More funds but locked centres in Naxal-hit Sonbhadra

On most days,the Panaura PHC opens for a few hours,though official summer timings are 8 am to 2 pm for the outpatient department. On Monday,after a two-day weekend break when there is no one manning it,the centre opens only around 1:30 pm.

Ram Prasad was one of the unfortunate ones to land at the PHC one such Monday. Running a fever for several days,he had come to Panaura covering a hilly terrain of nearly 5 km from his village Chaura. Around noon,they were still waiting for the locks on the PHC to be opened.

A sentry at a Provincial Armed Constabulary post barely 100 m away,said there was no point trying to meet anybody at the PHC as it was yet “early Monday”.

Sonbhadra Chief Medical Officer G K Kuril insists absenteeism is not usually the case. “But I will look into it since the matter (PHC being locked) has now been brought to my notice,” he said.

While the staff’s absence is often attributed to Naxal menace,locals are not convinced. “We live comfortably now. Earlier,they would come looking for shelter or food,but now with the police,our lives are easy,” said Kamlashankar.

At the Chopan community health centre (CHC),both the emergency ward and labour ward were locked on Sunday afternoon. While the staff claimed that the doctors were always present within the compound and that the CHC was opened should someone come,Health Supervisor Molly M G said: “Something like a pair of gloves is hard to come by. The last we got adequate supply was nearly five years ago. The medicines are in supply,but they are not in as much quantity as needed,” said Molly.

Still,Molly has supervised 73 deliveries during the last few months. Under NRHM,health centres get medicines,materials,funding and manpower.

An auxiliary nurse midwife (ANM) at the Billy sub-centre under Chopan block revealed that she had received 13,000 iron tablets a few days ago. The last consignment before it was supplied to her nearly three years ago. “These iron tablets will finish in a jiffy because women come to me from as far as Jugail,nearly 40 km away,” said the ANM. On the way,they cross at least four sub-centres.

She said these women came all the way because they knew that she “would be present”. “This centre is a portion of my house. Wherever this is not the case,the ANMs are usually absent,” she said.

Kuril said the ANMs are not given medicines in large quantities because they are not trained doctors. “One or two centres may not have had the medicines,but we distribute them regularly and adequately,” Kuril claimed.

In the absence of facilities,the women approaching these health centres end up paying from their own pockets for benefits which are due to them from the government. Most of the time,this money is paid from another grant from the government — Rs 1,400 for institutional delivery,under the NRHM.

“We pay anywhere between Rs 400 and 1,000 as part of suvidha shulk (service tax),” said Prem Nath,a resident of Tiara Kalan in Chatra.

Many ANMs admit taking the money,but add: “We try to do our best. But how long can we buy medicines for patients from our own pockets?”

‘Funds lying in CMO account’

Being a ‘Left-wing extremist area’,Sonbhadra district was given Rs 2.31 crore as “special district intervention”. Of this,Rs 1.93 crore was allocated for purchase of mosquito nets and funds were released to PHCs and CHCs,but not utilised,said a review of NRHM implementation in UP,conducted by a Central team last May. The statutory audit report by concurrent auditors for 2009-10,said the review,found that most of the bills provided by the district against utilisation of funds “carry white fluid over the printed serial number of bills and the same are handwritten”. Further,funds released to the district for various purposes were “lying in the bank account in name of Chief Medical Officer (Family Welfare),” said the review.