Imposing structures, but where are the specialists? : The Tribune India

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Imposing structures, but where are the specialists?

The only Community Health Centre in the Kandi area of Nurpur Bedi is at Singhpur village on Garhshankar road. The structure is reassuring, the board at the entrance proclaims how the facility offers specialised treatment in medicine, surgery and gynaecology.

Imposing structures, but where are the specialists?

The Hoshiarpur Civil Hospital where the post of gynaecologist has been lying vacant for four months. Tribune photo



Arun Sharma

Tribune News Service

The only Community Health Centre in the Kandi area of Nurpur Bedi is at Singhpur village on Garhshankar road. The structure is reassuring, the board at the entrance proclaims how the facility offers specialised treatment in medicine, surgery and gynaecology.

Still, Monu, a resident of nearby Lalpura village who's brought his wife for a checkup, is told at the very outset that he will have to take her to the Ropar Civil Hospital, 32 km away, as there is no gynaecologist in the hospital. Actually, it does not have a single specialist.

The 30-bed CHC, that caters to the 1.1 lakh residents of 140 villages, only has a medical officer and a dentist on a regular basis.

On rolls, the centre has five medical officers and a dentist, but two of them have to attend to medical facilities at Kahanpur Khui village and Nangal on alternate days. Another doctor is posted at Morinda on deputation. The remaining doctor is on leave for postgraduate studies. So, in the absence of specialists, the OPD has at best 100 patients.

About 12 km away is located the Primary Health Centre at Abiana Kalan village. It is locked as the only doctor posted there has left for higher studies and the pharmacist got transferred.

In fact, there is no gynaecologist in all the government hospitals of the Kandi area at Nurpur Bedi, Garhshankar, and even the district hospital of Hoshiarpur. The deliveries are performed by the nursing staff most of the time. 

Twelve posts of gynaecologists, it is learnt, are vacant in government hospitals in the state for long, though Punjab, ironically, bagged national awards for safe deliveries and for reducing the infant mortality rate last year.

Things are a tad better at the 50-bed Garhshankar Civil Hospital, that caters to the nearly 2 lakh population of the town and 150 villages. However, the only gynaecologist posted here has been unavailable for most of the time since June last year. The specialist proceeded on leave in June, joined in December and has been absent since March 15. No alternative arrangements were made.

The hospital conducts nearly 7,000 blood tests every month but no pathologist has been deployed. Though an orthopaedician, general surgeon, ophthalmologist and ENT specialist are available, they conduct surgeries depending on the availability of an anaesthetist, whose services are procured from the private sector at the time of an emergency. Patients requiring surgery are asked to wait or look for other options in case the private anesthetist is unable to spare time.

In the absence of sufficient medical officers, the specialists have to attend to emergency duties on a rotational basis owing to which the OPD services are badly affected, says a doctor.

According to the Indian Public Health System guidelines, a sub-divisional hospital requires at least seven medical officers while the Garhshankar hospital has only two.

At a distance of 42 km from Garhshankar, the staff as well as patients at the district hospital of Hoshiarpur find themselves in a much comfortable position. The hospital has 15 specialists, including three general surgeons, and as many ENT specialists. Besides, four dentists, two paediatricians and two dermatologists are also available.

The post of a gynaecologist has been vacant here for the last four months when the only gynaecologist resigned. Senior Medical Officer Dr Vinod Sarin says the OPD and normal deliveries are being handled by another lady doctor. For caesarian deliveries, the general surgeons are put on duty, he adds. Those familiar with the functioning of the Health Department cite the unfavourable working conditions as the main reason behind the shortage of specialists.

Punjab Civil Medical Services Association president Gaganjit Singh Moga claims that many people prefer to join government service but leave after a few days due to excess workload. "The state government has not reviewed the cadre, so the strength of doctors at hospitals has remained the same for years while the number of patients has increased manifold," he reasons. "Moreover, a specialist besides regular duty is required to perform emergency night duty, VIP duty and attend courts for medico-legal cases as well."

Dr Moga says that when a hospital has only one gynaecologist, the doctor is required to remain on duty for 24 hours as the number of patients has increased drastically due to several schemes introduced by the Centre as well as the state government for the welfare of mothers and children. "They are always under scanner and responsible for achieving the target fixed to reduce the mother mortality and infant mortality ratio," points out the association leader.

Director, Health Services, Dr Harinder Singh Bali, when contacted, said regular walk-in interviews are conducted to recruit specialists and out of 336 vacancies, 40 have been filled recently.

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