Lack of qualified medical practitioners in government facilities prevents the masses from seeking the right healthcare services, while fraudulent quacks continue to play with people’s lives in Jodhpur district.

Jodhpur, Rajasthan: Waiting outside the clinic of a local quack in Shergarh, Haakim Khan revealed the reason he preferred a quack — an unqualified person who claims medical knowledge or other skills — to a qualified doctor for his  treatment: “There's always a long queue at the local government hospital. I need to leave early for work every morning. That is why I'm here. If need be, this quack even comes home to examine patients.” 

The Rajasthan government has made treatment at all indoor and outpatients departments (OPDs) in government hospitals free, with also medicines being dispensed free of cost. In the rural parts of Jodhpur district, there are 640 sub-health centres, 86 primary health centres and 28 community health centres — yet, most of these lie unmanned. Nearly 80% of the medical posts in rural areas lie vacant, or doctors are on deputation. This makes the government’s initiatives on healthcare ring hollow.

Missing doctors, few ANMs and dearth of diagnostic services

Phalodi is a relatively large town in Jodhpur district, 135km from Jodhpur city. Yet, healthcare facilities and emergency services here remain abysmal. In the absence of specialised medical personnel, some 5,000 people from the town travel to Jodhpur for even the simplest diagnostic services and treatment every month, reveals opposition leader and politician Ramesh Thanvi.

At the Phalodi District Hospital, of the 136 approved medical positions, which includes that of 16 specialists, none have been filled. There are also many posts of healthcare staff that continue to lie vacant.

"In the absence of doctors, patients are referred to Jodhpur for treatment after some first aid. This often results in patients dying on the way," Shiva Purohit, a concerned resident, told 101Reporters.

There are 32 gram panchayats under the Phalodi Panchayat Samiti. Of these, only 13 gram panchayats have Auxiliary Nurses-cum-Midwives (ANMs) to attend to them. These ANMs attend to the other gram panchayats rotationally. Thus, each gram panchayat is catered to for a week to a fortnight, and only vaccination drives can be managed here. The Shergarh Community Health Centre (CHC) is managed by just two doctors who have to tend to 200 to 250 patients in the OPD. The situation is hardly any different in Baap town or in Balesar block

To make matters worse, the ANMs lack access to adequate vitamins, vaccines, medicines and painkillers to attend to the monthly schedules and needs of infants, toddlers or pregnant mothers. Speaking on condition of anonymity, an ANM told 101Reporters that if basic facilities were made available at the sub-health centres, it'd not be as difficult to manage normal deliveries of newborns and the treatment of local villagers.

“However, sub-health centres remain deprived of facilities and equipment, while health officials remain engrossed in meetings,” she said.

Furthermore, the sub-health centres in Bilada, Balesar, Belwa , Shergarh and Phalodi lack diagnostic services. Hence, their service is limited to vaccination. Villagers are forced to visit the nearest community health centre, where medical practitioners are mostly absent; for even common ailments, they are often referred to Jodhpur for treatment. This leaves them with little choice but to seek help from quacks.

No users for costly medical equipment 

Ironically, the lack of medical personnel has another side to it. Following the deadly first and second waves of the coronavirus-induced pandemic, a lot of expensive equipment was made available by many individuals and charitable organisations to rural hospitals.

In Phalodi and Bilada, emergency equipment such as oxygen concentrators made available during the Covid-19 pandemic are now gathering dust due to the lack of medical practitioners. Balesar hospital, too, was equipped with an oxygen plant, which now lies shut. Of the 160 oxygen concentrators sent, only five were used; the rest are lying here unused. This was confirmed by Balesar Block Chief Medical Health officer Dr Rahish Khan Meher.

Action against health fraud

“Whenever a complaint is lodged by villagers, we take prompt action. We made around 10 arrests but they eventually received a bail from courts,” shared Dr Rahish Khan Mehar

Shergarh Block Chief Medical Health Officer Dr Dhiraj Bissa also claimed that they "keep taking action against quacks from time to time. Right now, we are looking into complaints against two quacks”.

But truth be told, there have been only 10 complaints against quacks in the past decade here, which may serve as an indication of their popularity. Complaints are lodged only when a life is lost due to incorrect medication or diagnosis — as was the case in April 2022, when a child died after being injected by a quack in Sointara village of Balesar block.

In the rural parts of Phalodi, nearly every resident is at the mercy of quacks. In remote villages, these fraudulent health workers have even set up nursing homes within pharmacies. Lack of medical facilities at the sub-health centres, too, has proved a boon for these practitioners in Belwa, where 10 to 12 quacks operate from a one-room 'clinic'. It's a similar story in several other villages. Although health officials round up quacks from time to time, they appear to always be released later. Once free, they are back to their so-called practice.

Quackery and quacks

An investigation by 101Reporters into the quackery prevalent in Jodhpur district revealed some alarming facts. A Bengali quack operating from a one-room clinic in Bhakri ka Bas settlement in Gopalsar village, Belwa, for the past three to four years claimed he was an RMT degree-holder from West Bengal, which qualified him for medical practice.

“Different rules prevalent in different states of India prevent recognition of one’s degree, or allow medical practice,” he claimed.

It wasn’t clear, though, why he could not practise as a medical doctor in West Bengal and had to travel to operate a clinic in a remote part of Rajasthan.

Similarly, a quack operating from a medical pharmacy in Shergarh confessed to having a degree in nursing.

“Private hospitals pay just Rs 8000 to Rs 10,000 a month, which is hardly enough to live on. I treat patients on the strength of my nursing degree,” he said.

Besides the inadequacies of the prevalent healthcare system, there's another reason for the popularity of these supposed medical practitioners — in a government hospital, doctors usually prescribe medicines after examining a patient; quacks, on the other hand, start with an injection or a drip. Unaware villagers tend to be impressed by this and conclude that they are receiving the right treatment for whatever illness they are suffering from.

Edited by Rina Mukherji 

This story is part of our series on ‘Rural Diagnostics’ that attempts to highlight the availability of such medical services in rural India. Read another article For the faint-hearted: New programme 'lowers cardiac deaths by 50%' in rural Telangana published under this series.