SHILLONG: At a time when Meghalaya is reporting abnormally high maternal and baby mortalities, it has come to light how bureaucratic apathy two years ago scuttled an internationally acclaimed voluntary group’s assistance to prevent fatalities.
It all began on July 13, 2018, when London-based Gynaecologist Dr Himansu Basu approached via email the National Health Mission Director Pravin Bakshi for joining hands with Rotary’s global initiative called CALMED (Collaborative Actions in Lowering of Maternity Encountered Deaths) which has been designed in collaboration with Geneva University Hospitals.
The first response of the officials was that the government would not be interested if there was any cost burden on the department. When explained that Rotary Clubs in UK, Japan and India were going to pump in $43,000 (nearly Rs 31 lakh) covering the basic costs, the response was a little positive.
For taking it further, Dr Basu flew in from London to tie up the loose ends. During across-the-table dialogue, the officials threw a new spanner.
They inflexibly declined to spare the doctors from PHCs, field staff like ASHA (Accredited Social Health Activists) workers for a fortnight for undergoing the training citing that similar central sponsored programmes were already in place in Meghalaya.
That was virtually the end of the road for the project in Meghalaya.
At the initiative of Rotary Club of Shillong, which is the main prop of the project, NEIGRIHMS was approached as a possible alternative collaborator. And the idea clicked instantly.
Department of Community Medicine led by Prof Star Pala agreed to join hands. All was set to launch the unique training programme this summer.
As luck would have it, COVID pandemic came in the way.
Not to be undeterred, Dr Basu and six noted UK-based gynaecologists have chosen on-line training which has been specially crafted for areas like Meghalaya which are “in low resource setting”.
Six mortality-prone districts of the state have been identified for providing the critical training during the next three years.
The team is eager to launch the training particularly because COVID generated additional risk of 8.3% and 38.6% on maternity and infant mortality.
Incidentally, Meghalaya’s official stats show that annually over 200 mothers die at child birth. Over 50% of the child births in the state take place at home, mostly at the hands of untrained personnel. Institutional delivery is relatively minimal, considering the distance from home to the nearest health care centre and lack of conveyance support in the villages.
Besides, it has not been helped by the fact that of the 546 health care centres in the state only 43 have 24-hour coverage of doctors and nurses.
The CALMED, it is reported, has been effectively implemented in Sikkim and Gujarat by training field workers to handle maternity cases, both institutional and home.
According to Dr Basu, because of travel restrictions, the revised plan is to provide top class on-line training to “Master Trainers” (doctors and trained nurses etc), lower level trainees and ASHA workers.
The two-week distance training programme is expected to commence soon and the visit later by the facilitators from UK to demonstrate training skills, role plays and in situ simulation training is expected to reduce the yawning gap between child births and availability of trained hands.
This, the team visualises, will significantly reduce the maternal and infant mortality rates in Meghalaya.