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Second Wave Laid Bare the Woes of Rural Uttarakhand’s Health Infrastructure

Situated at an altitude of two,745 metres, Harshil Ghati in Uttarakhand attracts individuals from throughout India who admire the pristine great thing about distant mountain villages set amid the echo of the fast-flowing Bhagirathi river. But the very remoteness that makes up this paradise became a curse for the individuals of the hill state when covid got here calling in April-May this 12 months.

Like elsewhere in India, the second wave of the pandemic took the hill people of the district unexpectedly. Shilpa Negi (33) of Bagori village within the valley was staying in Dunda village close to Uttarkashi when she developed a fever. Like most different individuals of Harshil Ghati, she had migrated to Dunda due to excessive chilly within the area from October onwards.

“When my body started breaking down due to high fever, I understood that I too had got Covid. Our entire village was sealed in the last week of April. First aid is available at a Community Health Center (CHC) in Dunda, but if seriously ill, one has to travel to Uttarkashi or Dehradun only,” she stated. Uttarkashi, the place Shilpa’s first youngster was born, is about 25 km from Dunda and about 170 km from Dehradun.

Dearth of healthcare

Many villages in Uttarakhand have been plagued with insufficient and inaccessible healthcare, scarcity of medical doctors and auxiliary nursing midwife (ANM), and poor entry to the dear Covid vaccine – which many hill people see as the one means out of the pandemic.

Till September 27, as many as 7,393 individuals misplaced their lives to Covid within the state.

The Primary Health Centre at Harshil. (Image: Varsha Singh)

Uttarkashi, with a inhabitants of three.30 lakh, has one district hospital, two group well being centres (CHC) and three main well being centres (PHCs). Two pregnant girls died within the district hospital on September 10 and 20 this 12 months. For one, the seek for a health care provider began at three o’clock, and ended at 9 pm.

Sarita Rawat, head of Bagori village, lamented the state of PHCs, saying that the one in Harshil, which has as many as eight villages underneath it, is a main well being centre simply in identify.

The PHC received its first physician in June this 12 months, after ready for nearly a 12 months because the administration complained of scarcity of medical doctors in district hospitals in the course of the second wave of Covid.

Sarita, now ready for her second dose of the Covid vaccine, added, “We are being given the Covishield vaccine. Its second dose is given after 84 days. We don’t feel this is right because till we are fully vaccinated, the threat of corona will remain with us.”

When this correspondent reached the Harshil PHC on the afternoon of September 15, it was mendacity vacant. The ward boy was present in a home close by. On requesting to satisfy the physician and the ANM, they had been solely accessible for a gathering the following day.

For Dr Aastha Negi, it’s her first appointment as a doctor in Harshil PHC. Staff nurses employed on contract throughout Covid have gone on examine depart. There is one ward boy. There isn’t any cleansing workers.

(Left) Dr Astha Negi stands amidst the ICU arrange in Harshil PHC. But there is no such thing as a one to run it; (proper) Susheela Semwal, the only ANM employee who handles 4 villages and 1,400 households, at Harshil PHC.

To a query on enchancment in Harshil PHC after the second wave of Covid, Dr Negi stated, “We now have seven large and five small oxygen cylinders and two oxygen beds. This is our ICU, but we do not have trained staff to operate it. It is not possible for a doctor to provide 24-hour service. We often get emergency cases such as a head injury from a falling stone, and the facility of an X-Ray machine should have been here. We usually attend to patients by giving first aid.”

ANM Susheela Semwal, who handles 4 villages — Harshil, Bagori, Dharali and Mukhba — which collectively home about 1,400 households, is equally hard-pressed.

She is accountable for implementing authorities well being programmes akin to normal immunisation, women-child healthcare, vitamin week, and National Rural Health Mission. For her, work associated to Covid is a further duty.

She can be charged with implementing the vaccination drive for employees in apple orchards of Harshil, priest households of Gangotri, BRO camp of Bhairoghati and employees engaged within the snowy Nilang valley.

