VADODARA, Nov 15: The X-ray unit-and-laboratory and the dispensaries are the two arms of the Vadodara Municipal Corporation's health care programme. Yet such are their own inadequacies that they scarcely seem capable of taking care of others.Consider the full- and part-time dispensaries scattered all over the city. Each has to handle more patients - an average of 100 a day at the full-time dispensaries and 75 a day at the part-time ones - than it can efficiently take care of given its manpower and infrastructure. Vacancies cause doctors to double up as family welfare officers; there are no suitable applicants for the 25-odd reserved posts for medical and paramedical personnel.Till a couple of years ago, there were two nurses to a shift in Bachawad, the main health centre. Now there's only one. Two nurses have retired in the meantime, but there are no applicants for the posts. ``The nurses theoretically get holidays in lieu of double duty. But it's difficult to implement it in practice'', admits Resident Medical Officer Dr Ramesh Naik.In the Navidharti and Fatehpura dispensaries, the doctors also work as family planning officers. ``This affects the work as well, as different doctors have different styles'', says Dr Mangala Mahajan of Fatehpura, while Dr Manorama Mukundan of Navidharti remembers a time when doctors were either with family planning centres or dispensaries.The rush of patients tells on the infrastructure as well. While the common medicines - all sold at a token rate of Re 1 - are available in plenty, shortage of anti-biotics often causes doctors to prescribe less effective medicines till the arrival of a new stock. ``Thus treatments take a bit longer'', says a doctor on condition of anonymity.Vitamin and iron tablets, too, are often in short supply. According to in-charge Medical Health Officer Dr Dhurandhar Pathak, the shortage crops up ever so often because the VMC's general board takes a long time to approve the annual contract rate.If the dispensaries are limping along with vacancies and inadequacies, the civic unit where an X-ray costs Rs 40 - against Rs 150 in private clinics - is victim to the notion that less expensive services are decidedly inferior, according to a doctor.Radiologist Dr Bharat Shah, however, says he cannot handle more patients as he has only one X-ray machine and two vacancies for technicians. In the laboratory, too, the pathologist's post has been empty for the past five years and that of the microbiologist's for the last three years. ``Though we carry out their work, it is stressful'', says Prachi Parikh, a staffer.In another shocking instance of unexploited potential, equipment for haematological tests and an automatic clinic chemistry analyser are underutilised in a corner of the laboratory, simply because not many of the general public know of their existence. The two pieces together cost Rs 24 lakh and the rates for them are one-fourth that of private clinics.Dr Pathak holds out little hope for the future, maintaining that the reserved posts cannot be converted into general vacancies.On the controversy stirred up by making doctors double up as family planning officers - five doctors transferred from dispensaries to FP centres last year alleged it was illegal to draw their salaries from the centres - Deputy Municipal Commissioner (Administration) H S Patel says that personnel are just not available for the centres. ``Duties of doctors had to be changed as three new centres were opened last year,'' he adds.Patel says the VMC has asked the State government several times to fill up the posts but to no avail. ``We now plan to appoint doctors on an ad hoc basis'', he says. This step, however, will require the general board's approval.
