In the past one month, 40 children under the age of six years have allegedly died in the tribal region of Melghat in Maharashtra. Activists blame lack of medical infrastructure and shortage of specialist doctors such as paediatricians and gynaecologists in the tribal belt to be contributing to these deaths.
In a court hearing yesterday on September 13 in the Bombay High Court, it was highlighted that from August 1 till August 31, 40 children have died in the Melghat region in Amravati district. Of these, 24 stillbirths (born dead) were reported. The state government also informed the court that nine child deaths have been reported from August 23 to September 8.
The Bombay HC was hearing the decade-old public litigation interest (PIL) filed by the social worker Bandu Sampatrao Sane and activist Rajendra Sadanand Burma. While highlighting the children’ deaths, the PIL also drew attention towards the lack of health services and shortage of medical specialists in the tribal belt of Melghat.
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The bench of Chief Justice Dipankar Datta and Justice Girish Kulkarni came down heavily on the state government for rise in the number of deaths of the tribal children. “Don’t we have value for human life?” asked the bench to Advocate General Ashutosh Kumbhakoni, who appeared for the Chief Minister Office, Maharashtra.
“Your focus should be on controlling the deaths of children. 40 children dying in a month along with 24 still born. This isn’t disheartening (sic),” the bench was quoted.
As per the state government, septicemia, preterm with low birth weights, congenital heart disease, pneumonia, hydrocephalus are the leading causes of deaths of children in the tribal belt. Gaon Connection accessed the copy of the affidavit filed by the state government in which it claimed that ‘none of these child-deaths have been caused due to malnutrition’.
Last month on August 24, during the hearing of the petition, the high court had warned the state government of stern action if tribal kids continue to die of malnutrition in Melghat.
In a recent RTI query, the Women and Child Development Ministry stated that till last November it had identified 927,606 severely acute malnourished (SAM) kids between the age groups of six months and six years across the country. Of these, the third highest — 70,665 SAM kids — were in Maharashtra.
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According to petitioner and social worker Sane, the situation remains grim in Melghat where young children continue to die due to lack of health services.
“Between April, 2020 and August, 2021, Melghat has seen deaths of 120 children in the age group zero to six years, 50 stillbirths and two maternal deaths,” Sane, who attended the court hearing today, told Gaon Connection. This amounts to at least seven deaths every month in the Melghat region alone.
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Shortage of specialists
At present, there are two sub-district hospitals at Dharni and Achalpur, two rural hospitals at Churni and Chikaldara, 11 primary health centres (PHCs) and 92 sub centres providing health service to 315,000 population in 324 villages of Melghat.
“These hospitals and Primary Health Centres are at present unable to provide quality health service due to the lack of proper infra-structure and specialist medical officers like paediatricians, gynaecologists, radiologists and physicians,” stated the petition.
“If the medical infrastructure of these hospitals and health centres are improved and specialist medical officers like paediatricians, gynaecologists, radiologists and physicians with sufficient supportive staff are appointed there is a possibility of controlling the situation,” suggested the petitioners.
“There are no specialists at primary level. The medical officer at PHC is not capable of performing the job of a gynaecologist or a pediatrician. We have been demanding gynaecologists and paediatricians at the primary health centres,” said Sane.
The petitioners highlighted that due to the lack of medical infrastructural facilities and specialist medical officers, patients are often referred to the district hospital in Amravati, which is about 100–150 kilometres away.
There is no blood bank for people in 324 villages of Melghat. In view of the lack of treatment and more referral health services, people in the tribal region prefer going to babas (quacks and traditional faith healers) instead, pointed out the social worker.
According to Sane, children’s deaths in the tribal belt increase in the monsoon season. “Many deaths are recorded during the rainy season in the months of August, September, October. During rains, people are unable to visit the hospitals. Even if they visit, they do not get quality treatment,” he said.
Besides, “families here are dependent on paddy cultivation and since Melghat is a tiger reserve area, most households live in their farms to protect livestock and crops from wild animals attack. People do not want to go to far off hospitals”, the petitioner explained.
Children dying, vacant health posts
In the court hearing on September 13, it was highlighted that in Pune, of 22 sanctioned posts of specialist doctors, 21 are filled. In Nagpur, all 12 sanctioned posts are full. However, of the total 53 posts in Gondia, only 25 are filled and in Gadchiroli, of the total 58 posts, only 27 are filled. Both Gondia and Gadchiroli are predominantly tribal districts of Maharashtra.
Defending the state government, the Advocate General said that “it isn’t that we aren’t appointing doctors. The ones appointed aren’t reporting to work … we are already paying higher salaries to these medical officers yet they don’t want to go.”
The chief justice has suggested considering volunteers, who can visit door-to-door in these areas to know the ground reality. “Apart from all these specialist doctors, there should be a nutritionist as s/he may be able to take care of the meals of the sick children. Also, tell your dept [department] that just because it is Gondia & Gadchiroli medical officers won’t go there. Even judicial officers are there,” the bench said.
The Advocate General assured to deal with the issues in the next hearing.
PIL demands
In view of the rising deaths of tribal kids, the petitioners have demanded that the state should evolve a policy for appointment of regular specialist paediatricians, gynaecologists, physicians and radiologists at two sub-district hospitals, two rural hospitals and 11 primary health centres in Melghat.
After the hearing, the state government assured the court that no further deaths would happen in the region and will address the issue of shortage of doctors at the primary health centres, Sane told Gaon Connection.
Besides specialist doctors, the petitioners have also demanded cooked food to be served at the anganwadi centers to the beneficiaries instead of the take home ration (THR). They have also asked for improving the quality and the quantity of the supplementary food given to the beneficiaries of Melghat under the Integrated Child Development Scheme. However, there was no discussion on this issue today, said Sane.
