During 2015-16, JMS continued its focus on strengthening PHCs and in taking the lead for various health related issues.
Public dialogues in PHCs: JMS conducted public dialogues in two more PHCs- Toranadinni PHC and in Hirekotnekal PHC. Around 60 women participated in the public dialogue in Toranadinni PHC while around 35 participated in the one held in Hirekotnekal. These public dialogues were preceded by meetings with women in JMS sanghas in the villages attached to the sub-centres of the PHCs. At these meetings women listed several problems such as dysfunctional lab, non-availability of doctor, writing prescriptions to buy medicines outside instead of providing them free in the PHC, no representation of local women in the ARS of the PHC, not conducting deliveries in the PHC and so on. Following these discussion a date was fixed and informed to the concerned PHC staff as well as to the taluk health officer to be present. In the both public dialogues taluk health officer was present and acted on several issues promptly. For example, in Toranadinni PHC, there was no lab technician post sanctioned for the PHC and they were referring all pregnant women for basic tests to Kavital PHC, 10 km away. Women suggested that the THO depute a lab technician on ANC check –up days at Toranadinni PHC so that pregnant women at least get all aspects of care and are spared the trip to Kavital which is again another 10 kms away and is inaccessible. This was agreed. Similarly women demanded to why there was no doctor available 24X7. The THO said that there is acute shortage of doctors in the district and this is a rampant problem everywhere. However with compulsory rural posting of medical graduates, they assured that the problem will be resolved soon. But this of course depended on state level decisions he added. In both PHCs, women demanded to know why doctors were writing prescriptions to buy medicines outside. In response the in -charge medical officer in Toranadinni said that people themselves demand and he is forced to write. Then the women confronted and asked him, “Who is the doctor here? You? Or the patients? On all other matters you say ‘I know better’. How is it that you write prescriptions when patients ask you?” The MO was embarrassed and the THO instructed the doctors not to write prescriptions outside but to indent properly and provide all medicines from the PHC’s pharmacy. In both PHCs, women demanded to be made members of the ARS. In Toranadinni, the MO held additional in charge. So it was decided that the women’s names will be included when the fulltime MO takes charge. In Hirekotnekal two women from the sangha become members of the Arogya Raksha Samiti (ARS).
Increased vigil on the private sector:
JMS participated in KJC’s protest in Kalburgi district against the widespread, unethical hysterectomies, exposed through KJC’s fact-finding exercise. Women returned from the protest and held meeting in the sanghas to share how several women had lost their uterus unnecessarily only because doctors wanted to make money. Following these discussions, JMS decided to hold a public meeting on the issue. They discussed the issue with the MO of Potnal PHC and decided that the focus of the discussion should be on the importance of the uterus and what role it plays in protecting women from various long-term health problems. Given that as ARS members in Potnal PHC JMS women had developed a good rapport with the lady medical officer she was very happy to hold this public meeting. It was decided that the public meeting will be held in the PHC premises on a Thursday which was the local market day in Potnal which attracts people from several surrounding villages. On the day of the meeting there were more 200 people. Narsamma from JMS gave a brief overview of how women in the neighboring district had lost their uteruses to greedy private practitioners who were instilling fear in them about cancer with the sole intention of making profit at women’s expense. She said even in Raichur district such a problem was there and cautioned women about it. She said that women should seek immediate care for any women-related problems and demanded that all PHCs stock adequate medicines required them. This was followed by an explanation of the National RTI/STI prevention and control program and what kinds of services and treatment was available and the precautions one needs to take prevent RTI/ STI by the Male worker. The Medical officer then spoke about the importance of uterus in a woman’s life beyond child-bearing. She cautioned women against demanding for hysterectomy. She urged them to seek immediate and complete care for all gynecological problems and assured that they would provide the same in Potnal PHC. Narsamma asked women to share and discuss any such advice for hysterectomy in the sanghatan before going ahead with the surgery. Following this meeting women in several sanghas discussed the issue and reported of specific hospitals in the taluk towns which specialized in uterus removal operations. Subsequently individual women have been approaching the sanghatan who along with KJC activists have been facilitating a second opinion /consultation with a gynecologist. JMS also decided to also focus on private providers to track such violations.
