The Hindu : Kerala / Thiruvananthapuram News : Doctors’ strike hits field activities

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Wednesday, May 07, 2008
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Kerala

Kerala - Thiruvananthapuram

Doctors’ strike hits field activities

Staff Reporter

Utilisation of funds, planning affected

Immunisation, outreach programmes hit
Government depending on NRHM staff

Thiruvananthapuram: Lack of supervision by doctors has been affecting public health activities and fund utilisation by ward-level sanitation committees.

With fever cases and incidence of leptospirosis going up in various parts of the district, the slackening in field-level disease prevention activities has been posing a headache to the district health administration.

Even the planning of activities has not been proceeding smoothly as the striking government doctors are not attending any conferences or signing reports.

Now that the District Collector will evaluate all ward-level activities on a weekly basis, the district health administration has decided to depend on the National Rural Health Mission employees, especially the Block Arogyakeralam Coordinators (BACs) to monitor and coordinate epidemic prevention measures in each ward.

The BACs, who have been given the task of closely monitoring the health activities in their respective areas, report directly to the District Medical Officer or the NRHM district programme manager. With the Health Services already having a good network of field-level health workers, the deployment of BACs has caused some resentment among the existing field staff who feel that their work is being duplicated. At least in some blocks, the standoff between BACs and health workers has been creating problems for administrators.

The BACs have now been given specific checklists on activities expected to be carried out in each ward, including house visits by health workers, source reduction activities, disease surveillance and vector indices monitoring.

However, in the absence of supervision by medical officers, many are sceptical as to how much actual work will get done.

Fund utilisation

Disbursement of funds from the National Rural Health Mission for ward-level sanitation committees to implement pre-epidemic preparedness activities and cleaning programmes, were completed in the beginning of the year.

However, much of the funds continue to remain unutilised in the district as the medical officers have distanced themselves from all NRHM activities and have refused to collect the cheques.

The Corporation wards and municipalities, which were given Rs.10,000 in a single lot have utilised the funds but this is not the case with the panchayats, which have not been submitting the statement of expenditure on time for getting the money released. With the doctors intensifying their strike, funds have not been issued to many panchayat wards.

Immunisation camps and other outreach programmes too have been badly hit due to the doctors’ strike. With a spate of VIP visits in the city, the district health administration has also been finding it difficult to arrange medical teams to accompany the VIPs.

Figures in the district show that, from January, 62 cases of dengue fever were reported especially from many the wards of Vizhinjam and Vilappil. Viral fever cases have also been going up in Vellarada, Kanyakulangara, Poovar areas.

The high incidence of leptospirosis this year in the district — 59 cases since January, including two deaths – have also been a source of worry for health officials. “Both dengue and leptospirosis are preventable if the public cooperates with health workers. One of the deaths due to leptospirosis that occurred in Vembayam was due to the sheer carelessness as the infection was contracted by a worker who was hired for cleaning activities. If proper health education was provided, this would not have happened,” a health official said.

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