CHAPTER XVI
MEDICAL AND PUBLIC HEALTH
SERVICES
(a)
Public Health and Medical Facilities
in Early Times
Little is known
about the medical facilities which were available in ancient times in the area
comprising the present Fatehgarh Sahib District. But it may be presumed that
the Ayurveda, was the system practiced then by the physicians, known as vaids.
They used herbs, minerals, chemicals, etc. for medical purposes. It was fairly
advanced in diagnostics. The important principals of hygiene and public health
along with the dietary values of each article of food and its effects on human
health mentioned in the Ayurveda Texts continue a good treats on public health.
Muslim rulers introduced the Unani system of medicine, which became more
popular in urban areas due to the patronage of the rulers. But in the rural
areas, Ayurvedic system continued to be practised. The factors responsible for
the popularity of these systems were availability, cheapness and conditions then
prevailing. To sum up, in early times the field of medicines was shared by
Ayurveda and Unani systems and a good number of quacks and faith-healers on
whom a section of society pinned its faith.
The advent of the
British led to the gradual introduction of the western system of medicines
known as Allopathy. The beginning was made in this direction in the last
quarter of the 19th Century, by the then rulers of the
The work of
providing medical relief was greatly accelerated after
(b) Vital Statistics
The
statistics regarding births and deaths are most important for planning of
health programmes. These are helpful in determining the growth rate of
population and finding the percentage of deaths. Keeping of birth and death
statistics is no doubt more than a century old practice, but it was not
scientific in early days. The mode of collection of vital statistics prior to
1901, in the erstwhile
The Director, Health and Family Welfare,
The Registrar General of
The registration area
has been divided in two sectors,
i.e. rural and urban areas. The
registration hierarchy in these sectors is as under:
Rural Areas.- In the rural areas, the Station House
Officer of a police station has been notified as the Local Registrar Births and
Deaths for the villages falling under his jurisdiction. Although it is the
responsibility of the head of the household to get the vital events registered
with the Local Registrar, the services of the Chowkidars are provided to the
villagers who record the events in the Chowkidara Book and get it
registered with Local Registrar within the scheduled time limit, i.e.14 days
for deaths and 7 days for births.
Urban Areas.- In the urban areas, the Municipal
Corporation/Municipal Councils/Nagar Panchayats
are the Local Registration Centres. The Municipal Medical Officer of
Health and in his absence, Executive Officer/Secretary/ Administrator is the
Local Registrar, Births and Deaths.
The birth rate, death rate and
infantile mortality rate in the Fatehgarh Sahib District from 1992 and 1996 to 2001 are given below:
Year
|
Birth rate per thousand population |
Death rate per thousand population |
Infantile mortality rate per thousand live births |
|
22.4 |
7.9 |
56.7 |
|
|
1996 |
19.7 |
8.1 |
56.4 |
|
1997 |
19.6 |
8.1 |
55.8 |
|
1998 |
19.9 |
7.8 |
55.2 |
|
1999 |
19.4 |
8.2 |
41.2 |
|
2000 |
18.9 |
8.1 |
50.3 |
|
2001 |
18.8 |
7.9 |
51.2 |
(Source: Civil
Surgeon, Fatehgarh Sahib)
Important Causes of Mortality.- The important causes of mortality in the district are
typhoid group of fevers, diabetes, heart diseases, pneumonia and respiratory
diseases. The statistics regarding deaths registered from various diseases in
the Fatehgarh Sahib District, during the years 1992 and 1996 to 2000 are given
in Appendix I at page ____________.
(c) Diseases common to the District
There are many diseases, which occur in the
district. The common diseases which occur in the district are gastro enteric
diseases, typhoid group of fevers, respiratory diseases, tuberculosis, malaria,
smallpox and plague. Epidemic diseases, viz, plague, cholera and smallpox are
three notified diseases under the Epidemic Diseases Act, 1897. Of these plague
and smallpox have been eradicated or controlled to the effect of no incidence.
Although the statistics of mortality due to these diseases can not be computed
for the area constituting the present area of Fatehgarh Sahib District for the
period prior to its formation, old records testify the facts that the area
suffered intermittently from the visitations of cholera, smallpox and plague.
The diseases which occur more frequently are called common diseases. These
common diseases are briefly described below:
(i) Fevers.- Fevers are the main cause of deaths in the district. These include
ordinary fevers, typhoid, influenza and other seasonal fevers, including
malaria. These fevers are the result of infections, unhealthy living and
imbalanced diet, leading to low resistance. The causes of these fevers have become
almost chronic and it is extremely difficult to eradicate them. In the past,
these fevers were cured with various medicines, including quinine. But, at
present, their place has been taken by sulpha drugs and antibiotics, which have
been found to be very effective. Healthy living and better diet would lessen to
a considerable extent the incidence of general type of fevers.