Addressing Vandalism of Potnal PHC by miscreants: In early December 2015, following the death of a young boy who got electrocuted in a local hostel, the mob ran amuck and vandalized the PHC in Potnal on the grounds that there was no doctor and the ambulance did not arrive on time. The Lady medical officer who had been posted to the PHC following JMS’ protests had gone on maternity leave the previous month that had led to widespread disruption of services in the PHC. JMS had made written representations to the THO about the same. However when people brought the boy in a very critical state to the PHC the nursing staff did attend on him and made arrangements for the ambulance. But the boy passed away before the arrival of the ambulance. The irate mob then attacked a staff nurse, ransacked the PHC, broke windows and furniture and set fire to mattresses and medicines. The additional police force was called in and it was more than 6 hours before law and order could be restored. Following the incident police rounded up more than 100 men from the village and arrested them. There were complaints that those who had nothing to do with the incident were imprisoned. Following this incident, JMS women met the DC and condemned the attack on the staff and vandalism of the PHC. They urged him to conduct a peace meeting in the village and restore PHC services. They also urged him to instruct the police to arrest only those who were involved in the attack and restrain them from making indiscriminate arrests. The DC urged JMS to wait until some normalcy is restored to hold any public meeting in the village. Now the OPD services in the PHC have been restored. Following this JMS has been documenting cases of women who have suffered hardship after Potnal PHC was vandalized. These cases are being planned to be presented at a public meeting in the PHC premises in April in an effort to build a public opinion to protect the PHC and seek a public commitment from the local leaders to prevent any such attacks in the future.
Campaign Against Privatisation of Health Care
Jagrutha Mahila Sanghatane, Potnal
Protest in front of Potnal Primary Health Centre, Raichur
On 1st August 2013 Jagrutha Mahila Sanghatan Potnal led a protest against absence of doctors and critical staff at Potnal 24X7 Primary Health Centre. Even as the World Bank supported construction of a new PHC building was nearing completion and inauguration was being planned, 200 women from various sanghas fore-grounded the issue of a maternal death in the PHC and drew attention to the vacancies of doctors, lab technicians, pharmacists, ASHA workers and ANMs in the PHC and that an empty building without staff was a sham, an eye wash which was taking a toll on the lives of poor working class dalit women.
Participation in People’s Health Movement:
The People’s Health Movement was started in the year 2000 at the backdrop of the failed promise of Alma Ata Declaration -1978 summarized in the phrase ‘Health For All by 2000’. In the mobilization that happened in Karnataka JMS was a part. As a part of reflecting upon the health situation of Dalit Communities two small enquiries were undertaken with the support of Community Health Cell, Bangalore. One, accessibility of Dalit Children to Anganwadis and the second, the accessibility of primary health care services to Dalit communities in Primary Health Centres. JMS representatives than participated in the first State Health Assembly at Davangere (November 2000). Ms. Mita Deshpande, represented JMS at the first National Health Assembly at Kolkotta (December 2000). JMS also participated in the second state health assembly organized in Bangalore in 2005. From the year 2005 the active participation of JMS in the Karnataka State Circle of PHM, i.e. Jana Arogya Andolana Karnataka (JAAK) increased. JMS has been one of the active people’s organisaiton in the Right to Primary Health Care Campaign in the district of Raichur. Besides, JMS was the (Manvi) Taluka Nodal organization for the Community Monitoring and Planning pilot project during theyear 2008-09. The CMP was piloted in 4 districts of Karnataka (Chamrajnagar, Tumkur, Gadag and Raichur). CHC was the nodal organization for the Raichur district in Karnataka and it was implemented in the district in partnership with Roovari (Raichur), JMS (Manvi) and Samuha (Deodurga) in Raichur district.