in the government's affidavit.
Senior advocate P N Ravindran, appearing for the eight endosulfan victims, suggested that the apex court should independently verify the facts, considering there are two differing reports before it.
"Based on the suggestion, the Supreme Court tapped the District Legal Services Authority for a report," said P S Sudheer, another advocate appearing for the survivors.
The Supreme Court directed all authorities of the state government to cooperate with the secretary of DLSA by providing necessary information and logistical support to facilitate site visits.
'We call for urgent action from govt'
The CERV undertook a study on the healthcare facilities in Kasaragod by visiting hospitals, healthcare staff in endosulfan-affected areas, and also the District Hospital and General Hospital, officials of the Department of Health Services, and endosulfan-affected families.
The study was led by CERV office-bearers Prof M A Rehman, Prakash Bare, and K K Ashokan. Based on their findings, CERV said: "We call for urgent action from the government and invite more public support to the district administration to ensure that the endosulfan victims and their caregivers get opportunities and facilities to make life easier".
Here are its findings submitted to the Supreme Court:
1. Partially functional Medical College:
Kasaragod Government Medical College provides only outpatient (OP) services. The majority of medical staff have been deputed to other medical colleges in the state.
The district does not have tertiary healthcare facilities.
2. One neurologist with no technical support
The District Hospital in Kanhangad has 11 speciality OP consultations. A neurology OP was recently started with the appointment of one neurologist. This is the only super speciality service available in the district. However, there is no technician to operate the EEG machine. The hospital said it conducted interviews twice but there was no qualified person to attend them.
3. Structural Limitations:
The District Hospital was upgraded to 400 beds from 250 beds but no additional infrastructural facilities and staff were provided. The hospital is currently running with temporary staffers. According to the standard measure, there should be a distance of 1 metre to 1.5 metres between beds in wards. But in the General Hospital, there is a gap of only 50cm between two beds, causing a lot of inconvenience to in-patients.
4. The General Hospital in Kasaragod town was upgraded from Taluk Hospital without additional staff and infrastructure. The Primary Health Centre in Periya was upgraded to a community health centre without providing additional staff.
5. Lack of beds in ICU/ terminal care facilities:
There are only five beds in ICU with ventilator support. They are not enough to cater to the needs of the general public. So any recommendation for special provisions for endosulfan-affected patients is meaningless without additional resources.
6. Lack of specialised palliative care services
Though hospitals have Palliative Care Units, there are no special palliative services for endosulfan victims in the district. The one special mobile wing (with one doctor and one nurse) for endosulfan patients provides services only once a month. These services are provided through PHC and FHC. It is difficult for the mobile unit to effectively cater to the needs of a large district such as Kasaragod.
7. Physiotherapy
Physiotherapy is a continuous process but therapists from primary health centres do not visit regularly. Without regular therapies, there will not be any improvement for the child, said parents.
The district hospital has a physiotherapy unit with three staff members. It is open from 8 am to 3 pm. Its mobile unit provides home service once a month. But there is no physiotherapy facility specially for endosulfan victims in District Hospital. Caregivers of endosulfan patients don't have space to sit with their children with intellectual disabilities.
7. Accessibility to health services
Patients needing specialty care seek treatment in Kannur Government Medical College, Mangaluru, and far-flung places such as Kozhikode and Thiruvananthapuram, putting an additional burden on caregivers for accommodation and travel. Patients also find it difficult to travel.