‘ICMR likely to be roped in to identify causes of malnutrition, infant deaths’

A total of six teams comprising top officials from Mantralaya and the Amravati Zilla Parishad visited different parts of Melghat on Friday

MELGHAT: The state government may rope in the Indian Council of Medical Research (ICMR) to identify reasons behind the high incidence of anemia, malnutrition and infant mortality cases in Melghat, health secretary Nipun Vinayak said on Friday after a tour of the tribal-dominated region in Amravati district along with other top officials.

‘ICMR likely to be roped in to identify causes of malnutrition, infant deaths’

“Access to medical care and nutrition have improved considerably in the region in recent years. Though this has brought down cases of malnutrition and infant deaths, such cases persist, which is troublesome. We may request ICMR to conduct a study on the underlying causes, following suggestions received from activists today,” Vinayak told Hindustan Times.

The health secretary was touring the region after the Bombay high court (HC) ordered the secretaries of the public health, women and child welfare and tribal development departments to visit Melghat and conduct an on ground assessment, on November 24. The court issued the directive after petitioners in a bunch of public interest litigations (PILs) submitted an affidavit about at least 65 infant mortality cases between June and November this year.

A total of six teams comprising top officials from Mantralaya and the Amravati Zilla Parishad visited different parts of Melghat on Friday.

Vinayak visited an anganwadi in Bihali village, a primary health centre in Semadoh village and the Dharni sub-divisional hospital. He interacted with doctors and medical staff, frontline health workers and representatives of non-governmental and community-based organisations at each location, asking about their observations, workload and challenges. Groups of villagers also intercepted his cavalcade along the route and submitted letters listing their complaints and demands.

Lack of docs, funds

Key issues raised at these interactions included lack of doctors, medical staff, funds at health centres and government hospitals; absence of roads connecting health centres with interior villages; and illiteracy and prevailing superstitions among tribals that prevent them from seeking medical care.

At the Semadoh primary health centre, which serves more than 13,500 people residing in its jurisdiction, doctors cited lack of funds for repairing ambulances and operating generators during power cuts as major challenges.

“Our ambulances break down every 10-15 days as they travel through damaged, potholed roads while ferrying pregnant women and mothers with newborns. If we send the ambulances to the district headquarters, repairs take at least a month. So we carry out minor repairs here by arranging funds somehow, including by paying from our pockets,” Dr Mahendra Nade, who is in charge of the primary health centre (PHC), told the Vinayak-led team. “Even salaries of drivers of the ambulances are delayed by 4-5 months.”

Dr Nade requested that an allowance of ₹25,000 per year, which used to be provided to maintain ambulances, be reinstated to resolve the problem. The purse, granted under the Janani Shishu Suraksha Yojana, said the doctor, was revoked two years ago.

Shackled by superstition

At Dharni, the tehsil headquarters, Vinayak interacted with a large group of ASHA and anganwadi workers, who spoke about rampant superstitions among tribals. When newborn babies fall sick, tribals often resort to traditional healers (bhumkas) who scald the babies’ bellies with hot iron, they said.

“Even in cases where we manage to bring severely anaemic pregnant women to the health centre, they refuse blood transfusion, fearing it is ‘janwar ka khoon’ (some animals’ blood),” said Mamata Sonkar, PHC counsellor.

“Sometimes, they also run away from PHCs and hospitals,” she said, urging the police and administration to help trace such pregnant women and bring them back into institutional care.

Anganwadi and ASHA workers also said that many lactating mothers refuse to breastfeed their infants due to prevailing superstitions about feeding them jaggery water or honey. Though such beliefs have reduced over the last two decades, they are still widespread, said Rekha Navlakhe, an anganwadi worker.

“We need awareness programmes at a mass level to eradicate these superstitions,” she said.

Activists, on the other hand, raised concerns about procedural issues such as large number of vacancies, lack of coordination between departments and lack of uninterrupted electricity supply at health centres and hospitals. “A few PHCs have inverters which were procured a few years ago but are lying unused. These devices must be used or else it is a waste of resources,” said Bandu Sane, one of the petitioners in HC.

Vinayak listened to him and other stakeholders, and expressed happiness about several departments working together prioritising health and tackling malnutrition at the district level, saying, “The future looks better than the present.”

“We have many hopes from you,” Sane said while the interaction at Dharni hospital was drawing to a close. “Not hope but endeavour,” Vinayak responded. All six teams that toured different parts of Melghat will hold a review meeting in Amravati on Saturday and prepare a report, he said.