A recent study by a Dehradun-based non-profit shows the hill state has only 493 specialist government doctors available to serve over 10 million population across its 13 districts. Almost 60% shortfall in child specialists and gynecologists. Eleven districts have no psychiatrist.
Unavailability of female doctors is expected to impact the state’s performance on parameters like institutional deliveries, say experts. Pic: Unicef
A large number of countries across the world are reporting a surge in coronavirus cases due to the Delta variant of COVID-19 virus, and there are fears of the third wave hitting India in the coming few weeks. In this scenario, a recent report by Dehradun-based non-profit SDC Foundation on the state of specialist doctors in Uttarakhand paints a grim picture.
Based on the data collected through the RTI (Right To Information), the non-profit has found a dearth of specialist doctors in the hill state.
Fifty seven per cent posts of specialist doctors are vacant in the state. Of the total 1,147 approved posts for specialist doctors, only 493 are working, leaving 654 posts vacant, shows the recently released report.
The study titled ‘State of Specialist Doctors in Uttarakhand 2021’, shows that Uttarakhand has only 493 specialist (government) doctors available to serve over 10 million population across all 13 districts. This when the country is battling the ongoing COVID19 crisis.
“Almost 60% posts of specialist doctors are vacant in the state. This should be addressed as an immediate priority by both the newly elected CM [Chief Minister Pushkar Singh Dhami] as well as the Health Minister [Dhan Singh Rawat] of the state,” Vidush Pandey, researcher and member of the study team at SDC Foundation, said while releasing the second part of the report on August 6.
“Having adequate specialist doctors will not only help us sail through these tough times of COVID-19 but strengthen our health systems in the rural and hilly areas, which is much needed,” he added.
Of the total 13 districts, nine districts in the state have less than 50 per cent availability of specialist doctors. Four districts — Chamoli, Nainital, Haridwar, Champawat — have reported zero availability of public health specialists at a time when the country is preparing for the third wave.
This data was shared by the Department of Health and Family Welfare, Government of Uttarakhand in response to an RTI obtained by the non-profit on April 30 this year.
In 2018, as per a report by NITI Aayog, Uttarakhand was placed amongst three worst performing large states due to high vacancy in the posts of specialist doctors at district hospitals.
The SDC Foundation study released in two parts — first on July 24 and second part on August 6 — shows that of all hill districts, Tehri is the worst affected with only 13 per cent availability of specialist doctors. There are only two gynaecologists in Tehri that has a population of more than 600,000.
Moreover, there is only one child specialist in the district. There are no surgeons, ENT (ear, nose and throat) surgeons, forensic, skin diseases, microbiology and psychiatric specialists in Tehri.
Why is Tehri the most affected of all 13 districts? “There are no specific reasons behind this. But we can look at the Dehradun data. The district has more doctors. They are most comfortable working in a place like Dehradun. They have most facilities there,” Anoop Nautiyal, founder, SDC Foundation, told Gaon Connection.
“Though several government hospitals are being operated in the PPP [public private partnership] mode in Tehri, the Govt of Uttarakhand has to ensure that approved positions are filled quickly,” noted the study.
The report shows that the situation is extremely alarming in Haridwar district, which is the largest in terms of population in the state. Haridwar has only 40 specialist doctors against the approved 105 posts. This makes only one specialist available for more than 50,000 people in the district, found the SDC Foundation.
Among the other worst affected districts are Chamoli with 27 per cent availability of specialist doctors and Pauri with 28 per cent.
The state capital Dehradun has the highest availability of specialist doctors at 92 per cent. This is followed by Rudraprayag at 63 per cent.
Meanwhile, the experts pointed out that Nainital and Pauri have the maximum number of approved positions despite having less population and medical facilities. “We need to judiciously allocate our human resources and focus more in places where the burden on health facilities is more,” Nautiyal was quoted as saying in the report.
“Having poor distribution of medical workforce is going to impact our response to COVID-19. The findings have a large implication on rural and hilly areas, which remains ignored when discussing the public health system in Uttarakhand,” he added.
“I urge the government authorities to take stock of the situation and initiate measures to fill these gaps in vacancies of the specialist doctors in the state,” said Nautiyal.
As the threat of a third wave looms over the state, Uttarakhand has only 17 per cent of public health experts and 41 per cent of child specialists available to monitor the state’s progress and preparations for the raging pandemic.
District wise state of child specialists in Uttarakhand shows that Tehri is the worst affected as it has only seven per cent availability of child specialists. It is preceded by Chamoli (13 per cent), Almora (22 per cent), Pauri (23 per cent), Pithoragarh has 25 per cent.
At 120 per cent, the state capital Dehradun has the highest number of child specialists. It has 18 child specialists, more than the approved posts of 15.
It is followed by Uttarkashi (57 per cent), Nainital (52 per cent), Rudraprayag Champawat (50 per cent each), Udham Singh Nagar (38 per cent), Bageshwar (40 per cent), and Hardiwar (43 per cent).
The hill state, where many pregnant women have to be rushed to far off places either in expensive four-wheelers or a charpai (wooden cot), there is a severe shortage of gynaecologists in the state. The SDC Foundation study revealed that Uttarakhand has only 36 per cent of gynecologists and 64 per cent posts vacant. This can have a big impact on the health of women in the state, warned the public health experts.
“Accessibility is already a major challenge for women in hilly areas. Unavailability of female doctors will further exacerbate the issue and can impact the state’s performance on parameters like institutional deliveries, antenatal care, child nutrition,” Rishabh Srivastave, lead-research and communications, SDC Foundation, was quoted as saying.
Of 13 districts, 11 do not have even a single psychiatrist, making access to mental healthcare a big challenge in the Himalayan state. Mental health issues are on the rise as COVID19 pandemic continues to cause a general sense of insecurity, fear and anxiety about the disease, losing livelihood.
Meanwhile, Vidush Pandey, member of the research study, SDC Foundation, pointed out that a lot of specialist doctors have been deployed in administrative duties in the state. “This is completely unacceptable,” he was quoted as saying.
“Right now, we need the services of these doctors more than ever. State should look into the policy of posting specialist doctors on administrative duties and utilize their expertise in making the public health sector more robust and accessible in the state,” he added.
“Sadly, several specialist doctors are engaged in administrative roles such as chief medical officer and health directorates, and directors of several health departments. They are all specialists but working in admin roles,” explained Nautiyal.
Interestingly, Dehradun has 18 child specialists as against approved posts of 15.
The non-profit pointed out that it is after four years that the state has got a ‘full time’ health minister. This was done after Pushkar Singh Dhami was elected as the Chief Minister of the state, experts highlighted.
“We have welcomed the decision by the Chief Minister [to get a full-time health minister]. It is believed that if Uttarakhand had a full time health minister during the past four-five years then we would have ‘most likely’ done a better job in managing the COVID pandemic,” Nautiyal told Gaon Connection.
“We cannot say that things would have been a hundred per cent better. But a committed and full time health minister could have done a better planning and management of the pandemic accordingly,” he added.
Few days ago, several MLAs [Member of the Legislative Assembly] met the newly elected state Health Minister Dhan Singh Rawat. They raised the issue of having adequate deployment of specialist doctors in Uttarakhand.