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Journalism of Courage
At the Kandharapur primary health centre (PHC) in eastern Uttar Pradesh’s Azamgarh district, 53-year-old “ward boy” Jharkhande Yadav is a lone figure sitting in a room with a table, chair, three cupboards, and old furniture stacked against the walls. The adjacent room has no door or windows, and a rope has been tied to stop the entry of cattle. Still, it is filled with cow dung. There is another building 500 metres away, which is also part of the PHC, but is abandoned – with liquor bottles strewn around and plants growing inside.
Kandharapur has a population of around 3,000 people, and the PHC is the only government healthcare facility they rely on. It is one of 218 PHCs and community health centres (CHCs) in 52 Uttar Pradesh districts that are unfinished, some since 2005, according to information accessed by The Indian Express under the Right to Information Act. The Kandharapur PHC is among those under scanner for alleged financial irregularities, as per health department records.
When The Indian Express visited the PHC on September 28, Yadav said no patients had come since morning, while the pharmacist and another staff had taken the day off on account of a festival. The register, with patient entries, shows that 19 patients visited a day earlier and were treated in the single room.
As per government regulations, 15 staff members should be deployed at a PHC. The two structures missing doors and windows have been left abandoned for years, say locals.
Lalman Yadav (42), an autorickshaw driver living nearby, said: “This (PHC) is okay for basic problems like cold and fever. If someone falls seriously ill, we take them to Azamgarh district hospital, around 10 km away.”
Another PHC in Azamgarh, in Kaptanganj area, is being used as a makeshift residence by personnel of the local police station, a couple of hundred metres from the abandoned building. The 15-room building has motorcycles parked at the entrance, with policemen saying they use this since they haven’t been assigned a place for their barracks. The two buildings have cots, table fans, clotheslines and other belongings.
“I was posted here a couple of years ago, and since then, I have been living here. No one from the Health Department visits, and it is used by us as barracks,” said a police personnel.
Around 40 policemen live in two buildings of the PHC, while another structure is abandoned with plants growing inside.
Station officer, Kaptanganj, Vijay Prakash Maurya said, “I think people have been living in the Health Department building for quite some time as there was no government residence and the buildings were vacant.”
Azamgarh ASP (City) Shailendra Lal, when contacted, said the “PHC building is not used by policemen, and the information of policemen living inside the PHC building was false”. Azamgarh SSP Anurag Arya could not be reached for a comment.
Azamgarh Chief Medical Officer, Dr Indra Narayan Tiwari, said the PHCs in Kandharapur and Kaptanganj are yet to be handed over to the Health Department. “Both are under investigation by the SIT. The government has given directions to the agencies to complete their construction and hand them over to the Health Department. Then they will be under our control and we will give directions for them,” said Dr Tiwari.
Asked about the Kaptanganj PHC, he said, “I can’t say if policemen are living there or not. If it was handed over to us, we would have asked them to leave.”
In its records, the health department had noted alleged financial irregularities in this PHC.
More than 350 km from Azamgarh in Kanpur’s Chaubepur area, the CHC is operational. The CHC, which is supposed to have 30 beds, had 15 operational beds when The Indian Express visited, and one patient admitted. As per government guidelines, a CHC is supposed to have 25 staff members, including four medical officers. At the Chaubepur CHC, four doctors and 15 paramedical staff are posted.
As per government guidelines, a CHC building should have a main building, medical officer residence for four staff members, six category-2 residences, and six category-1 residences. However, at this CHC, there isn’t a single residence for any staff member, and officials say they manage with a doctors’ duty room.
Dr Vipul Chaturvedi, consultant at the CHC, said construction for residences is being done behind the main building.
The CHC didn’t have an operational X-Ray machine, which officials said is because they don’t have X-Ray films. In case an X-Ray is required, patients are sent to Ursula Horsman Memorial Hospital around 25 km away.
When The Indian Express visited the CHC at 4 pm, there was no doctor at the emergency ward. Asked what happens in case of an emergency, an employee said, “The doctor lives nearby. We will call him. There are no residences here, so doctors and consultants go home after 2 pm.”
This CHC is the subject of an SIT probe, as per health department records.
Asked about no residence for staff and the Chaubepur CHC in Kanpur not having an operational X-Ray machine, Kanpur Nagar Chief Medical Officer Dr Alok Ranjan said, “If you go there, you will find some things lacking. Efforts are always being made to fix the problems. For residences, we had sought a budget and it has been sanctioned. We will get the residences constructed. The rest of the problems will also be addressed. A radiograph machine will be brought.”
Narayan Singh (65) is used to travelling to Delhi, Noida or AIIMS Rishikesh whenever he or a family member falls sick. He says the PHC in Bijnore’s Sheikhpura, where he stays, would be a blessing once it’s up and running, but wonders why such an obscure location was chosen for it. “We call it a forested area… It should have been closer to the road,” he says.
The PHC is being built around 400 metres from the main road and the only thing visible from a distance is an overhead tank. It is surrounded by the tall sugarcane crops, and has no pucca road leading up to it.
When The Indian Express visited, there was one person guarding the area. In the past, wires, locks, gate latches, pipes, marble and a submersible pump have been stolen from the PHC. The guard said a few men also tried to steal the ramp railing but couldn’t succeed.
Two residences and a pump house were still being built at the under-construction PHC, and some wiring and flooring work remained.
The health department, in its records, noted: “Work in progress. The doors installed have to be replaced. The approach road has to be repaired. The floor of OHT is broken.”
It’s the same story at the PHC in Bhikkawala, where the health department made similar observations.
Gyan Singh Rawat (62), a resident of the village that falls on UP’s border with Uttarakhand in Bijnor district, said he is tired of waiting.
“Around two years have passed since this building was constructed, but there is nothing in it – no doctor, no medical facilities, no furniture. We have written multiple times to the health department through the JanSunwai app, but they transfer the application elsewhere.
“Many people from this village are in the Army or paramilitary forces, and mostly women and children reside here. In case of an emergency, who will take them to the hospital? That is why this PHC is important to us. There are private doctors, but you know their fees. There is a CHC around 8 km away, but it’s not in a good shape,” said Rawat, who retired from government service in 2011 and is currently a “village head” who raises residents’ matters before the authorities.
The village has a population of around 1,700. At the PHC, Medical Officer, Category-1 and Category-2 residences are still under construction. The paint on the outer wall of the PHC building has started wearing off and the approach road is broken.
Both projects were allotted in 2018-19. Work on the PHC in Bhikkawala was supposed to be completed by September 2023 and on the PHC in Sheikhpura by August 2023. The projects are 65% and 70% finished respectively.
Both PHCs are being built by the UP Housing & Development Board. Said an official from the government agency: “We had to employ two contractors for construction of the main building and residences. Part of the amount was released in April, which is why the construction of residences started late. It will take around two more months to complete the work. After that the building will be handed over to the health department. At the time of allotment, the project cost was Rs 1.38 crore, but prices of items increase from time to time. It takes about 200 materials to construct a building. So we sent a revised estimate of around Rs 2 crore, and it took some time for approval and release of funds.”
Vijay Goel, the Chief Medical Officer of Bijnor, said: “The construction agency had said they will hand over the buildings by November. However, there is a lot of work left and I will have to check with the engineers how much more time they need. So far, it is not fixed when both centres will become operational.”
On why PHC Sekhputa is being built in a secluded place, the CMO said, “It is very difficult to get land where there is no dispute. An approach road will be constructed soon.”
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