How government & private doctors united to help rural poor in Maharashtra

The project, anchored by the state’s Directorate of Medical Education, initially took off at two health care centres - at Jalgaon and Mumbai - set up by the Niramayseva Foundation in 2004.

Written by Anuradha Mascarenhas | Pune | Updated: August 27, 2018 6:45:34 am
How government and private doctors united to help rural poor in Maharashtra A camp in Nandurbar, Maharashtra. Maha Aarogya screening camps, surgeries form part of the initiative.

* At Shirur tehsil in Pune district, farmer Manik Ghavte’s three-year-old son Aarush got to hear his mother’s voice for the first time after he was given a cochlear implant a month ago.

* A growing cyst near her cheek bone had disfigured the face of a 35-year-old woman from Nandurbar and had begun to obstruct her breathing until she underwent a surgery conducted free of cost at Pune’s Sassoon Hospital.

* It has been a year since 18-year-old Sakshi Shejwal, a Class 12 student at a Nashik college and the daughter of a security guard, underwent a spinal surgery, estimated at Rs 14 lakh.

These stories are the result of a silent but dedicated effort in Maharashtra to connect people from economically weaker sections to quality healthcare and surgeries that are usually out of reach for many of them.

From getting private doctors to sponsor surgeries to convincing institutions to raise their CSR funds to mobilising an army of volunteers who help patients get to the nearest ‘Maha Aarogya’ camps where they are screened, the programme involves the state’s Directorate of Health Services, 140 private hospitals, 1,114 primary health centres and 20,000 doctors (both in the private and government sectors). At least 78,000 surgeries – cataract surgeries, ENT procedures, correcting orthopaedic defects and others — have been performed since 2016 while another 1.5 lakh have been planned this year.

The project, anchored by the state’s Directorate of Medical Education, initially took off at two health care centres – at Jalgaon and Mumbai – set up by the Niramayseva Foundation in 2004. But soon, as more health care centres came up in Nashik, Aurangabad and Nandurbar, teams of voluntary health workers worked round the clock to help patients from remote villages access these camps. As many as 45,000 volunteers have travelled to 12,000 villages to bring patients to the screening camps.

“Since 2004, we have carried out 1.25 lakh surgeries as part of this programme. Of these, at least 78,690 have been since 2016,” says Dr Milind Nikumbh, Dean of Government Ayurved College at Jalgaon and main coordinator of the Maha Aarogya camps.

Over Rs 22 crore has been raised from 21 charitable trusts and foundations and as many as 130 small camps and 14 large ones have been set up in under-developed areas of the state, including in Yavatmal, Solapur, Palghar, Osmanabad, Nanded, Sangli, Dhule, Beed, Satara, Chandrapur and Akola.

While the project has a core team of 22 people, including doctors from Maharashtra University of Health Sciences, who manage and coordinate these camps, leading private doctors have been encouraged to sponsor 500-1,000 surgeries each.

In Pune, Dr Ranjit Jagtap, cardiologist and founder of Ram Mangal Heart Foundation, and Dr Ramakant Panda, Managing Director of Asian Heart Institute, have agreed to conduct the cardiac surgeries. Dr Jagtap said that the cost of a paediatric cardiac surgery is usually between Rs 3 lakh and 4 lakh. “If it involves an ICU stay, the cost goes up further. However, we will sponsor at least 500 to 1,000 such surgeries and encourage society and charitable foundations to donate,” he said.

Dr Shailesh Puntambekar, laparoscopic surgeon from Pune has agreed to conduct 1,000 surgeries on cancer patients over the next two years while bariatric surgeons Dr Jayashree Todkar (Pune) and Dr Muffazal Lakdawala have also been roped in.

“We had set up a clinic at the Maha Aarogya camp and clinically evaluated peple who needed a bariatric surgery. While the Mahatma Jyotiba Phule Jan Arogya Yojana (the state government’s health insurance scheme) will be able to cover some of the expenses, for the remaining amount, hospitals have been asked to pitch in,” Dr Todkar said.

Dr Lakdawala said he had already received 10-15 referrals from these health camps and that his team would conduct around four to five surgeries a day as part of this initiative. “The aim is to perform 1,000 metabolic surgeries on people with obesity and diabetes from rural areas of the state over the next two years,” he said.

State Medical Education Minister Girish Mahahan, who played a key role in setting up the initiative, says the programme, part of the Chief Minister’s ‘Maha Parivartan’ initiative in the state, hasn’t come a day too soon. “There are so many files with names of needy people — really poor people – who cannot afford medical treatment, leave alone hospitalisation or surgery, for even minor ailments such as cataract. Various trusts – Tata Trusts, Mohan Foundation, Mukul Madhav Foundation and others – are helping us in this ambitious venture,” he said.

The volunteers, who bring patients from remote areas to the health camps and then facilitate their treatment in bigger cities, form a vitial part of this initiative.

Swapnil Nanavare, a voluntary health worker from Nashik’s Sigma Hospital, said most of the patients are from rural areas. “Patients from rural parts of Nashik who are examined and identified for surgeries in Mumbai are given tickets and even sent to Aamdar Nivas in Mumbai, where the patient and their relatives get food and accommodation for free,” he said.

Dr Nikumbh of the Jalgaon Government Ayurved College, however, admitted that the challenge was to get doctors to screening camps set up in Primary Health Centres (PHCs) in rural areas. “There are very few consultants and PHCs lack facilities. So the coordinators have to ensure that medical units at government and private colleges carry the equipment and instrument required for diagnosis and other investigations. If, during these camps, we identify patients who need immediate surgery, we can’t take them to the rural hospitals which have limited resources and expertise. The patients then have to be ruhed to Pune or Mumbai.

Rameshwar Naik, who is in charge of the Maha Arogya camps and is also Officer on Special Duty to the Medical Education Minister, said there are five to six categories of patients, including those who need to be put on medication, those who need to undergo pathology tests and those who require minor or major surgeries.

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