Complete picture: Know what NHM doctors are protesting for

SRINAGAR: On the sixth day of the strike by the National Health Mission (NHM) staff, almost a dozen odd protesting professionals were injured when cops blocked their advance on Srinagar’s high fashion street, Residency Road. Sheikh Muzafffar, the Block Monitoring Evaluation Officer (BMEO) received a serious head injury and another female protester is reportedly surviving with a fracture.

“We give special treatment to police officials when they are in distress but today they used so much of bad force against us,” Shaheen Nawaz, president of the agitating health professionals said. “We carried no stones in our hands.”

Nawaz said that the people who are peaceful and seek justice are being treated by the government like this. “See how many of our members were beaten and where they are?” He identified his members who were injured in the police action and have been shifted to SMHS and the Bone and Joint hospital in Srinagar.

Muzaffar apart, those who were injured in the police action included Masroofa, FMPHW from Ganderbal, Syed Iram from Baramulla, Afrooza (Srinagar), Masoofa (Pulwama), Sameena Bono (Khan Sahab), Rahila Bashir (Budgam) have injuries in their arm. Dr Supinder Pal Singh has a fracture in a finger. Afrooza Ahmad (Hajin) has left leg injury and Dr Tashakur lost his consciousness during the police action.

“Neither we are violating any law, nor have we resorted to violence,” Nawaz said. “Still we get injured.” In protest, they have now extended their strike till March 9.

For the last six days, as the doctors and the paramedics are protesting over the “deliberate decimation” as professionals, nobody from the state government has tried even approaching them. Their protest has led to near-collapse of most of the immunisation programmes as most of the health sub-centres in Kashmir’s periphery are locked. PHCs apart even the major hospitals have started taking a hit. One report said the crucial Lal-Ded Hospital had its ICU closed last night.

Scary Sight: An NHM female professional falls into a drain in Srinagar, after polcice charged them. KL Image: Bilal Bhadur

Health managers in J&K might be insisting that there is no impact on the ground but the fact is that when nearly 12000 people across the state will not report to their duties, there has to be some impact.

“We do not have major issues,” one of the spokespersons of the agitating NHM employees said. “Our focus is on two things: equal work, equal pay and regularisation of the services.”

When the doctors start explaining their position, it emerges an interesting story about how the government is sitting over a discriminatory set up in the health management system. All the protesting employees belong to NHM, which, of late, has emerged as a parallel set up to the Directorate of Heath Services. Earlier, they were restricted to the countryside but now they exist even in cities and other suburban habitations. Under NHM, the government is recruiting professionals on a contract and then forgetting their very existence, the NHM officials said.

“Doctors who belong to Directorate of Health Services have all the facilities that a government employee has: right to be on leave, sick leave, maternity leave and all the benefits including insurance and pension,” one young female doctor who is serving a south Kashmir sub-centre said. “I have been working 24 x7 for a week and then I come home which is not the case of a regular doctor.”

Police charging agitating NHM professionals in Srinagar. (KL Image: Bilal Bhadur)

One of the doctors had an interesting tale to tell. “Prime Minister Modi has announced that ninth day of every month is exclusive for the pregnant ladies for a complete ANC – anti-natal check-up. That is the national policy,” she said. “But in J&K, it does not apply to NHM staffers! We avail this and we have a day’s wage deducted by the officials.”

Interestingly, NHM staffers do not access to the insurance scheme that the government has negotiated for its employees. No provident funds are being deducted from them as well, which could be a serious labour issue for the managers in the government.

Another doctor asked, “Do not you think, it is strange that we as females do not have even right to be on maternity leave? Our leave days are being deducted from our wages and every day is counted even if it is a serious illness.”

Nawaz said they are seeking equal pay for equal service. “Why cannot we be paid the same amount that is being paid to the doctors in government especially when we perform better and we are rarely on leave?” he asked.

The agitating doctors said there is huge discrimination in their salaries. “In Delhi, we have evidence that doctors in NHM are being paid Rs 65000, a month and in Assam, it is more than Rs 85000,” one lady doctor said. In J&K, NHM doctors get around Rs 30,000 and that too when they have not availed any leave and are punctual.

National Health Mission (NHM) professionals protesting against systemic discrimination by the Jammu an Kashmir Govt. KL Image: Bilal Bhadur

The second major issue they are facing is that while they were engaged in NHM, time elapsed to the extent that some of them literally crossed the age-bar. “Next time, there are vacancies in government and we apply, some of us may not be eligible,” one doctor said. “The government is happy that the show goes on but they do not see what costs we pay for that.”

The agitating doctors said various states have initiated exercises envisaging regularisation of the NHM staffers. Rajasthan, Punjab, Himachal and Haryana have recently started it. “But nothing moves in J&K.”

NHM in J&K exists in allopathy and ISM. “Under NHM directly we are almost 8000 people but you add another three scheme that works through NHM – Non-Communicable Diseases (NCD), Integrated Diseases Surveillance Project (IDSP), Control of Blindness (COB) and Rashtriya Bal Surkhasha Karikaram (RBSK), then our population touches 12000 across J&K,” one leader of the agitating professionals said. “But then, who cares.” These include almost 1500 doctors, paramedics and health managers of various categories.

“The government already has a route available to manage our problems,” the ringleader said. “There is SRO 255 that can take care of our pressing career issue, our future.”

Since nobody in J&K government is taking the NHM reaction seriously, Jammu is expectedly joining the strike this week. Doda is already in. By next week, the health situation in J&K will flood the private sector.

Police on Monday foiled a march of National Health Mission (NHM) employees towards the Chief Minister's residence at Gupkar from Lal Chowk.KL Image: Bilal Bhadur

NHM, it may be recalled here was initiated in 2005 to bring “architectural corrections” in existing health care delivery with a focus on maternal and child health care. Till 2011-12, J&K government was contributing 15 percent in this centrally sponsored scheme, then it became fully funded for a year and now it is 90:10 between centre and state. With state’s contribution to the tune of Rs 291 Crore, so far, the centre has released Rs 1923.95 Crore until December 2016.

In the last more than a decade, NHM has gradually created a parallel set-up across the state. It funds surgical requirements, buildings, and immunisation and has a huge army on rolls. But given the service system in which they are delivering, they have emerged as the new underdogs of the healthcare system in which they do the most and are paid the least. Well before it becomes a major crisis, the government must talk to them. Better late than never.

Meanwhile, opposition National Conference has condemned the use of force on protesting NHM employees and said the Government should talk to the protesting employees rather than resort to use of force to silence them.

“These are respectable members of the society and are rendering service in various capacities across the State. The Government should sit down with their representatives and try to engage with them in an effort to explore some possibility of resolving those issues that are genuine – based on both similar cases that have been resolved in other States and also humanitarian grounds, a spokesperson of NC said in a statement said.


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