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Tuesday, November 24, 2020

Death of a woman in MP village in her 16th pregnancy shows gaps in the system — and inside a home

Death of a woman in MP village in her 16th pregnancy shows gaps in the system — and inside a home.

Written by Iram Siddique | Damoh (madhya Pradesh) | Updated: October 21, 2020 11:53:47 am
Death of a woman in MP village in her 16th pregnancy shows gaps in the system — and inside a homeSukhrani Ahirwar’s family in Padhjari village of Damoh district. (Express photo by Iram Siddique)

Regret is all that now consumes 23-year-old Savitha who tries to calm her two-year-old brother as he yearns for the comfort of his mother. His cries engulf the Ahirwar family’s two-room mud house that stands on the outskirts of Padhjari village in Batiyagarh tehsil of Damoh district.

It has been a week since Sukhrani Ahirwar, Savitha’s 45-year-old mother, bled to death on her way to a government hospital less than 5 km from their hut. Not many in the local health system were surprised — she had delivered a still-born and this was her 16th pregnancy.

“I tried convincing my mother to get sterilised but she and my father did not agree. I told her about how I myself had registered for sterilisation without informing my in-laws and got operated upon,” says Savitha, recounting her last visit to her mother two years ago. Sukhrani was then pregnant for the 15th time and was severely ill.

Sukhrani’s records with Kallo Bai Vishwakarma, Accredited Social Health Activist (ASHA) of Padhjari village, show that she delivered her first child (a girl) in 1997 and had four more daughters. In her sixth pregnancy in 2005, she delivered twins, a boy and a girl. Her pregnancies continued, and between 2009 and 2020, she delivered five more children and had three abortions. In all, she lost eight children.

Vishwakarma said she did take Sukhrani to a medical camp and tried to convince her to get sterilised but after the initial testing, Sukhrani slipped away, allegedly under pressure from her husband.

It was not only Savitha who worried about Sukhrani. Her records worried the district administration too. According to R R Bagri, Chief Medical Officer of Batiyagarh civic hospital, Sukhrani was counselled and advised sterilisation after her 15th pregnancy. “But she was hesitant and thought that she had already crossed 40 and would soon hit menopause. If her daughters had been with her, they could have convinced her,” said Bagri. The administration could do little without her consent.

While Sukhrani believed she had hit menopause, in July this year it came to light that she was five months pregnant at the age of 45. She visited the hospital only in September when she was seven months pregnant.

Sukhrani’s husband Dullah works as a farm labourer. He had to borrow money when his wife was identified as a “high-risk pregnancy” by the civic hospital in Hatta, an adjacent block, and advised consultation with a gynaecologist along with a sonography at the district hospital, about 40 km away.

“We got the sonography done. We spent about Rs 40,000 on tests and medicines,” said Dullah, who had taken her to a private hospital in Damoh, since they did not have an Ayushman Bharat card which entitled BPL families for a medical cover of Rs 5 lakh.

Asked why he didn’t support her sterilisation, Dullah claims she didn’t have the “courage” to go through with it.

In the eight months of a high-risk pregnancy, Sukhrani was given two iron dosages on September 12 and September 16. However, a month later, a severely anaemic Sukhrani suddenly went into labour at 3 pm on October 11.

Dullah called for an ambulance, which arrived in an hour. By then, Sukhrani had already delivered a still born. Vishwakarma said Sukhrani had bled profusely after the delivery. “I asked her to change the clothes to get to the hospital, but all she could muster was ‘Himmat nahi ho rahi hai’,” she said.

Sukhrani’s death is an outlier here but it also serves as a test case to highlight glaring gaps in health infrastructure here.

The Centre’s ambitious Ayushman Bharat scheme has reached only 2.67 lakh people of Damoh while 9.10 lakh are still waitlisted. Only upto 3,000 people have been treated under the scheme in the district hospital of Damoh while only four in private hospitals. Incidentally, 70 per cent of the hospital’s bill is due as per officials.

The Hatta civil hospital is the only one for a population of 1.75 lakh and caters to a few villages of the adjoining Chhatarpur and Panna districts too. It has five MBBS doctors, but no gynaecologist. Of the 3,000 pregnancies in a year, about 40 per cent are referred to the district hospital in Damoh. The balance 60 per cent deliveries are facilitated by the hospital’s 15 nurses in the absence of a gynaecologist.

When contacted, Chief Medical Block Officer for Hatta, P D Kargaiyan, said: “We have trained our nurses to carry out these deliveries since the hospital has not had a gynaecologist for about 15 years now. With no gynaecologist, it gets difficult to deal with a pregnant woman who is critically anaemic and is hence referred out.”

Back at the two-room house in Padajhir, Dullah has set out to immerse her mortal remains at the Ganga while Sukhrani’s eight children sit huddled in the two-room house. Two of her eldest daughters Sangita and Savita who work as migrant labourers have returned to Padajhir. Savitha who has two children almost the same age as that of her youngest brother says, “He cried for the comfort of her lap. I would take him with me but it will not help. If only my mother had the courage to get herself sterilised” she says. And the support of her husband.

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