Why pregnant tribal women of Gujarat are dying on way to hospitals

It has been over 25 days that Kishan Bhil, a 32-year-old tribal man from Turkheda village in south Gujarat’s Chhotaudepur has not gone to work. An agrarian labourer by profession, Bhil has had to play the role of stay-at-home father to take care of his newborn daughter.

“She was born on October 2 but I haven’t felt a moment of joy since she was born. It was the same day I lost my wife Kavita. I know it is not my newborn daughter’s fault. I am coping with grief while doing my duty as a father of three,” Kishan Bhil tells The Federal holding the child.

“I haven’t had the chance to name her even,” he says.

Kavita's husband Kishan inconsolable after losing his wife.

“At around 5 am on October 2, Kavita began having labour contractions. I woke up my uncle who lives with us. He told the neighbours and within half an hour the entire neighbourhood of Baskariya Falia — a hamlet of 10 families in Turkheda village — had gathered and managed to put together a makeshift stretcher with an old bedsheet tied on four corners with two bamboo staff.”

“We put Kavita on the stretcher and four of us — my uncle, two of my neighbours and I began to carry her to the main road around seven kilometers across the pahadi (hillock). An ambulance (108 GVK EMRI free services) that was called, was waiting to take Kavita to the primary healthcare around 25 kilometres near Kavant village in the district for delivery,” recalls Kishan.

“We must have covered barely around one kilometre only when Kavita went into labour and couldn’t stand the pain anymore. She delivered a baby girl with help of two women from Baskariya Falia who had accompanies us. But after delivery, she kept bleeding which got worse as we tried to move. Nobody knew what to do. The women helplessly kept changing blood drenched clothes that they used as sanitary napkin. We tried to carry Kavita for another 200 metre maybe when we lost her. The whole ordeal lasted for around an hour. We carried her body back home on the same stretcher. Her final rites were done by the evening of October 2,” shares Kishan breaking down.

“She didn’t have to die like this, she was only 28 years old. If only there were roads and an ambulance would have picked her from home, she would be alive today. This was Kavita’s third pregnancy. She went through the same ordeal while delivering her two other children — a five-year-old boy and a 3.5-year-old daughter. But she was lucky to have reached the hospital on both instances,” Jamsinh Rathwa, uncle of Kishan who accompanied him on the ill-fated day, told The Federal.

“For several years, we have been requesting the government to construct a road in the village so that it is easier to access the first ambulance service. But there has been no development. There is no health facility available nearby either,” he added.

The incident has left residents of Turkheda, a village with around 200 Bhil tribal families along the Narmada river, shocked. This is not the first incident in the tribal-dominated district of south Gujarat. There have been many women who have faced a similar fate as Kavita.

On October 21, another woman of the village had to be carried on a makeshift cloth and bamboo stretcher for 5 kilometres. But Ramila Rathwa, a 24-year-old woman was lucky. Her family managed to take her to the ambulance to Ambadungar, the village where the motorable roads end.

“Ambulances can come up to Ambadungar only. Beyond that there is no road. Half of the district has no proper roads. This is a story of almost every village of Chhotaudepur where not just pregnant women, but people in general have to carried on shoulders when they fall sick for even a basic treatment at the Primary Healthcare Centre (PHC), which is 25 kilometres away at Kavant,” tells Chotu Rathwa, husband of Ramila.

Kavita (standing) who lost her life this month before she could be carried to an ambulance.

“But Ramila had to be taken to the hospital in Vapi, after she failed to deliver at the PHC. They suggested we should rush her to the civil hospital in Vapi that is about 300 kilometres from Chhotaudepur. The government hospital in Vapi district is the nearest functioning hospital for us. But Ramila delivered the child on the way to the hospital in the ambulance,” adds Rathwa.

Noticeably, it has been five years since the first tender was issued by the district administration of Chhotaudepur to construct the road beyond Ambudungar. However, out of the approximately nine kilometres, only three kilometres has been constructed.

“For several years, the locals have been requesting the government to construct a road to their villages. A tender was invited five years ago but nothing has since been done. The village has no Primary Health Centre, there are no nearby health facilities either,” stated a notice by the Gujarat High Court division bench of Justice Biren Vaishnav and Justice Nisha Thakore to the state government.

“We can take judicial note of the fact that on the banks of Narmada, there is a developed area where the Statue of Unity stands. Unfortunately, because health services did not arrive at the doorstep, the lady succumbed giving birth to a third child. This is the state of affairs when we talk about equality and the right to life in a developed state like Gujarat,” read the notice further that came after the court took suo moto cognisance of the matter on October 5 this year.

Two days later, the Gujarat government immediately began the construction of a nine-kilometre road to Turkheda village to be built at a cost of Rs 18.5 crore.

“It’s been three years that work of building roads connecting the villages of Chhotaudepur has been halted. The district administration has never revealed why was the work left midway after constructing only around three kilometres. Owing to the circumstances, carrying patients in rickety stretchers in these areas has become a norm. If someone calls in the middle of the night, people immediately know what to do. They make a stretcher in minutes and are ready to walk till the ambulance,” says Praful Vasava, a tribal rights activist of the area and a former Aam Aadmi Party member.

“Most of the villages in Chhotaudepur has no PHC or accessible roads. In the last three months, three other women also met a similar fate as Kavita. People have requested the government to construct a road across the district for years, but there has been no development,” adds Vasava.

There is a 30-bed Referral Hospital and Community Health Centre (RH-CHC) in Bodeli, the district headquarters of Chhotaudepur. Locals, however, can hardly avail treatment there.

“There are supposed to be six doctors at the hospital. But currently there are three – a gynaecologist, a paediatrician and a general physician. However, they are available only for a stipulated time during the day on weekdays and on weekends the hospital is deserted,” tells Vasava.

“Two months back, one of the most prominent tribal rights activist Romel Sutariya died of a cardiac arrest on his way to the hospital in Vapi. He was one of the strongest voices raising these issues but even he did not get timely treatment,” Vasava points at the cruel irony.

Noticeably, in 2019, then health minister Nitin Patel announced an additional allowance for doctors amounting to 30% of the basic salary if they opted to serve in tribal areas. However, the move hardly had any takers.

According to Rural Health Statistics data for Gujarat 2022, there was a vacancy of 1,376 surgeons, obstetrics and gynaecologist, physicians and paediatricians, but only 127 positions were filled.

A village in Chhotaudepur which lacks roads and access to basic amenities, including healthcare. 

“I will go to Bodeli on Friday (November 1, 2024). The doctor is slated to be at the hospital till 2 pm,” says 21-year-old pregnant woman Yasoda Bhil.

“There will be a long queue of new mothers and pregnant women as the doctor will see us after 20 days. We were told there will be no doctor at the hospital for 20 days owing to festivities. I have been to the hospital twice since August this year. Although I am receiving treatment right now (pre-natal), there is no guarantee that there will a doctor available when I am due to deliver in five months. I will have to be carried in the cloth stretcher like others,” says Yasoda, a resident of Bandi village in Chota Udepur who has now resigned to her fate like other tribal women of the district.