Government system failure killing mothers in Madhya Pradesh

BHOPAL - A complaint by a patient that a doctor in a government-run hospital left her unattended in the operation theatre has turned the spotlight on the role played — or not played — by these hospitals in reducing deaths at childbirth in Madhya Pradesh, a state with one of the highest maternal mortality rates (MMR) in India.

Vidhya, wife of Anil Magarde, was admitted to the Betul district hospital Oct 3. She has said in her complaint: “Dr. Renuka told me on Oct 5 that an operation will have to be conducted and demanded Rs.2,500 for the same.

“I told her that Rs.1,000 has already been paid and the remaining amount would be paid after the delivery. I was taken to the operation theatre the same evening but left unattended by the doctor after administration of local anesthesia. Later, my family members took me to a private hospital where the delivery was conducted.”

Denying the charge, the doctor, Renuka Gohia, told IANS: “No extra money except Rs.100 towards registration charge was taken from her or her relatives. The patient’s family members shifted her from the hospital on their own without any reason. The delay in the operation was not for money but because her blood pressure had gone down after the administration of anesthesia.”

Vidhya has urged Betul Collector Vijay Anand Kuril that the doctor be asked to return the Rs.1,000 paid as well as Rs.25,000 spent in the private hospital. The collector has ordered an inquiry.

Civil society groups working to promote safe motherhood say Vidhya was lucky. In June this year, six women died within 15 hours in Bhopal’s Sultania Government Hospital.

As per the 2007 Registrar General of India survey, Madhya Pradesh has an MMR of 379 per 10,000 live births as against the national average of 301.

“Seventy percent of the national budget allocated for health support goes back unutilised. The system is not delivering results and that’s where the problem lies,” says Hamid El-Bashir, the Unicef representative in Madhya Pradesh.

“The cause for the high MMR in the state is not lack of resources alone but failure of the system,” says Seema Jain of Vikas Samvad, an NGO that works on safe motherhood. “No one is held responsible when a mother dies … most of the time it’s not even registered. It’s very important to keep a tab on a pregnant woman’s health.”

Besides negligent doctors, non-functional health centres, scarcity of blood banks, inadequate number of specialists in rural areas and poor transport system are other bottlenecks, she added.

“Approximately, 10,000 women die every year in Madhya Pradesh during pregnancy or within 42 days of delivery. These deaths may be due to haemorrhage, infection, eclampsia or unsafe abortion. A majority of these could be prevented once the system is made accountable,” says Rolly Shivhare, activist of the Right to Food campaign.

“These deaths are completely preventable and that is the greatest tragedy. It is a silent tsunami,” says Sachin Kumar Jain of the Madhya Pradesh Lok Sangharsh Sajha Manch.

“We have to ensure increased presence of skilled birth attendants at the village level, provide care before birth, address sociological issues and bring about a change in attitude of health personnel,” he said.

(Sanjay Sharma can be contacted at sanjay.s@ians.in)