Report of State Health Assembly, Odisha

The State Health Assembly started with the welcome address of Sri Ajaya Tripathy eminent public health expert of State JSA. Gournaga Mohapatra, Convener JSA, Odisha presided over the inaugural session and briefly presented the objective of the Health assembly and how the JSA born and it’s journey from 1999 to till date. He also informed the participants about the activity undertaken by Odisha JSA to make health for all.  Dr. Madan Mohan Pradhan, Deputy Director Health, Government of Odisha the chief speaker of the programme who has been closely associated with Jan Swasthya Aviyan from the beginning requested to gave the keynote address and set the context of the assembly. He spoke about the initial days of public health movement why it came and how people voices need to raised for appropriate health care.  Government both centers and state have been focusing on schemes. They have been forgetting about comprehensive health care to all. NGOs are becoming project oriented. Projects and funds are necessary but it is not that when they don’t have funds withdrawn from the place saying we have no more funds. That’s like suicidal. In that way, NGOs are doing more harm to the people. NOGs are also working vertically they confined within their project and programme. If they haven’t see the health, education, environment, livelihood in an interrelated manner or never raise the voice in the proper manner and proper time then it will not be possible to stand health for all. Health is not confined with 3Ds (Dieses, Doctor, and Drug). NIRAMAYA needn’t considered as free medicine scheme of Government that is comprehensive health. Each people of the state should live with a healthy life physically, mentally and spiritually. To have that we as a group have to raise the felt health need of people before concerned authorities. For that a strong movement is required and for movement evidence is essential. If the free medicine scheme launched and there are sufficient medicines procured and supply we then have to understand why and how the chemists’ shops are grooming. There is the visible and invisible cause behind every outcome. So, if out of pocket expenditure of common men is increasing then we need to realize what happens underneath. For that, we need to study on that point. Its’ may take as one instance. Certainly, there are ‘N’ number of issues we need to work. India has the unique feature of fighting against growing NCD and communicable diseases those are not inclined to go away. So the double burden has the serious impact on the society as a whole. India is in the bottom line of countries investing in health which is merely one percent. And we can’t imagine with meager on percent the dream like health for all.

Tusharkanti Ray senior Public Health Expert told its’ contrary that we have been shuttling between the logic of preventive and curative health care without thinking about the determinants of health. When a small neighboring country can able to give own people the best primary health care and education why not India. WASH, education, road, communication, nutrition, livelihood, environment along with the drugs, doctor, and disease combined form health. So, health can’t think in isolation and we can’t close our eyes to the vicious circle of profit, corruption, exploitations in healthcare sector contributed an increase of poor to poorer population.

Dr. Rashmi Ranjan Satapthy, Joint Director Public Health, in his address told he is coming in a short notice and prior to this occasion. He is the State nodal office or non-communicable disease. Out of pocket expenditure increased in non-communicable diseases. Government is all set to introduce an AAP so that patient can know where the service facility is available. Very shortly population base screening will available at people’s point. TB and other lifestyle diseases will be identified in a early stage and treatment can be start immediately.  The timing and facilities everything can access by the patient. There is a huge information gap. In 22 urban PHCs of doctors, medicines and other services are available but people are keeping coming to Capital Hospital. In that way they are losing time, money in travel and increasing caseload in Capital Hospital also hampered the service. He promised for all king of support to JSA in future.

Dr. Amit Sengupta told health is our right. It should be the country agenda. Health should get the prominent place. Fact is that malnutrition children are getting diabetes and hypertension at a very tender age. Jan Swastha Aviyan is not only isolating from basic facilities like livelihood, food, nutrition, drinking water, cleanliness etc. Man is not a beast and no man like to live in the filthy place if the situation is not forced on them. But our tendency is victim blaming. Illiterate and uneducated people are not idiots. People need to live with dignity. Giving medical services may help to give health 10% but 90% of health depend on health determinants? Government is emphasizing on maternal health and that also begins when a female conceived. What about women health? What about last 20 years before she gets married? What is primary health institution? Where are 24×7 services? The ASHA and Anganwadi workers are the primary caregivers in the rural pocket. Private health service is becoming the part and partial our life. There is a time when doctors were opening the clinic but today anybody can open a hospital. Tractor Company started Escort Hospital. There is no law to restrict. Doctors are nothing but one part of the entire private health system. Mow Health service is purely commercial. In corporate system, Doctors are nothing but servants to fulfill the quota or target given to them in a month by the owner. In India, people are spending money from their pocket from private health care. We are calling it 70:70 paradoxes. 70% of out of pocket money spending in private healthcare and out of that 70% spend on medicines. Treatment is becoming a market policy. The first session came to an end with vote of thanks given by Bijayalaxmi Rautaray.

Second session started with an open house discussion. The representative of different district raised their health issues and sharing the experiences with different field level intervention and solution.

Ashutosh Mishra, from Dhenakanal told the members of Rogi Kalyan Samiti haven’t the knowledge about RKS and most of the members are unaware about the membership in the committee. Huge corruptions are going on of RKS fund at field level. So for better utilization of the fund committee members should be sensitize and capacitate. Chinamayee Pattnaik of Koraput shared, they have a study on adolescent girls. Out of 400 adolescent girls of the age of 11-14, not a single had normal hemoglobin level. Strangely girls living in residential schools are 56% anemic. Where in the red level 39% of girls from residential school are identified them out of school living in villages have 19% in red grade. Why girls are the residential school not only for education but their health should be lookout. Residential schools need to intervention on proper health care to increase the hemoglobin level. They have introduced drumstick plantation among 400 households in association with Horticulture department. The result is very good. People are no more interested to give leaves to others because they are telling our female members needs more so they will no more anemic. Her suggestion was to improve adolescent health intervention is very essential.

