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Medics avoid tribal areas: Maharashtra tells High Court

Jul 04, 2013

A Public Interest Litigation on malnutrition has exposed poor medical coverage in the western Indian state.

The government of Maharashtra today informed the Bombay High Court that there was a paucity of doctors for postings in the tribal areas where malnutrition is rampant.

An incentive to offer 20 per cent additional marks to medical students for pursuing further education if they were to take up such postings has not worked, the state’s government has contended.

While the centrality of doctors in promoting proper nutrition might be debatable, the government’s inability to promote medical care in the tribal areas of the state flies in the face of plans for universal health coverage across the country.

Experts argue against using medical doctors for addressing malnutrition, especially as the ends are  best served through a host of other actors like ASHA workers or ANMs or schemes like the mid-day meal,

The government’s counsel informed that a third of the posts for doctors remained vacant, provoking questions why the positions remained vacant and if resorting to interim arrangements by bringing doctors from nearby rural hospitals was at all helpful.

"Why don't you people fill up these posts?" Justice D Y Chandrachud and Justice S C Gupte asked, saying that the court was alive to the difficulties faced by poor people dependent on the rural hospitals.

The government has expressed its inability to recruit specialists to fill up the posts in the tribal areas of the state, arguing that doctors signing the bonds for service were refusing to go there and have moved court challenging such postings.

The court observed that this was happening despite much money spent by the government on doctors signing such bonds so that they pay back to society by serving such underserved areas.

The government’s statement came as the Maharashtra Hight court was hearing a PIL filed by Purnima Upadhyay, seeking proper implementation of schemes intended to curb malnutrition in Melghat and other tribal areas of Maharashtra.

The court was told that there was no coordination between various departments like the Women and Child Welfare, Public Health, Tribal Development and Medical Education.

The judges responded with a suggestion to constitute a core committee with a nodal officer to take care of the issues in tribal areas.

The High Court had earlier reprimanded the government for its lackadaisical approach and warned that contempt notice will be issued to the secretary of Public Health department if concrete steps were not taken within two weeks.

However, the court expressed satisfaction today saying that at least some progress has been made.

The court also asked the state to give details about constitution of a committee to consider the issue of doctors signing bonds to serve in rural/tribal areas.

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