(ii) Respiratory Diseases.- Respiratory diseases, which are next in importance only to fevers, are also responsible for deaths in the district. These are caused by different types of smokes, fumes vapors of chemical gasses released by the burning of charcoal, coke, etc. These gasses pollute the surrounding atmosphere all the time, thus affecting the health of the people. Smoke irritates the eyes, the throat and the lungs constantly. The insanitary conditions in the slums also cause the outbreak of these diseases.
In order to check the spread of such disease the
Factories Act, 1948 lays down that there should be a proper disposal of gases
entering the atmosphere and any harmful effluents should be removed to far-off
places, where they do not adversely affect the health of the people.
Proper diagnostic facilities available in
dispensaries and at the public health centers, hospitals, provision of
institutional facilities, domiciliary treatment and follow-up of cases from
diseases such as tuberculosis and chronic bronchitis have brought down the
mortality figures considerably.
(iii)
Malaria.– Malaria was the common fever in the
area of present Fatehgarh Sahib District in early days. Malaria spreads by
mosquitoes is caused by blood parasite called ‘Plasmodium` which is present in
the blood of the malaria patient. Malaria had been undoubtedly the most
important public health problem in the State. It is essentially a rural problem
and general poverty and backwardness of rural area are a hurdle, which, the
people of affected areas cannot be expected to surmount as they have no means
to do so. It was dreadful disease for years together and took a heavy toll of
lives in the district. Malaria epidemics occur from year to year after
excessive monsoon rainfall. Quinine, the only remedy for malaria was
distributed in rural areas through various agencies. It no doubt lowered the
incidence but could not eradicate the disease. It was only after the
At the time of
The malaria unit in the Fatehgarh Sahib District is
manned by 1 Assistant Malaria Officer, 1 Assistant Unit Officer, 4 Medical
Laboratory Technicians, 8 Multipurpose Supervisor and 82 Multi Purpose Health
Workers.
Malaria Clinics.-There
are 10 malaria clinics in the Fatehgarh
Sahib District. The blood slide of every fever case is prepared and is examined
immediately. If found positive for the malaria parasite, then radical treatment
is given immediately on the same day. Data regarding collection and examination
of blood slides, malaria cases found positive (p.vivex and p. faleirparium),
radical treatment given and API for the year 1992 and 1996 to 2001 is given
below:
|
Blood slides Cases found positive |
|||||||
|
|
Collected Examined |
|
Radical
Treatment |
API |
|||
|
1992 |
61,750 |
61,750 |
1,021 |
30 |
1,051 |
2.24 |
|
|
1996 |
70,999 |
70,999 |
555 |
18 |
573 |
1.12 |
|
|
1997 |
70,945 |
70,945 |
500 |
4 |
504 |
0.98 |
|
|
1998 |
70,101 |
70,101 |
37 |
- |
37 |
0.07 |
|
|
1999 |
69,681 |
69,681 |
12 |
2 |
14 |
0.02 |
|
|
2000 |
57,853 |
57,853 |
2 |
- |
2 |
0.003 |
|
|
2001 |
58,813 |
58,813 |
9 |
- |
9 |
0.017 |
|
(Source:
Director Health and Family Welfare,
(iv)
Communicable Diseases.- Plague,
cholera and small pox are the main communicable
diseases (epidemic diseases) notified under Epidemic Disease Act, 1897. Out
of these three, plague is not endemic where as other two are endemic. Small pox
has been eradicated and the plague has now become non-existent. A brief
description of each of these is given below:
Plague
No case of Plague has been
reported in Fatehgarh Sahib District since its formation in 1992. As in the
past it was one of the most horrible disease to maintain control and check,
anti-plague measures are adopted every year to control this horrible disease.
Sanitary Inspectors and Swasth Sahaiks are deputed to destroy rats by
cynogassing the rat holes, baiting with zinc phosphate and by laying rat traps.
The other factor responsible for its disappearance is construction of pukka
houses, wherein because of cemented floors, rats can not make holes for their
hiding. As a result of these measures
the district is free from this infectious disease.
Cholera
Cholera used to occur in
an epidemic form before
In recent years the number
of Cholerae cases has been remained under check because of the strict
porptylactic and other anti Cholera measures taken by the health department.
Small
Pox
Small pox used to take away a heavy tole
of life in the past, particularly in the last quarter of the 19th
century. Vaccination, introduced in the first decade of the century against
this disease does not seem to have evoked any popular response till the turn of
the twentieth century. In the area of the present Fatehgarh Sahib District, the
rulers the then Princely States introduced vaccination system to prevent these
diseases. In
(V) Tuberculosis.- Tuberculosis
(T.B.)is one of the major public health problem in the district. It has been
persisting because of the spread of infection and less resistance among the
people. Since the cure of tuberculosis requires a sufficient and long time,
domiciliary treatment is carried out in the district. After diagnosis,
medicines are prescribed and necessary precautions are explained to the
patients so that they could continue their treatment staying at home.
Previously the stress had been on treatment of cases both at sanatoria and in
hospitals but now treatment is given to make cases non-infectious and
thereafter the patients are advised to continue treatment at home.
