ON January 24, Divya Dinesh Baswat (25) urgently required a caesarean operation. Her hometown Wada in Palghar has a 30-bed rural hospital with no gynaecologist. Baswat decided to approach the nearest private hospital. Immediately after the delivery, there was need for an intensive care unit to stabilise the newborn. Palghar’s government hospital did not have a single ICU bed. So, the newborn had to be transferred to the hospital in the neighbouring district Kalyan in a critical condition. On Friday, the boy succumbed to abdominal pain. The grieving parents and the Asha workers do not know the cause of his death, but they blame the lack of medical facility in the district for the newborn’s demise.
Carved out as a separate district on August 1, 2014, Palghar with a projected population of 29.9 lakh has still not woken up to the need of specialist doctors and a district hospital. A proposal to upgrade the 30-bed rural hospital into a 200-bed one remains pending at the health ministry level.
Lacking any specialty service, such as gynaecologist for delivery, orthopedic surgeon for treating road accidents, general surgeon, ophthalmologist and anaesthetist, medical officers have to refer serious patients to other hospitals. The closest one Thane Civil hospital is 100 kilometers away and Mumbai’s R N Cooper hospital is 70 kms away, rendering the prospect of treating a patient in the golden hour ineffective.
In 2013-2014, 221 patients were referred out of Palghar. This rose to 284 in 2014-2015. In 2015-16, till December, 228 patients have already been referred to nearby tertiary hospitals.
It is mandatory for a district to have its own district hospital where specialty services of gynaecologist, orthopedic, anaesthetist, general surgeon, ENT, ophthalmologist and upgraded laboratory are available. However with construction of a new hospital being delayed, patients are often forced to either shell out money in private centres or travel to other districts.
Currently, Palghar has three sub-district hospitals in Jawahar, Kalsa and Dahanu. None have specialist doctors. There are nine rural hospitals in Palghar, Talasari, Wada, Vikramgad, Mokhada, Virar, Boisar, Vangaon and Manor.
Recently, a road accident victim required an urgent surgery and ICU admission. “Sometimes we are able to stabilise a patient and then transfer him or her to a higher centre. But on several occasions, immediate surgery is required and we are not equipped to handle it. We receive at least two patients requiring ICU admission every day,” a contractual medical officer said. He has not received his salary for the past four months. Palghar has 45 such doctors on contractual basis, all awaiting salaries.
The district’s post of the highest medical official, a civil surgeon, is lying vacant. A temporary doctor has been put on deputation. In Palghar town, out of the three medical officers’ posts at the rural hospital, two are lying vacant. A MO from Dahanu has been requested to temporarily fill the second post. A 12-hour shift is alternated between the two MOs to run the hospital. “Sometimes during high patient load, we both work 24 hours at a stretch,” the medical officer said. Of the four posts for class IV employees in the hospital, only one is filled. A patient rushed in often has to be carried by relatives due to lack of manpower.
Several ASHA workers claimed that poison cases were the worst-handled. “There is anti-venom available for snake bites, but poisoning due to fertilisers is fatal. Such patients have to be transported in ambulances to Thane or Mumbai,” said Tanuja Bhoir, an ASHA worker.
According to doctor Rao Khande who is the civil surgeon on deputation, 19 additional posts required at the district hospital are still under consideration. “The construction of the district hospital is yet to start,” he pointed out. Doctor Shashikant Jadhav, joint director at Directorate of Health Services, said the proposal for constructing a district hospital was awaiting approval at the ministry level. “The process will take time. We need land allocation for the new building’s construction. PWD is responsible for constructing the hospital,” Jadhav said.