Maternal death due to non-implementation of healthcare schemes in Nagaland's Mon District

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Moba Changkai versus State of Nagaland & Ors, Writ Petition No. 179 (K) of 2016 Guwahati High Court, Kohima Bench. Synopsis (Issue, facts, prayers): This writ petition was filed in the Kohima Bench of the Guwahati High Court on account of the maternal death of Lt. Bemang who could not survive her seventh pregnancy, an obstructed labour case due to the non functional sub-centre. The event of the death was attributed to the poor implementation of the government maternal health scheme in the Sub-Centre of Monyakshu under Mon District, catering to a population of about 6500. The Sub-Centre is defunct, closed throughout the year depriving the communities Right to Life of good health. The health centre is bereft of any medical facility and services, lack of medical equipments aided by untimely and expired supply of drugs in the centre. The only time it remains open is during immunization drive. This petition was filed after a fact finding was conducted on the maternal death and the health centre. The petitioner prays for compensation against the state authorities who failed in securing the fundamental right to life of good health, equality and dignity enshrined under Article 21, 14 and 15 of the Constitution of India. The petitioner also further seeks for the proper implementation of the maternal health schemes, the Indian Public Health Standard guidelines, conducting of child death review, maternal death review, timely supply of drugs and others. Status (In court): The case was listed for motion on 27.09.2017 and notice was issued to the respondent parties. However, even after the lapse of 7 months the respondents have not filed the counter affidavit in the court. On the last date of hearing, the court has granted further time, as last chance to the respondent authorities to file the response. The case is likely to be listed on the last week of June. Description: Background Mon District, the eastern part of Nagaland is one of the most backward districts in the state. Monyakshu, the biggest village under Mon district and one of the most interior villages in Nagaland, of over 6500 population, is situated in the Indo-Myanmar border. About half of the village population is children and an average family comprising of eight to nine family members. Despite a huge population, the village does not have a functioning health centre to cater to the needs of the people and the only Sub-Centre has perpetually remained dysfunctional. The villagers in this area have been neglected by the state authorities wherein there is in absentia of any governmental facilities and services and the lack of accountability on the state authorities has only perpetuate this deliberate negligence leading to human rights violations of securing health care, educational institutes and facilities and poor sanitation, till date. The cause of maternal deaths and health related problems, in the State of Nagaland, have never been addressed in the court of law. Cases of such nature is one of the first where there has never been intervention, wherein, the organization has taken up the case in filing a petition addressing on the lack of apathy of the state governments and holding them accountable in failing to secure the right to health of the citizens in the village of Monyakshu. Development of the case: The fact finding team went to the village of Monyakshu for looking into the aspect of availability of health services. On interaction with the village chairman it was reported to the team of a maternal death prior to the visit of the team. To understand on the issues perpetuating the death, the team went and interacted with the father of the petitioner wherein it was informed that Lt. Bemang died on her way to Mon District Hospital because the Sub-Center, located just half a kilometer away from the residence of the petitioner was defunct and closed. The mother died on her way, due to obstructed labour case. A close study of the report finds that the dilapidating structure and the dysfunctional center was one of the reasons for the cause of death. With no visit from the doctor, lack of services and facilities, disabling the mother in availing any kind of treatment or test prior to her pregnancy, lack of referral services and no timely intervention in time of medical need were some of the reason which resulted in the untimely death. On further interaction it was also observed that the village of Monyakshu, there was a high prevalent case of child deaths. The deceased’s two children, below the age of 5 years, had also succumbed to it. A petition has been filed in the Kohima Bench of the Guwahati High Court. The petition seeks for direction and implementation of, the Indian Public Health Standards in the sub-centre, conducting of the maternal death review, carrying out child death review n the village of Monyakshu, availability of referral services, granting of the maternal benefit scheme, National health Mission, scheme under JSY and JSSK ensuring maternal care to women, granting a lump sum amount of INR20000 under the National Family Benefit Scheme on account of dead of primary bread winner of a family to be furnished by the Social welfare Department in the State of Nagaland. Respondent No.1 in this case is the State of Nagaland, through the Chief Secretary, who has not filed any reply in the court, till date. Respondent No.2 is the Commissioner and Secretary of Health and Family Welfare Department who has not filed any reply in the court. Respondent No.3 is the Principal Director at the directorate level of the health and Family Welfare with no reply filed. Respondent No.4 is the Mission Director of the National Health Mission in the State of Nagaland who is responsible for the implementation. No reply has been filed till date. Respondent No.5 is the Commissioner and Secretary of Social Welfare Department. Submission has been made by the concerned counsel that para wise reply has been prepared however the affidavit has not yet been filed till date. Respondent No. 6 is the Director of Social Welfare Department at the Director level responsible for the implementation of the scheme in the State of Nagaland. No reply has been filed by the respondents. Respondents No.7 and Respondent No.8 is the Medical Superintendent and the Chief Medical Officer respectively. Replies have not yet been filed. Respondent No. 9 is the Union of India who has also not filed any reply till date.