23 July 2011
By, Shailvee Sharda
Waterlogged Room Forces Unnao PHC’s Incharge To Sit In Pharmacist’s Room, No Anaesthetist For Caesarean Cases
The new primary health centre in Mohaan area of Unnao district, nearly 40 kilometres from the state capital challenges the tenets and mandate of the National Rural Health Mission.
Soaked to the core in rain water, the walls of the PHC drip all the time. So much so, that the incharge Dr Gaurav Singh has to use his pharmacist’s room to attend patients. The damp walls and ceiling of the ward leaves no option, but to refer patient to a higher centre. Still, few patients turn up to get some free medicines.
A reality check on Friday by TOI found that things are worse at ground zero.
The Mohaan PHC is attached to the community health centre (CHC) in Hasanganj, and caters to a population of 50,000 villagers. Located about 6.5 kilometres away, the higher centre is slightly better, although it is the first referral unit (a centre where pregnant women are referred in case of an emergency). There are six doctors including a gynaecologist, but no anaesthetist to help her attend caesarean cases. Patients with broken or fractured bones have to go private or government hospital in Lucknow.
Interestingly, radiologist posted at the CHC is under suspension since June 2010. The CHC in charge Dr AK Tripathi said that he had written several times to the chief medical officer, Unnao, but things have not moved. Incidentally, the suspended doctor is the only radiologist in the entire district. Same is the case with the ones needing planned surgeries. But patients have to manage for their transportation, as there is just one ambulance and a driver with the CHC. There is no dearth of medicines for common ailments, but for specific ones, patients cannot depend on the CHC.
In the state capital, right under the helm of affairs things are more or less the same. A PHC in Bakshi ka Talab area has not been able to open in the last four years because of a pending policy matter. The one in Naderganj has cold storages to keep vaccines. But none of them were working when TOI team reached there. Unpleasant smell emanated from one of them suggesting that the machines have not been used for quite some time. So, if vaccines react and cause an adverse effect in infants, one shouldn’t be really surprised. Locals claimed that in the absence of the doctors, the attendant gives first aid to patients and refers them to the CHC in Sarojininagar, where threat of hospital infection looms large. The walls were damp and cleanliness a tragedy.
The NRHM audit team covered 12 districts and found that in many places the number of patients reporting was less than the expected. The in–patient admission was even worse. They found that in many places, attendants were made to pay for the service. Jashodhara Dasgupta of Healthwatch UP–Bihar who has studied elements of patient care services at the grass root level also confirms this.
When asked to comment on the issue, government officials maintain a steady silence. Some of them however put the blame on unavailability of human resource to run the facility. “There is shortage of doctors, nurses do not want to work in rural areas and technicians are disinterested. Buildings do not make a hospital,” said a senior government doctor.
Table to show gaps in patient–care services listed by the central team RAE BARELI
- Labor room not in good condition
- No waste management system found
- Patients forced to buy certain medicines from outside
- Ambulances not being used due to unavailability of drivers
- Overall shortage of nurses. Lab technicians have almost nothing to do
- Health facilities underutilized. But mothers discharged within 24 hours of delivery due to shortage of beds.
- Biomedical waste protocols neither known nor maintained
- 24X7 services are a myth here as people who could not manage postings in Lucknow get themselves deputed here Poor cleanliness and presence of expired medicines in emergency tray
- Ultrasound machine was found to be out of order
- Availability of safe drinking water lacking
- Certain medicines were being supplied without demand
- Sterilization services not present
- Expired kits and used drugs / syringes were piled up in one of the facilities
- A sub centre could not be used as it was in the CHC premises
- Of 657 listed emergency drugs, only 70 were available.
- Minor OT lacked air conditioning making it difficult to perform surgeries
- Mobile medical unit project could not take off as vehicles were not registered
- MMU vehicles too big to venture in remote villages. So, they were collecting dust and fungus
- Mother lying on unhygienic beds. Even the mattress was not covered with sheet. No baby corners
- Only 36% of institutional delivery target achieved
- Food not provided to JSY beneficiaries
- Non–operational MMUs.
- Sub–centers not connected with ambulance
- Blood bank not functional.
- No medicines to patients being discharged from hospital
- Team informed that 85% work in modular OT was done. Physical verification proved the claim untrue.
- Deliveries being conducted by untrained personnel