To make issues worse, ASHA employees of the realm have been on strike for nearly 50 days over wage calls for. But Susheela doesn’t complain, although she admits that had there been some extra ANMs, her work would have been simpler.

On September 17, a crew of pharmacists and ward boys from Harshil PHC visited Gangotri, about 23 km away, for the vaccination drive. When requested whether or not they had been educated in Covid vaccination, the ANM’s reply was evasive. “We are already doing general vaccination,” Susheela stated.

(From left) Rekha Devi, Gram Pradhan at Sukhi Village; Roshni Devi, Kshetra Panchayat Sadasya; Kiran Devi, Mahila SHG Adhyaksh. (Image: Varsha Singh)

The dearth of ANMs was flagged by Rekha Devi, head of Sukhi village, too. “There is only one ANM for 1,200 families of four villages in our area, namely Sukhi, Jaspur, Purali and Jhala. Being a mountainous area, one has to climb from village to village on foot. ANMs should be appointed according to the population of a village,” she stated.

Roshni Devi, a member of the kshetra panchayat of Sukhi village, received her first dose of vaccine on June 18, however it was not straightforward for her. “When vaccination started in March, one had to register on the COWIN portal. We couldn’t do that. When vaccination started via Aadhaar cards, we got the jab but it was administered at Bhatwadi PHC, 19 km away,” she defined.

In Pauri, about 165 km from Uttarkashi, the scarcity of well being employees can be stark.

Kamlesh Devi, the ANM of Bironkhal block with a inhabitants of 30,000, stated, “There are 18 sub-health centres with one ANM post in each centre. Only five ANMs are working as of now. The responsibility of 20-25 additional villages also falls on the five ANMs.” Gitanjali Bisht, the ANM at Dwara village, echoed her phrases concerning the workers scarcity.

Vaccination groups traverse unsteady mountain paths enroute to those distant villages. (Image: District Information Officer, Chamoli)

According to data on the web site of the Uttarakhand well being division, the state has 2,270 ANM posts, of which 547 are vacant and 323 are contract employees. Similarly, of the 1,117 posts of workers nurses, 349 are vacant. Worse, many medical doctors and nurses have gone on depart after getting a tough deployment within the mountainous area. Such workers is counted within the statistics however not in hospitals.

Vaccination woes

From April to June this 12 months, Uttarakhand was within the grip of Covid with our bodies mendacity alongside sufferers outdoors hospitals in Dehradun and Haldwani.

There was little vaccine hesitancy among the many shocked populace presently, however there was a extreme scarcity of vaccine within the state. By July, solely 13 per cent of Uttarakhand’s grownup inhabitants had been given each doses. However, inoculation numbers accelerated as provide elevated from August.

State immunisation officer and Uttarakhand in-charge of National Health Mission Dr Kuldeep Singh Martolia shared knowledge associated to vaccination. According to registration knowledge recorded on the COWIN portal, 94.9 per cent individuals of the state have been given the primary dose of the vaccine, whereas 39.5 per cent individuals have been given the second.

Dr Dhan Singh Rawat, who took over as state well being minister in July 2021, is bound of attaining 100 per cent vaccination within the state by December. “Our CHC-PHCs are fully prepared for the third wave of Covid. Ward boys, lab technicians and doctors are being recruited,” he stated, additional speaking about recruitment of greater than 200 ANMs by October.

According to data obtained by way of RTI by SDC Foundation of Dehradun, 654 posts of specialist medical doctors had been vacant until April 2021 within the state. Also, solely 17 per cent public well being specialists, 41 per cent paediatricians and 36 per cent gynecologists are on obligation within the state when in comparison with the present posts for every.

(This story was produced with the assist of Internews Vaccine Stories Production Grants)

(The creator is a Dehradun-based freelance journalist and a member of, a pan-India community of grassroots reporters.)

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