The Indian Express    03.08.2012

Cleaning employees assist in deliveries at crunch-hit municipal maternity homes

Usha Devi’s newborn came into the world a few hours after the
Northern Grid collapsed for the first time early on Monday morning.

When Usha went into labour at the 14-bed municipality-run
maternity home in Khichripur, East Delhi, late on Sunday night, a nurse
who was assisted by a cleaning staff helped her deliver — in a room lit
by candles.

The centre is one of the 30-odd maternity homes in the city,
sponsored by the government as part of its Janani Suraksha Yojana
programme to promote “institutional” deliveries. Most of these centres
suffer from an appalling lack of facilities and staff.

“The labour room was dark and hot. I was in pain. I did not know
that a nurse, not a doctor, was attending to me. She saved my life and
my baby,” Usha said.

When the Northern Grid failed a second time on Tuesday, the
healthcare centre was once again without power. Usha and her child lay
in the ward, where another expecting mother, Aarti, was writhing in
labour pain.

Though not qualified, a cleaning staff administered her a drip.“We have learnt a few things because of the perennial staff shortage. We help the nurses,” she said.The auxiliary nurse midwife agreed: “We have learned to work without doctors. The sweepers have become our assistants.”

SORRY STATE

Delhi Health Minister Dr A K Walia said: “Most of these centres
are managed by the civic agencies. We have been telling them to arrange
for basic facilities like ultrasound machines.”

These centres have been around for over a decade and were supposed to
be open round-the-clock. But it has been alleged that doctors — some of
who are posted under National Rural Health Mission — were seldom
available at night.

“We have eight-hour shifts. If the doctor is on night duty, a
nurse still has to manage the other shifts alone. Babies will not wait
to be born at the hands of a doctor. There is acute shortage of
doctors,” a doctor at the Tri Nagar maternity home in North Delhi said.

Sources said there’s no ambulance for emergencies, though the
rules state that there should be one at each centre. And at Patparganj
centre, which has an ambulance, the vehicle cannot be used as the driver
has been on leave for a month.

There are instances, sources said, when nurses have to fetch
water from outside for deliveries because of erratic supply and poor
storage facilities. At Geeta Colony, Tri Nagar, Shakurpur Basti and
Patparganj centres, there is no running water in the labour room.

Spokesperson for the city’s three municipalities, Yogendra Mann,
said tender notices would be issued for generators and inverters at the
these homes. “We discussed with the Delhi government ways to develop a
system for making CATS ambulances available at these centres whenever
necessary,” he said.

“We are getting doctors from NRHM and are in the process of recruiting more through UPSC,” he said.

SEPTIC CONDITIONS

Even without the basic facilities, these centres perform anywhere
between 50 and 70 deliveries every month, government sources said.

Doctors said their hands were tied because of the lack of diagnostic
equipment. Moreover, there is no operation theatre as, in accordance
with the policy, they are supposed to perform only “routine deliveries”.

A doctor at the Patparganj home said: “At the slightest sign of
complication, we are supposed to refer our patients to the nearest
government hospital. I don’t know why we (doctors) are posted here when
we don’t have any support system to help the patients.”

A gynaecologist of Hedgewar Hospital said: “We are already
overburdened. Our gynaecology ward has a waiting list of three months
for an ultrasound.”

That is not the only problem. A nurse posted at the Geeta Colony
centre said: “Distance between (government) hospitals and our centre is a
huge factor when the clock is ticking. There are instances of women
delivering on the way to hospitals.”

Doctors at the Patparganj home said nurses conduct deliveries in
“septic conditions” because no staff has been appointed to do the
after-delivery cleaning.“There is no water supply in the labour room. Shortage of sweepers means there is no one to do the cleaning,” a doctor said.