Ladakh: 39-year- old Deachen Dolma, who hails from Ma-chu village of Ladakh’s Lingshed region, was six months pregnant when she was diagnosed with a condition called ‘oligohydramnios’ or low amniotic fluid.
Her baby died in the womb. Deachen laments, “I got jaundice when the baby was due. I couldn’t deliver the baby at home. I was taken to Leh on animal via Sumdo which takes around four hours from Ma-chu.”
Deachen’s is a tragic tale, but it is not hers alone. The Charkha Development Communication Network feels that it is a tale of the region, a terrain that is windswept, remote and difficult to access not only by visitors, but even for the locals.
In order for pregnant women and their families to access reproductive health services, the distances are daunting.
To add to the distress, the facilities available are in a sorry state.
Block Medical Officer (BMO) Diskit Dolma says, “When we visited villages in summer 2015, delivery rooms in some villages were in bad condition. Not a single doctor has visited the place.”
The facilities for deliveries that the sub-centres are supposed to provide are not available.
The community members lack faith in the capabilities of the sub centre staff. For instance, even though ante-natal services are provided at the centres, most women prefer going to the PHC at Lingshed.
Here too, things are far from satisfactory. There is no medical supervisor or doctor at the PHC. The remoteness compounds the existing problems of service delivery in core health services in maternal health. For a woman to be brought from Youlchung village via Khupa-La (Khupa Pass) to the PHC, it takes around an hour and a half on foot, covering a distance of 17 kilometres.
From villages further down from Khupa La, such as Skumpata and Gongma, it could take slightly less.
Distances also prevent frontline health functionaries, the ASHAs and ANMs from participating in training sessions organized by the Department of Health and Family Welfare in Ladakh.
The ASHA worker at Photogsar village says,” Letters sent to us by the Department do not reach us on time. There is no bus service to the village; private taxis do not ply either. Even communication through Digital Satellite Phone Terminals (DSPT) is erratic due to network problems.”
“Not having a road is the biggest challenge. We have pucca road only till Wanla village. After the Public Works Department handed over the task of road-construction in 2011 to General Reserve Engineer Force, a 10 km pucca road was constructed but got washed away in recent floods. A pucca road to Lingshed is still a distant dream,” he adds.
Deachen says they have to face a lot of difficulties in winter when the roads are closed.
“During an emergency, community members first contact the BMO who informs the Chief Medical Officer (CMO). The CMO takes it forward to the Deputy Commissioner of the district who then formally conveys to the Air Force that a helicopter is required for ferrying the sick to District Hospital, Leh,” she adds.
This system too has loopholes as the helicopters cannot fly in cloudy weather.
“Due to these hardships we prefer taking the pregnant woman to Leh and staying there before the road gets closed during the winters,” says Sherab Dolker of Skumpata village.
The remoteness act as a deterrent even for the medical staff posted in the region.
Arguably the odds that are stacked in a region like Ladakh are high. According to Dr. Tsering Norphel, Deputy CMO, Leh district, infant mortality rates and maternal mortality rates are higher in remote areas.
The extreme weather conditions, rough terrain, poor road and digital connectivity make it extremely hard for service delivery – especially in regions that are on the margins of development and accessibility.
Yet this precisely is the challenge that the authorities must face up to. This is where policy attention, resources need to be focused – so that the precious lives of infants and their mothers living in these areas are not lost. (ANI)