While Mumbai has an obscene array of five star health care, neighbouring Thane district is a picture of neglect

If you are a tribal woman in Shahpur, and pregnant at that, your chances of getting a sonography done are only on the third Wednesday of every month at the subdistrict hospital. There is no radiologist here.

In the whole of Thane district (comprising 15 talukas), there are only two government radiologists who work almost 24 hours to cover all hospitals. Most tribal women shell out Rs. 700 to Rs. 800 — a sum they can ill afford — to pay for private practitioners rather than wait for weeks.

For the past four or five months, the government has not distributed folic acid tablets, and essential drugs are always in short supply in this tribal-dominated taluka, which is barely 100 km from Mumbai.

If a woman manages to reach her full term of pregnancy and goes to the same subdistrict hospital for delivery, it can be a great misfortune if she has to use the toilet as Savita Mukne from Vashind discovered last month.

Ms. Mukne, escorted by Accredited Social Health Activist Anju Dongre, went outside the labour room to find the two toilets shut and used as storerooms. Ms. Dongre recalls: “It was on February 25, I took Savita out of the labour room to find the nearest toilet which was a little further down, and to my horror, the baby’s head popped out. I was in a dilemma and had to keep holding the head while a vehicle was procured to get Savita back into the labour room. ”

The child suffocated in the meantime, and Ms. Mukne, in a critical condition, had to be rushed to the Thane civil hospital that night, a good three-and-a-half-hour drive. It took her six days to recover. “See what problems this lack of toilet has caused,” Ms. Dongre said.

While Mumbai has an obscene array of five-star hospital care, the neighbouring Thane district is a picture of neglect. At Jansunwai, or public hearing, held at Shahpur on Thursday, under the community-based monitoring programme of the National Rural Health Mission, government doctors and officials tried to save face while a litany of complaints was read out against corruption, the condition of primary health centres (PHCs) and lack of anganwadis (in 25 villages), improper supply of medicines, including folic acid tablets, for months, and the non-availability of rations for midday meal schemes.

Bharat Masal, medical superintendent of the Shahpur subdistrict hospital, said that every month only 30-35 cases were taken up for sonography since the radiologist, who comes from Thane, could only work between 9 a.m. and 1 p.m. Because of rampant misuse of sonography for prenatal sex determination, the law was strict about uploading information in respect of each case on the Internet on the same day, said Mahesh Renge, resident medical doctor of the Thane civil hospital.

The government offers a radiologist a salary of Rs. 50,000 a month at the Shahpur hospital, but there are no takers. Of the 95 total sanctioned posts at the hospital, 18 are vacant. There are 2,000 women in the high-risk category registered themselves with the hospital who are given preference for sonography, Dr. Masal said.

One other issue was the non-supply of grain last June to September to women running self-help groups (SHGs) who cook midday meals. The public distribution system (PDS) centres refuse to stock up grain since it is not profitable, said an official. The SHGs had to put in their own money to buy grain or get it from the PDS shops they ran. A grave issue was the lack of supply of folic acid tablets, crucial during pregnancy since most of the tribal women suffered from anaemia.

Indavi Tulpule of the Shramik Mukti Sanghatana said that for four months, there was no supply of folic acid tablets. Pooja Singh, Additional District Health Officer, admitted that there was a shortage, but said the government launched a new Weekly Iron Folic Acid Supplementation scheme, under which four lakh tablets were given to Shahpur taluka alone on January 28. However, these tablets were sent for testing last December, and the report did not come in. While Dr. Singh said the tablets were released, the taluka medical officer said they were not available.

Lack of supply of medicines at the nine PHCs and 60 sub-centres in Shahpur came in for much criticism. At the Vashind PHC, medical officer Vinay Devlalkar almost got beaten up because he could not provide the drugs required and he rarely gets what he indents for. He has to buy extra medicines to meet the demand. The State rarely gives what the PHCs require and even Dr M.S. Dhere of the Dolkhamb PHC admitted to being low on essential medicines.

At the PHC at Tanki Pathar, the contractor vanished without fitting a water tank. Now bullock-carts ferry water to the facility. The two doctors and the staff cannot live there. The condition of other PHCs, too, is pathetic with leakages during monsoon and poor construction. Access is also an issue for many people. One PHC is located near a poultry farm, and people want it relocated because of the high risk of infection.

Dr. Nitin Jadhav, State coordinator of SAATHI, an NGO for community-based monitoring, said these issues were raised at other public hearings in the area but they were not resolved. “There has to be a process to resolve them at local levels,” he said.