Article Source: merinews.com

Date of Issue: April 12, 2007

Author: Sunita Ahshi

Title of The Article: Basic health rights of a child denied in UP 

Uttar Pradesh, the largest and the most populated state in India fails to provide its citizens basic health care facilities. Most of the children in the rural areas have been deprived of the routine immunization which is essential for every child.
 
SIXTY PER CENT of the pulse polio immunization took place in Lonpurva in Kheri district of Uttar Pradesh on Sunday and Monday last. And this is in sharp contrast to the nearly nonexistent essential routine immunization in the village. 

Tikaram (45) and Usha (40) have never visited a doctor or a Primary Health Centre in their life. Two of their sons died within two years of their birth due to some unknown disease. Their fourth son, Gyanedra (8) had developed pertussis (whooping cough) four years ago. But some local herb cured him. By the grace of God, he along with four of his siblings is healthy without any routine immunization. Apart from the Anganwadi workers who come to the village to administer polio drops, two quacks Gautam and Suresh are the only hopes for them.

Tikaram and Usha are considered as the most enlightened couple in the village. Tikaram is the first person in the village who attended undergraduate classes after clearing his intermediate in 1983. Usha aspires to be the Gram Pradhan in the near future. Both hate the very utterance of the PHC, located at a stone's throw distance from the village.

"My neighbours used to go there for BCG and Measles vaccination of their children but always found the PHC's door locked. Why do we waste time?" Tikaram asked. The villagers have also forgotten that there was a functional Ayurvedic Hospital as there was no vaccine or medicine available. There are about 300 children below the age of five in Lonpurva but none of them are covered under routine immunization programme. About 100 children have died of unknown diseases in the past two years. 

The scene is the same in Sukhaipurva under Kothawan block in Hardoi district. One-year old Aditya has pertussis. There is no sign of physical growth in one-and-a-half-year old Khushbu. Prema, her mother has not heard of any immunization programme other than pulse polio. "The doctors in the nearest PHC in Kothawan say each vaccine costs Rs 60. Where can I bring that much of money from when my whole day's earning is Rs 40, that too when I get some work", said Nirmala, Aditya's mother.

Not surprisingly, the records available with the district health office show that in August this year, there was no BCG, DPT, OPV, Measles, DT or TT vaccine available in Kothawan block. No monitoring agencies of the government or health workers have visited the villages in the block whereas it was their duty to go to every village twice a week to carry routine immunization.

The situation is same at Sandila and Madhoganj blocks. There is no record of routine immunization available with the district health offices. Unofficially, the district immunization officers admit that it is around 15 per cent only. They cite shortage of staff and vaccine as main reason behind the poor show. Reports of UNICEF project immunization in Kheri are 18.8 per cent and in Hardaoi is 19.3 per cent. The doctors have a readymade answer that it would take time to improve the situation.

Shubhendra Singh, the Gram Pradhan of Lonpurva says the doctors don't stay there and the Chief Medical Officers are transferred every four-five months. "A trend analysis demonstrates that UP's coverage (of essential routine immunization) hovers between 20-22 per cent. Unless routine immunization services are strengthened, there will be generalized reoccurrence of diphtheria and pertussis, as well as measles and neonatal tetanus and it will be difficult to reach the goal of polio eradication," read a UNICEF report.

But Shuklapur village in Hardoi shows a murkier trend. "There is no vaccine and no doctor in Shuklapur PHC. There is not a single house in the village where at least one child has not died before reaching the age of five. The PHC remains closed most of the days," fumed Munni, a forty-year-old lady.

Rani Verma, midwife and Suman, health visitor of the PHC have their records complete with total immunization. "There are 580 families in Shuklapur of which 250 are children. We regularly visit the village to vaccinate them," said Verma.

Dr Rahul Sharma, Surveillance Medical Officer of National Patient Safety Partnership (NPSP) in Hardoi admits that the death rate of children goes unrecorded. "It is due to death of the children that each family, out of fear of loosing more, has at least four children. Improving their quality of life would have been the best measure to create health awareness," said Dr Sharma.

Ramendra Janwar of Nehru Samarpan Sarokar Sansthan, a local social organization had organized a free immunization camp three years ago in Lonpurva but received poor response. "Most of the villagers stayed away because of ignorance. The national immunization programme is totally a paper work. Those who can pay go to private hospitals or quacks because vaccines of BCG, DPT, Measles, and Tetanus are available there", he said. "There used to be a Swasthya Rakshak for universal immunization and Ante-natal checks for pregnant women. But the post was abolished in early 1990s,"Janwar further informed.

However, the government in its budgetary plan for rural health this year, has committed to contractual appointment on 1281 vacant posts of doctors and health workers in villages and construction of 3640 PHCs and 372 CHCs. Last week, the state also constituted a 33-member State Health Mission under the Chairmanship of chief minister Mulayam Singh Yadav. Its aim is to provide better health service and minimize mother and child death rate in rural areas. One can only hope to see some change in the above stated scenarios and health issues in UP are handled on a priority basis.