S R PAREEK
Ratlam, Madhya Pradesh: Sukheda Primary Health Centre (PHC) in Ratlam’s Piploda block stands for everything that is wrong with the rural healthcare services in Madhya Pradesh. The six-bedded PHC, which used to manage 15 to 20 deliveries a month almost three years ago, sees none at present, all thanks to the transfer of the lone trained Auxiliary Nurse Midwife (ANM) in 2019.
Now, the village women have to travel 60 km to the district headquarters, or 20 km to Jwara or Piploda villages for even basic healthcare. Sukheda has a population of almost 7,000.
Anita (26) of Sukheda shivered as she relived the ordeal she underwent before her second child’s delivery. “I was in the eighth month of my pregnancy. One evening, I suddenly began to experience pain. My family members got worried, and they rushed me to Sukheda PHC. Much to our dismay, the staff there redirected us to Ratlam citing lack of facilities.”
“I was in extreme pain. Though my family repeatedly called 108 ambulance to take me to Ratlam, the service was not available. They then began to frantically search for a private vehicle. Finally, we got one for Rs 2,000, and just as we crossed 10 km, the baby came out. We then decided to return home,” Anita told 101Reporters.
Essential services missing
Medical services at Sukheda PHC are in a disarray not just due to the lack of trained ANMs. The posts of lab technician, pharmacist and male supervisor are also empty at present. In short, lab machines are useless as no tests can be done in the absence of trained manpower. Even something as common as medicine for high blood pressure is mostly unavailable here.
As per the National Health Mission guidelines, outpatient department service, 24-hour emergency, inpatient service, antenatal and postnatal care, newborn care, medical termination of pregnancies, laundry and food services for indoor patients are among the essential services that the PHC should offer. However, Sukheda PHC does not have even a provision for food supply!
A source linked to the PHC said that food was not being provided as the PHC saw no deliveries. “No delivery means no admission. For those who come to get small ailments treated, hospitalisation is not prescribed. That explains the non-availability of meals,” she explained. The PHC does wash bed sheets and covers regularly, for which it gets funds from the patient welfare committee.
Sukheda PHC got its medical officer only a month ago, after a gap of one year. Talking to 101Reporters, Medical Officer Dr Seema Chouhdari said, “It is true that women have to travel 20 km to Piploda community health centre (CHC). I have already notified my senior officials about the issues affecting the PHC’s functioning, though I have taken charge here only a month ago. I have been told that an ANM will be appointed soon, which may help restart delivery services here.”
Sukheda has two ANMs at present, but they are not trained in dealing with deliveries. One of them is under training for maternity care at Piploda CHC. As of now, the PHC is handling vaccinations, intravenous therapy, and treatment of viral and seasonal diseases. According to Dr Seema, about 55 pregnant women coming under Sukheda PHC limits now depend on Jwara and Piploda health centres.
While many village women are anaemic, five have low haemoglobin count. All of them have to go to Piploda to get iron injections. As per the National Family Health Survey (NFHS-5), 7.9% of women in Ratlam district need medication for BP. They also have to rely on Jwara and Piploda centres.
It is the same case with family planning advice and services. Parvati (36) (name changed) and her husband had visited the PHC seeking family planning information, but were redirected to Piploda. “Considering the distance and time to commute, we decided not to go there for a vasectomy.”
Officials feign ignorance
Former medical officer Dr RC Verma claimed the facilities were satisfactory during his tenure. “Now, almost 20% of pregnant women prefer to go to private hospitals,” he said, adding that a trained ANM’s presence was crucial to ensure the PHC’s functioning.
“Patients and their families bear the brunt of staff crunch. We are ready to support the health department to improve the situation. But they have to start first,” said sarpanch Mahavir Mehta.
Claiming that he was unaware of the situation on the ground, MLA Dr Rajendra Pandey assured of action after speaking to the health officials concerned. Block Medical Officer Dr Yogendra Gamad said except for a trained ANM, Sukheda had all facilities. He, however, refused to comment on the non-functioning of the lab. “Soon more resources and trained ANMs will be appointed,” he said.
(The author is a freelance journalist and a member of 101Reporters, a pan-India network of grassroots reporters.)