By Shweta Bhandral
Dr Anuradha Rana, a gynaecologist and obstetrician, is based in Pathankot, a business town in Punjab which shares borders with Jammu and Himachal Pradesh. Since Anuradha gets patients from all the three states, she is able to recognise the vast differences in healthcare facilities and knowledge of women’s health in rural versus urban areas. According to her, it boils down to the three ‘i’s: innocence, ignorance and illiteracy.
“There is a need for more NGOs to work at the grassroots level for healthcare. Women’s health in India will only improve with self-care, and awareness is the only way to do it,” she avers.
An army officer’s daughter and an army officer’s wife who had travelled and lived across India all her life, Anuradha had no particular reason to choose Pathankot – which is a travel hub and also shares a border with Pakistan – to settle down.
“As a typical army wife, I didn’t get the opportunity to work for almost 12 years after completing my MD, as we kept moving from one place to another. When we were posted in Pathankot, the kids were slightly older and I decided to look for a job. I got a position in a nearby town Sujanpur and wanted to prove my worth to myself. So I worked extremely hard just like any new doctor would, day and night. Patients started trusting me, and I made a name for myself.”
Two years later, Anuradha got an offer to be a partner in Ram Mission Hospital, Pathankot, where she still works.
Now 53, Dr Anuradha Rana is the first name that locals recommend for a women’s doctor. She delivers 90 to 100 babies in a month on average, half of which are natural births. With her outpatient fee fixed at just Rs 100, she sees over a hundred patients every day.
This fee is also exempted for some patients. “What you do in private practice is in your hands,” shrugs Anuradha. “I wish to serve women and girls coming from far off small villages with little or no resources.”
Talking about most common problems that women suffer from in this area, the doctor shares, “The biggest health issue is nutritional anaemia. Women from villages in Himachal come with haemoglobin levels as low as six.”
Studies confirm that 53 percent of women in Punjab and Himachal, and 40 percent in Jammu have nutritional anaemia. Overall, in India, more than 53 percent of women suffer from anaemia, which indicates a lack of access to nutritious food.
The next most common issues faced by women in smaller towns and villages are genital infections and polycystic ovarian disease. Sadly, there are hardly any studies on the prevalence of these ‘women’s diseases’.
“A lot of these problems can be dealt with if women are literate and aware,” regrets Anuradha. “Most of these women are ignorant and somewhat innocent. They come to me only when the problem becomes unbearable for them and has reached the last stage, medically speaking.”
Another significant health issue is post-natal care. New mothers suffer from depression, hormonal changes and body changes all at the same time, besides having a new baby to look after.
“Safe motherhood is a woman’s right. We have to sensitise men and families about this,” says Anuradha, adding that even families and authorities in metro cities neglect this point.
The healthcare system also suffers from an infiltration of quacks in small towns and villages, either due to a faith factor or because people are intimidated about going to large hospitals and prefer self-medication.
Data from National Health Profile tells us that in India, there is one government allopathic doctor for every 10,189 people; one government hospital bed for every 2,046 people; and one state-run hospital for every 90,343 people.
At the same time, according to Indian Medical Association, there are more than one million quacks practising in India.
Due to Covid, the aversion to hospitals has risen further. As a solution, Anuradha suggests, “There is a need of good counsellors at the primary healthcare level. The system needs to gear up; panchayats need to work in this direction. We should have educated ASHA workers who should be equipped with knowledge of basic healthcare.”
The state of women’s health in semi-urban and rural India is evidence of systemic patriarchy: women are not important enough for their families or the state. Prioritising women’s health will need political will, grassroots upliftment and education.
First published in eShe’s January 2021 issue