The situation of sub health centres is no better than the two PHCs in Pernem. The sub health centres, which look after the health of the people in the initial stages, provide primary medication to villagers.
The sub health centres located in different villages are branches of the primary health centre and have two primary duties to perform — one proactive and the other curative. Under proactive, their duty is to create awareness among people by holding different awareness programmes on different sicknesses, diseases, precautions and the medications to be taken. Under curative they provide OPD where the doctor is available for the people in these sub health centres.
Catering to population of 80,000, there are 12 sub health centres under the Community Health Centre Tuem and three RDMs and the Primary Health Centre Cansarvarnem has 18 sub health centres.
In Mandrem Constituency, the sub health centres are at Virnoda, Tuem, Parcem, Agarwada, Morjim, Madhlamaj Mandrem, Sawantwada Mandrem, Keri, Arambol, Palyem and Corgao. The RDMs are located in Morjim, Mandrem and Arambol.
In Pernem constituency, the sub health centres are at Purva, Ozari, Halarna, Khutwal, Ibrampur, Hankhane, Hasapur, Chandel Hali, Nagzar, Bhendale, Varkhand, Porascadem, Khajne Amere, Ugvem, Mopa-Tamboxem, Torxem, Phakirpata and Patradevi.
Serving to a population of four to five thousand, the sub health centres have staff of two health workers (male and female), one peon and a doctor. While the staffs are full time the doctors are available only on specific days.
The first duty of the health workers here is to visit at least 200 houses per day, talk to people, provide them information about different sicknesses and diseases, inform precautions to be taken, give instruction to maintain hygiene and then report the same to the health officer.
The doctors, who visit the sub health centres, have a schedule and are available only on specific days in a week. The duty of the doctor is to check patients and give necessary medications. These centres prove helpful to the people, who cannot travel all the way to the primary health centres.
But are these sub health centres successful in providing these basic facilities in village?
The major problem and demand of the people is to have full-time doctors. Since not everyone can visit the primary health centres, many people visit the sub health centres for treatment but with no proper availability of doctors, not everyone gets to meet the doctor when he is available.
People have been complaining there is no fixed timing for the doctor to visit the centre. They reach the centre after finishing their duty at the primary health centres. Since there is no specific timing for the doctor, people who visit the sub health centres have to wait for hours for the doctor to arrive. Some patients with diabetes even come on empty stomach for the check-up but with no fixed timings, even they have to wait for hours.
Sometimes it also happens that with the busy schedule of the doctor at the main centre they don’t get to visit the sub health centres and villagers are forced to wait for hours together and the health workers are also not aware when the doctor will arrive.
People are also complaining that even the full-time health workers do not follow their timings. Secondly if a certain doctor is in charge of a particular health centre then there is no assurance that he will be continuously available. People say that this has happened many a time when they have started with a particular treatment and have to change the medication when the doctor changes.
The other problem is shortage of medicines due to which people are forced to buy them from private medical stores.
People also said that the full time health workers, especially the males are found absent from the centres. Sources said they do their personal work or go out to play cricket in the village.
Heath officer of Tuem Community Health Centre Uttam Desai said, “We check on the sub centres twice a month. There is neither lack of servants nor shortage of doctors. The timing of the doctor is different since they first finish their duty in health centres and then visit sub centres and that too only twice a week or alternate days. Also we have a proper supply of medicines and if medicines fall short then we arrange it from other centres or hospitals”.
