Delivery is still a ‘life-and-death\' question for women of Telangana\'s interior areas

ADILABAD: Despite the technological advancements in the medical world, giving birth to an offspring is still considered a life-and-death question for women in interior areas of erstwhile Adilabad district in Telangana. The plight of pregnant women in tribal areas of erstwhile Warangal, Khammam, and Karimnagar districts in the state also remains more or less the same.

Without proper medical facilities, pregnant women sometimes end up giving birth to newborn babies in precarious situations — even along the roadside, or on the banks of rivulets and in ambulances. Some women lost their lives mid-way to the hospital.

Kodipe Mallu Bai, 30, of Nagavelli village in Bejjur mandal might have never thought of giving birth to a new baby on the roadside in Komaram Bheem Asifabad district on July 23, 2022.

As ambulance failed to take Mallu Bai on-time to the nearby PHC (Primary Health Centre) in Bejjur due to the lack of road connectivity and an overflowing rivulet, health workers available in the ambulance performed the delivery to Mallu Bai on the roadside and later shifted her to PHC later. The newborn girl, however, died after three days.

Speaking to this correspondent, Mallu Bai expressed her anguish over the lack of healthcare facilities for them and believes that her newborn baby would have been saved if she had reached PHC at the right time. “Poor road connectivity is a nightmare for pregnant women,” she said.

Many such incidents took place this year in the erstwhile Adilabad district.

In another incident, Mesram Bheem Bai, 27, of Mothiramguda in Untoor died due to a delay in shifting her for delivery to a government hospital in Utnoor in Adilabad district on July 8.

Thodasam Sangeetha, 27, of Ramjigondnagar Colony of Lakkaram Gram Panchayat, died during the delivery at Danthanpalli PHC in the Utnoor mandal in Adilabad district in the first week of September.

Madavi Panchapula, 30, of Gundamloddi village of Adilabad Rural mandal, who gave a birth to a baby girl, died of complications that she developed after the birth control surgery at Rajiv Gandhi Institute of Medical Sciences (RIMS), Adilabad on September 30.

The victim’s family members alleged that Panchapula died due to the negligence of doctors.

Many pregnant women living in interior areas that fall in the ‘Tiger Corridor’ are facing difficulties in getting regular medical check-ups and scanning due to the lack of proper road connectivity in the Penchikalpet mandal in Komaram Bheem Asifabad district.

The issues related to the poor road connectivity and poor cell phone signals, inability of ambulances to reach interior villages and lack of preparedness in the family to the nearest hospitals have resulted in the death of several pregnant women or the incidents of delivery happening en route to the hospital in the erstwhile Adilabad district.

Apart from infrastructural deficiency, negligence of hospital staff was also blamed for the death of many pregnant women in rural and tribal areas.

According to official sources, as many as 20 pregnant women have died during delivery in the government hospitals, and 2 pregnant women deaths took place in transit to the hospital for delivery in the last year in the erstwhile Adilabad district.

Only one Gynecologist in government hospitals in the district

Shockingly, there was no gynecologist for the last one and half years in government hospitals or clinics — 20 PHCs and two Urban Health Centers and a district headquarters hospital — in the entire Komaram Bheem Asifabad district. Just a few days ago, a gynecologist was recruited on a contract basis.

The district faces acute shortage of medical staff despite the fact that it was identified by the Central government under the Aspirational District Programme (ADP) in 2018 with an aim to quickly and effectively transform 112 most underdeveloped districts across the country.

According to rough estimates, approximately 25 deliveries take place every day in the government hospitals in the Komaram Bheem Asifabad district. Across the district, there could be at least one emergency case which needs the expertise of a gynecologist to perform a cesarean surgery.

Additional DMHO (Agency) Dr Kudimetha Manohar said the medical and health department has identified nearly 250 inaccessible villages in the erstwhile Adilabad district.

Manohar said each family on average will get the benefit of at least Rs 1 lakh worth free medical services per year at government hospitals if all services were provided, otherwise they will spend an equal amount for medical services at private hospitals. Health services at private hospitals have become a financial burden on the poor and middle class.

