S R Pareek
Ratlam (Madhya Pradesh): Sunita Patidar of Jaora town believes that regular intake of kadha (a herbal decoction) has kept her out of harm’s way when COVID-19 peaked. So impressed was she with the medication that she decided to rely only on ayurveda for any future treatment.
So when she developed a cold and cough a few days ago, she headed to the AYUSH hospital in Jaora, located 30 km from Ratlam district headquarters, in the hope of getting some relief. Much to her dismay, neither a doctor nor a compounder was present. Two days later, she managed to meet the compounder, who informed her that medicines were not available. She had to return empty-handed, still sick and coughing.
As many as 39 AYUSH centres are there in Ratlam district, but most of them function in the same fashion as the hospital in Jaora does. In the state Budget for 2023-24, a total of Rs 342 crore was allocated for AYUSH hospitals and dispensaries. One look at any of the centres in Ratlam, and it becomes difficult to understand where all the money is going!
‘Fully-functional’ clinics are locked up or ‘ailing’, when the core idea of establishing them under the Central government’s National AYUSH Mission (NAM) is to promote and develop traditional systems of medicine and healthcare, including ayurveda, yoga and naturopathy, unani, siddha and homeopathy.
Compounder Keeps Dispensary Afloat
A compounder runs the AYUSH hospital in Jaora from a nearly 80-year-old building that leaks when it rains. The place has a musty smell and the frayed wires keep one in permanent fear of fire and electric shock.
When 101Reporters visited the place, there were about 10 patients at the hospital who were attended to one by one by the lady compounder. She is the one and only person who works here, though the hospital has two sanctioned posts of doctors to cater to a population of 75,000 in the Jaora Assembly constituency.
Two sanctioned posts of female AYUSH health workers also remain vacant, with one transferred and the other attached to the Collector’s office. There are two chemists at the dispensary, sitting before the empty shelves awaiting medicine stocks that hardly arrive.
District AYUSH Officer Dr Balraj Singh Chauhan admitted that compounder Anita Vyas only treats the patients coming to Jaora hospital.
“Yes, there is a shortage of doctors. But the compounder consults with the district doctors before giving medicines,” he claimed.
A medical compounder is like an assistant to a doctor with practical knowledge of dispensing drugs. They are health professionals, but do not have the power to prescribe medicines. Meanwhile, the patients treated by Anita claimed they have never seen her consult any doctor!
Likewise, the AYUSH Department-run Ayurveda hospital in Hatnara village of Ratlam is also dependent on the compounder.
“The hospital has approved posts of a doctor, compounder, women health workers, pharmacist and a part-time sweeper. Of them, doctor and health worker posts are lying vacant,” compounder Anil Mehta told 101Reporters.
The building is in such bad shape that the hospital now operates from two rooms of a village school, after the panchayat took necessary steps to shift the facility.
Having a building, however, does not mean everything will operate smoothly. When this reporter visited another dispensary in Nagra village, located 5 km from Ratlam city, it was empty.
A woman rushed in after 15 to 20 minutes, saying she was in charge of cleaning. Two gunny bags found lying inside the dispensary had medicines in them. Those responsible for maintaining the stock had not even opened and sorted them.
As per records, a doctor, compounder and chemist were appointed here. The out-patient department register did not have any entry after March 29, the last record was about the visit of 13 patients to the dispensary. Surja Ram, a villager, claimed that doctors and compounders are mostly unavailable.
37 Needed, Just 7 Available
At present, only seven ayurveda doctors work under the AYUSH Department in Ratlam district against the sanctioned 34 posts. Similarly, only five of the total seven community health officers are in service.
“We will appoint more doctors across the state soon. The recruitment process to select 710 doctors is on,” said Dr Chauhan, when asked about this severe staff shortage.
During a recent visit to Ratlam district for audit purposes, Divisional AYUSH Officer Jyoti Panchal had ordered that drugs should not be dispensed without consulting a doctor. Ironically, most of the dispensaries in the district — Khajuri Deora, Semliya, Madhopur, Asawati, Upalai, Naugaon Kala, Riyawan, Rattagarh Kheda, Umran, Malwasa, Birmawal, Talod and Kelkachh, to name a few — are run by Class IV employees who do not have the authority to prescribe medicines.
“The district AYUSH officer says if the patients are not treated, then class IV will not get any salary. If we give medicines, action will be taken against us. If we do not, then also our fate remains the same. The shortage of doctors is really affecting us,” a Class IV employee said on condition of anonymity.
Budget Allocation
The AYUSH Department does not seem to be in need of funds, if the state Budget announcement is taken into account. Of the total Rs 5,608.63 lakh provided under the NAM in 2020-21, the government spent over 90% (Rs 5,142.49 lakh). Of the Rs 3,123.80 lakh sanctioned in 2021-22, Rs 2,575.19 was utilised. The allocation rose to Rs 11,441.78 lakh in 2022-23, of which 82% was utilised.
Ratlam district too allocates a quarterly budget for the AYUSH Department. Recently, the department organised special camps for women, with a set budget of Rs 40,000 per camp.
Not just the local dispensaries, even the AYUSH wing in Ratlam city has been sequestered in such a way that most of the patients are unaware of its existence.
(SR Pareek is a Ratlam-based freelance journalist and a member of 101Reporters, a pan-India network of grassroots reporters, where this article was originally published)
