April 11, 2011

Barwani Maternal Deaths

Barwani district located in south-west of Madhya Pradesh has a population of 10, 81.039 of which 7,24,735 or 67% belong to Schedule Tribes. (2001 census). The terrain of the district is hilly and dry, with frequent droughts. Agriculture and labour work are the primary occupations of a large percentage of the district’s population. Barwani has been identified by the Government of Madhya Pradesh as one of ten districts with very poor indicators, low population density and weak infrastructure, in need of special attention. According to the Madhya Pradesh Human Development Report 2007, the district has the second lowest Human Development Index amongst all districts of Madhya Pradesh. This report also gives the MMR figures for the district based on 2002 data as 905 per 1,00,000 live births (SRS, 2003).

In the District Hospital, Barwani between April to November 2010 there had been 25 maternal deaths, 9 of which occurred in the month of November 2010 alone. Incidentally, none of the CEmONCs in Barwani District conduct cesareans or manage complicated deliveries; only 1.5% of births are delivered by cesarean section, suggesting that many women who need this life saving service are not receiving it. The draft study report on JSY evaluation in Barwani District conducted by National Health Systems Resource Centre (NHSRC) mentions that only 1.9% of estimated pregnancy related complications in the district are being managed in the District hospital. Given the topography, there have been instances where women in labour have travelled upto 100 kms from their villages to seek treatment in Barwani District Hospital, only to be referred to Indore Medical College Hospital, located another 150 kms away - this despite the fact that District Hospitals are supposed to be dealing with such cases.

The point of contention is not merely about general deficiencies in infrastructure, but also the negligent and careless attitude doctors in the District Hospital and poor management by senior officials, which has resulted in local people being put through derogatory treatment, harassment and even in death. A rally was held on 28th December to protest against this extreme callousness and ill-treatment regularly meted out to women in pregnancy and labour by the public health system, and particularly the District Hospital. Nearly a thousand people from far-flung adivasi villages of the district demonstrated under the banner of Jagrit Adivasi Dalit Sangathan (JADS), a mass organization active in this area for more than a decade now. Contrary to expectations that some corrective action would be taken by the District authorities, what came as a rude shock was the arrest warrant issued by the district administration against the leaders of JADS and 200 people who participated in this protest.

The National Alliance for Maternal Health and Human Rights decided to undertake advocacy on this issue and made submissions to the National Human Rights Commission (NHRC), Planning Commission, Department of Women and Child, the Chairperson of the Parliamentary Standing Committee (H&FW) and NRHM Mission Director, Madhya Pradesh. We have to date received positive responses from the NHRC, Parliamentary Standing Committee and the Mission Director. The NHRC has issued notices to the District Magistrate, SSP of Barwani and CMO of Barwani District Hospital and demanded a report within four weeks. The Parliamentary Standing Committee has requested for a submission of all related reports to be placed before them for their consideration. Further the NAMHHR co-organized a meeting entitled ‘Civil society Action on Maternal Health: A Strategic Meeting’ on the 1st March where the findings of the three member fact finding team consisting of civil society activist were shared. During the course of this meeting the future course of action to be taken was also charted.

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