Guns have a higher place in society than women in Madhya Pradesh's Bhind district, perhaps best known as the former haunt of bandit queen Phoolan Devi.
"If a person's gun gets stolen, he loses all respect in society. They say that a man who cannot protect his gun is good for nothing," says Pahalwan Singh Badoria of Hamirapura village in the Ater block of Bhind.
This warped logic perhaps explains why men look after their gun more than their wives, who are among the most underweight and anaemic women in India. At 380 deaths per 100,000 live births, Madhya Pradesh has a very high maternal mortality rate (MMR). "Of the 70,000 women who die at childbirth, Madhya Pradesh accounts for 7,000 deaths," says Hamid al-Bashir, state representative, UNICEF.
According to the Sample Registration Survey, India's MMR dropped to 301 in 2002-03 from 398 in 1997-98. The Union health ministry widely credits the drop to a rise in the number of hospital deliveries of babies, a fact that is not borne on the ground. Though the Primary Health Centre (PHC) in Shivpura village in Ater block has medical staff of seven – including two doctors and three Auxiliary Nurse Midwives (ANM) – only one ANM was present on Friday. The PHC, which is the nodal health centre for a population of 30,000, treated only one patient that day. "This PHC faces a cremation ground and the burning corpses scare people away. No one stays overnight because they fear ghosts," says ANM Sumeera Badauri.
The cremation ground is the least of the problems. The PHC gets electricity for two hours a day, and has no running water, not even in the delivery room. "The water from the hand-pump is brackish water and unfit for use, so we send the sweeper or the patients' attendants to fetch buckets of water from the village a kilometre away," she says.
Villagers claim it is not ghosts but the poor quality of service that keeps them away. "You were lucky you found the PHC open today, they must have known you were coming. It is always locked, so we don't waste time going there. We go to private doctors or the District Hospital in Bhind town 30 kms away," says Sanjay Singh Badauri of the neighbouring Sheopura village.
In Sheopura, the health subcentre functions as the community urinal. "A nurse comes twice a month but now the roof has collapsed, so perhaps she will stop coming," he shrugs.
Pregnant women usually walk, bus or pillion-ride on a bicycle on kutcha roads to reach the District Hospital. At times even that does not help. Anil Singh's wife Rekha died of bleeding when pregnant with their third child. "We rushed her in a hired car but she died while we spent half-an-hour getting the paperwork done for hospital admission," says Singh, also of Sheopura village.
It is debatable whether Rekha would have lived if she had reached the District Hospital in time. The hospital has no blood bank and there is none in all of Bhind. "We acquired all blood-banking equipment two years but did not get a licence because we do not have the 1,000 sq foot area needed to run a blood bank," says the district chief medical officer SM Ojha.
If you are wondering how the hospital functions without blood, here's the answer. "We ask critical patients to go to Gwalior. The city has many hospitals," he says. And those who die trying to reach care become another statistic.