Mohammad Riyaz Malik
Covid-19 – the global pandemic has exposed the lack of basic health care facilities not only in developing countries, but many first world countries have also faced criticism for lapses in their health services. As per a report by the Organization for Economic Co-operation and Development (OECD), developed countries like the USA spends 16.9% of its GDP on healthcare (out of pocket and public) while India, on the other hand, spends only 3.6% on its total healthcare – the least among BRICS countries. Despite spending a good percentage of GDP on their healthcare, the US witnessed a nightmare. But what India is facing is quite an unfortunate situation as it was registered as the second-most-affected country by active and total cases, and third by fatality on September 8. India has lost 76,322 lives till September 10 as it continued to report highest single-day spike of 95735 new cases.
Hospitals in cities are overburdened, one can only imagine the situation in rural and remote areas where even the primary health care services have been a concern. More so in hilly areas, where lack of roads and transportation adds to the challenge of reaching the health centers and hospitals only to find doctors, medicines and medical equipment unavailable.
Poonch, a border district located 250 kilometers from Jammu city in J&K, is often in news for cross-border tensions along the Line of Control (LoC) with the neighboring country. In its Mandi tehsil, a hospital building was constructed in the year 2019 with total expenditure of Rs.70 Crore. Another Rs.20 Crore has been spent by the administration for constructing a building adjacent to the existing one. The hospital at sub-district level had brought hopes for the locals who have spent years compromising with their health due to lack of basic services. The unavailability of doctors and lack of basic supplies & equipment at this newly constructed hospital, however, has severely disappointed villagers in this remote tehsil.
“We have to walk 4 to 5 kms to reach hospital at Mandi only to find no doctors. The most challenging issue is that of the ‘out-of-order’ ultrasound machine which makes it difficult to diagnose many issues specially in women,” shared 40-year-old Peer Tariq Hussain, a resident of Saujian sector in Mandi. He explained that disappointed patients either return to their village in the evening or those with serious issues and ability to spend money on transport, visit district hospital in Poonch town. “At Poonch hospital, they conduct the ultrasound examination but ask us to return in 2-3 days to receive the reports. This means spending too much either on transport or on accommodation in Poonch,” shared Peer emphasizing how this whole situation burns hole in the pocket of the poor people. In many extreme cases, lives have also been lost due to the unavailability of money to be spent on treatment.
39-year-old Mushtaq Ahmed from Urai village has been visiting hospital in Mandi for the last five months for the treatment of his wife. “Unable to get ultrasound done in this hospital, we were forced to go to Poonch several times. During the lockdown period, private taxi owners demanded Rs. 5000 instead of Rs. 500. I had to take loan to be able to provide for my wife’s treatment,” shared a helpless Mushtaq.
For a population of over a lakh, scattered over high mountains, this hospital could have been a life saver. When these issues were discussed with Block Medical Officer, Mandi, Mushtaq Hussain Shah, he expressed his helplessness and said, “At present, only 1 of 5 positions for specialist doctors and 4 of 8 positions for medical officers are fulfilled. Rest of the positions remain vacant.” Referring to the Poonch block, he said that at present there are still 15 vacancies for 64 health centers. Similarly, of 80 vacancies for the cleaners, only 20 are fulfilled. There are only two vacancies for pharmacists, and both unoccupied. Six posts of staff nurse have not been filled.
As per him, the medical equipmenthas been facing issues for the last eight months. Digital X-ray facility has been provided by the administration, but the staff is still awaiting some necessary kit required for its proper functioning. Recently, hospital has also received a ventilator but there is no one in the staff with the technical expertise to operate the same. In such situation, how can one be prepared to face a pandemic that has killed thousands of people across the country?
Expressing concern over the condition of the hospital, Abdul Ahad Bhatt, a senior social worker from Poonch, said that “On one hand, we are fightingthis Corona virus, and on the other, shortage of doctors. To do justice to the people of Mandi, administration should treat this case as priority and take actions to fulfill the shortage of staff at the earliest to ensureavailability and accessibility to basic health care in this remote area,” shared Abdul.
On July 16, all the sarpanches from the Mandi block met District Development Commiss-ioner in the presence of Block Development Chairman, Shamim Ahmed Ganai toshare their concerns regarding the problems they face at the hospital. Two months have passed but nothing concrete has come out of that meeting.
“Despite being categorized as one of the most backward areas, the people of Mandi have been patient and trusted the administration. As their leader, I request the higher authorities and the leaders to pay attention to our plight and provide us with solutions only then wounds will be healed,” requested Mubashir Hussain Bande, Mandi Headquarters Sarpanch.
Mohammad Riyaz Malik