Link-
http://www.sentinelassam.com/saturday/saturday.php?sec=15&subsec=0&ppr=3&dtP=2011-06-04
Dated : Saturday, June 04, 2011
Desperately Seeking Doctors In Orissa’s Red Zone
A doctor is a rare sight in Malkangiri, one of Orissa’s poorest districts and the site of Maoist insurgency. Yet, the people here - caught between militancy and chronic malnutrition - are in desperate need of affordable health care.
Anaemia and disturbed conditions are the twin curses of the district. Take the case of Minati Kirsani, a young woman who was seven months pregnant. A resident of Petal, a pre-dominantly tribal village in Malkangiri, Minati suddenly developed acute stomach cramps. She was taken to the Paplur Public Health Centre, around 10 kilometres away.
An ayurvedic doctor, Prassanna Ku Patra, attended to her. He administered a dose of glucose intravenously, but Minati’s condition deteriorated rapidly. Finally, her hapless husband, Raghuram, acting on the advice of the doctor, decided to take her to Chitrokonda hospital, which is about 40 kilometres from Paplur. But no transport was available so her husband had to take her back to her village. She did not survive.
Patra, the only doctor in these parts, who routinely has to handle cases from 15 villages, sounds helpless. “Minati’s case was quite complicated. Here in this new Public Health Centre (PHC), we have almost no infrastructure. No lights, no water supply, no ambulance facility. And the general fear of the Maoists has ensured that timely public transport is not available. I did my best, but unfortunately couldn’t save this patient’s life,” he says.
Tulema Hental of Badpada village, which is in an inaccessible region of Malkangiri, is another mother who died in childbirth. When Tulema first went into labour, nobody in her family realised the seriousness of the situation. The baby emerged in the breech position, and the young mother bled profusely. The local midwife, Kali Hentalo, tried to salvage the situation, but Tulema’s condition continued to deteriorate rapidly. At that late stage, the family tried to take her to a hospital in Chitrokonda. But because of a bandh call given by the Maoists, no transportation was available that day and Tulema could not survive.
The stories of Minati and Tulema are not unusual in Malkangiri, where the official Maternal Mortality Rate (MMR) is 30 per 200 live births, as per the office of the Chief District Medical Officer. Out of 14,982 deliveries in 2009-10 in the district, only 6,122 took place in an institution. The growing presence of Maoists in Malkangiri has taken a heavy toll on health care delivery. While the insurgents have not directly attacked any health establishment or health personnel so far, the frequent road blockades, ambushes on police parties, and threats to government officials in the affected area, have left health care services in a complete disarray. Of the 111 sanctioned posts for doctors in the district, 71 posts are lying vacant, 50 per cent of paramedical posts remain unfilled and half the PHCs here have no doctors.
Legislators cutting across party lines and officials admit that most of the doctors and para-medics emerging from state-run medical colleges don’t wish to work in Malkangiri because of security concerns, despite attractive pay packages and incentives from the state government. Their fears are not unfounded: R. Veenil Krishna, Malkangiri’s district collector, was recently abducted by Naxalites even as the country watched in helpless anxiety.
Says Malkangiri’s chief district medical officer, C.H. Pravakar, “Women and children here are severely under-nourished. Although no formal study has been done, our health workers from villages like Janbai, Jodamba, Badpada, and Jantapai inform us that nursing mothers here are clearly anaemic and the high MMR levels bear this out.”
Pravakar also admits that many maternal deaths don’t even get reported. “We are trying our best to deliver good health service, but what can we do? First, the area is almost inaccessible, given the bad roads. Second, ‘bandh’ calls by the Maoists for at least 20 days in a month ensure that there is no transportation available. So how do we send the medicines and food material under schemes like the Integrated Child Development Services (ICDS)?”