Many doctors are feeling a heavy workload and they could not concentrate on more cases due to the shortage of doctors.

“We have big hospital buildings but no sufficient staff, including specialized doctors, in Komaram Bheem Asifabad and Adilabad districts,'' said a senior doctor.

Birth Waiting rooms are of no use:

Birth waiting rooms, which are being run for the safe deliveries for the tribal women by the ITDA (Integrated Tribal Development Agency), Utnoor, are also not functioning properly.

The birth waiting rooms were set up to improve the health condition of anemic pregnant women by providing them with nutritional food before their delivery and also to conduct safe deliveries in the agency areas.

Many pregnant women feel that delivery has become a ‘life and death problem’ since they may lose their life before giving birth to a new baby.

Paramedical staff, ANMs, and Asha workers, who track the health status of the pregnant women, are also failing to shift the pregnant women in advance to the nearest government hospital.

The health condition of pregnant women, who developed labour pains, will further deteriorate while shifting them in bullock carts, autos through bumpy roads, and wading through flowing rivulets and streams or on Cot or ‘Dholi’.

Medical experts feel that the deaths of pregnant women and newborn babies could be averted if the medical staff and para-medical staff working on the ground level could be active.

Dr Naitham Sumalatha of Adilabad said she was shocked to know that a woman came from an educated family and the urban area did not undergo medical check-up till her sixth-month of pregnancy and when tested, she was found to have only six per cent of hemoglobin.

She said pregnant women should have at least 11- 14 per cent hemoglobin. But, in most cases, Adivasi women will have 5-6 percent hemoglobin.

Many Adivasi families have stopped the cultivation of food crops and also vegetables in their backyards even for their own consumption unlike in the past, and are now focusing on commercial crops like cotton. This new trend has also impacted the health of the Adivasis especially women and children.

Forest Dept clearance is a major hurdle

Pregnant women risk their lives while giving birth to children because of poor road connectivity in the Tiger Corridor in Kagaznagar Forest Division in Komaram Bheem Asifabad district.

People of Jilleda, Murliguda and ‘Gorre’ of Penchikalpet mandal have requested the officials to lay at least a gravel road to reduce their difficulties but no action was taken.

Talandi Yashoda and Mahesh, a couple from the Koya tribe, were dreaming about their baby who will see the world soon but their dreams were shattered with the death of the newborn baby — after the delivery was conducted without medical assistance at their home — in Jilleda village in Komaram Bheem Asifabad district.

The unfortunate incident happened as Yashoda’s family members failed to take her to the government hospital due to a lack of road connectivity on July 4 in 2021.

Thalandi Madhukar of Jilleda said people of Muraliguda gram panchayat that falls on Tiger Corridor have been facing hardships due to lack of road connectivity and people suffering from seasonal diseases and were unable to go to a government hospital in an emergency in time due to lack of road connectivity.

He said there were incidents where a youth who attempted suicide by consuming pesticide died on the way to reach the hospital in the past.

Asha worker Tarabai of Jilleda said they were taking care of pregnant women at their level but taking them for regular medical checkups and scanning has become a major problem due to the lack of road connectivity.

Thirty-year-old Rodda Yellavva of Dattojipet village gave birth to a baby on the banks of the overflowing stream near Gangapur (Kawal Tiger Reserve Core area) when it did not allow the vehicle to cross to reach PHC for delivery in Kadam mandal in Nirmal district on July 21, 2021.

After the stream receded, the mother and newborn baby were shifted to a government hospital in Kadam where they were treated and both were fine.

'Doctors do not stay at mandal headquarters'

Non-availability of the medical officers is also a major cause of concern. Doctors working at PHCs were reportedly operating private medical practice in the nearby towns and are not available in case of emergencies as they are reluctant to reside in mandal headquarters.

Madavi Raju, a village elder (Patel) of Kunikasa of Gadiguda mandal of Adilabad district, said it was unfortunate that pregnant woman Madavi Rajubai of their village died at a young age due to the delay in shifting to RIMS, Adilabad in August, 2021.