Situated over 300 km from state capital Bhopal, Barwani hit the headlines recently for maternal deaths and the poor state of its healthcare system.

Activists of local NGO Jagrit Adivasi Dalit Sangathan (JADS) were thrashed by the police when they demonstrated outside the collectorate office to highlight the issue.

After a lot of protests, a team comprising Dr. Shubha Sri, a local obstetrician and gynaecologist, and health activists Sarojini N. and Renu Khanna visited the district Jan 21-22 and met the families of the victims in eight villages.

They held a press conference here Tuesday, and spoke about the dire situation of maternal healthcare in Barwani.

They gave the example of Balta Bai, 20, a resident of Ubadgad village of the district. On June 6 last year, she experienced sudden labour pains and was taken to the community health centre (CHC) of Pati block in a cloth sling by her family.

However, no doctor was present as it was a Sunday. A nurse did her check-up and sent her to the district hospital in an ambulance.

At the hospital, a nurse hit her for screaming in pain, and told her to go to either Indore or Ashagram (a private hospital in Barwani). The nurse even told Balta's father-in-law: "Take her to Ashagram, otherwise we will lodge a complaint against you."

When Balta was finally taken to Ashagram, doctors declared that her child was dead  and needed to be taken out immediately. The hospital charged Rs.10,000 for the operation and kept her hospitalised for eight days.

The night she was discharged, she once again complained of pain on reaching home. Her family took her to the district hospital, where a nurse called her "a whore", and threw hot water on her stomach.

"At the time of the interview in January, Balta was six months pregnant and was not receiving antenatal care," Shubha said.

The team also narrated the case of Durga Bai, a 32-year-old resident of Semli village of the district. She was taken to Pati block's CHC Dec 26 last year when she was expecting, but was referred to the district hospital.

There, the nurses tried to force the baby out by pushing. Durga was anaemic, but the nurses did not make any provision for blood and left it to her family to arrange for a it. Durga's mother then pawned off her silver necklace for Rs.1,000 to pay the donor.
However, Durga died during delivery.

"We find that the outreach services and antenatal care coverage are very poor. Anaemia is widely prevalent. We find some women with haemoglobin at dangerously low levels of 2 gms/dl. Anaemia contributed directly to seven of the 26 maternal deaths," Shubha said.

"The health care facilities are ill equipped to provide emergency obstetric care. The multiple referrals contribute to significant delays... leading to the deaths," said Sarojini.
"We have met Health Secretary S.R. Mohanty and Director Health Dr. Manohar Agnani of the (state) government with our findings and they assured us of immediate action," Khanna said.

Madhya Pradesh’s health indicators are generally poor compared to the rest of the country. Its maternal mortality rate (number of deaths during childbirth) is 335 per 100,000 live births, compared to the overall India figure of 254.

Barwani is among the poorest and most backward districts of the state. About 67 percent of the total population of 10,81,039 belong to the scheduled tribes.

Most of the maternal deaths happened in the tribal community, the report said.