Because they get little medical care near home, people have to walk miles, carrying their sick relatives in bamboo baskets or on a cot, to get them to the nearest town. The roads are very bad, and waters from the Balimela reservoir has ensured that some 151 villages remain completely cut off from the mainland. Earlier, there was a regular launch service, but after the Alampaka incident of 2008 - in which 38 security personnel were killed in a Naxalite attack - there is only one service a day. The few boats available take over six hours to traverse the 40 to 50 kilometres from the Balimela spillway to the villages on the bank of the reservoir. This leaves people with no option but to suffer and wait endlessly, should they face a medical emergency.
A visit to the villages here comes as an eye-opener. Six years ago, a PHC was opened in Badpada. It is yet to see a doctor to this day. In the nearby village of Papermelta, Sania Matem, 60, holds the slight, feverish form of her two-year-old grandson in her arms. There is fear on her face as she pleads with anyone she comes across for medicines to save the child. Her daughter-in-law had died while giving birth to him, and here again her family could not provide her with timely medical attention because of a ‘bandh’ called by the militants.
Dr Khirod Chandra Mahanto, a senior doctor at the Chitrokonda community health centre describes life in these parts, “Everything comes to a standstill here after 6 pm, because of the fear of the Naxalites. Earlier, doctors and auxiliary staff would respond to a call from an interior region, not any more. It’s the fear factor that operates here.”
One auxiliary nursing midwife from Badpada put it this way, “If a district collector here can be abducted, then what about ordinary people like us? Who will guarantee our safety? We want to work and serve the people but not at the cost of our lives.”
When the district collector, R. Veenil Krishna, was asked about the problem of reaching health care to this Naxalite-affected region, understandably, after his own brush with danger, he was not keen to speak too much on the issue. However, he did say that the district administration in the interior pockets of Malkangiri is very conscious of the problems, and was trying hard to improve the situation. Incidentally, Krishna will now be Personal Secretary to the environment minister Jairam Ramesh, who was impressed to see the courage of the bureaucrat.
Yet, one wonders if Krishna’s words are of any consolation to old Sania Matem, as she desperately seeks medical attention for her frail and sickly grandson.
Sarada Lahangir
http://www.sentinelassam.com/saturday/saturday.php?sec=15&subsec=0&ppr=3&dtP=2011-06-04
Dated : Saturday, June 04, 2011
Desperately Seeking Doctors In Orissa’s Red Zone
A doctor is a rare sight in Malkangiri, one of Orissa’s poorest districts and the site of Maoist insurgency. Yet, the people here - caught between militancy and chronic malnutrition - are in desperate need of affordable health care.
Anaemia and disturbed conditions are the twin curses of the district. Take the case of Minati Kirsani, a young woman who was seven months pregnant. A resident of Petal, a pre-dominantly tribal village in Malkangiri, Minati suddenly developed acute stomach cramps. She was taken to the Paplur Public Health Centre, around 10 kilometres away.
An ayurvedic doctor, Prassanna Ku Patra, attended to her. He administered a dose of glucose intravenously, but Minati’s condition deteriorated rapidly. Finally, her hapless husband, Raghuram, acting on the advice of the doctor, decided to take her to Chitrokonda hospital, which is about 40 kilometres from Paplur. But no transport was available so her husband had to take her back to her village. She did not survive.
Patra, the only doctor in these parts, who routinely has to handle cases from 15 villages, sounds helpless. “Minati’s case was quite complicated. Here in this new Public Health Centre (PHC), we have almost no infrastructure. No lights, no water supply, no ambulance facility. And the general fear of the Maoists has ensured that timely public transport is not available. I did my best, but unfortunately couldn’t save this patient’s life,” he says.
Tulema Hental of Badpada village, which is in an inaccessible region of Malkangiri, is another mother who died in childbirth. When Tulema first went into labour, nobody in her family realised the seriousness of the situation. The baby emerged in the breech position, and the young mother bled profusely. The local midwife, Kali Hentalo, tried to salvage the situation, but Tulema’s condition continued to deteriorate rapidly. At that late stage, the family tried to take her to a hospital in Chitrokonda. But because of a bandh call given by the Maoists, no transportation was available that day and Tulema could not survive.
