Next-door clinics make healthcare affordable -Paras Singh & Mohammad Ibrar

-The Times of India

NEW DELHI: The so-called mohalla clinics, or neighbourhood health centres, are an important part of the ruling Aam Aadmi Party’s electoral campaign. AAP had promised 1,000 across Delhi, but opened just 189 till December last year, attributing the failure to start the rest to bureaucratic hurdles. TOI visited eight mohalla clinics in north, east and central Delhi to find that while patients were mostly satisfied with the services, some shortcomings were still to be overcome.

At a mohalla clinic, medicines, tests and consultations come for free. According to Delhi government’s outcome budget, 212 diagnostic tests are available at the clinics, though on average just eight are done daily and around 100 patients are looked after at each clinic in a day. At Patparganj in east Delhi, Dr Preeti Saxena told TOI, “I am already done with 90 patients and the day is far from over.” Tarunchand Chauhan, a Multi-Task Worker (MTW) at Ashram in south Delhi, disclosed that most patients come for basic ailments for which they earlier had to budget time and money at a private doctor or a dispensary in another place.

Mahmood Khan, 62, a resident of Batla House in south-east Delhi ailing for some years, finally found relief three years ago when a mohalla clinic opened near the flour mill in Ashram where he was employed. He has a meagre salary and the medical costs were eating into it. The mohalla clinic has left him happy and he told TOI that he now gets free Metaprolol tablets, which he earlier bought for Rs 120 per box. This is money that people like him in the lowest economic classes can ill afford to spend on medicines.

At the Geeta Colony clinic in east Delhi, Rajender Pratap, 44, said that they had to earlier go to the Budhh Bazar municipal dispensary. “The permanent feature of that dispensary was a lengthy queue,” Pratap recalled. “This facility closer home saves us time and money on travel.” Another patient, Surya Chakraborty, a temple priest, said that he now brings his family to the facility regularly. “It was here that I tested positive for diabetes,” he said. The priest gets regular sugar tests done at the clinic and saves on the Rs 200-300 it would cost him elsewhere. “I also get my Glibenclamide tablets for free at the clinic. I used to pay Rs 50 for them each time,” he said.

Gayatri Devi, who lives opposite the rented flat housing the mohalla clinic at Ganesh Nagar in east Delhi, was glad to have a healthcare facility nearby. “Earlier, I had to take my children to Pandav Nagar which has the nearest government dispensary. Like me, many others here can’t afford private clinics,” she said. She was also happy that a lady doctor sat in the clinic, easing health discussions for women of the locality. In fact most praise for the clinic came from women who could now access safe treatment close to their homes.

The proximity to clinics has helped people avoid worsening of health conditions in time. Urmila Devi, 60, suffered frequent muscle cramps and weakness until the new mohalla clinic in her locality identified her problems as thyroid deficiency and provided her free medicines. Similarly, Mohammad Mursheed, 55, a tailor of Yamuna Pushta found out that his breathlessness was due to asthma. “I was using traditional medicine, but with the clinic barely a few steps from my home, I started getting free treatment there,” Mursheed said.

The patients did point out some of the problems they faced at the clinics. Gayatri Devi pointed out that the clinic at Ganesh Nagar had three small rooms to cater to over 100 patients every day, so there is no waiting room, and the rainy season can be challenging for visitors. The thin manpower can also chafe. “Because there are no guards, we usually depute 4-5 staffers to handle the crowds,” said a doctor. Shishupal Singh, an east Delhi student preparing for the civil services exam, grumbled that the clinic employees were brusque and arrogant, little realising that this could be due to the staff being burdened with extra responsibilities than contracted for.

The mandatory requirement of an Aadhaar card for tests at mohalla clinics can be a pronounced problem in certain places. The Hanuman Mandir clinic near Yamuna Bazar caters mostly to the night shelter there. Rajesh Singh, caretaker of the shelter, said that 90% of the inmates are substance abusers and so are wary about revealing their identities. Nain Kumar, overhearing the conversation, added, “Only zukham-bukhar are treated here because you don’t require Aadhaar for these.”

Doctors, who are contracted to run the clinics and are paid Rs 40 per patient, talked of administrative shortcomings, including shortage of medicines and delayed salaries of technicians and helpers. “I have hired two MTWs and pay them on my own because their contract was not renewed,” disclosed a doctor in an east Delhi clinic, requesting anonymity. Despite these drawbacks, mohalla clinics, praised by former UN secretary general Ban Ki-Moon, can systematically reach healthcare to the urban poor and the concept is being replicated in states like Andhra Pradesh, Karnataka and Telangana.
 
The Economic Times, 21 April, 2019, please click here to access

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