Maharashtra’s boat ambulances lie unused as doctors quit
The river ambulances, operating on a stretch of the Narmada river, have been anchored after the doctors appointed to serve on them quit to join more lucrative postings under Ayushman Bharat.
Three boat ambulances launched to serve 33 tribal villages inaccessible by road in Nandurbar district have been lying unused for two months. The river ambulances, operating on a stretch of the Narmada river, have been anchored after the doctors appointed to serve on them quit to join more lucrative postings under Ayushman Bharat.
The 33 villages, spread over 200 km, are situated in a hilly terrain. The only alternative access to the villages, and its tribal population of 25,000, is a trek up its slopes. “Our salaries were low on the boat ambulance and working hours tedious. Salaries would also come late,” Dr Sandeep Barje, who resigned in October last year, said.
Dr Barje, serving on the ambulance, used to earn Rs 24,000 per month. But after joining a Health and Wellness Centre, he now earns Rs 40,000. Nandurbar has over 170 health and wellness centres, a concept launched by the BJP-led Centre under Ayushman Bharat to upgrade existing sub-centres and their services. A homeopathic or ayurvedic doctor posted at such centres expects to earn Rs 25,000 as fixed salary and Rs 15,000 in incentives. District officials said they have lost a lot of doctors employed under health schemes to the national programme.
The district health officer of Nandurbar has sent a proposal to convert the boat ambulances into health and wellness centres. “If the boat ambulances are upgraded, we expect better services,” Dr Nitin Bodke, district health officer, said.
In Bharad village, Janubai Pawara (55) suffered a snake bite on January 4. While a boat ambulance was available, there was no doctor to administer her anti-snake venom. Villagers had to wait for a private boat, which took them to another village from where they travelled to the Dhadgaon rural hospital, making the 70-km journey in about three hours, to get primary treatment.
“If the boat ambulance was still there, the delay could have been prevented,” said Latika Rajput from NGO Narmada Bachao Andolan. Pawara survived.
The first boat ambulance was launched in 2003-04 by the European Commission. Later, the Maharashtra government introduced two more. Of three sanctioned posts for doctors, currently all remain vacant. District officials admit doctors are attracted to better salaries offered at the health and wellness centres.
When contacted, district collector Mallinath Kalshetty said funds would be made available if doctors were willing to work on the boats. Dr Bodke said, “We are trying to fill up the posts for boat ambulances. We have submitted a proposal to the deputy director in Nashik. The advertisement for fresh postings will be published once approval comes.”
The boat ambulances anchor at a village on a scheduled day, conduct screening, immunisation, check-ups of pregnant women and offer primary treatment. Those in need of specialised treatment are ferried to the nearest hospital.
Each ambulance has a doctor, a helper, a navigator and an auxiliary nurse midwifery (ANM). Three posts of helpers also continue to be vacant. In the absence of doctors and helpers, ANMs are unable to navigate the boat or function alone.