Rajasthan government is celebrating an 84% increase in institutional delivery. But even after spending Rs 42,500, Shantilal's wife succumbed to maternal mortality.
Shantilal Lohar lives in rural Rajasthan with his parents and five daughters. In a film made by Community Correspondent Shambhulal Khatik, we see him helping his youngest get ready. Inexpertly, he ties a pony tail. Both father and daughter are very happy with the result! But behind this touching moment of filial affection lies a horrific tragedy. Shambhulal’s five daughters have lost their mother to systemic lapses and negligence in rural healthcare infrastructure.
“There had never been any complications during the five pregnancies my wife had before this one,” Shantilal asserts. The local ASHA worker tasked with ensuring the health checkups of pregnant women, Meena, also asserts that there were no prior problems with the sixth pregnancy. “She had had the ante-natal checkups, had received her vaccines and were taking the mandated iron and folic acid pills,” she adds.
Two days before her scheduled delivery date, Pushpa Bai started experiencing pain. Shantilal took his wife to the local Primary Health Centre (PHC) at Kuraj where a nurse examined her and told her to come back when the pain increased as everything was ‘fine’ and she had not dilated enough. Four days later she started experiencing pain again. With the help of the ASHA worker, Pushpa Bai was taken to the district hospital in an ambulance. There were no doctors in the hospital. Nurses examined her and told her she had two more days to go before delivery and once again she was sent home.
The very next day she started experiencing excruciating pain. Shantilal hired a car and drove Pushpa to the nearest private clinic, five kilometers away, not choosing to trust the government health facilities. “We reached the clinic at 6.30pm. The doctor examined her and started the treatment. We were assured that everything was fine, the baby was fine,” remembers Shantilal. Three hours later their stillborn child was delivered. Pushpa Bai started bleeding profusely. The doctor suggested that she be taken to a private hospital in the district capital, Rajsamand town. “But they refused to admit her in that critical condition. They told me, ‘We cannot do anything here. Take her somewhere else,’” Shantilal recalls.
Shantilal took his wife to a private hospital in Udaipur, over sixty kilometers away. The doctors there started her treatment and concluded that her treatment had been delayed too long and resulted in the death of her child. But even this hospital did not have enough blood in their bank to make up for the continuous blood loss that Pusha Bai was suffering from. By the time Shantilal arranged for the requisite amount of blood the next morning, his wife had passed away.
Pushpa Bai’s death is a chronicle of negligence that is routine in the lives of marginalised, rural women. Government hospitals and health facilities are understaffed with doctors despite the promising schemes like Janani Suraksha Yojana (JSY) and National Rural Health Mission (NHRM). The JSY is touted as bringing down maternal mortality by ensuring more women opt for institutional deliveries as opposed to home births. But as Pushpa Bai’s story reveals, government health facilities are ill equipped to deal with such cases and plagued with a shortage of qualified staff. In the vacuum created by the absence of such health facilities, unscrupulous private clinics have come up. “This was all because of the doctor. How can he not know whether the child is dead or alive inside the womb? He made her deliver anyway because he wanted the money,” says the bereaved widower.
Shantilal couldn’t save his wife despite shunting between two government and three private health facilities. Is this all we have to look forward to with so many promises of better days to come? For this family, all the schemes have proven to be empty promises. Rajasthan has one the worst maternal mortality ratios in India at 244 maternal deaths per 100,000 live births. The national maternal mortality ratio stands at 178, for a comparison. Pushpa Bai is not just one more faceless figure in a statistics. Her story, her five motherless daughters should move us to question the celebratory rhetoric of progress. In a nation where a woman dies due to willful negligence and apathy of government health clinics, we have no right to talk about the success of government schemes. Instead, we should focus on the abyss of apathy and callousness that make even one such death possible.
To ensure that Pushpa Bai's death does not become yet another figure in official statistics, call the Chief Medical Officer of Rajasmand at +91-2952221713 and urge him to appoint doctors wherever there are none, strengthen the referral mechanism and study cases of maternal mortality.