Odisha’s health infrastructure needs review
The Orissa High Court’s observations in the Martha Sabar death compensation case must send the Odisha government into a soul-searching. What happened with the tribal woman from Gajapati district seven years ago shook the HC bench comprising Chief Justice Dr S Muralidhar and Justice M S Raman. It was amply evident in the verdict: “It shocks the judicial conscience that a poor tribal woman had been carrying a dead foetus for a week before her death with not one person in the healthcare system being able to provide her the needed care and treatment and which neglect resulted in her inevitable death.”
For the record, a nine-month pregnant Martha Sabar approached a primary health centre with chest and abdominal pain complaints on March 18, 2015. With the medical officer and ANM absent, she went home without any basic treatment or prescription. The woman who had previously lost her first child during an institutional delivery returned to the district headquarters hospitals six days later with complications relating to non-movement of the foetus. As the report of the enquiry committee appointed by the HC suggests, a gasping Martha was not provided even oxygen support, let alone any intensive care.
On March 25, 2015, she delivered a dead child without a doctor in the labour room. Hours later, the tribal woman perished. Martha Sabar and her family members’ heartrending ordeal must not recur in a state where the maternal mortality rate (MMR) continues to be a bane. The sample registration system data puts MMR in Odisha at 136 per one lakh live births for 2017–19. Though the state has shown improvement, it lags behind Bihar, Punjab, UP and Rajasthan in terms of performance. Poor rural healthcare infrastructure, gaping holes in medical and paramedic staff positioning, and access to diagnostics remain major challenges despite many schemes and a surge in the state’s health budget. The Rural Health Statistics 2021 reveals that doctor vacancies in PHCs stand close to 31%. As the HC noted in the Martha Sabar case: “There has been a clear violation of the fundamental right to health of the deceased, which constitutes an integral part of the right to life guaranteed in Article 21 of the Constitution of India.” While the HC has laid down a clear action plan for the state to follow, such systemic deficits must be addressed immediately.