PHM India: People's Action for Social Accountability in Health

1 Nov 2013


India, Karnataka State, District: Tumkur

B.Obalesh is a Dalit Human Rights
Activist and is an active member and State convener of Jana Arogya
Andolana Karnataka (JAAK), the People's Health Movement Karnataka
(India). He is also an active member of COPASAH  - Community of
Practitioners for Social Accountability and Action in Health.  As a
Dalit Human Rights Activist  he has been 
mobilizing members of manual scavenging community
and has been recording issues of their health rights denial as part of the right to health campaign of PHM 
Karnataka.   On 19th
October 2013, a protest rally was organized  and a brief account of the same is
shared with you all. – ed.

200 people (mainly pourakarmikas) from madhugiri, Pavgada and Tumkur town participated in a protest rally organized jointly by Janaarogya Andolana Karnataka (People’s Health Movement, Karnataka State Circle), Slum janaandolana (Movement of Slum Dwellers) and progressives organizations (Samvada, Thamate and Jeevika). The protest focused on the key findings from the rapid assessment and Right to Information applications  ( RTIs) filed in Madhugiri and Pavagada taluk hospitals and tumkur district hospital.

People converged first at the Deputy Commissioner’s  (DC) office and submitted the memorandum. The DC patiently heard all the issues protestors presented which ranged from non-responsive health staff, lack of basic amenities, not providing medicines claiming they were out of stock even though hospitals were purchasing medicines from ARS funds, from user fee funds in addition to what was supplied by the state, referral to private hospitals on flimsy pretexts, having to pay bribes for services to obtain disability certificates and deaths due to neglect by doctors and health staff.

KB Obalesh shared the key findings from the rapid assessment:

  • Vacant positions of health staff in all categories
  • Poor maintenance of hospitals
  • Lack of basic amenities like drinking water and toilets
  • Routine writing out of prescriptions even though district and taluk hospitals were using funds from ARS and User fees to purchase medicines locally in addition to what was being supplied by the state
  • Referral to private hospitals for even routine diagnostics and treatment including normal deliveries
  • Non-functional ARS and so on

He drew attention to the Auditor General’s report (obtained through RTI) which indicted the district hospital for:

  • Financial irregularities
  • Non-utilization of funds and unreasonable delays in undertaking activities
  • Non-replacement of sub-standard drugs supplied by the Drug Logistics Society
  • Non-recovery of fees from private nursing schools
  • Misuse of funds from Special Component Plan to buy equipment for the dialyses centre

In response the DC agreed to undertake surprise visits to the hospitals and take action against erring officials and ensure that hospitals were functional in the district. He sought a copy of the Auditor General’s report and promised to take it up with the District Surgeon. He said recruiting doctors has become a huge challenge with most doctors opting to work in private /corporate hospitals and unwilling to join the public health system. He said that people should raise all these problems and protest against injustice but refrain from violence and damage to public property. He expressed solidarity with the protestors and said he will do all that is humanly possible to improve the public health system.

The rally then proceeded to the Zilla Panchayat office. ZP Secretary and Vice- president of the ZP received the memorandum on behalf of the ZP CEO. During the interaction that followed, Altaf from Slum janaandolana pointed out that by sanctioning new private nursing homes and clinics everyday the government was actually supporting the growth of the private sector which was exploiting the poor and the marginalized. He demanded that the district stop recognizing private hospitals. Instead the government system should be strengthened and there should be strict vigilance on the existing private hospitals in the district.   

ZP Secretary promised to call for a meeting of all medical officers in the district and facilitate an interaction with the protestors so that the latter can directly raise problems and sort it out. He also urged people to make us of the sanitation scheme to construct toilets so that several illnesses and diseases can be prevented. Protestors pointed out that presently there is no oversight of taluk hospitals and PHCs by the ZP which are under its jurisdiction and demanded that there by better supervision and coordination. Protestors also pointed out the ZP had not responded to any of the previous memorandums and that demands had been only piling up. ZP secretary said he will bring it to the notice of the CEO and promised to address the issues raised in the memorandum in consultation with the protesting groups.

Recognizing that the rally and protest was only the first step the protestors agreed to continue and sustain the campaign and keep watch and follow up on the promises made. The District committee met after the protest and decided to undertake the following actions as next steps:

  • Each partner organization will take responsibility for visiting hospitals, health centres and address issues arising from there.
  • Legal petition to State Human Rights Commission and launching a complaint to the Lokayuktha on auditor general’s report.
  • Letter campaign about some of the core issues identified in the rapid assessment
  • A 3- day capacity building training for students, progressive groups and committed activists in the district
  • Undertaking a survey on malnutrition among children from the scavenging community

  Report and mobilisation by
K. B. Oablesh, Jana Arogya Andolana Karnataka (JAAK) and  Thamate (NGO)



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