Maharashtra: Sent back home by rural hospital, year-old baby dies in Nandurbar

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She had fever and diarrhoea, and had been vomiting for over a week before her death. On January 13, she also contracted cold and suffered coughing fits. According to her mother, Moyesha Gajjar Naik, she took Riya to the rural hospital on January 10, where, within 15 minutes, the doctor in the out patient department checked her daughter and sent her back home. “He gave me medicine and said no admission is required. What could I do, I returned,” Moyesha, a tribal, said.

Riya is the sixth child of Naik and was delivered at home.

Her father Gajjar Naik, a farmer, said the baby did not recover despite medications. The baby was also not referred to the civil hospital in Nandurbar, at least 80 km away, he said. The child suffered from severe dehydration, weight loss and constant fever in the six days before her death. The local Aanganwadi worker in Toranmal hamlet has been on leave. The Aanganwadi helper did not visit Riya’s house to check her condition. “I did not know she is unwell,” Kelubai, the Anganwadi helper, said.

The baby’s mother, Moyesha Naik (in green), outside her brick hut. Express photo by Tabassum Barnagarwala

While Moyesha was a lactating mother until a few months ago, she was not a beneficiary of the Dr APJ Abdul Kalam Amruta Aahar Yojana in Toranmal anganwadi. Riya took the Aanganwadi meal rarely. “She sometimes got khichdi once a day. Eggs also came sometimes,” Moyesha said.

In 2015-16, 465 children had died in Nandurbar. During monsoon, 202 children succumbed to various infections.

According to Integrated Child Development Services (ICDS) guidelines, a child must receive eggs at least four days a week and daily breakfast and lunch. Several kids like Riya in Nandurbar are, however, not beneficiaries of the ICDS.
Dr Santosh Pawar, the doctor at the rural hospital, prescribed two sachets of ORS, an anti-vomiting tablet and a paracetamol for the baby.

Even though the hospital beds were empty, she was not hospitalised. “I thought the symptoms were moderate,” Pawar told the The Indian Express. Pawar said that he did not conduct a typhoid confirmatory test as technician was not there. According to norms, a bonded candidate or a doctor who has committed to serve in a rural posting is not given an entire hospital’s duty as medical officer in the absence of a senior medical officer or superintendent.

The new Toranmal rural hospital with its 30 beds was started in 2014. On Friday, there were only three patients admitted and an out patient of 30 patients were on the list— much less than expected. The hospital’s x-ray service was shut due to vacancy in the technician’s post. The posts for paediatrician, gynaecologist and aneaesthetist have not been filled for a year. The entire hospital has just one staff nurse and one doctor in a single shift.

Riya’s case paper showed she had suspected typhoid, but the doctor did not conduct any test to confirm it. An acute staff shortage has crippled the health system of Nandurbar where there is a vacancy of 24 of 33 class I medical officers. In Toranmal hospital itself, top most post of medical officer is vacant. Two staff nurses work in a shift of 36 hours each. Across the district, there is a vacancy of 10 of 17 gynaecologists, and eight of the 17 posts for paediatricians are vacant.