On the day the Union government announced the ambitious National Health Protection Scheme (NHPS), Neelu Verma sat inconsolable in a Madhya Pradesh government hospital antenatal care (ANC) ward. On Wednesday, Neelu (25), in labour at the time, lost her baby in the Betul district hospital after she was denied a stretcher and forced to walk to the ANC ward. She was bodily lifted off the ground by hospital attendants and had walked a few steps before she delivered her baby. Neelu is a trained nurse herself.
She is unable to comprehend the post-mortem report that puts the cause of death as “still birth’’ not from the fall to the ground. Surrounded by newborns and happy mothers in the ANC ward, where each crying baby reminded Neelu of her loss, she chose to leave the hospital on Friday with several sutures still fresh from surgery.
Even before her nightmare in Betul, Neelu was referred to the district hospital by the community health centre in Ghodadongri, where she claimed no doctor was on duty.
The government in New Delhi may have announced the “world’s largest government-funded healthcare programme”, but 1,000 km away Betul is the grim reality: an abysmal health infrastructure that an insurance cover can do little to change.
On preventive healthcare, Jaitley on Thursday had said: “…1.5 lakh centres will bring healthcare system closer to the homes of people. These centres will provide comprehensive health care, including for non-communicable diseases and maternal and child health services. These centres will also provide free essential drugs and diagnostic services.”
The death of Neelu’s baby and the CHC’s referral to Betul are under investigation, but that means little for her family. “The negligent staff and the government system is to blame for this. If only I had some time, I would have taken her to a private hospital,” her husband, Vikash Verma told The Indian Express.
Vikash remembers the frantic search for a stretcher when they reached Betul in an ambulance from Ghodadongri. Neelu, doubled over in pain, said she could not walk. “An attendant flatly told us that all expecting mothers walk to the labour room. I went looking for a stretcher but could not find one. When I returned, it was all over. My wife had collapsed and the baby had died,’’ said Vikash, a collection agent with a private insurance company. “All we wanted was a baby.’’
According to the family, the two attendants on duty had almost forced her to walk towards the ward, “each holding one of her hands”. “She sat and refused to get up and must have barely walked 15 steps when the delivery took place,” her mother-in-law Girija Verma said.
On Friday, a stretcher and a wheelchair were on standby at the Betul hospital ward but staffers did not volunteer to help expectant mothers who arrived there. The distance between the road where the ambulances drop mothers and the ward gate is not much but access is difficult due to a steep climb and a pipe that cuts across the route.
After her B.Sc (Nursing) and training in a private hospital in Gwalior, Neelu was confident about handling labour, particularly when she felt her own baby kicking.
“I told her my delivery appears imminent. I am ready to support, please do it now but the nurse (at community health centre Ghodadongri) insisted that fetal heart rate was low and normal delivery could lead to complications that she couldn’t handle,” Neelu said.
According to Neelu, no doctor was at the CHC because of holiday and she was referred to the district hospital at Betul for a caesarean section. “At Betul hospital I told the attendant I won’t be able to walk even few steps but she insisted I had to. Barely had I walked few steps I delivered and the baby died few steps from the ward gate,’’ she said.
Block Medical Officer Dr Sanjay Shukla said the fetal heart rate was only 80 and that between 150 and 180 normal deliveries take place at the CHC and only emergency caesarean section deliveries were referred to the district hospital. The CHC can carry out c-section only when they are planned by calling doctors from Betul or Bhopal.
Disputing the charge that there were no doctor on duty at CHC, Dr Shukla shows records that say two normal deliveries were performed that day. The CHC has a staff of 35, including four doctors and eight staff nurses that catering to a population of more than two lakh in Ghodadongari, one of the largest blocks in the state. Dr Shukla admitted that the CHC lacked some facilities.
Dr Shailendra Sahu claims he was on duty when the nurse was examining Neelu. “I was nearby. Generally male doctors don’t venture till when it’s absolutely necessary. The nurse was authorized to carry out the Doppler test. I signed the referral letter and called the ambulance,’’ he said.
Neelu got married in May and left her job in Gwalior after she got pregnant. “Today she neither has her job nor her baby,” said her father in law Dhanraj, a senior technician with the railways.