Citizens of V K Salagar, Karnataka (India) reclaim their Primary Health Centre-KJC(Karnataka People’s Health Movement)

Citizens of V K Salagar, Aland Taluk, Kalburgi district, Karnataka (India) reclaim their Primary Health Centre

Following the state government’s decision to take back all the Primary Health Centres (PHCs) from NGOs and other private entities, the people of VK Salagar in Aland taluk of Kalburgi district in state of Karnataka (India) held a public dialogue recently with the district administration to discuss the urgent measures required to “clean up the mess and undo the damage done by Karuna Trust”, the Bangalore-based NGO which had been managing the Primary Health Center in VK Salagar for the past 10 years.

Led by the Kalburgi district committee of Karnataka Janaarogya Chaluvali (KJC)*, the public dialogue was attended by 50 people (mostly women) from 4 villages that come under V K Salagar PHC. The district administration was represented by the Taluk Health officer (THO) Aland taluk, and the medical officers and other staff of the PHC. People brought up several issues that needed to be addressed by the district administration on a priority basis. These were long-pending issues that had been raised by the people with Karuna Trust in the past but there had been no response from them.

Discussions between people and the district administration focused on 10 key issues:

1. All 14 vacant posts in V.K.Salagar PHC have to be filled immediately : PHC staff on deputation or on contract basis is not acceptable to the people.Ravi from V.K. Salagar demanded to know what steps the district administration had undertaken to fill the vacant posts and wanted the THO to commit to a clear-cut deadline for the same. The THO said that the district administration had already written twice to the Director of Health and Family Welfare to fill in the vacant posts in V.K.Salagar PHC. As a stop gap measure he introduced the two doctors deputed to V.K.Salagar PHC (one MBBS(allopathic) and one AYUSH(Indian System of Medicine). He also took cognizance of the fact that women complained that the MBBS doctor had not been seen in the PHC even once.
2. The Doctors and staff quarter for V K Salagar PHC which is under construction has to be completed immediately within a month and all the PHC staff appointed has to stay in the quarters. Ambika, an elderly woman from V K Salagar fondly recalled the selfless services of Dr. Muktha Saheb who worked in V K Salagar PHC before Karuna Trust took over the PHC. Explaining the sacrifices and commitment of this Government doctor, she said the people of V K Salagar want doctors and all PHC staff to stay in the Government quarters. In response, the THO said that persons like Dr. Muktha Saheb were truly selfless and assured that the all PHC staff would stay in the headquarters.
3. All drugs in the essential drug lists for the PHC has to be made available free of cost for the patients at the PHC. The practice of writing prescriptions outside has to be stopped immediately: Women said that the AYUSH (Indian System of Medicines) doctor was seeing all patients including the antenatal women.  People questioned the rationale of the AYUSH doctor treating patients with allopathic medicines and demanded that the AYUSH doctor need to prescribe their medicines and those medicines should be made available at the PHC.  Women gathered showed the prescriptions written outside by the medical officer. Several of these prescriptions included substitutes for IFA tablets and pain killers and multivitamins. The THO then gave a strict warning to the medical officers not to prescribe any drugs outside.  He also admitted that V K Salagar PHC had not been indenting drugs. He said that he would need one more month to ensure supply of drugs directly to the PHC and promised that by June 1, 2016 onwards V K Salagar PHC would get its own drug supplies.
4. All neonatal deaths in the last one year in V K Salagar PHC have to be immediately audited and it has to be made public and immediate actions to be taken to correct the errors: Indubai,  of V K Salagar shared how her daughter had lost her first born baby two weeks ago due to delay in referring her to the General hospital, following which there was a discussion on how the PHC had failed to pick up high risk pregnancies even in the past. The THO said all neonatal deaths will be audited and remedial actions undertaken immediately. People demanded that the audit report and Action taken Report be made public.
5. PHC staff collecting money after the delivery has to be stopped immediately and necessary actions to be taken against the staff involved in such practice:Ujala Lengti,  brought the issue of rude behaviour by staff nurse and collecting money for deliveries.  THO confronted the concerned staff nurse and gave his telephone number to the people and asked them to call him directly on such issues.
6. Running water facility to be made available at the PHC immediately: Women complained that for the past 10 years, families had been bringing water from homes for drinking and cleaning up after delivery. Complaints to Karuna Trust had fallen on deaf ears. Women demanded running water facility in the PHC immediately. The public works engineer from V.K.Salagar, Mr. Swamy said a borewell connection had been provided to the PHC 10 years ago. After the PHC was taken over by Karuna Trust, this water source was poorly maintained and been destroyed. He said that Zilla Panchayat had sanctioned money during the Karuna Trust period for re-boring. However no one knew what had happened to the funds. As an immediate measure, the THO said arrangements would be made with the Gram Panchayat to supply water through tankers.
7. Abdomen examination has to be done for all pregnant women in the PHC. Writing scans to private scanning centers to be stopped immediately and has to be done to the district hospital if necessary:Women complained that abdomen examination of the pregnant women is not done in the PHC. The medical officers complained that they don’t have a fetal stethoscope for abdomen examination. The THO ordered that the fetal stethoscope will be obtained immediately. Further the doctor examined women only if they had a scan report and the doctor referred women to private scanning centres in Kalaburagi town. The THO said that all women should not be referred indiscriminately for scans and he strictly instructed the doctors to refer women only to the district hospital.
8. Drugs for RTIs and STIs to be made available at the PHC. Large -scale hysterectomies in the villages to be investigated and actions taken immediately: Jyothi Pawar from V.K.Salagar Tanda raised in just two small lambani tandas that comes under V.K.Salagar PHC, 38 women have undergone hysterectomy. Many of these women were under the age of 30 years and had first approached the PHC but had not received any treatment. Women demanded good and effective medicines at the PHCs for RH issues of women. Women also said that there had no awareness / education session on issues related to women and child health in the PHC for the past 10 years.The THO agreed to initiate IEC activities related to RH issues immediately and sought people’s cooperation in these efforts. He also promised that all medicines related to RTI/STI treatment will be available in the PHC in one month’s time.
9. Ambulance facility to be made available for the PHC immediately:People reminded THO about the public hearing last year where the issue of ambulance service for VK Salagar PHC was discussed. They said even now V.K.Salagar is in a very pathetic situation and neonatal deaths take place due to lack of emergency transport. One of the women attending the meeting had brought her daughter-in-law for her first delivery. She told the THO that the doctor had called for an ambulance and was told that it would take 2 hours to reach. In response, the THO immediately called Narona CHC and arranged for an ambulance. He promised to post a government ambulance to V K Salagar PHC immediately within 3 days.
10. All national programs to be undertaken in full swing with immediate effect: People of VK Salagar will be closely monitoring the implementation of above actions by the district administration over the next one month. As committed by the THO, Aland taluk, they are expecting a fully functional PHC by 1st June 2016. They plan to hold another public meeting in the first week of June 2016 to constitute the Arogya Raksha Samiti at the PHC level with representations of women from various villages to ensure continued monitoring of the PHC in the coming days.

About the author:

*Karnataka Janaarogya Chaluvali (KJC)- Karnataka People’s health movement),Karnataka(India);comprises of  progressive social movements, community collectives,  informal sector and other workers’ unions, women’s collectives,  doctors, filmmakers, public health practitioners and lawyers. KJC is a people’s struggle to protect marginalized communities’ health rights and defend the public health system against the onslaught of commercialization and privatization in health care.