Health Care in a shambles: 60 doctors post vacant Tribal-dominated district is in shambles due to the non-availability of doctors. Although the district has seven community health centres, three primary health centers for 10 blocks and 37 primary health new centres but doctors are not posted BASANT RATH, JOURNALIST. Merinews.com THE HEALTH sector in this tribal-dominated district is in a shambles due to the non-availability of doctors. Although the district has seven community health centres, three primary health centres for 10 blocks and 37 primary health new centres, adequate doctors are not posted there. While there is a dearth of specialists at the community health centres, the District Headquarters Hospital has 10 vacancies, including that of seven specialist doctors. Key posts in the departments such as medicine, orthopedics, skin, anaesthesia, pathology and surgery are yet to be filled at the DHH. At primary health centres, while 50 posts of surgeons are vacant, no doctors were posted in the past 10 years for 11 speciality departments. Surprisingly, at least 20 hospitals in the district are being run by only health workers and nurses while some hospitals are managed by 4th class employees. Health service in Kosagumuda, Papadahandi, Dabugam, Jharigam, Chandahandi, Nandahandi, Tentulikhunti are in a shambles with no doctors appointed over the years. The situation in remote areas in worse with doctors playing truant. In certain hospitals medical authorities go on closing the hospitals at peak hours. The private practice by the doctors in also blamed for the degradation in health care services. Tribals in the remote areas mainly depend on quacks and those who sell indigenous medicines. Some people, who do turn up at the nearest health centre, are more often treated by nurses and health workers. While those who can afford to pay for medicines go to hospitals at Visakhpatnam in Andhra Pradesh or Berhempur Medical College, the poor have no other alternative but depend on quacks. According to a survey, the district tops the list for infant mortality in the state. Though the local administration claims the introduction of several schemes for safe motherhood and child care, for want of minimum facilities, women are dying at the time of delivery. Even the life of the newborn is not safe. Though money was by the government to take pregnant women to the nearest PHCs or CHCs, the funds allotted for the purpose are being siphoned off by the officials concerned. The situation is worse in the rural areas in spite of recommendations by various organizations, including the district administration have not been able to do enough for these tribal-dominated tracts that report a large number of deaths due to under-nutrition, endemic malaria, diarrhea and other diseases. Rising graph of maternity deaths, mostly expectant mothers from minority community, has become a major cause of concern for health planners in this tribal dominated district. Even a government sponsored health service network has failed to live upto the expectations. While in the district mortality of children below five years remained at nearly 90 per every 1000 children and this district has come down to the second position in list of infant mortality rate (IMR) in orissa. Recently a NGO described the scenario with regard to safe child birth in Nabarangpur as exceedingly bleak. In rural areas with predominant tribal population, thing have gone from bad to worse. In ordinate delay in reaching govt hospitals often results in the death of pregnant mothers. Many women from this community prefer to delivered of their babies at home under the care of elderly woman relatives and untrained attendants. Besides anemia caused by multiple pregnancies has also contributed to the sport in maternity causalities. Most of the pregnant women hardly ever receive gynecological support for safe delivery. The grim reality is that only 25 per cent pregnant women have access to institutional delivery facilities while the rest languish and perish in the process due to utter neglect. As a matter of fact little over 20 per cent pregnant women receive timely antenatal care while the much-touted government sponsored health scheme for women has failed to come to their rescue. With governmental health service on the average of break down quacks rule the roost and run a parallel health service network aggravating the situation further. These self styled doctors are wreaking havoc in remote areas bereft of primary health service. Having little expertise, the quacks resort to crude and unscientific methods for childbirth and very often the exercise ends up with the death of the expecting mother or the child often both die. But ironically two-third of these maternity deaths go unreported. For obvious reason quackery goes on as government doctors play truant and skip duty in remote areas. There are allegations that some doctors demand bribe from relatives of pregnant women for delivery. On the other hand malaria eradication programme has failed to takeoff in the district, people who are at the receiving end of the epidemic, alleged that menace continues to grow in ferocity because doctors and health officials don’t pay regular visits to the malaria-affected areas for slide tests. With cases of malaria and brain malaria on the rise allegations of bungling of programme funds are flying thick and fast. Local MP, Pradeep Majhi, criticized the state government for not filling posts of doctors and specialists in the district. The newly constructed District Headquarters Hospital has good infrastructure but it is of no use as many posts of doctors are lying vacant. More than 3Lakhs people depend on this hospital for health problems. A resident’s forum here has alleged that working doctors were more concerned about their private practice than their responsibilities in the district hospital. Even the doctors who are working at PHCs and CHCs are not staying at their respective headquarters. Although crores has been spent for up gradation of the hospitals with good infrastructure, large number of vacancies has hit the health care.