Healthcare is a casualty here

Melghat, Maharashtra, May 22 | Updated: May 23 2007, 05:30am hrs
Poor health facilities and the failure to curb malnutrition in Melghat in Maharashtras Amravati district despite several central and state schemes and international funding -- has forced local authorities to seek private help.

Authorities in Amravati district recently reached out to ICICI Bank, Tata Teleservices, Hindustan Unilever and HDFC to see if a tri-sectoral partnership be forged with the private sector and non-government organisations.

The companies have agreed to provide funds and management skills to government doctors, health workers and NGOs in tribal areas, including Amravati, say authorities. The companies will also help chart out a new village workers programme, strengthen the government's health and integrated child development schemes and provide micro-finance to such schemes.

The authorities say, as a first step, the state has started recruiting MBAs for the National Rural Health Mission.

The NGO data on malnutrition in the region give a different picture from what the state government claims. For instance, in Melghat, of the 35,000 children under 5 years of age, 75% are malnourished, says Ashish Satav of Mahan, an NGO involved with health care. But the state government claims that less than 50% are malnourished. Tribals in Melghat complain about being left out of the BPL list and also for not receiving in full the sanctioned amount of money provided in various schemes.

They also complain about women not receiving adequate monetary aid prior to child delivery if there are registration delays, irregularity in providing medication, aanganwadis (women and child care centres) being located far away from the villages and poor quality food.

Such high incidence of malnutrition amongst Korku tribals in the region is attributed to poverty, ignorance of government schemes, consumption of unhealthy food, lack of nutritional sense, heavy alcoholism and having too many children.

Satav says the child mortality in the under-5-year age group in the region is around 130 per 1,000 (the state government puts it at 55-70) and infant mortality (of children under 1 year of age) is about 85 per 1000 (the official figure is less than 42).

At a hospital in Dharni, Gita, the mother of a malnourished child in a BPL family said she did not get any benefits from the central government, before or after delivery. According to the National Rural Health Mission, women from BPL families must get Rs 500 eight months after pregnancy and another Rs 200 if a child delivery takes place at a government institution.

Complicating the situation are the differences of opinion between officials and NGOs. Says DB Dahekar, sub-divisional officer, Dharni, Melghat, There are over 140 NGOs operating out of Melghat. They just move around the region, find isolated cases of malnutrition and play it up to get huge funds from international organisations. But, in fact, the state government is doing a lot of work to improve the situation.

According to Amravati district officials, in 2006-07, they had utilised the entire Rs 25 lakh they received from the European Commission for training, building awareness and village referral plans. They say they have also spent 80% of the Rs 32 lakh received as grant under the National Rural Health Mission on strengthening of sub-centres. In Yavatmal, about 2,200 self-help groups are doing good work under the Integrated Child Development Scheme. But they allege that the central government has not been paying them regularly due to lack of funds, thereby dampening their morale. Against a demand of Rs 7 crore in 2006-07, the Centre has been able to disburse just Rs 5 crore, says an official.

In Kharya Timbhru alone, 11 children died due to severe malnutrition in 2006. Says Samoti Kasdekar, a resident, The primary health centre is about 6 km away. So, no one really bothers to travel the distance. Though they are to get free medicines from the state government, some of them go to distant private shops due to lack of medicines in the government centers.

Sanju Selukar, a mother of four children, says, Though the village has an aanganwadi, the food served is of very poor quality and the same khichdi is served daily. Even protein and vitamin powder is not given. Even the Nagpur district has its share of complaints about the aanganwadi system. In Karhandla village in Nagpur district, Devidas Deshmukh, a social worker, says, the aanganwadi for about 25 children is a very small room and that children are hardly given nutritious food. He says the attendance of doctors and nurses at the public health center is poor too. But authorities say the Centre schemes do not cover enlargement of aanganwadis.