Expanding Health Services to Melghat Region in Amravati

Melghat, a hilly forest area in the Satpura mountain ranges is a habitat for Tiger, Bison, Bear, snakes and many more animals. Melghat stands for its name, which means ‘cluster of Ghats’. A tribal corner in the northeastern fringes of India's richest state-Maharashtra- Melghat is an apt example of almost everything that has gone wrong in India's response to malnutrition and child deaths.

The health related data in Melghat possess the punch of an eye opener: every 14th child dies in Melghat before reaching the age of six, often owing to malnutrition-related causes. These numbers put Melghat almost at par with less-developed sub-Saharan nations such as Senegal and Tanzania.

With an under-five mortality rate of 74, Melghat has twice as many children dying before the age of five as Iraq. A child in Melghat is thrice as likely to be severely malnourished compared with an average child in Maharashtra, according to ICDS data. Melghat comprises of Dharani and Chikhaldara tehsils of Amravati district and has been witnessing 460 child deaths on an average every year in the last five years, of various causes linked to malnutrition

For the population of over 3 lakhs in Melghat, there is only one Sub-District hospital, two rural hospitals and 11 Primary Health Centres (PHC). But for a region which has already witnessed thousands of Child deaths, till recently there was only one paediatrician and no Gynaecologist.

Clearly, Melghat has unacceptably high maternal mortality, infant mortality and malnutrition. With doctors reluctant to serve in resource limited settings, and hesitant to stay in villages in Melghat, the poor and rural people in this region would find it very difficult to access a healthcare that they could afford. Many die prematurely- unsung and unwept.

The villages of Melghat-with treacherous roads, closed schools and mostly without electricity or piped water-appear to be in a time warp, left behind by India's famed engine of economic growth. In several villages, child deaths are more frequent than the visits of public servants.

Beginning 1998, Dr Ashish Satav, a physician and Kavita Satav, an ophthalmologist- both faculty at MGIMS, chose to leave the comforts of teaching at MGIMS and decided to take a path less traveled by- the couple chose to live in a village in Melghat. They were fully supported by MGIMS. Over the last two decades, this couple has invested the best years of their life to care for patients with medical and eye related problems. Mahatma Gandhi Adivasi Dawakhana and Dr. Sushila Nayar Netralaya, at Utavali in Dharni Block, where the couple worked offered much needed respite to tribal, poor and rural people.

An equally important health problem in Melghat is mothers dying during deliveries and parents not being able to celebrate the first birthday of their children:

In January 2012, MGIMS asked Dr. Shakuntala Chhabra, the former Head of the department Gynaecology and the former Dean of MGIMS to supervise all activities related to health care issues related to Melghat. MGIMS decided to go beyond the walls of a medical school and a hospital and planned a community based healthcare facility where its doctors , nurses and paramedics would actually stay and treat patients.

Shri Brihad Bhartiya Samaj, a Mumbai based trust funded MGIMS to convert the existing hospital into a makeshift hospital where pregnant women could be cared for, and delivered and pneumonia and diarrhea - the deadly villains that kill babies could be treated. MGIMS also acquired necessary equipment, upgraded the diagnostics and treatment related facilities and built hostels where young graduates and faculty could stay, enjoy internet connectivity and do their professional duties. MGIMS bought land to build a multispecialty hospital in Utavali village and also bought four flats in the vicinity.

Now a team of obstetrician – gynaecologist, paediatrician, anaesthetist, medical officers, interns, nurses and other paramedics is working 24/ 7 to offer preventive, promotive and curative services this region so badly needs.

MGIMS is conscious of the fact that for an effective public health to function, all stakeholders should join hands and work together. The Sub District Hospital Dharni and our centre work in tandem, We expect the central and the state governments to recognize our activities and fund our projects aimed at reducing mother and child deaths.

Four nurse midwives visit 52 villages once a month and provide community based antenatal services, advocacy about antenatal, postnatal, neonatal care in the villages. They are supported by 4 medical officers – who visit these villages 4 days a week.

Over the last four years, we have cared for 20467 outpatients, admitted 1811 inpatients, performed 700 surgeries, delivered 210 babies, performed 85 caesarean sections and operated on 30 women who required hysterectomies and surgery for ovarian tumours.

The first caesarean section was performed on 21st January, 2012. The mother and the child went home a week later. A woman with cancer of ovary underwent hysterectomy on 15 February, 2012. The woman is doing well 2 years after her operation.

We have also been arranging screening camps in the villages : we screened 226 individuals in March 2012, 1036 in February 2013, 1107 in 2014, 1107 in 2015 and 1883 in 2016. We also assessed children with cleft lip and cleft palate in December 2013. Plans are afoot to launch family life education and community based disability detection.

The Dr Sushila Nayar Hospital at Utavali is also active in the following villages- close to the hospital- where nurses, paramedics, interns and medical officers pay regular visits to collect data on determinants of ill health, educate children, adolescents, men, women and elderly about various health-related problems, provide them point of care medical help and also help those who require medical care in the hospital. Active in 65 villages around the base hospital, the team plans to provide community based healthcare in 35 more villages, soon.

Sr. No

Village

Population

1

Tangada

474

2

Rora

512

3

Kadhaw

800

4

Mangiya

818

5

Bulumgawan

645

6

Sonabradi

936

7

Kund

110

8

Rangubeli

390

9

Dharanmahu

2022

10

Chethar

632

11

Duni

2000

12

Kekababod

1004

13

Chatawabod

1471

14

Jutapani

1256

15

Diya

1445

16

Chichagat

1180

17

Dhulghat

1010

18

Hatnada

394

19

Shirpur

1448

20

Hatida

1040

21

Takarkheda

406

22

Patiya

1825

23

Bherdaburu

1087

24

Titmba

2695

25

Chikhaldhana

290

26

Harda

787

27

Chwarakund

1090

28

Baru

1207

29

Forestmalur

201

30

Gobarkhau

1064

31

Zapl

630

32

Kutanga

2108

33

Khamda

316

34

Bairagad

2543

35

Ukupati

840

36

Bhokarbardi

1800

37

Kakrmal

850

38

Kalpi

630

39

Tangtangdhana

180

40

Mandu

1218

41

Talai

1165

42

Ranitamboli

1440

43

Mandwa

745

44

Karda

1278

45

Dhahinda

1700

46

Nirgudi

763

47

Sawalkheda

820

48

Ratnapur

2070

49

Pankhya

749

50

Ghuti

1003

51

Talaikamp

1055

52

Mokha

1100

53

Utavali

1100

54

Bhondilawa

876

55

Dhakrmal

938

56

Gonwadi

1685

57

Kusumkhoth

1089

58

Bod

1065

59

Tembli

1845

60

Chutya Nandgaon

701

61

Babanda

774

62

Chakarda

1845

63

Jirtdhana

239

64

Hardoli

847

65

Chikhalpat

130

  • Site Last Modified: Wednesday 30 June 2021, 10:54:44.

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