Gujarat High Court Seeks Collector's Report On 'Hard Reality' Of Rural Health Facilities After Pregnant Woman Dies On Way To Ambulance

While hearing a suo motu plea on an incident where a pregnant villager who, after being "carried on a cloth stretcher" as there was no road, died on her way to the ambulance pickup point, the Gujarat High Court on Thursday called for a report from the concerned Collector indicating the"hard reality" of the situation and a plan for meeting out such medical emergencies. 

A division bench of Chief Justice Sunita Agarwal and Justice Pranav Trivedi were hearing a suo motu plea initiated by the high court on October 3 after taking cognizance of news reports of the incident.

The news reports indicated that the deceased woman, a resident of village Turkheda in Chhota Udaipur district was carried on a cloth stretcher by the village residents, who had to cover a distance of 5 kms to reach a pick-up point where ambulances could arrive and take her to a primary health centre about 25 kms away for delivery. The court had in its October 3 order noted that as per the reports, the village residents had covered a kilometre on the rocky terrain when the woman went into labor, delivered a baby-girl and breathed her last.

During the hearing on Thursday (October 17) advocate DM Devnani appearing in the matter said, “The PIL is drafted on the lines of the order passed by the Hon'ble Court. There are three issues at this stage which are at large...The first issue in my humble submission subject to what the learned Advocate General has to say, what would be the medical facilities available in the entire state for…when we talk about equality, the Hon'ble Court has observed at one stage there is Statute of Unity standing tall and on the other side are these tribal villages. What are the health facilities that the state today has with regard to not only this village but such tribal and remote villages which will require some attention of the state through my Lords".

With respect to the second aspect Devnani pointed to the lack of infrastructure facilities and said, "the report indicates that there are no roads available now. This is also something where the state has to respond to the Court that despite the village is being at a remote...they might be at the remotest place but at least they should have that infrastructure of connectivity of roads, so that they can reach these primary health centres, during such incidents".

He submitted that this was one such incident but there might be medical emergency such as strokes, heart attacks adding that the residents of the villages are in a very remote area.

"Through this Suo-motu, the Hon'ble court has indicated that this, the remotest tribal states should also have, districts rather the villages should have some infrastructure connectivity so as to reach. 108 is available on call. If there is a, call in Ahmedabad 108 through GMERS (Hospital) or the hospitals nearby where they are posted even for this Hon'ble court, there is a point before this Hon'ble court. Nearby points so as to see immediate help can arrive so as to see these lives are not lost. This is what is indicated by the Hon'ble Court subject to what the state has to say," Devnani said. 

Meanwhile the Advocate General appearing for the State began by submitting that the incident should not have happened. He thereafter referred to an affidavit and said the deceased was residing with her husband in Baskar Faliya, village Turkheda, and their three children.

Pointing to the affidavit he said, "The entire area where the village Turkheda is situated is a tribal and forest area, having hilly terrain. The said village Turkheda consists of total 7 faliyas (cluster of houses/hamlets) scattered across different elevations with some located at considerable height whereas some on a sloppy area towards the base of the hills near river bank. Like the above-referred family in order to have advantage of natural irrigation through the water from river, the total spread-out of all this 7 faliyas is around 2491.28 hectares".

He submitted that the population of Baskariya faliya is 97 whereas total population of the village is 1996. He said that each faliya has its own cluster of home trails and homes scattered around the area and made from local materials like mud, stone and thatch blending with natural environment.

He thereafter referred to three photographs of the area attached with the affidavit demonstrating the home of the deceased having a kachcha (unpaved) approach road leading to the house of another person located at the distance of 9.1 meters where the "unfortunate incident is reported to have taken place".

The Advocate General further said, “This particular place would be at a distance of 4 to 5 kms from the sub-centre, where the facilities are available, of Turkheda village which is located in Sauda faliya of Turkheda village". 

Referring to the photographs he submitted, “Fortunately and luckily, this is an area which is full of connectivity. In fact, according to our information, practically all the houses have the mobile phone, many a times the occasion has arisen, the phone has come, registered with us and the ambulance has gone. This time we did not receive any phone call". 

At this stage the high court orally said, “We understand that there are remote areas but what our concern is even if the areas are remote, primary health centre at a distance of 25 kms…”

The Advocate General said that the ambulance is to take them to sub-centre or the primary centres depending on the complications and the deceased was taken to sub centre earlier while undergoing the treatment.

At this stage the high court orally said, “There is a need for more forces to help them to reach in such situations because there was a miscalculation of her condition at the time of delivery but then there was no support. So, if she has visited the centre as you have said on four times, and she was checked by the person at the health centre, there should be some kind of scheme that they can call them or the person can come from the sub-centre. This has to be seen by the Collector. I think you should get a report from the Collector and depute one person of the state government to go there and have a stock of the situation. These are the remote areas. There are tribal villages, they need bare minimum facilities to survive and health and medical emergencies should be the first priority.”

The advocate general then referring to the photographs taken from the drone facilities submitted that there are motorable roads and that if any phone call had come (for ambulance) they would have rushed.

The Court then said: “This shows they have roads but they don't have any conveyance. How will they travel?...Sometimes, it happens that people are not so responsive at that point of time". The high court further orally pointed to increasing the connectivity of the ambulance to the primary health centres. 

At this stage the advocate general submitted that they shall see to it that the Collector's report is made on the issues raised. To this the court orally said, "Collector's report. Not defending or justifying...with a proposal kind of thing that now what better facilities can be provided". 

The advocate general also said that the vehicle in use should be such that even in extreme weather conditions like during rainy season, help can reach to the people. 

Taking note of this the court orally said, “These kinds of vehicles can also be deployed, jeep or bolero type of vehicles. It is to be worked out...And the people who are from the village, there may be few people who are quite intelligence, they can be trained to meet these kind of emergencies as to what should be done by them. There must be Asha-worker, there must be...Asha-Vadi. Then there are...midwives and so they can be deployed in plenty and then people can have direct access to those people”.

The Advocate General then submitted that the connectivity is there, but perhaps if the residents of the area do not have mobile phones then it can be facilitated for them. He further submitted that they shall see to it that the Collector gives a report "without there being any attempt to defend the hard reality". 

Before parting the high court orally said the report should also mention "plans" which can be made for "at least meeting out those medical emergencies".

The matter is next listed on November 29. 

Case Title: Suo Motu v/s State of Gujarat Through Chief Secretary & Ors.