By Khabar Lahariya:
Editor’s Note: As part of Youth Ki Awaaz and Khabar Lahariya‘s collaboration, the following is the story of Leela, an 18-year-old from Banda. Having suffered a tragic accident, she is unable to afford treatment while the state authorities claim that she never came to them for help, highlighting the major structural problems of healthcare for the poor in India.
Zila Banda, Block Mahua, Village Kanjipur. Leela, 18, has been struggling to stay alive for a year. She has multiple wounds all over her body. She has been hooked up to a catheter for the entire year. Poverty-stricken, her mother and father cannot get treatment for Leela. Her mother has gone to many administrators, big and small, to plead with them to help Leela.
Leela’s mother Ranno told the KL Banda team that last year, 19th September, Leela went out with her friends to get mud for the whitewashing of the house. Leela and three other girls fell down into the quarry when a mound of earth they were walking on collapsed.
Quarries are part of the landscape in Bundelkhand, and are often leased to powerful locals, known as the “sand mafia“. There are many mining projects going on in this region, given the abundance of minerals available in the ground, and often, people who live in the area find informal work in these quarries. However, there are multiple safety risks to the people who live and work where these large mining projects are going on. The risk of falling into the quarry because of improper safety precautions is one, but there are also other risks.
Recently, an explosion in a quarry killed seven and injured eight in Sonbhadra, which is about seven hours from Banda. In addition, mine workers are likely to be exposed to chemicals and suspended particulate matter all day, and get respiratory and eye diseases – and since mining creates air and water pollution, the health of non-mine-working locals also suffers. Development work in these regions, therefore, often makes the lives of the locals very difficult – as in the case of Leela and her family.
The zila administration came to get Leela out after she had fallen into the quarry. They even had to get a JCB machine to get the girls out of the quarry. The other three girls didn’t get hurt very badly. Leela, however, broke both legs, a hip, and some rib bones. When she was admitted to a government hospital in Banda, the doctors referred her to Kanpur. She remained admitted at the Kanpur hospital for two months.
“We didn’t have money for the treatment. We sold our land and gave the hospital 2.5 lakhs, but that only covered the treatment of one leg. One leg, the hip, and the rib bones still remain untreated.” Lying in bed for months on end, Leela ended up getting genital bedsores.
DM Suresh Kumar says that if Leela’s family had come to him about this, he doesn’t remember. If they come again, the government can help in Leela’s treatment.
There are some major structural problems when it comes to healthcare for the poor in India. A 2014 study revealed that India spends less on public health than some much less developed sub-Saharan African countries. Household expenditure, and other private expenditure – that is, money coming out of the patient’s pocket – is, in India, 71% of the total expenditure on health. The government needs to seriously invest in healthcare to change this alarming ratio.
Large healthcare expenses, in the wake of an accident like Leela suffered, can often push relatively stable households below the poverty line. In January this year, Times of India reported that according to the draft of the National Health Policy, 18% of all households faced catastrophic healthcare expenditure in India, and over 63 million people face poverty because of this expenditure. This turns into a vicious cycle – poverty creates living conditions that encourage communicable diseases, which then cannot be treated because of exorbitant healthcare costs.
The government has multiple health insurance schemes. One of these is the Rashtriya Swasthya Bima Yojana (RSBY) launched in 2008, which covers all of India and is one of the first insurance schemes that includes informal sector workers. It covers hospital care up to Rs. 30,000 for Below Poverty Line (BPL) people.
However, there are multiple problems with it. People need to be enrolled in this program to be eligible for benefits, which involves paying an enrollment fee of Rs. 30, which may seem like a lot to a household that does not have the ability to save and lives off everyday earnings. There is also a lack of information about RSBY in these areas, according to a study done on neighbouring states like Bihar and Uttarakhand. To build such awareness is entirely the responsibility of governmental entities – why did no one alert Leela’s mother about this scheme, or any similar ones, when she went to various government offices? Another barrier is frequent migration and travel among the poor (likely in search of work), which prevents them from registering when enrollment stations are open – a reality that a scheme to benefit informal labourers must acknowledge. Another, of course, is the lack of technical implementation – the scheme depends on “smartcards” which need to be scanned to deliver healthcare, and all empanelled hospitals or enrollment stations do not have the smartcard machines yet. Finally, another barrier is discrimination and indifference.
According to the RSBY website, in Banda district, RSBY is in its 5th year of implementation. Their goal is to enroll about 120,000 people. So far, 32,296 have been enrolled – about a fourth of the goal – and about 555 hospitalizations have occurred under the scheme, as of March this year.
Leela’s parents don’t even have enough money to eat. Leela’s mother leaves her, lying in bed in her wounded state, to walk 13 kilometres into the jungle every day to collect wood which she sells for 20-30 rupees in the market. This is how the family sustains itself. Her mother says, “I’ve gone to everyone, from the Pradhan to the DM, to request them to get Leela’s treatment done. Nobody has agreed to help.”
Brought to you in collaboration with Khabar Lahariya.