GULBARGA: Ayahs double as medical staff at some PHCs. Some centres turn into drunkards’ haven at night. No ambulances in some centres. Some 24/7 PHCs exist in name only due to shortage of staff.
A reality check of the functioning of some of the community health centres and 24/7 PHCs (primary health centres) in Gulbarga and Bellary districts by Express on Friday night has thrown up these shocking revelations. With Gulbarga and Bellary being at the bottom on health parameters, it is this deficit in rendering healthcare which causes major concern.
A report in The New Indian Express dated August 19 stated that government hospitals in Gulbarga district face an acute shortage of doctors. Also, there have been as many as 73 cases of infant deaths in July, with around 1,600 deaths in the past two years.
In 2013, the government decided to convert PHCs in Gulbarga and a few other places in the state into 24/7 centres following low health indicators in these places, and especially a high infant mortality rate (IMR). Apart from Gulbarga, the places that are supposed to have 24/7 healthcare are Bellary, Raichur, Bijapur, Gadag, Bagalkot, Koppal and Yadgir.
Accordingly, PHCs were to give medicare round-the-clock, be equipped with a dedicated labour room, infant warmers, newborn care corners and other equipment necessary for a baby’s survival. However, when Express conducted a spot check, it found that most PHCs and health centres don’t fulfil all the parameters. In fact, though some are open 24/7, acute shortage of nurses and gynaecologists defeats the purpose. Though a total of 27 gynaecologist posts are sanctioned for the PHCs and taluk hospitals, only seven are filled.
There are 85 PHCs in Gulbarga district and the MBBS doctors who were appointed on contract basis look after general cases. Of the 232 sanctioned posts of nurses, only 143 are filled up. Hence, in some PHCs, ayahs and ASHA (Accredited Social Health Activist) workers double as medical staff.
And in some cases, this deficit in service could invite public wrath, like at the Shahabad community health centre in Chittapur taluk in Gulbarga disrict.
When Express visited this centre, it was witness to people’s anger. When people found that the medical staff were not responding to the pleas of a pregnant woman and made her visit the centre thrice on Friday, they grew angry. The final straw came when the staff asked the pregnant woman to go to the Gulbarga Government Hospital (GGH) at 8pm without providing a vehicle. The enraged people made the nurse and ayah come out and locked the centre for over two hours. They relented only after assurances by the in-charge District Health Officer.
At the 24/7 Kadaganchi PHC in Aland taluk, only one nurse and ayah are employed. “As there is no watchman, we don’t open the door at night unless we get confirmation that it is a delivery case,” said Sulochana, the nurse. She said she handles normal delivery cases with the help of the ayah. Complicated cases are referred to the GGH. Though the centre boasts of a doctor, he treats out patients during the day, she added. There is no ambulance to send the complicated cases to GGH. However, one positive aspect is that the baby warmer is in good condition.
The scene is no different at Fartabad and Aurad [B] PHCs. Here too, nurses handle delivery cases. While Aurad PHC is plagued by frequent power disruptions, Fartabad PHC has to contend with a non-functioning babycare equipment.
The PHC sub-centre at Pattan village was closed on Friday night. A resident of the village, Sharanabasappa, said a nurse and an ASHA worker visit the village during the day and dole out medicine to the patients. They refer complicated cases to GGH. The villagers said the doctor is conspicuous by his absence.
What officials say
“The IMR statistics in Gulbarga district is not up to the mark. It is in this direction, we have converted all PHCs in Gulbarga and other districts into 24/7 centres so that deliveries can take place in a safe manner. During the night, there will be three staff nurses on duty, along with a medical attendant. If there is an emergency, the duty doctor is called immediately so that the situation can be handled in a better manner,” said NRHM officials.
When asked about how the PHCs will be managed, especially in the night, as the problem of doctor shortage has been reported, sources at the NRHM said that contract nurses working on shifts will also be used. NRHM reproductive child health project director Dr Ramesh told Express that the mission has asked for a report from the Gulbarga district authorities with respect to the 73 infant deaths in July.
(With inputs from Bhukker Madhu Kumar in Bellary, and Nivedita Niranjankumar and Akshay Prasad in Bangalore)
Scene in bellary
A spot check conducted at night at a PHC located in Bandihatti area on the outskirts of Bellary city showed that it closed down for the night. Enquiries with locals revealed that the PHC turns into a haven for drunkards at night. They have a free run of the PHC as there is no one to check their activities, locals said. A government allopathic and maternity, child health centre located in Radiopark on the outskirts of the city too falls in the category of Bandihatti PHC.