Rural Healthcare in India Often Fails to Meet the Smallest of Expectations

Even though community health centres have been set up to provide free healthcare, the professionals working there and the treatment given to patients leave much to be desired.

Vandana, a young woman married into a farmers’ family, lives in Nabipur village in block Trivediganj, in the district of Barabanki, right in the centre of Awadh in Uttar Pradesh. She had been complaining of a discomfort in her vagina for some time and but been ignoring, as per customary traditions for Indian women, but when it reached unmanageable proportions, she decided to pay a visit to the local health centre for diagnosis and treatment.

Community health centres, or CHCs, are part of the country’s public health programme and as per the rule, are known to offer consultation and even treatment free of charge. The whole point of healthcare facilities in rural areas is to provide access to those who are living their lives in far-flung places and are unable to afford it. However, the intended benefits of these centres don’t always reach the common man or woman who are, in theory, the intended beneficiaries.

At the Haidergarh CHC, Vandana was in for a brutal shock. Not only was there an outright demand for money in order to perform an operation that she apparently needed for her condition, but there was also a severe aftermath. Her father-in-law Rajkumar runs us through the details, “When we took her to the hospital, we were told it’s not a big deal. They said it’s a ‘do minute ka kaam (two-minute job)’, but we had to get the fee arranged for the procedure.” He mirrors our surprise at this disclosure, “Yes, we were all taken aback. ‘Isn’t it supposed to be free of cost?’ we asked them.” But Rajkumar says they were met with some irritation upon this, “They just said no, it wasn’t, and even urged us to get the money quickly. The amount they asked for was Rs 4,000.” Not a measly amount for a farmer’s family, they finally managed to get together Rs 2,000 and told them it was all they could do, especially at such short notice. Rajkumar alleges that the minor irritation they had been subjected to earlier turned into a blatant anger from the hospital. He further states that it was their frustration at not being given the full amount they had demanded that was responsible for what followed.

Vandana, who had not been part of this kerfuffle and had been taken inside for the surgery prep, woke up to a horrendous scene post the surgery. The pain had become worse and heavy bleeding followed soon after – the stitches, it seems, had come undone. She could not believe what had transpired. Says Rajkumar, “When they operated on her, they were totally careless. They cut through her flesh and did a shoddy job of stitching her up.” Apart from the rage, there is a confusion too, “I do not understand it. The doctor had called it a ‘baaye haath ka kaam (piece of cake)’,  he said that it was just a quick, standard job. Then what happened? All her stitches came undone. What kind of practice is this?”

But there was more to follow. When Vandana’s family asked for a night’s stay at the hospital, so that help would be at hand for her recovery, they were refused point blank. Says Rajkumar, “We were told that we had to take her away immediately. This was merely half an hour after the unsuccessful operation had been performed on her.”

Watch her story here:

What happened to Vandana is not an anomaly. India has the most shameful statistics on rural health benefits on the ground, especially the health of rural women. Rural maternal health continues to be in a dismal shambles – an Indiaspend study of government data and research findings highlighted a shocking gap in care  for pregnant women and new mothers, and non compliance with WHO guidelines in reducing risk and complications. You could even say that Vandana got away easy. Death from medical negligence or outright medical malpractice is a common feature in rural India.

When we meet Vandana, she is back home, in visible pain, trying to go about her domestic duties and the rearing of children. But it does not seem possible – for our interview, she propped herself up against the wall and we had to often pause filming, because she did not, understandably, want her grimacing face to be a permanent part of the video. “I can barely move”, she says, continuing, “I have to bend down if I want to accomplish the simplest of tasks. Using the washroom is an impossible task… I cannot even sit comfortably.” Her daily routine affected for the worse, the family was back at the hospital after a few days, demanding answers – but the rude shock was to continue, as were Vandana’s list of miseries. Says Rajkumar, “They refused to even have a second look at her. They told us to take her away immediately, maybe to Lucknow for proper treatment.” When Rajkumar reminded them that it was their doctors who had said she would be on her feet, cured in no time, they dodged the question entirely. “We’re not going to have another look at her,” they said, with finality.

We had to make a few rounds of Haidergarh’s government hospital before we finally got an appointment with the surgeon, Dr M.K. Gupta. According to him, there had never been any operation of this sort at the centre. “We have never even seen the patient,” he says gruffly, calling for the register as proof, “You can see yourself, there is no record of this.” Rajkumar tells us that they were never given official receipts for their payments, only “slips of paper” and stern advice to “keep quiet”.

“We are poor farmers,” he says with an air of semi-resignation, because he hasn’t given up completely, “We go to these hospitals so we can be treated properly and for free. But here, we have got neither. Till date, we have had to buy all our medicines ourselves as well.” At this point, he holds up the prescriptions and tells us of the back-breaking expenditure, “We’ve spent about Rs 6,000-8,000 on medicines alone by now.”

“After all this, if Vandana had been fine…,” he adds, and tells us that they now intend to take her to Lucknow, because she cannot continue to live this way.

And even as the hospital staff and Gupta stick to their stand, denying the very existence of such a patient, angry at the “false accusations” – because if there was never any patient, how could there be misconduct? – Rajkumar says out loud what we all know as the truth. We don’t need data to agree with his claim, “They’ve taken money from a lot of people to perform these ‘operations’. They think nothing of it.”

This piece first appeared on Khabar Lahariya. It has been edited to meet style guidelines.

Khabar Lahariya is a rural, video-first digital news organisation with an all-women network of reporters in eight districts of Uttar Pradesh.