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'I was denied medical services': Buxar woman who delivered stillborn alleges religious bias

Updated : May 07, 2020 06:30 PM IST

It has been over a year since the Buxar district hospital had a functional ultrasound machine

ASHA worker Aamna has complained to the Dumrao Deputy Development Commissioner about the discrimination Sunaina had to suffer

In peak labour pain, 22-year-old Sunaina Khatoon (name changed), had to wait over 10 hours and travel 60 kilometres in two stages in Buxar district for her first delivery. But the delay on account of two government hospitals turning her down, and the lack of private centres because of the COVID crisis proved fatal for the foetus.

As her labour pain started around 3 am on April 29, Sunaina accompanied by her aunt Salima, travelled 10 kilometres to the nearest primary health centre in Simri block, only to be referred to the Buxar district hospital 20 kilometres away.

The family alleges religious discrimination at the PHC, saying the hospital staff did not even examine Sunaina to check the possibility of a normal delivery there.

“We were first made to wait outside for a long time,” said Salima.

“The nurse, on knowing our religion, asked us to stay away saying we would spread coronavirus. Despite our requests, we were rudely told to go to Buxar, without any examination,” she said.

Sunaina’s labour pain was aggravating. Since an ambulance was not available, the family hired an auto rickshaw and travelled another 20 kilometres to reach the Buxar district hospital. Another harrowing experience awaited them there.

The medical staff asked for blood tests and an ultrasound. The blood tests were performed, but ultrasound was a problem as the Buxar district hospital did not have a functional ultrasonography machine. Patients are required to bring their scans from private centres outside.

Since most diagnostic centres in the vicinity were closed, the family was unable to get an ultrasound. “The doctor refused to attend to me without the ultrasound scan,” Sunaina told CNBC-TV18 over phone.

Most private hospitals were either closed or unaffordable. “We lost time in finding centres, I was in tremendous pain,” Sunaina said.

Health centres in the Buxar and Dumrao blocks, including the Dumrao Community Health Centre, were closed for non-COVID patients.

So the family rushed Sunaina to a private clinic 30 kilometres away. It was almost 10 hours since Sunaina had started from her house for the delivery. At the private clinic, she delivered a still born baby, the victim of denial and delay in medical care.

Sunaina has been in depression ever since. Her husband, a daily wage labourer in Hyderabad, has not been able to make it back to the village due to the lockdown.

Buxar district has 56 COVID-19 cases so far and the administration has shifted focus to containment of the virus with a just a barebones health infrastructure to fall back on. 26 COVID patients till now have been discharged.

For a population of 1.7 million people, Buxar has around 300 public sector hospital beds spread across 7 PHCs, 4 community health centres, a sub-divisional hospital and a 100 bedded district hospital, but no government-owned ultrasound machine, let alone super-specialty care. Scores of small private hospitals, nursing homes, and diagnostic chains have sprung up to fill the void, but most of them stayed shut during the COVID crisis. The situation of private facilities is similar across Bihar, according to State Health Secretary Sanjay Kumar.

No functional ultrasonography machine

It has been over a year since the Buxar district hospital had a functional ultrasound machine.

Incidentally, Union Minister of State for Health Ashwini Choubey is an MP from Buxar. During his visit to the district six months ago, he had to face angry protestors over lack of healthcare facilities and ultrasonography machines in the state-run hospitals.

After multiple rounds of protests, an ultrasound machine was procured early this year. However, the department has no radiologist or technician to operate it.

“We have been facing this problem for almost a year. We have requested for a radiologist, but with the COVID crisis, we have not been able to process the hiring,” Civil Surgeon Dr Usha Kiran Verma said.

On the specific case of Sunaina, Dr Verma said an enquiry was being conducted.

“We have not got the time to look into the matter in detail. We are still gathering information on why the delivery was not performed at the district hospital. We have got other similar complaints,” Dr Verma said.

Other cases, where patients have been asked to procure an ultrasound report from private diagnostics, or refused delivery owing to no scan, have been registered.

Dr Upendra Kumar at the Aditya Emergency Hospital in Kesath, who performed Sunaina’s delivery said the baby could have been saved if the mother had received timely medical attention. Her last ultrasound report done 15 days ago showed a healthy baby and signs of a normal delivery. “When she reached my clinic, the foetus was already dead, a foetal sound check revealed. Jerks while travelling in the auto rickshaw and delay in getting care could have caused the loss,” he said.

Communal discrimination at PHC

Aamna (name changed), an ASHA worker in Simri block said since the spread of coronavirus from the Nizamuddin Markaz, there have been instances of discrimination against women from the Muslim community. Pregnant women have been the first victims, she says.

“For the last 10-12 days this has been very clear,” she said.

“None of the Muslim women are attended to at the PHC. Doctors and ANMs (auxiliary nurse midwives) don’t even see the patient to decide how critical the case is. They just ask the name and if the patient is Muslim, they refer it.”

Aamna says another Muslim woman she had brought to the PHC for delivery on April 23 faced a similar ordeal.

Chandni, a 25-year old, who was in active labour, was not allowed entry into the PHC after her name revealed her religion. Aamna says since the woman’s water had broken and the delivery needed to be performed at the earliest, they hired an auto rickshaw for Rs 400 and approached private clinics in the area, most of which were shut.

One of the private clinics agreed to deliver the baby for Rs 12,000. “That’s a huge amount for a poor family. The family struggled to arrange the money and paid it in parts. But at least the baby was safe,” Aamna said.

Aamna has complained to the Deputy Development Commissioner, Dumrao about the discrimination Sunaina had to suffer.

“If it was not true why will I risk myself?,” Aamna said.

Investigations on

Arvind Kumar, DDC, Buxar said he had received some complaints. “These matters are being looked into by the Civil Surgeon and the Program Officer,” he said.

Prem Chand, manager at the Primary Health Centre in Simri Block, Buxar said referrals were only of those patients who had a complication. However, he could not conclusively ascertain the reason for the referrals of both Sunaina and Chandni.

In April, 122 deliveries had been noted in the PHC register according to Prem Chand. Of these, six deliveries were of Muslim women, he told CNBC-TV18 over phone.

But the investigation of this matter has been slow as the administration’s emphasis is on dealing with the COVID-19 crisis first.

Santosh Kumar, District Program Officer of Buxar district, who is heading the enquiry said, “In the initial enquiry, the PHC staff said other Muslim women have delivered in the PHC in last few days. May be this was a one-off case or the manner of referral was not proper. We are still investigating,” he said.

Another similar complaint about denial of medical services based on religion has been received from the area and is under enquiry. Santosh Kumar said there was a general sense of scare of COVID-19 among people and healthcare workers. Shortage of personal protective equipment have added to the fears, he said.

“These instances are happening around the country. We also have to be sensitive to the healthcare staff that is reporting to work,” he said.

Another ASHA worker in the area also mentioned similar experiences. “Even when we go for door to door COVID-19 surveys, many people refuse to talk to us. Some are scared of revealing their symptoms and fear being sent to isolation wards. But many cover their faces when they see us, saying you are a Muslim and you will spread coronavirus.”