Today, we volunteered at a public hospital in a small agricultural village approximately 10km East of Faridabad. The hospital serves as a hub for the nine surrounding villages and Tuesdays is the day for pregnant women to receive their pre and post-natal checkups. Checkups are simple, including a basic urinalysis for glucose and protein, a simple hemoglobin test, blood typing, vitals, delivery date estimate, etc. Ultrasounds are available in large hospitals or private clinics, but it sounds like many of the women just do without them. Determination of a child’s gender before birth is illegal in India due to male favoritism. The female volunteers here were allowed to help at the ultrasound clinic last week and found the doctor quickly scanning over regions where the patient might be able to guess her child’s sex. Often, the doctor would know the gender but be unable, by law, to tell her patient.
As a result of this law, the pre-natal checkups also include a questionnaire as to the mother’s caste, number of attempted deliveries, number of abortions, number of living children, and the gender of those living children. The government will investigate any suspicious activity regarding abortions. For instance, a mother who has a living female child and who aborts her next fetus will likely be scrutinized.
[The following paragraph has been updated due to a misunderstanding during translation] If you read this post previously, you will recall that I said the cost of pre and post-natal healthcare depended upon one’s caste. I have since learned, however, that it’s the other way around. Mothers are actually paid different amounts depending on her caste. Because education and health care are so limited in rural villages, it has been common for mothers to deliver their children at home (using midwives) without seeking professional medical attention. This has resulted in abnormally high maternal and infant mortality rates. Therefore, the government has instituted the “National Rural Health Program” that actually pays certain mothers to give birth at the hospital. Today, the women were grouped into three caste categories: the General Caste (highest), Schedule Caste (middle), and Backwards Caste (lowest). A woman from the Backwards Caste, for instance, is given Rs 1500 ($30) as an incentive to have three pre-natal checkups, three post-natal checkups, and deliver her child in a hospital. Women from the Schedule Caste receive Rs 500 ($10) and women from the General Caste do not receive any financial benefit because they are believed to be wealthier and more educated.
Furthermore, the hospital staff members and people called “ashas” receive a financial bonus (appx. Rs 500-Rs 1000, or $10-$20) for each child delivered in a hospital. An asha is a person who, from what I understand, serves as a motivator for the proper health care decisions of approximately 1,000 people. He or she keeps records of the people under his or her care and educates people about different health options such as the benefits of going to a hospital to give birth. These are just some of the government’s methods of incentivizing proper health.
I spent the majority of the day determining blood types (AB positive, O negative, etc.), performing hemoglobin tests, conducting simple urinalyses with basic equipment, and preparing samples for tests of malaria.
The most shocking aspects of the day were the frigid temperatures within the unheated hospital, the lack of alcohol swabbing before pricking, and the staff’s handling of blood covered slides and bloody fingers without gloves or even thorough washing. This is not due to any oversight or negligence. It is just common practice here. And for those of you who are curious, yes, I wear gloves that I bring with me.