Specialists at CHC, 2016
- Required 1,440
- In position 505
- Shortfall (%) 65
Shortfall of male health workers at sub-centres 2,471
- IMR in Maharashtra: 19
Source: Rural Health Statistics, SRS
***
Ismail Sheikh바카라s baby, born at just 24 weeks, is in Nashik Civil Hospital. The tempo driver from Dhule is anxious바카라he knows tragedy had befallen 187 babies here last year. 바카라I felt my child may not survive if I admit her here, but had no choice,바카라 he says. Tabrez Sheikh, an NGO worker who helped Ismail with the formÂalities, says everyone in this neck of the woods is berÂeft of choice. 바카라Patients from Palghar, Kasara, Dhule, Jalgaon, Ahmednagar, Jawhar, Mokhada and Thane seek treatment here,바카라 he says. Those place-names range across a varied social map: urban and distinctly rural (and adivasi) Maharashtra. There바카라s a snapshot here of three layers of healthcare, progressively thinning as one loops outward. Nashik Civil is the nucleus. It has added equipment and filled vacant posts since last year바카라s tragedy.
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바카라Our infant mortality rate is half compared to last year,바카라 says Dr G.M. Holey, additional civil surgeon. High base, but still.
Every month, some 250 babies are admitted here and another 1,500 outpatients land up too. There are 541 beds, 275 nurses and just 12 doctors, who perform all but heart and brain surgeries. The Sick Newborn Care Unit has 32 nurses, and seven posts are vacant. Troubling, because nurses can be as critical as doctors in childcare. 바카라The posts will be filled soon,바카라 says senior nurse S.V. Patil.
The hospital has 36 incubators, twice the number in 2017. 바카라But there are still no ventilators,바카라 says Holey. If this crucial element in emergency life support is missing, it adds to the systemic weaknesses. Remember, patients show up at district hospitals as rural areas are already devoid of healthcare infrastructure.
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When such weak systems inevitably crumble바카라as they did in Gorakhpur, Calcutta, Odisha and Kolar바카라doctors can do little but cite 바카라late arrivals, infections and extreme malnourishment바카라 as key causes of death. As Holey says, 바카라The hospital alone cannot be held responsible.바카라
Three hours from Nashik, at Patangshah Cottage (or Kutir) Hospital in Jawhar, a taluka of Palghar district, things are worse. This hilly terrain is good only for marginal farming; economic migration is rampant. Of the 1.5 lakh population here, 90 per cent are adivasis and 80 per cent live in villages. Children under six are 16.6 per cent of the demographic. Cottage was set up in 1947 by the last raja of Jawhar with just 10 beds바카라upgraded to 30 when it was transferred to Bombay state in 1948.
As many patients at Nashik Civil are from this region, Cottage could have been a vital link in the healthcare chain. Instead, the situation is grim at the taluka바카라s only big hospital, which caters, in turn, to people further upcountry바카라Mokhada, Wada, Vikramgad etc. 바카라Our 100 beds always have over 200 patients,바카라 says a nurse, and a doctor gloomily adds: 바카라During monsoons, it바카라s one bed for three patients.바카라
The sole incubator바카라essential for premature newborns or those with birth defects, low birth weight or other conditions바카라바카라is working most of the time바카라, and, as Cottage has 36 baby warmers, but no ICU, 바카라during emergencies, we recommend patients to Nashik Civil,바카라 the doctor says.
The gaps leap out at you. Specialists are missing바카라a paediatrician but no paediatric surgeon, a sonograph machine but no doctor or operator. A private doctor with his own sonograph tests patients at Rs 500. Three of 14 doctors never report to work. Of the 15,000 litres of water it needs, the municipality provides only 2,800. The hospital buys water at Rs 350 per 5,000 litres, but not clean water바카라that it cannot afford.
There바카라s no major operation theatre here, nor a blood bank. Only 66 of 94 sanctioned doctor and nurse posts are occupied. But there are three generators. 바카라Despite load-shedding, we have no power problem,바카라 says an office superintendent.
The last link in this chain is the primary health centre in Jamser, 8 km away. 바카라We have installed 10 beds, though we are a six-bed setup,바카라 says Dr Kiran Patil, who believes every district requires a multi-specialty hospital. Even PHCs, which are meant to deal with minor illnesses, pregnancies and so on, need to be upgraded. Right now, they cannot even handle deliveries바카라the panic only rises each time cases are forwarded to Jawhar and from there to Nashik. Often too late.
By Neel Shah in Nashik
