HT Focus: Punjab doctors assigned a difficult revival

  • Prabhjit Singh, Hindustan Times, Chandigarh
  • Updated: May 09, 2016 11:14 IST
Senior medical officer Dr Anand Singla (left) manages a daily average footfall of 200 at the outpatient department with just one gynaecology specialist (centre) and a fresh medical officer (right) for support at Moonak CHC, one of 100 priority institutions of the Punjab government, in Sangrur. (Gurminder Singh/HT )

Pigeons outnumber patients at the community health centre (CHC) of Bareta town in Mansa district. Its three young doctors smirk at their paltry salary of Rs 15,000 a month, make do without a nurse or specialist, and one of them just came to know about his transfer to the doctor-less primary health centre (PHC) of off-the-grid Phafre Bhai Ke village.

Read more: 95 doctors refuse to take Punjab govt’s Rs 15,000 salary bait

For almost a year, the Bareta centre was locked up, given up for dead, until a month ago the team of three arrived to resurrect it, with no paramedical support and with six-odd private clinics competing in the town of 1-lakh population. Thrown into difficult-terrain Sangrur, Mansa, Bathinda, Muktsar and Fazilka districts, besides Pakistan border areas such as Tarn Taran, Amritsar, and Gurdaspur, the young doctors coming in have accepted all the challenges.

The subdivisional hospital at Moonak in Sangrur district has specialists in medicine, surgery, and gynaecology, but it has an another problem — they run the outpatient departments (OPDs) as well, struggling with a daily average footfall of 200 in the absence of medical officers. It is among the 100-odd “top priority” hospitals of the Punjab health department. The list includes district hospitals, 41 sub-divisional hospitals, and 37 CHCs. The sick hospitals of Bareta in Mansa and Rama Mandi in Bathinda district aren’t even lucky to find place on this schedule.

CHC in private hands

A government hospital in private hands, the Rama Mandi CHC is a peculiar case. The postgraduate students of Bhuccho Mandi’s Adesh Medical College and a contractual ayurvedic doctor from National Rural Health Mission (NRHM) run its show. Second-year gynaecology student Dr Divjot sits in the OPD with classmate Dr Nancy of third-year medicine. “We refer the patients to Talwandi Sabo (subdivisional hospital),” said Dr Divjot, when asked how they manage surgeries without specialists.

With no radiographer hired, patients depend on outside shops for even a simple X-ray examination. “That’s none of our concerns,” said Dr Divjot.

Members of the hospital’s paramedical staff said many patients were referred to the private Adesh college even for deliveries. “We do not force them,” said Dr Divjot.

SMO-less hospital

Crowded with poor patients from Rama Mandi and other far-flung Mansa and Sangrur places, the Tawandi Sabo subdivisional hospital in Bathinda district has urgent requirement of a senior medical officer (SMO). Five of its eight posts of emergency medical officer (EMO) are vacant, and the facility serves 72 villages of Bathinda.

A young MO (medical officer) and a senior doctor were struggling with the rush of emergency cases, while officiating SMO Dr Darshan Kaur was away “on deputation”. Her second-in-command, an ophthalmologist, explained the rush: “There are no MOs at Maur and Rama CHCs and at a few other rural centres.” Dr Darshan Kaur explained over telephone her own challenges: “We want police protection, as the EMOs preparing the medico-legal reports (MLRs) of patients injured in frequent fights in rural pockets are often forced to show serious injuries to make ground for police case.”

No cure for chemists

The radiologist at Talwandi Sabo quit a month ago, leaving the field open to private diagnostic centres from Bathinda to Mansa, who fleece patients for CT and ultrasound scans that are common in the Malwa belt. In the absence of radiographers, general doctors manage the ECG at several centres. The area’s last radiologist also left the Bathinda district hospital a month ago.

A tuberculosis patient at Talwandi Sabo paid Rs 1,500 outside for medicine, while a man with a broken leg shelled out Rs 11,000 at a chemist’s shop facing the Mansa district hospital. “I will look into the matter. The TB patients must get all medicine free of cost inside the hospital only,” said the Talwandi Sabo officiating SMO. Patients at the mercy of chemists is the scene in every district, even after an SMO of the Phagwara civil hospital was suspended recently for similar reasons.

Kids not treated well

As the state is short of paediatricians, with a recent advertisement seeking 111, Mansa district is a glaring example where private child clinics exploit the opportunity.

The long queue of mothers with children in laps is a daily scene at Guru Nanak Child Hospital, Mansa, where the government district hospital has only three posts of paediatrician. Private hospital owner Dr Daljit Singh Gill, who was government MO in 1999, recalls: “The job was suffocating, and I realised I had better prospects in my own practice.” He examines 50 cases a day.

Mother o’ mother

The new mother and child health (MCH) centres in district hospitals have own worries. For moving paediatricians from main hospitals to these centres in the absence of adequate paramedical staff is a big ask. The two child specialists at the Mansa district hospital now sit in the adjoining MCH centre but can’t do much without nurses and other support. It’s a similar case at the Rupanagar MCH, crowded for want of nurses to assist doctors.

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