By Arun Pratap Singh
Dehradun, 6 Oct: The recent death of a new-born baby in an ambulance during delivery in Pithoragarh is just another pointer to the fact that the public health system in Uttarakhand is in disarray. This incident is not unique in itself, though. It made the headlines because the new born girl who died happened to be the niece of Gangolihat MLA Meena Gangola. The baby died during the delivery because the Community Health Centre in Gangolihat could not handle even a delivery case satisfactorily. Since it was a high profile case that hit the headlines, the DG Health today ordered an inquiry into the case to find out if the doctors were responsible for the death during delivery. If a CHC, expected to be a fairly well equipped hospital, can’t handle a delivery case properly, one can imagine, what must be happening in Primary Health Care Centres (PHCs) across the state. Uttarakhand has currently 1765 Sub Centres of health, 239 Primary Health Care Centres (PHCs) and 55 Community Health Centres including First Referral Units (FRUs) and just 12 District Hospitals in 13 districts. It is also interesting to note that there is only one district hospital in the state which has a capacity of more than 300 beds. Incidentally, this hospital has also been converted into a medical college and no other hospital has so far been designated as Dehradun district hospital. It may be recalled that Dehradun is the state capital and it receives patients from across Uttarakhand in large numbers. In addition to the PHCs, CHCs and district hospitals, the state has 27 Sub Division level hospitals called SDHs. However, it is interesting to note that the figures have not changed or improved much in the past 12 years. Each CHC has a sanctioned post of one physician, one gyaenocologist and one paediatrician. It may be noted that there is one position of Obstetrician & Gynaecologist in each of the 55 CHCs to handle gynaecological cases and pregnancies but never have there been more than 30 gynaecologists posted in the 55 CHCs of the state. In addition, there are 220 positions of specialists in all the 55 CHCs of the state. However, more than 60 percent of the positions are lying vacant for long. There have been long periods of time in past 12 years when no more than 67 specialists were posted in the CHCs. In between, some positions do get filled up with contractual doctors but these positions do not remain occupied for long. In many cases, the contractual specialists have their own clinics and nursing homes and use their position to refer the patients to their own facilities. As far as nurses and midwives are concerned, there is an official requirement of 624 positions but the occupancy in these positions has never been satisfactory. There is a serious shortfall of about 300 nursing staff in the CHCs. In all the state hospitals and Health care centres, the total sanctioned strength is of 3584 nurses but the shortfall remains high all the time, sometimes reaching as high as 68 percent in these 12 years. What to speak of the public healthcare infrastructure and status in the hills, the government is not able to run even the CHC in Doiwala in Dehradun on its own. Presently, there is only one doctor posted there and the unit is running in PPP mode. Most of the positions of doctors in the trauma centre in Rishikesh, which is supposed to handle most trauma cases from the Garhwal hills have been vacant for long. There are a significant number of vacancies in the 404 bed Doon Hospital, 120 bed Deendayal Upadhyay Hospital (Coronation) and Gandhi Shatabdi Hospital in Dehradun. Most health posts located in various parts of the city and around have no doctors and they hardly function, existing merely on paper. Incidentally, when the BJP Government had come to power in 2017, there were serious attempts to post specialist doctors in the hills. Those posted in Dehradun, Haridwar, etc., for a long time, were transferred to the hills. However, the situation is back to square one now. Most of the specialists have managed to return to Dehradun or Haridwar or US Nagar. Some of those who still remain posted in the hills have also managed to get themselves attached to the Health Directorate or some projects in the state capital. Chief Minister Trivendra Singh Rawat, who holds the health portfolio, too, has more than 40 departments directly under him with 3 positions in his cabinet lying vacant, at present. As such, he is hardly able to devote the required amount of time and energy to improve the functioning of the ailing health services in the state.