Why doctors are choosing to work in Chhattisgarhs

Maoist-affected areas
Sanchita Sharma, Hindustan Times, New Delhi

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Updated: Oct 24, 2016 07:39 IST

Over the past two months, 84 super-specialists and medical officers have signed up to work in Sukma
and Bijapur. (HTPhoto)

I am Dr Ayyaj, a medical graduate who joined an Indian Administrative Service. Currently

working as district collector, Bijapur (Chhattisgarh). My district is predominantly tribal,
densely forested and Naxal-affectedWe are developing district hospital as a state-of-art
facility. Need post-graduate doctors and general duty doctors. Specially looking for
radio(logists), anaesthesia and paed(iatrician)s. Other disciplines are also welcomed.

Bijapur district collector Ayyaj Tambolis SOS shared on WhatsApp and Facebook
onSeptember 6, got 116 responses 50 from specialists and 66 from general practitioners.
Of the doctors who responded, 50% are visiting Bijapur before deciding, the rest have
queries about salary, facilities for family etc, that they want resolved before deciding, says
Dr Tamboli.

Most doctors whove applied are from other states, mostly Maharashtra and Andhra. Once
the road to Bhopalpatnam (town bordering Maharashtra and Telangana) is ready by next
summer, connectivity to Maharashtra, Andhra and Telangana will improve and well get more
doctors as these states as they have a surplus.

These three states account for around a fourth of Indias close to 53,000 MBBS seats
Andhra has 27 medical colleges and 3,800 seats, Telangana has 20 medical colleges and
2,750 seats, and Maharashtra has 48 medical colleges and 6,245 seats.

How they did it

The SOS is one among a clutch of initiatives the Chhattisgarh government began in April this
year in partnership with the Public Health Foundation of India (PHFI) to get doctors and
medical staff to live and work in districts torn by left-wing extremism. Till October 9 this year,
168 lives were lost to left wing terror, including 33 civilians, compared to about 90 deaths this
year in the current unrest in Kashmir.

Were not changing but twisting the rules of the game to improve healthcare delivery in
underserved districts, says Subrat Sahoo, principal secretary, health department,
Chhattisgarh.

More autonomy to district collectors and access to flexi-funds such as National Health
Mission (NHM) and district mineral funds (DMF) have made it possible for them to offer
specialists salaries that are two-and-a-half to three times of what theyd get elsewhere, says
Sahoo.

Specialists earn between Rs 2 and Rs 2.5 lakh a month, depending on their specialty, says
R Prasanna, director of health services. A paediatric and general surgeon, for example, was
offered Rs 2.6 lakh Rs 1.59 lakh from NHM and Rs 1.1 lakh from DMF.

Money is not enough, the administration soon realized, so they followed up on other
incentives.

We examined why civil servants and army personnel adjust easily in remote districts and
identified infrastructural and social support as key issues to help them adjust, says
Prasanna.

So Sukma and Bijapur gave doctors a brand new transit hostel to live in and access to the
same facilities as the district administration. The contract said they would be relieved in two
years, they got incentives for career advancement, such as 3 marks per year for PG and
priority in training programmes overseas, and other support, such as help with school
admission for their children and job placement for their spouses, depending on their
qualification, says Prasanna.

Doc in the jungle

The results are showing. Over the past two months, 84 superspecialists and medical officers
have signed up to work in Sukma and Bijapur, where there are mine-clearing vehicles and
CRPF camps every 5km of NH-43, but no private hospitals or clinics.

Six months ago, vacancies were higher than the number of serving officers in the health
centres.

On March 31, 42 of the 55 sanctioned posts of superspecialists and medical officers were
vacant at Sukma, and at Bijapur, 56 of the 67 posts had no takers. Within six months, the
vacancies are down to 18 in Sukma and 20 in Bijapur.

The district hospital at Sukma, home to 2.6 lakh people, mostly tribal families, got its first
gynaecologist this month when state-awardee Dr Aruna Naidu, 44, moved from her
Secunderabad home in Telangana.

In neighbouring Bijapur last month, Dr Kushal Madhukar Sakure and Dr Arun Chaudhry,
both 28 years old, moved from Aligarh to run the gynaecology and obstetrics unit at the
district hospital.

Dr Tamboli says that getting radiologists and anaesthetists to live and work in Bijapur is a
challenge, but since surgeries have more than doubled in both hospitals, these specialists
are on call from Jagdalpur district hospital the last safe town three hours away by road.