The stories of Minati and Tulema are not unusual in Malkangiri, where the official Maternal Mortality Rate (MMR) is 30 per 200 live births, as per the office of the Chief District Medical Officer. Out of 14,982 deliveries in 2009-10 in the district, only 6,122 took place in an institution. The growing presence of Maoists in Malkangiri has taken a heavy toll on health care delivery. While the insurgents have not directly attacked any health establishment or health personnel so far, the frequent road blockades, ambushes on police parties, and threats to government officials in the affected area, have left health care services in a complete disarray. Of the 111 sanctioned posts for doctors in the district, 71 posts are lying vacant, 50 per cent of paramedical posts remain unfilled and half the PHCs here have no doctors.
Legislators cutting across party lines and officials admit that most of the doctors and para-medics emerging from state-run medical colleges don’t wish to work in Malkangiri because of security concerns, despite attractive pay packages and incentives from the state government. Their fears are not unfounded: R. Veenil Krishna, Malkangiri’s district collector, was recently abducted by Naxalites even as the country watched in helpless anxiety.
Says Malkangiri’s chief district medical officer, C.H. Pravakar, “Women and children here are severely under-nourished. Although no formal study has been done, our health workers from villages like Janbai, Jodamba, Badpada, and Jantapai inform us that nursing mothers here are clearly anaemic and the high MMR levels bear this out.”
Pravakar also admits that many maternal deaths don’t even get reported. “We are trying our best to deliver good health service, but what can we do? First, the area is almost inaccessible, given the bad roads. Second, ‘bandh’ calls by the Maoists for at least 20 days in a month ensure that there is no transportation available. So how do we send the medicines and food material under schemes like the Integrated Child Development Services (ICDS)?”
Because they get little medical care near home, people have to walk miles, carrying their sick relatives in bamboo baskets or on a cot, to get them to the nearest town. The roads are very bad, and waters from the Balimela reservoir has ensured that some 151 villages remain completely cut off from the mainland. Earlier, there was a regular launch service, but after the Alampaka incident of 2008 - in which 38 security personnel were killed in a Naxalite attack - there is only one service a day. The few boats available take over six hours to traverse the 40 to 50 kilometres from the Balimela spillway to the villages on the bank of the reservoir. This leaves people with no option but to suffer and wait endlessly, should they face a medical emergency.
A visit to the villages here comes as an eye-opener. Six years ago, a PHC was opened in Badpada. It is yet to see a doctor to this day. In the nearby village of Papermelta, Sania Matem, 60, holds the slight, feverish form of her two-year-old grandson in her arms. There is fear on her face as she pleads with anyone she comes across for medicines to save the child. Her daughter-in-law had died while giving birth to him, and here again her family could not provide her with timely medical attention because of a ‘bandh’ called by the militants.
Dr Khirod Chandra Mahanto, a senior doctor at the Chitrokonda community health centre describes life in these parts, “Everything comes to a standstill here after 6 pm, because of the fear of the Naxalites. Earlier, doctors and auxiliary staff would respond to a call from an interior region, not any more. It’s the fear factor that operates here.”
One auxiliary nursing midwife from Badpada put it this way, “If a district collector here can be abducted, then what about ordinary people like us? Who will guarantee our safety? We want to work and serve the people but not at the cost of our lives.”
When the district collector, R. Veenil Krishna, was asked about the problem of reaching health care to this Naxalite-affected region, understandably, after his own brush with danger, he was not keen to speak too much on the issue. However, he did say that the district administration in the interior pockets of Malkangiri is very conscious of the problems, and was trying hard to improve the situation. Incidentally, Krishna will now be Personal Secretary to the environment minister Jairam Ramesh, who was impressed to see the courage of the bureaucrat.
Yet, one wonders if Krishna’s words are of any consolation to old Sania Matem, as she desperately seeks medical attention for her frail and sickly grandson.
Sarada Lahangir
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