|© UNICEF India/2009/Ferguson|
|Poornima Gosain lies on the hospital bed at the Panitola Primary Health Centre while village health worker Monimoti Modi stands by her bedside.|
By Sohini Roychowdhury
UNICEF has announced that the IKEA Social Initiative, a corporate philanthropic partner, is expanding its support for programmes in India. Here is a profile of one IKEA-supported project.
ASSAM, India, 24 February 2009 – A woman’s eyes open wide in shock. A second later her face crumples and a shriek cuts the air. Her husband hugs her nervously to soothe her. In the village of Dikomnahoroni, expectant mother Poornima Gosain has felt the first contractions of labour.
Her husband, Arun, rushes to inform the village health worker, Monimoti Modi, that Poornima is ready to give birth. Ms. Modi is an Assam State Accredited Social Health Activist, or ‘ASHA’. She advises Arun to use his mobile phone and dial 108.
“My wife has gone into labour, and we need an emergency transport,” he informs the call centre, hundreds of kilometres away in the state capital of Guwahati. “This is village Dikomnahoroni. The nearest delivery centre is the Panitola Primary Health Centre.” He hangs up and looks reassuringly at his wife. “Don’t worry, you will be fine,” he says. “They are sending an ambulance. We will get you to the hospital in time.”
It takes half an hour for the ambulance to make its way through treacherous, pot-holed roads to reach this secluded village in Dibrugarh District. Soon, Poornima is admitted to the hospital.
Emergency support, a phone call away
Expectant mothers in India face numerous risks at the community level. According to findings from a UNICEF-conducted survey on maternal and perinatal deaths, poor road access and lack of transport pose significant challenges to reducing maternal mortality here.
UNICEF Assam advocated with the state government to provide efficient and safe emergency transport for pregnant women, newborns and sick children – with the aim of linking communities to health facilities, reducing maternal mortality and increasing the number of institutional deliveries (as opposed to home births). Overall in India, 60 per cent of women do not have institutional deliveries, and 33 per cent do not have a skilled attendant at delivery.
In 2006, the Government of Assam, under the aegis of the National Rural Heath Mission, set up a call centre in Guwahati to provide 24-hour, advanced life-support ambulance services in local communities in the state. This service, named ‘Mritunjay’ (victory over death), is provided free of charge. By dialling three digits – 108 – family members can save a woman’s life.
“If this situation arose earlier, there would have been no ambulance to transport Poornima to the health facility,” says Ms. Modi. “She would have had to have a home birth like the last time, during which she suffered an injury that took several months to heal – or else hire a cart, which would have taken several hours to reach the hospital. Like many women in the past, Poornima would have delivered en route.”
Wheels of change
The Guwahati call centre has three dedicated telephone lines that can handle 90 calls at any given time, answered by round-the-clock operators. Anyone from the 12 districts where the call-centre facility is available can simply dial 108.
Each ambulance is equipped for cardiopulmonary resuscitation, an emergency medical procedure for a victim of cardiac arrest, with a ventilator and a technician who works to ensure that the patient reaches the hospital safely.
When a pregnant mother or anyone else requiring emergency care is on the way, the call centre alerts the health facility of the patient’s imminent arrival. “By doing this, the hospital or delivery centre is ready with specialized care and medicines,” says Dr. P.C. Hazarika, Joint Director of Health Services, Dibrugarh District, Government of Assam.
‘A life-saving mechanism’
Since the launch of ‘Mritunjay’ in Assam, more than 6,400 institutional deliveries have taken place, including at least 57 births inside the ambulance. On average, the emergency lines receive 6,500 calls each day.
“The call-centre facility has gained tremendous acceptance by the communities in building strong linkages with health care services,” says UNICEF Assam’s Chief of Field Office, Jeroo Master. “With support from the IKEA Social Initiative, UNICEF and allied partners were able to advocate with the state government to scale up the call-centre facility to several districts as a life-saving mechanism for villages that are totally isolated.”