56 of 108 sanctioned doc posts vacant in N’pada

Friday, 07 September 2018 | AJIT PANDA | NUAPADA

The long unending queues in front of the doctors in different health centres in Nuapada district reveal a pitiable state of the health services in the district.

The CHC in Khariar, which is one of the two First Referral Units (FRUs) of the district, is the most crowded one due to inflow of patients from Boden and Sinapali blocks of Nuapada district, besides from three other blocks of neighbouring Balangir and Kalahandi.

The average number of outdoor patients usually remains between 250 and 300 daily, the number exceeding 400 at times during the peak periods from June to October. One doctor here attends to 70 to 80 patients a day, which does not include the patients admitted in the IPD and those visiting the doctors at their residences.

No one knows how these doctors maintain medical accuracy at such frenetic a pace. “A doctor normally can handle average number of 25 to 30 patients a day, larger-than-average caseload would not allow her /him to give the attention a patient need,” says a senior doctor of District Headquarters Hospital (DHH).

The WHO prescribes a doctor to population ratio of 1per 1,000. But in Nuapada district the ratio stands at present at 1 per 13,423. Data available with the Medical Council of India (MCI) reveal that the doctor to population ratio for Odisha was 1:2,749 in 2017 against the national ratio of 1:1,597. The wide gap of ratio among districts in the State reveals how distribution of doctors is not uniform and backward districts like Nuapada suffer the worst discrimination.

Nuapada district has 108 sanctioned posts of doctors, but 56 of them are lying vacant, which include even the posts of specialists. Supposing that all the vacant posts are filled, the doctor to population ratio of Nuapada district would still stand at 1:6,463, said sources.

“With only 52 doctors in hand, it becomes very tough for the health administration to manage the affairs across the district,” says the district health authority. “People complain about more concentration of doctors in the DHH at Nuapada, but it struggles with only 17 doctors plus four appointed last year on corpus fund,” add the authority, informing that including three administrative level posts of ADMO - TB, FW and Leprosy, the DHH has a vacancy of 33 of the 40 sanctioned posts. This includes the posts of consultant of medicine and surgery and specialist posts of orthopaedics, medicine, psychiatry, surgery, OG, skin and VD, Anaesthesia, dentist and ophthalmologist. Four of the existing specialists joined here recently on KBK promotions, but due to their seniority, they hold the administrative posts and are preoccupied with office work,” says a district official.

The Khariar CHC has a vacancy of three specialists’ posts such as surgery, paediatric and medicine. There is only one pharmacist in the Drug Distribution Centre who manages 300 patients daily. A temporary arrangement of a medicine specialist has been made recently, who attends the CHC three days a week. But looking at the patients load in the CHC and considering the increasing dependence of people on medicines available under Niramaya, it needs filling up of all the posts.

The CHC was given the status of Sub-divisional hospital last year, but the requisite number of posts for this hospital has not been created. “DPR of the sub-divisional hospital has already been made, but the posts of specialists and necessary infrastructure are yet to be created,” says an official of the Health Department.

As a referral unit, the Khariar CHC receives patients from Boden and Sinapali CHCs and most of these are OG (obstetrics and gynaecology) and paediatric cases. Unfortunately CS or tubectomy is not conducted here due to absence of an anaesthesia expert in spite of presence of two gynaecologists.

Previously, anaesthesia experts from the DHH were visiting this CHC regularly, but all the cases are now referred to the DHH.

“What is the use of spending Rs 30 lakh per annum from corpus fund in salary of an O and G specialist posted here, if all the cases are referred to the DHH,” asks a junior health functionary referring to the recent posting of an OG specialist in the CHC from corpus fund.