Analysis: COVID-19 exposed already-existing cracks in Meghalaya’s health infrastructure

In Meghalaya, which holds about 2678 active cases (as of May 8), the health infrastructure is already crumbling even though the peak is yet to come.
By Ibankyntiew Mawrie | SHILLONG:

The second wave of COVID-19 has rattled the health systems in Meghalaya, with doctors and health officials sounding alarms about the existing infrastructure being insufficient to handle the crisis.

Till that extent, the lockdown in the state of Meghalaya should not come as a surprise even though the centre has asked states to use the option as a last resort, considering the severe economic damage and distress to weaker socio-economic sections the first wave caused last year.

Big cities like Delhi, Mumbai and Bengaluru, which have proportionately higher resources and spending ability, are currently reeling in a much worse situation due to rising death tolls and full hospital beds.

In Meghalaya, which holds about 2678 active cases (as of may 8), the health infrastructure is already crumbling even though the peak is yet to come.

Albeit, government officials have said that the number of active cases are significant for a state of the size of Meghalaya.

However, if that is true, a smaller state should also not have to spend significantly higher to cater to a small population. Currently, the population of Meghalaya stands at 38.2 lakh, according to a March 2021 report of the Meghalaya Democratic Alliance (MDA).

But does the current pressure on the infrastructure mean, we have not spent even the required amount?

For the budget of 2021-2022, Meghalaya allocated Rs. 820 crore towards health. In the budget presentation, the government iterated on spending towards early childcare, maternal health and immunization, and strengthening hospital and clinic infrastructure.

However, even as experts across the world and research bodies in India cited the forthcoming of the second wave, no accommodation was made for an expected COVID wave striking the state.

Recently, speaking to the The Northeast Today (TNT) on the state’s preparedness for COVID, Meghalaya’s Health Minister AL Hek said that the total number of oxygen supported beds in Meghalaya is 609, with 65 ICU beds.

This is a low number even for normal circumstances for a state which has a population of about 38 lakhs.

“We have to remind ourselves that there is a limitation, be it oxygen cylinders or hospital beds,” Meghalaya Principal Health Secretary Sampath Kumar had told The Northeast Today (TNT) last week.

“There is an acute shortage of oxygen supply. There is so much demand and supply is limited,” he had said.

According to a World bank report titled ‘Meghalaya Health Systems Strengthening Project,’ although Meghalaya’s per capita health expenditure is marginally higher than the national average, it was less than half of other smaller northeastern states like Mizoram.

Likewise, the state has been constantly suffering from problems even before COVID.

Meghalaya, has one of the highest rates of maternal and infant mortality (MMR and IMR) in the country.

The state recorded over 13,000 infant deaths in the age group of 0-12 months and around 1000 maternal deaths over the last five years up till 2020.

One of the primary reasons for this is also the high number of home deliveries which take place, wherein certain deliveries are still carried out by unprofessional and untrained individuals.

According to the state's statistics of 2011, the number of home deliveries stood at 53.9 per cent.

The truth behind the number is also the lack of health infrastructure in the rural parts of the state. Last year, a pregnant woman from the Rongrong village, East Garo Hills, was carried 7 km on a bamboo stretcher to the nearest primary healthcare centre (PHC) for her delivery.

This is just one of the many instances highlighting the underdeveloped state of health in Meghalaya.

Slow Changes Are Happening

Many policies have been brought to the state in recent years for improving the dwindling health situation. Though slow, some changes are taking place.

According to the Meghalaya Democratic Alliance (MDA) report of 2021, about 65,000 pregnant mothers have been registered under the state’s MOTHER (Meghalaya's Outcomes Oriented Transformation in Health, Education and Rural Development) programme and more than 40,000 childbirths have been captured, since the launch of the programme.

The National Health Mission (NHM), in partnership with the state government, has also pushed for improving institutional deliveries, which has seen a steady percentage rise across the districts. In some districts, such as East Jaintia Hills, institutional deliveries in 2021 have risen by almost 10 percentage points compared to 2020.

The state has also seen a shortage of specialist doctors for reducing maternal and infant mortality. In 2020, the Meghalaya government had approved postgraduate courses to address this at an immediate basis.

The state also received an amount of Rs 350 crore from the Asian Development Bank (ADB) for investment in health infrastructure in the state. The assessment report for the same is pending.

(Edited by Ibankyntiew Mawrie)

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