Union Rural Development Minister Jairam Ramesh, in a letter to Health Minister Ghulam Nabi Azad, has acknowledged that Maoists do not “obstruct” government health programmes.
Mr. Ramesh has defined delivery of health services to Maoist-controlled areas as an “opportunity” to reach millions of tribal people in the remotest areas of the country. However, government health workers and administrators cite Maoist intervention as a reason for non-delivery of health services.
In underdeveloped areas of Chhattisgarh, especially in Maoist-controlled districts, government healthcare is virtually non-existent. In most cases, primary health centres (PHC) are miles away from villages and people could hardly make it to the PHCs due to non-availability of transport, hostile terrain and extreme climatic conditions.
In addition, health workers rarely visit the PHCs due to what is perceived as “Maoist threat.” Even in a place like Chintagufa in Sukma district, next to a Central Reserve Police Force camp on the main arterial road, the health centre is only occasionally visited by health workers, the villagers told The Hindu .
Moreover, according to data released by the Chhattisgarh Health Department, a huge percentage of health workers’ posts are vacant across the State. For example, in Dantewada, 60 per cent posts are vacant. The situation is more or less the same in all tribal districts.
Interestingly, the National Rural Health Mission (NRHM) has also failed to fill the vacant positions announced by them. The demand-supply gap of health workers has been met by quacks and barefoot Maoist doctors, who provide basic health care to villagers.
Mr. Ramesh has said in his letter, a copy of which is with The Hindu , delivery of health services in Maoist areas is “both a challenge and an opportunity.” “It is an opportunity since the health programmes are not obstructed by the Maoists, and if delivered effectively, [it] has the potential to soften the local tribals’ attitude towards the government,” wrote Mr. Ramesh.
Mr. Ramesh has suggested to Mr. Azad to introduce some “flexibility” in the NRHM to deal with “health challenges” in Maoist areas. He has strongly recommended government support for four non-profit health organisations, which have done substantial work in central India. These are Ramakrishna Mission (RKM) in Narayanpur and Jan Swasthya Sahyog (JSS) in Bilaspur district of Chhattisgarh and the organisations led by Dr. Abhay Bang and Dr. Prakash Amte in southern Maharashtra.
He feels the NRHM should not only be used “to support existing institutions,” but also to create “new [health] networks,” and, therefore, “such organisations” should be supported under the NRHM.