The representative from the RARE Mr. Nagi, told whatever government introduced should give regularly. They are giving three months then another three months a gap. It may be sanitary napkin in Khushi programme or Chhatua programme(take home ration). Meghana Sahoo representing the transgender community told nobody is telling about the third gender. They are more discriminated against than a female. Counselor needed to normalize the mental pressure on a transgender. Proper health and sanitation related counseling are needed. In the hospital form, there is no place for transgender. Even the doctor also doesn’t know about the health problem of transgender. One doctor inserted a cathode tube in urine intact of the implanted vagina of a transgender. Within I month two transgender commit suicide and two murdered. What about other. Transgender health should be in the medical education as most of the doctors are unaware about it.

Swapna from Project SWARAJ, Cuttack told in d-addiction center they are unable to keep women and adolescents. Urgently government needs to give separate facilities for women and adolescents. Upendra from TATA trout, Balesore told time is now to give attention and care for the preventive health. GKS is not functional in village level where a gig amount of flaxy fund is unutilized. Bibhu Prasad Sahoo from Ganjam told in IREL plant area 70 people died in kidney disease when 200 patients diagnosed there. Before giving clearance to any plant health impact also analyzed along with social and environmental impact. Health and family welfare department should rename as Health, Hygiene and Family Welfare department.

Alaka Sahho from SEVA organization Berhampur told task force needed for every district to monitor the public facilities. D. Sworupa from SAKAR told emphasized should be for hospital cleanliness and infection control. Bulbul Swain from Surakshya told about acute mental health, gastric and urine problem and govt. should emphasize on it.

Geetanjali Panda from CCWD told for health card City Health officer is not renewing. Where is the book nobody knows? In Insurance card beneficiary name also missed out. There has  a huge corruption in insurance card.  In Chandrasekharpur UPHC most of the free medicines are not available, when patients demand they advice to purchase from outside.

Tapasi Praharaj from AIDWA and panelist of the assembly told whatever facilities available in public facility Jan Swasthya Aviyan should be informed to the community. She also told women health should be more focuse. Usharani Behera, BGVS and panelist told health depends on education, income, culture, food, and nutrition many more that need to address.  Santosh Patro from Oxfam told Right should speak in a right spirit. Accountability standard is there but is it reached? Citizen voices need to strengthen. Grievance redress mechanism is nowhere. Sashikanta Nayak from The Union, Jharkahand told Government is setting the highly ambitious target. All are electorally dividend. Community monitoring is diluted. When there is no such vaccine not yet came how can you eliminate TB. In govt. monitoring, only the quantity target asked in video conferencing. No one bothered about the quality.

In post-lunch session, Bibhuti Bhusan Das Community leader from Khordha shared people are not aware about the facilities available for them and how to access those. They are forced to pay or cheated by the broker. They are innocent and poor. They don’t know the corruption but need immediate health care. When they failed to get anything then no more believe in the government health system. Renubala from CCWD told Saliasahi the largest slum in Bhubaneswar in every household you can witness a dengue patient. They are using private health care. Urban PHC staffs should make people sensitized. Shradhanjali Sahoo from Sahayog told in Municipality Hospital doctor prescribed her for private labs for diagnosis and her grandfather denied for diabetes medicines in free when just now Joint Director Public Health told 4 types’ diabetes medicines are freely available. Anil from Jagatsinghpur told doctor also needs to know what the schemes available are for people.

Banamali from ISRD told child marriage has severe consequences by premature and lbw baby. People coming from remote areas are wandering for support in MKCG Medical College. So help desk need to set up in front of the hospital gate so people can easily get required support. Another woman from Bhubaneswar slum shared now in the capital hospital they are paying user fees. But they have to stand in a queue for the test. Even the security other people ignored which patient needs emergency care. Utkal Keshari Mohapatra from Sahayog told he is a student and witnessed the problem of accessing medicines by the poor people. The government declared schemes but in implementation out of 10 medicines patients are getting 2-3 medicines of low cost. Out of three counters for NIRAMAYA at Bhubaneswar, only one line is for ladies. More ladies counter needed. So, they will not wait for a long time.

The hospital is ours. We have to keep clean our place. Patient, family members are making hospital campus filthy which his very unhealthy and may spread to infection. Along with right people should make aware of their duties to the cleanliness of hospital. Sandip from Bhubaneswar shared when we are telling about river connectivity, road connectivity then why not we are thinking about departmental connectivity. That is very much necessary and then only we ensure health for all. Kalipad Ray from Bhadrak told in his district there are 193 sub-centers. Out of which 90% centers are not functioning. IFA tablet and Vitamin B syrup before expired date destroyed in many places when people are not getting medicines. Sanjit from Laxmipur, Korpaut told health Schemes handbook needed for wide publicity of demand.

Amiya Biswal from USS told about the health budget and with a minimum budget how the quality health will provide to the people. In simple word Basant Nayak from CYSD narrated about health budget. He told that in one year a G.P is getting 50 lakhs untied fund. So, the nearest Block health officials need to support a sarpanch in planning for preventing care in health. Sudarsan Chhotray told in last election peoples manifesto presented to different political parties. Ruling BJD and Congress almost accepted the demands. So, we have to prepare manifest and meet them to make health as their priority area.

Sujata from HRLN told we need to take the campaign in a mission mode. In conditional cash transfer schemes when because of two child norm the poor, the tribal and women vulnerable groups are suffered. It should be universal It’s the right. The third and fourth child has the same right. In last Dr. Amit Sengupta told about the national health assembly and global health assembly. Before end Gouranga Mohapatra discussed about the participation in National Health Assembly and how their raise the state health issues.

At last Sadasib Swain, Secretary CCWD shared about the vulnerable peoples’ food security issues and with his vote of thanks, the Assembly closed.

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