No End to Lack of Accountabiliy at Sub-Divisional Hospital Madhupur

Medical Negligence. Corruption. Cases of lack of accountability at Madhupur Sub-Divisional Hospital in Deogarh District of Jharkhand are rampant. Community Correspondent Mukesh continues to report violations and urges authorities to take action.

Since November 2013, Video Volunteers Community Correspondent MukeshRajak, along with the community in Madhupur district of Jharkhand, has been raising a voice against the lack of accountability at the Sub-Divisional Hospital in the district. Be it the case of a still birth to Aamna Bibi as a result of being left unattended in labour or the death of a 12-year Kundan Das, who succumbed to rabies after a fox bite and was unable to get treatment at the same hospital, his reports have exposed repeated instances of negligence on part of the hospital authorities.

A latest report by Rajak exposes corruption amongst the Auxilary Nurse Midwives (ANM) of the hospital, who force pregnant women to pay up for their services post delivery.  “Patients owe us some fees that they’d anyway spend at private clinics or on celebrating the new life. There are many overheads like medical tests and we also clean up the beds they bleed on,” say the ANMs of this hospital. This is despite provisions of the Janani Suraksha Yojana that promise free of cost, end to end healthcare for all women living below the poverty line. 

“On 16th August at around 09:00 PM, I visited the Hospital to get some information about DOTS centre. I found a pregnant woman lying on the bed without bed sheets and witnessed a patient’s relative being mistreated by the ANM,” says Rajak.

Hari Yadav, a resident of Madhupur says that when he took his daughter to the hospital to deliver, he saw that the hospital lacked basic amenities like toilets and bedsheets. Only one toilet was open. When Mukesh reached the hospital and intervened, the hospital authorities opened the second toilet.  However, this was not the end of the Yadav’s  ordeal.

At the time of discharge, the ANMs started asking Yadav to pay up. When he refused, they started misbehaving with him. Yadav agreed to pay Rs 150 because that is all he could afford. However, the ANMs refused to accept that amount and started demanding more. Yadav was threatened, unless he paid up, his daughter’s discharge formalities wouldn’t be processed.  Finally,hehad to borrow money to pay up the ANM. In this video report several other pregnant women and their families, as well as 15 Sahiyas from the area testify to this being a usual practice at the hospital. Women are charged anything between 200 INR and 1000 INR.

“On a follow-up visit the next day, I learnt that there were more patients who were not only being forcefully charged money after the delivery but also were forced to buy some medicines from outside. While one of the patients spent 580 INR to purchase medicines from outside, another was forced to pay 600 INR for her delivery by ANMs PratibhaKumari and Shanti Kumar,” says Rajak.

In a bid to put a stop to this practice, Rajak approached the Medical Officer In Charge (MOIC) of the hospital who said that he wasn’t aware of the situation and that he would only take action if he received a written complaint from the victims.

Mukesh then mobilized 15 Sahiyas from the village and filed an application with their signatures and submitted it to the MOIC.

[caption id="attachment_12414" align="alignnone" width="1024"]3. Screening to the Sahiya jpg Screening to the Sahiyas[/caption]

On the 25th of August, we received an update from Mukesh. He’d submitted a complaint to the MOIC on the 24th of August 2015. Soon after, 3 ANMs along with aSahiya and a driver visited the2 complainant's homes and asked them to sign some papers. The signatories claimed to know nothing about what papers they signed, in fact, they’d been told by the ANM that they would be hired as Sahiyas if they signed the papers. Mukesh then took the 2 patients, 2 sahiyas from their village and their relatives to the MOIC. The patients then narrated to the MOIC how the ANM took their signatures and had, in the past, demanded money from them. The MOIC however, didn’t show any indication of support. To their horror, they found that the MOIC was completely supporting the ANM, and even showed the signed papers which read “Didi log humse paisa nahi lihai" (The ANM has not taken any money from us). It became clear that the MOIC was not going to help.

Mukesh then reached out to the Civil Surgeon as well as the Regional Deputy Director (RDD) of the region to seek redressal. The RDD reached the hospital the next day to investigate the matter and has promised to take action.

[caption id="attachment_12416" align="alignnone" width="1024"]1. RDD, R.P. Singh during the inspection on the alligation alliged to the ANM by the Sahiya and the Patient RDD, R.P. Singh during the inspection[/caption]

“There is a need to eradicate loopholes through positive intervention, if we want these schemes to function and truly benefit women,” says Mukesh Rajak who has been reporting on lack of accountability at the Sub-Divisional Hospital, Madhupur for over a year and a half now. His reports, intervention and community mobilization have challenged the status-quo and have forced authorities to sit up and take action.

In the meantime, Mukesh approached  District Collector, Arava Rajkamal, on the 3rd of September. The new Collector was formerly SDO in Madhupur, and is well liked by the people for his honesty. Mukesh screened his video, and was promised a visit to the hospital by Rajkamal. Mukesh also gave him an update on the RDD’s promise to investigate, and asked that the investigation report be shared with him. As promised, DC Rajkamal visited the hospital on 10th September and has asked the RDD to file a report on the matter within a day. Stay tuned for more updates. 

 

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