Abokali Jimomi
For those in Nagaland who live in areas where healthcare is a challenge due to lack of facilities, lack of well-equipped hospitals, lack of transportation, and bad road conditions, even appendicitis becomes a matter of ‘life and death’.
For pregnant women who are poor the scene resembles an obstacle-race when complications develop and they need to reach the only hospital 30-40 Kms away, because the nearest PHC was closed. A hazardous journey to the hospital without money is just the first hurdle; finding no doctors or nurses is the next, and even if a doctor finally arrives, to have no power supply, no equipment, no medicine becomes the final jump, a total anti-climax, from the frying pan into the furnace.
It would take a lifetime’s savings for a daily wage earner to hire a helicopter costing anywhere above Rupees 50000 to travel in 15-30 minutes to Dimapur, Guwahati or Shillong for medical emergencies as usually done by few in Nagaland. Footing the bill of private hospitals is another matter altogether.
Government-run hospitals like the Zunheboto District Civil Hospital are the last hope for many citizens but these hospitals are chronically ill, apathy permeating their walls and floors; a dystopian portrait of decaying public health service.
What happens to the sick and poor when the only hospital has no doctors, no nurses, no generator, no toilet, no ultrasonography, no X-ray machine, not even a roll of gauze? Although the irony is that private pharmacies operating nearby the hospitals are fully stocked. Should the sick just give up?
The Government of India, Ministry of Health and Family Welfare’s safe motherhood intervention programme, Janani Suraksha Yojna (JSY) promotes institutional deliveries among poor pregnant women providing cash for delivery and post-delivery care. Supplementing the JSY, the Janani Shishu Suraksha Karyakram (JSSK) was launched on 1st June 2011 to provide for all states completely free and cashless services to all pregnant women and to sick infantsin all Government institutions in both rural and urban areas.
The free Entitlements for pregnant women are: Free and cashless delivery, free C-section, free drugs and consumables, free diagnostics, free diet up to 3 days for normal and 7 days for C-section, free provision of blood, exemption from user charges, free transport from home to health institutions, free transport between facilities in case of referral, free drop back from institutions to home after 48 hours stay and similar entitlements for sick infants till 30 days after birth.
In a stark contrast to all the free entitlements, many pregnant women in Nagaland despite opting for institutional birth have received nothing free, not even a disposable syringe.Unfortunately, without Government health institutions performing properly the schemes, however great, do not reach the intended beneficiaries.
On the other hand, in a remote corner of Nagaland in Tuensang District, in the middle of a jungle, is a superbly maintained and fully-functional PHC with a doctor round-the-clock, with well-equipped labour room and delivery ward, managed by the Eleutheros Christian Society, who also holds annual medical camps conducting hundreds of surgeries for free for villagers from places where roads haven’t reached.
This makes us realize that geography and remoteness of a place are not the only major reasons obstructing the poor from accessing healthcare solutions in Nagaland. If resources were managed responsibly by the department and if citizens consciously monitor their respective health service centres, our rural health infrastructure wouldn’t be in such a state of despair.
