Gorakhpur: On June 8, 2021, Chief Minister Adityanath announced that he was adopting four community health centres in Uttar Pradesh – two in Gorakhpur and one each in Varanasi and Ayodhya.
He also urged MPs and MLAs to adopt a CHC or a primary health centre and contribute in improving the condition of medical facilities in the state. The CHCs adopted by the chief minister in Gorakhpur – Jungle Kaudia and Chargawa – have not been able to function with full strength from the time they were set up.
They do not have sufficient doctors and staff, nor are there basic medical equipment like X-ray machines. The centres do not admit patients, conduct surgeries or provide obstetrics services.
The Jungle Kaudia CHC was built in 2014 and handed over to the state health department in 2015. The Chargawa CHC was inaugurated by the chief minister himself in October 2017.
Both the hospitals have only been able to operate their out-patient departments till now and do not admit patients for treatment yet.
The revised guidelines for CHCs released by the Indian Public Health Standard (IPHS) in 2012 states that in plain land areas, a community health centre has to be established for a population of 1.20 lakh. This CHC will not only be the health administrative unit at the block level, but will also function as the gatekeeper for referrals to higher medical institutions.
The guidelines have it that both out-patient and in-patient services of general medicine, surgery, gynaecology, paediatrics, dentistry and AYUSH will be provided at the CHC. Each CHC should be a 30-bedded hospital with an operation theatre and labour room, and with X-ray, ECG and laboratory facilities.
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Each CHC must have a general surgeon, physician, gynaecologist, obstetrician, paediatrician, anaesthesiologist, dental surgeon, two general duty medical officers, one AYUSH medical officer, 10 staff nurses, two pharmacists, two lab technicians, operation theatre technicians and 46 staff including a dental assistant, a radiographer and five ward staff.
This must also include six employees for administrative work. The guidelines also say that that the CHC should be in the center of the block headquarters and must have electricity, roads leading to it and drinking water supply facilities. The centre must also have boundary walls and gates.
Jungle Kaudia CHC.
Five and three and a half years after having been set up, the Jungle Kaudia and Chargawa CHCs, respectively, are still far from following these guidelines.
At present, only one surgeon, one dental surgeon and two medical officers are posted at Jungle Kaudia CHC. There are paediatricians, gynaecologists and anaesthetists.
There are two pharmacists in the Jungle Kaudia CHC but the post of chief pharmacist is vacant. There are X-ray technicians but no X-ray machine.
Dr. Manish Chaurasia, the in-charge of Jungle Kaudia PHC, has now been appointed the superintendent of the CHC as well. He informed The Wire that the X-ray machine will arrive at the hospital in a week. Commissioner Ravi Kumar N.G. has also asked for the installation of an ultrasound machine. An oxygen plant will also be set up as the authorities are planning to build a paediatric ICU here. In addition, 10 oxygen concentrators have been provided.
After the adoption of this CHC by the chief minister, treatment of pregnant women, including deliveries and admissions, has started here. Along with COVID-19 vaccination drives for those between 18 and 44 years, regular vaccination drives are also ongoing at the CHC.
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Along with water, faulty power transformers have been repaired. The hospital premises have been cleaned but the 200 metre-street leading to the hospital from the main road is badly damaged.
Dr. Chaurasia said that doctors and paramedical staff attached to the hospital, who are deployed at other places, are being transferred back.
In December 2017, when this correspondent paid a visit to the CHC for ground work on a report, it was three months since a doctor had been at the CHC.
Two doctors were posted here but both had been on leave for a long time. Only five medical personnel, a pharmacist and a nurse were running the hospital. At that time the hospital premises had overgrown grass and the operation theatre was covered in dust. Medical personnel were getting the premises cleaned by employing labourers from outside as no sweeper had been appointed. There was no watchman either. Due to lack of regular cleaning and maintenance, the walls and toilets were damaged.
The overhead water tank installed at the hospital was also non-functional at the time and there was an acute water shortage in the premises. A hand pump was the only source of water.
In the first two years since it was set, 20 officers had taken stock of the hospital and yet the situation remained the same.
Awadhesh Kumar, a health activist in the area, said that locals prefer the Jungle Kaudia PHC over the CHC for treatment. The CHC premises usually remain unpopulated except for sterilisation camps set up occasionally.
With the chief minister adopting the CHC three and a half years later, attempts to streamline all arrangements have begun.
Jungle Kaudia block has a population of about 2.5 lakhs. There is one CHC, one PHC, four additional PHCs and 27 sub-centres in the area.
Chief Minister Adityanath on June 16 inspected the CHC, giving instructions to ensure cleanliness and arrangement of X-ray machines as well as all other medical equipment. Adityanath made inquiries on various departments and also asked for doctors to stay there regularly, through the night.
A release by the government says that two vaccination centres are functioning out of the CHC, one for 18 to 45 year olds and the other for those above 45. The government has also promised a mini-pediatric intensive care units and emergency services soon.
Uttar Pradesh chief minister Yogi Adityanath visits a COVID-19 control room in Muzaffarnagar, May 17, 2021. Photo: PTI
Chargawa
Set up in 2017, the CHC in Chargawa is located near Khuthan village. Though the hospital building has been completed, work is underway for electricity and water supply. The hospital is yet to be handed over to the health department. Two rooms in the hospital have been allotted to Unani and Ayurvedic medicine OPDs each.
Since its inception, the hospital has only been offering OPD services. Patients are neither admitted nor operated here.
Around 200 patients visit the allopathic, Unani and Ayurvedic OPDs at the CHC daily.
There is currently a dearth of doctors, nurses, pharmacists, and other staff in the hospital. The CHC superintendent said that there are four medical officers of whom one has been deployed from the Ministry of AYUSH. The CHC does not have a specialist at present.
Out of ten positions, there are only three nurses posted at the hospital. Though the hospital has X-ray technicians and other accessories, an X-ray machine is still awaited.
The posts of chief pharmacist and a pharmacist are also lying vacant. A ward boy has been deployed here from Chargawa PHC. A dental hygienist is there but no dental chair has been installed yet. A lab technician and a pathologist are currently available at the CHC.
The road to the hospital is only ten feet wide but there is a plan to widen it to 30 feet. The hospital has a boundary wall but no gates are installed. The wall has also been damaged. A JCB machine can be seen levelling the ground inside the hospital premises.
Chargawa is one of the largest blocks in Gorakhpur with a population of about three lakhs. There are 35 gram panchayats in the block. The major portion of this block falls in the urban area. Chargawa PHC is located at the northern end of the city, near BRD Medical College.
Commissioner Ravi Kumar N.G. inspecting Chargawa CHC on June 11.
Commissioner Ravi Kumar N.G. inspected Chargawa CHC on June 11. He was accompanied by the Additional Director (Health) and the Chief Medical Officer. The commissioner has asked for the assessment of resources required to develop the CHC into a model one. He said that an oxygen plant would also be set up at the CHC. Necessary resources will be provided to convert it into a state-of-the-art medical facility, under care of doctors and medical staff so that better health facilities can be offered to patients. He also directed the authorities to repair the boundary wall and clearing the premises.
The condition of the two prominent CHCs located within 20 kilometres of the chief minister’s home turf, however, is a stark reminder of the condition of health infrastructure and facilities in remote areas of Uttar Pradesh. The question is, had the chief minister not adopted these two hospitals, did they stand a chance for improvement?
Translated from Hindi by Naushin Rehman.