Deprived Childhood
DHARNI: Kali Jambra had a nightmarish time last month. On June 17, her seventh child was due and even 12 hours after she went into labour, she had not delivered the baby. The nearest primary health centre (PHC) is 22 km away from her village, Hirabambai in Dharni taluk, Amravati district.

Luckily for Kali, a community health physician from here, Ashish Satav, was in the village for a gram sabha (village council) meeting and he sent her to the sub-district hospital at Dharni, 45 km away. But her ordeal did not end as an operation could not be performed at the hospital. There was no blood bank and no surgeon; the anesthetist went away as there was no work. The lone gynecologist was helpless.

Finally, a civil surgeon was called from Amravati, about 145 km away, and Kali was operated on the next day. She survived but her baby was already dead. She has a son and five daughters, the eldest who is already married. "I wanted another son," said her husband Sakharam. The child Kali lost was a girl.

Understaffed
The sub-district hospital at Dharni is the only one for the entire sub district, but it does not have a pediatrician. Last year it was also understaffed. This year, of the five specialist posts, only the gynecologist and anesthetist were filled.

Gynecologist S. K. Gawde wants to leave as he is paid a "lowly" Rs. 12,000. Though he is allowed to have a private practice, the predominantly Adivasi population is "too poor to pay."

"I am a specialist and yet I get the same salary as an MBBS doctor. Why should I stay here? We need some incentive to come to this backward area. We should be paid at least Rs. 25,000 a month," he said.

Of the 17 nurse posts, three are vacant. Most specialists are hired during the monsoon when malnutrition gets acute. A pediatrician was being deputed, said hospital sources.

At Hirabambai, which became notorious for hundreds of child deaths in the 1990s, eight children under six died last year, three of them due to malnutrition. Last month, Savita Jambhekar lost her child after she delivered it during the eighth month of pregnancy.

Of the 211 children registered with the two anganwadis (childcare centers) in the village, 87 are moderately malnourished while four are in a serious condition. Ranu Dhande, an anganwadi "sevika" (child care giver), said rations were not available on time and so she was serving the children a rather inedible meal of sooji (semolina) and salt. But the villagers complain that the "sevikas" keep the rations for themselves.

However, Shamim Sheikh, an "arogya doot" or health worker, who is part of Dr. Satav's tribal health programme in Dharni, said she weighed the children every month. Of the 190 children under six on her register, four were severely malnourished and the numbers were likely to go up during the monsoon. Last year, 19 children were acutely malnourished.

Samili Morerana, ninth months pregnant, complains of abdominal pain. Last year, she gave birth to twins in the eighth month of pregnancy at home (for almost all women here, delivery takes place at home). Both died after three days. Samili is very weak and weighs 40 kg. She has a three-year-old daughter.

Sagarbai Rawat is still crying for her only daughter, three-year-old Reshma, who died last year of malnutrition and complications due to tuberculosis. She wishes that she had a photograph of her daughter. The mother of three boys, she underwent a tubectomy.

Sakun Jawarkar's 10-month-old daughter, Anjani, died last September. "We took her to the Dharni hospital but she did not survive. She had fever and boils all over," says Sakun.

Despite the horrific situation at Hirabambai, little has changed. But Ms. Sheikh is optimistic that this year things may be better, thanks to a good harvest last year. But the situation could worsen during the monsoon. The health of these young mothers, which is weakened by several childbirths, is also cause for concern. And so is the alarming lack of health care at hand.

Grants Yet to Come
Last year, the Government paid the parents of every child admitted to hospital or a PHC Rs. 40 a day, plus free food. In 2004-2005, Rs. 1,700,000 was spent to keep parents with their ailing children. However this year, the grants are yet to come. Last year, government officials pooled in to launch "Karn" Yojana, a scheme for adoption of malnourished children and paying them special attention.

"This year, we will register a trust with some contributions from the Government and then launch the scheme," said P. S. Dalu, additional district health officer. The scheme for pregnant mothers, under which Rs. 400 is paid in cash and Rs. 400 in kind, is also yet to be restarted. The Government has nominated health workers for 700 hamlets and also a team of 22 doctors who are paid Rs. 6,000 a month to travel and take care of malnutrition during the monsoon. They are also given vehicles.