Speaking against Silence and Stigma in West Bengal Jahanara Bibi could have been just another child bride from rural Bengal, silent and accepting of a violent and abusive marriage. Instead, she summoned the courage to take legal action against her violent husband and become financially independent. Today, she tells the stories of the women in her village as a Community…

Jahanara Bibi

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Doctors refuse posting to a small village in a border district of West Bengal even as people suffer due to lack of medical services.

Basanti Roy is an Accredited Social Health Activist (ASHA) in Badalpur village of South Dinajpur District in West Bengal. ASHAs are community health workers who play a pivotal role in ensuring positive maternal health outcomes. But Basanti could not save her own relative. “She was my nephew’s wife. I called the ambulance before her labour pain started but it arrived late. First I took her to the hospital at Rashidpur. There was a delay. Then we took her to the hospital in Kaldigi where they were able to perform a caesarean section on her. After the operations she started having convulsions. We shifted her to a bigger hospital in the neighbouring district of Malda where she passed away.”

Government health facilities in West Bengal have repeatedly come under the scanner. A 2014 study found that not only is there a shortage of doctors in the hospitals, but the facilities were also under performing and inefficient. The situation in Badalpur is illustrative of this scenario. The primary health centre (PHC) here serves a population of 50,000 when government rules mandate that there should be one PHC per 20,000 of population. Further, the PHC is operational only between 9am and 2pm. Ailing patients have to travel upto twenty kilometers to the next government health facility.

Community Correspondent Jahanara Bibi’s report reveals that pregnant women fare the worst due to the prevailing situation. Poor connectivity and bad roads further delay ambulances and women in labour end up giving birth at home or on their way to the hospital. Lakshmi Barman’s daughter-in-law gave birth at home. “Ambulances are always late. We kept calling but it arrived an hour later. My daughter-in-law had already given birth. We took the mother and child to the hospital and they stayed there for three days. We had to spend quite a lot of money, about 5000 rupees. If we didn’t have to spend so much we could have cared for her nutrition better,” she says.

The government’s Janani Suraksha Yojana (JSY) claims to provide free maternal health and delivery services in addition to a cash incentive of 1400 rupees to women in rural India who choose to give birth at government health facilities. But in areas like Badalpur where basic facilities are not available, poor families end up spending a large chunk of their income on out of pocket expenditures. The National Family Health Survey (NFHS) reveals that health expenditure in low income household is often the cause of indebtedness and impoverishment with hospitalisation costing upto twenty times the monthly income in the poorest households.

What is even more ironic is that a new hospital, with facilities like in patient department, doctors’ living quarters and other facilities was constructed in Badalpur in 2014. But it lies vacant with its fully air conditioned wards and state of the art equipment because doctors are not willing to get posted in this remote village. It is a crying shame that doctors getting their degrees in the subsidised government medical colleges are too busy earning money to bother disbursing essential health care to those most in need. While the government of West Bengal has enacted stringent laws to combat medical negligence in private hospitals and nursing homes, it needs to step up and improve service provided through the state health care facilities. To help people in Badalpur please call Sukumar Dey, the Chief Medical Officer, Alipurduar on +91-3522255640 and demand that the vacant hospital be made operational immediately.

Article by Madhura Chakraborty