37 maternal deaths in 1 year: Nandurbar district reels under poor health facilities; the only 2 women hospitals out of service

Several key posts in these hospitals have been vacant for years, and with no specialists, they are forced to turn away women in medical need most of the time.

Several key posts in these hospitals have been vacant for years and are forced to turn away women in medical need most of the time. (Express Photo)

Written by: Rupsa Chakraborty

5 min readMumbaiOct 10, 2022 05:05 PM IST First published on: Oct 1, 2022 at 03:49 AM IST

Nandurbar, a tribal-dominated district in Maharashtra around 450 kilometres away from Mumbai, witnesses a heavy toll of stillbirths and infant deaths till date. The two sanctioned women hospitals — one inside the premises of the Civic Hospital in Nandurbar taluka, and another in Dhadgaon taluka — in the district are out of service, and exist only on papers.

Several key posts in these hospitals have been vacant for years, and with no specialists, they are forced to turn away women in medical need most of the time. Many social activists blame the state government over the lack of incentives extended to the doctors, which prompts them not to work at rural health facilities.

According to data procured by The Indian Express through Right to Information (RTI), as many as 956 stillbirths (death of a baby before or during delivery) were recorded in Nandurbar within five years — between 2017 and 2021; with 1,698 infant deaths (death of a child below one year) during the same period. Most of the deceased suffered from preventable diseases like respiratory diseases, sepsis, prematurity, and pneumonia among others. Many could have been saved with proper treatment by medical experts on time. That is why women hospitals, which have four main verticals to cater to the needs of women — surgery, maternity and gynecology and paediatric — are so important.

Also Read | Lack of specialist doctors, medical staff major cause affecting tribal women & children: Bombay HC

The district has witnessed 37 maternal deaths — five in Dhadgaon taluka and seven in Nandurbar taluka — in 2021-22 so far.

Dhadgaon taluka emerges lowest in the health index, with high cases of malnutrition, stillbirth and infant deaths. In 2018, the district authorities completed the construction of the women hospital in Dhadgaon, but posts for medical experts needed to run the hospital were sanctioned only after four years i.e. in September 2022. It is still being run as part of the rural hospital.

“It is more of a general hospital than a women hospital. Staff from rural hospitals are being stationed at the hospital as the posts had not been sanctioned for years,” said Dr Charudatta Shinde, district Civil Surgeon, adding that this hospital receives around 200 patients daily in the outpatient department (OPD).

The hospital’s blood unit has also been lying dysfunctional due to the unavailability of staff.

Also Read | Malnutrition rises to 15% in June-July due to seasonal migration in Nandurbar

“It is a blood storing unit, but even for that we need medical officers with a three-month special training. There is also technician training. Once they get qualified, we apply for an approval to run the unit. We, however, cannot apply for it as we do not have the staff,” Dr Shinde added.

On this, Latika Rajput, a member of the state-appointed core committee and the Narmada Bachao Andolan (NBA), said that women hospitals require a large amount of blood on a daily basis, and that is why blood banks are crucial for them. “Many women suffer from acute anemia. Blood is required during the delivery of a child. Blood banks/units are essential, or else women could die while waiting for blood to be transported from other hospitals… The frail nature of health systems and the referral of pregnant women further add to maternal deaths,” Rajput said.

In Nandurbar taluka, the condition of the women hospital is even more saddening. Out of the nine posts sanctioned in 2017, only one for a medical superintendent has been filed — that too in September this year i.e. after five years. “We have been trying to fill up the posts, but we do not get doctors. We are planning to hire several doctors on bond, after their post-graduation, to bridge the gap,” said Dr Shinde.

Several resident doctors, however, told The Indian Express that lack of infrastructure and basic amenities should be blamed for the situation; they opt out of rural bonds due to that. “These hospitals do not have basic medicines or equipment to treat a patient during an emergency. The doctors have to refer patients to district hospitals, which is time-consuming. And, if a patient dies on the way, the relatives beat up doctors… These hospitals or even PHCs do not have water,” said a resident doctor from Mumbai.

The civic society, meanwhile, demanded that the government must consider providing the doctors with better incentives, so that they agree to work in rural areas for a time-frame. “After coming to rural Maharashtra, doctors get stuck here for years — no new posting or transfer. So, the government should provide the doctors with an assurance to transfer them to their chosen places once they work in rural areas for a certain period of time,” said Latika.