The only hope during any health problem of the tribals living in the remote villages of Sunabeda panchayat in Nuapada district is an ASHA worker. A PHC is supposed to cater to the people of the 52 villages of Sunabeda and Soseng Gram Panchayats located inside the Sunabeda wildlife sanctuary in the district. A doctor, one pharmacist and an ANM have been posted in the hospital, but no one likes to stay there because the area is considered to be Maoist-affected.
Banita Naik gave birth to a baby 11 months ago, but she is yet to get support under the Mamata scheme. Kasturi Bag has also not got the benefit under the scheme although seven months have passed since the birth of her baby. There are many others —Chanchala, lalita, Indumati, Gotri, Rosanti, Triveni, Jaimati and Suka etc, a total of about 50 women of Sunabeda and Soseng Gram Panchayats, who have registered their names with the Anganwadi worker (AWW) for support under Mamata but unfortunately have not yet received the payment.
There are also women who were not allowed to even register their names. Nrupati, now mother of a six-month-old baby and her sister Gomati, a mother of a one-year-old baby, were not allowed to register their names for the Mamata scheme. “We requested the AWW to register us when we were pregnant, but the AWW did not care,” say the sisters.
There are more than 50 such tribal women in Sunabeda and Soseng Panchayats of Nuapada district, who are either pregnant or lactating and are eligible for the financial support under Mamta scheme, but have been deprived of the benefit.
Mamata scheme was floated by the State Government in 2011 as a conditional cash transfer scheme to enable mothers to compensate for some wage loss and get adequate rest and nutrition and also to incentivize positive health seeking behaviours like immunization and appropriate child feeding practices etc. It is meant for pregnant and nursing mothers in rural areas during their first and second pregnancy, where the first installment of Rs 1,500 out of the total incentive of `5,000 is given in the sixth month of pregnancy if the women register their names in the Anganwadi Centre and get immunised.
The other installments are given in due course, when the women fulfill certain conditions like immunisation and adoption of breast feeding practices etc. But due to negligence of the service providers of ICDS and health departments, the women of these remote villages are deprived of their rights.
“We have submitted all the required forms and documents, even the bank account numbers, to the ICDS office, but no action has been taken,” say the ASHA and AWW of Sunabeda village. “We do not know, what the cause of the delay is,” they add.
Santara Bhunjia is the ASHA of Sunabeda village. She has given the list of 10 lactating women to the ICDS office of Komna during last one year along with all the required documents for release of support under Mamata, but the women have not received any support. “My daughter-in-law was one of them, she was registered for the Mamata scheme but never got the support,” says Santara. “She was very week during her pregnancy. The baby died just after birth in the hospital. The doctor said that the water of the womb had been drained, which caused the death of the child,” said Santara who had shifted her daughter-in-law to the CHC of Komna, covering a distance of 34 km ghat road from her village, for safe delivery but failed to save the life of the child. Had the lady been supported in time, she would not have lost her first child. 90 per cent of the pregnant and neo-natal women in Sunabeda area are low weight and anemic.
The only staff of the PHC of Sunabeda staying in the village is attendant S Majhi, who is a doctor cum pharmacist for the people. He even attends to home delivery cases when the ambulance does arrive to take women to the Komna CHC.
“I am also facing a lot of difficulties due to non-availability of medicines.” says Majhi.The headquarters hospital in Nuapada has not issued medicines to the Sunabeda PHC for several months, hence there is a shortage. Majhi is not authorised to take the medicine from the headquarters and the pharmacist who is authorized has not turned for more than a year.
Some of the women are fortunate enough to be admitted to the CHC at Komna for institutional delivery of child and thus have got supports of Rs1, 400 under Janani Surakshya Yojana (JSY). A total of seven such women of the village Sanbaheli under Sunabeda Gram Panchayat have got the support under the JSY as they were admitted in time in the CHC.
But, nine others who could not be admitted to the health centre due to lack of transport were deprived of the benefit of JSY. There are posters of 108 ambulance services in every village but no one has benefited from this.
Khadang, Datunam, Jalmadei, Dhekunpani and Siletpani etc. are some of the villages on the plateau, where the women are the most unfortunate and deprived of basic health and nutrition facilities. None of them has visited any health centre. They do not take any medicine even during their pregnancy. As there is no Anganwadi centre in their villages, they are even deprived of the supplementary nutritions. This might be resulting in more number of maternal and child mortality. As there is no independent study of this situation in this area of Nuapada, it is not possible to assess the real situation.
“We can only guess that the situation might be grim in Sunabeda as there is lack of health facilities in the area,” says Udit Panda a social activist. The delay or exclusion in Mamata scheme is not limited to the interior pockets of the district, it also happens in villages which are located very nearer the CHCs. These villages are not even in any conflict zones like Sunabeda, Sudhansu Naik , a social activist says. There are five to six such cases of exclusion in every village. In Maharajore village of Boden block, five women did not get the benefit last year.Four women of Kusumkhunta and Mahulpadar villages of the block did not register under the scheme also.