With the health facilities inaccessible to the people living in the rural areas surrounding the National Capital, patients have no option but to travel around 15-25 kilometres for medical care at the urban areas in emergencies. In this situation, imagine what a woman at an advanced stage of pregnancy would go through in case of labour pain at odd hours as most of the hospitals close their maternity services by evening.

Since government health facilities with maternity services are closed during night, where would a pregnant woman go for safe delivery?

Roadside delivery
“Poor health facilities in the villages and adjoining areas of Delhi are a major cause of roadside deliveries or deliveries in vehicles,” says a doctor from a Delhi government hospital.
According to a source in the health department, in the last two weeks, two incidents of roadside delivery have come to light. One of the two incidents that took place in the Jahangir Puri area resulted in stillbirth.

Case 1
A few days ago, a pregnant woman residing at Najafgarh’s Ranaji Enclave of the Nangli Dairy area had labour pain. Since the gynaecology department of the hospital in Najafgarh was closed at that time, the family decided to take her to the Safdarjung Hospital in an ambulance, which is about 22 kilometres away from their village. However, she couldn’t sustain the labour pain and delivered in the ambulance with the help of ambulance staff.

Case 2
In another incident, a pregnant woman living in Jai Vihar of Najafgarh was taken to Rao Tularam Memorial (RTRM) Hospital with labour pain. She was getting treatment at the same hospital. However, due to lack of facilities, the emergency department referred her to Deen Dayal Upadhyay Hospital. However, on the way, the labour pain increased and she had to deliver in the ambulance itself with the help of ambulance staff.

Onus on administration
The Government of Delhi, Municipal Corporation of Delhi (MCD) and the Central Government are responsible for providing health facilities to the people of the National Capital. The villages that come under Delhi are situated in and around Kapashera, Rajokari, Najafgarh, Bawana and areas in Rohini where three big hospitals of Delhi government are located. These are: Rao Tularam Memorial (RTRM) Hospital, Satyavadi Raja Harishchandra (SRHC), and Maharishi Valmiki Hospital.
Crores of rupees have been spent on building the hospital, yet these health facilities lack basic medical care. It is because these hospitals over the years have been reduced to mere dispensaries.
Apart from this, more than a dozen government dispensaries of the Delhi government and the MCD are also present in the areas, but all lack proper health facilities.

Gynaecology departments close early
Many departments in the three major hospitals of Delhi, namely RTRM, SRHC and Maharishi Valmiki, remain closed during the night. Women visiting these hospitals for delivery are generally referred to the hospitals located in the urban area due to lack of facility for their treatment.
According to a government hospital source, there is a shortage of senior resident doctors at the hospitals. Apart from the shortage of doctors, there is a lack of facilities related to surgery, blood banks, and ICU in the hospital. Moreover, the ultrasound machines are not in working condition. Due to lack of primary facilities, the administration is forced to close the departments in the evening.

Referrals
In case of an emergency, patients from Narela and Bawana are referred to the Ambedkar Hospital located in Sector-5, Rohini. The distance from Narela to the Ambedkar Hospital is about 23 kilometers, whereas the distance from Bawana to the hospital is about 12 kilometers. However, the distance from Najafgarh to the DDU Hospital located at Harinagar is about 25 kilometers. Covering the distance in an emergency, especially for a woman in labour, is a difficult proposition.

Lack of ambulance service
It is also being informed that there is a lack of proper ambulance services in many of the hospitals in Delhi. This is why, patients from these hospitals are sent to urban hospitals either by private vehicles or with the help of CATs ambulances.

What do the locals say…?

Krishna Prasad, a resident of Bawana said that the government spent crores on construction of Maharishi Valmiki Hospital. However, neither a sufficient number of doctors are present in the hospital, nor medicines and tests facilities are available. ICU and CCU facilities have been closed since COVID epidemic. Rakesh Sharma, a resident of Narela said that the ultrasound facility in Satyavadi Raja Harishchandra Hospital is closed. The Gyne department gets closed in the evening, because of which the pregnant women are bound to go to other hospitals.

Doctor’s dilemma
Dr. SK Kakraan, Medical Superintendent, Maharishi Valmiki Hospital, said due to lack of ICU facility in the hospital, pregnant women are referred to another hospital to avoid trouble for the patients in emergencies. Soon, the Mother and Child Care Unit are going to start at the hospital which is going to solve the problem.
Dr. Amitabh Bhasin, Medical Superintendent, RTRM Hospital, said there is lack of senior resident doctors at the hospital due to which the women and maternity department is facing problems. Moreover, there is no ICU at the hospital. This too is the reason why patients are referred to other hospitals in the evening.