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Govt's idea of maternal health: Two sonography machines in 8,398sqkm

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Twenty-two year-old Sangeeta Wagh travelled three hours to reach the Shahapur rural hospital in Thane last Wednesday, the only day the hospital does sonography tests. “My village, Kalabonde, is located on a hillock. In the monsoons not even a private vehicle or motorcycle can reach the village so I had to trek for an hour to reach the motorable road near Dolkhamb village and take a jeep to Shahapur,” says the pregnant Thakar tribal, who is two-months pregnant and visibly weak. But when Wagh was finally called in, she exited in a jiffy holding a bright yellow sheet (see image) that referred her to a private facility, Tanmay sonography centre. “They will not do the scanning since there is no sonologist available,” she says.

Wagh is worried about the Rs800 that she was told to pay at the private centre.
“If we had the money why would I come here taking so much trouble?” she asks.
Her 26-year-old husband Lakhu, who works as a farm labourer, has more immediate concerns. “We’ll be able to save money if we take the ST bus instead of the jeep on our way back,” he says, asking his wife to hurry.

But isn’t Wagh supposed to be covered under the multi-crore Janani Suraksha Yojna which takes care of investigations, treatment and transport of all mothers below the poverty line? Additionally, tribal women and non-tribal women are supposed to get Rs350 and Rs200 respectively for every delivery, so that they can have access to a good post-natal diet.

Moreover, what comes across as strange is that there is no dearth of funds. The Centre allocated a total grant of Rs404.67 crores for the scheme which is aimed at reducing maternal and infant mortality rates in Maharashtra for the year 2011-12. In fact, dna is privy to documents that show that an additional, unspent balance of Rs.183.72 crores from 2010-11 was also distributed to districts for implementing the scheme.

The staff at the rural hospital explain that they are forced to do this as many expectant mothers referred to the clinic are suspected to have complications. “If we call them back and there is no sonologist available next week too, then?” asks a nurse, who is also a local tribal. “I understand the problem they face in coming here and being made to return empty-handed but we can’t help it.”

The largest district in the state has only two sonologists. The sonologist at Thane cannot be spared as the Civil Hospital caters to the urban population from five civic corporations and seven councils. This means, if the sonologist at Shahapur rural hospital does not turn up, needy tribals are simply sent back.

Sending the sonologist from Thane to Shahapur will mean keeping the facility at the Civil Hospital shut.

Dr Puja Singh, the assistant district health officer, Thane, says she will take up the issue with the rural hospital. “This is wrong,” she told but admitted that the district health administration finds its hands tied as only two sonography machines cater to 122 primary healthcare centres spread across 8,398 sq kms.

“Due to the new strict laws that prevent sex-determination, no sonologist can work at more than two centres. So finding private practitioners to come over becomes difficult.”

Activists like Indavi Tulpule of Shramik Mukti Sanghatana (SMS) who work in the area point out how the rules on sex determination are creating an escape route for authorities from providing the poor with facilities. “Either the government should openly express its inability to stop sex-selection in its own hospitals or create exceptions for sonologists in government facilities,” she says.

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