In order to control
the tuberculosis, the National Tuberculosis Control Programme (NTCP) has been
launched in the country in 1962. The aim of the programme is to reduce the
infection in the community so that not only the existing patients are cured but
the danger of fresh to the susceptible population is reduced. NTCP operates
through District Tuberculosis Control Officer, which is a comprehensive control
programme for the whole country especially for the rural areas. This programme
envisages integration of specialized T.B. service at the district headquarters
with the general medical services at the periphery in the rural areas. All
cases having cough, fever and weight loss from quite a long period are examined
in T.B. treatment centres. The B.C.G is an effective vaccination against
tuberculosis. The District T.B. Officer
supervises the set up to eradicate tuberculosis from the District. During the
year 2000-2001, there were 6 X-Ray Centres, 6 Microscopic Centres and 6
Referral Centres in the Fatehgarh Sahib District. The number of patients
treated under National Programme for the control of Tuberculosis from 1993-94
to 1999-2000 in the Fatehgarh Sahib District, is given below:
|
Year |
Persons given treatment |
|
|
1992-93 |
272 |
|
|
1996-97 |
691 |
|
|
1997-98 |
451 |
|
|
1998-99 |
187 |
|
|
1999-2000 |
136 |
|
|
2000-2001 |
104 |
|
(Source: Civil Surgeon, Fatehgarh Sahib)
(vi) Gastro-Enteritis, Dysentery and Diarrhoea.-Gastro-enteritis, dysentery and diarrhoea are the other diseases which
effect the people of the district. Although the mortality from these diseases
in past was on high side but it is under control in recent years, as a result
of the step taken by the health department and other social service agencies.
(d)Medical and Public Health Services
After
The medical and health services in the district are
controlled and looked after by the Civil Surgeon-Cum-Deputy Director. He is
also an ex-officio District Registrar, Births and Deaths. He is
assisted by an Assistant Civil Surgeon, District Family Welfare Officer,
District Health Officer, District T.B. Officer, etc, for implementation of
various health programmes in the district. He functions direct by under
administrative control of Director Health and Family Welfare,
In the Fatehgarh Sahib District,
Civil Surgeon is assisted by 85 Medical Officers, 2 Dental Surgeons, 1 Chief Pharmacists, 55
pharmacists and other miscellaneous Class III and Class IV Staff.
Hospitals, Community Health Centres/ Primary
Health Centres/ Subsidiary Health Centres and Dispensaries
The
development of indigenous system of medicine has also gained considerable tempo
in recent years. Due to the popularity of the Ayurvedic, Unani and Homeopathic
system of medicine amongst the masses and also encouragement given by the
Government, a number of dispensaries opened
in the district. However there is gradual improvement in providing
medical facilities since the formation of the district. The Government had
spent Rs 6,95,93,000 on health services in Fatehgarh Sahib District during
2000-2001. The number of medical institutions functioning under each system of
medicine in Fatehgarh Sahib District during 2000-2001 is described below:
Allopathic Medical
Institutions.- As on
area-wise break-up is given below:
|
Tahsil |
Rural |
Urban |
Total |
|
Fatehgarh
Sahib |
27 |
5 |
32 |
|
Bassi
Pathana |
1 |
1 |
2 |
|
Amloh |
2 |
5 |
7 |
|
Khamano |
12 |
- |
12 |
( Source: Civil Surgeon, Fatehgarh Sahib)
The
management-wise break up of the above allopathic institutions is 50 State
Public and 3 State Special. The list of hospitals, community/ primary health
centres and dispensaries in the Fatehgarh Sahib District is given in Appendix II on
pages _______ to _______
Ayurvedic
and Unani Medical Institutions. – There were 10 Ayurvedic and 2 Unani medical
institutions in the Fatehgarh Sahib
District during 2000-2001. All these institutions were under the control of
Director Ayurveda,
|
Serial No |
Name of the Institution |
Ayurvedic/Unani |
Rural/Urban |
Tahsil |
|
1 |
Sirhind Mandi |
Ayurvedic |
Urban |
Fatehgarh Sahib |
|
2 |
Brahman Majra (Sirhind) |
-do- |
-do- |
-do- |
|
3 |
Chunni Kalan |
-do- |
Rural |
Fatehgarh Sahib |
|
4 |
Baras |
-do- |
-do- |
-do- |
|
5 |
Daulatpur |
-do- |
-do- |
-do- |
|
6 |
Mandi
Govindgarh |
Unani |
Urban |
Amloh |
|
7 |
Farjullapur |
Ayurvedic |
Rural |
Amloh |
|
8 |
Salana Jiwan Singh Wala |
-do- |
-do- |
-do- |
|
9 |
Reona |
-do- |
-do- |
-do- |
|
10 |
Raillon |
-do- |
-do- |
Bassi Pathana |
|
11 |
Kheri Naudh Singh |
-do- |
-do- |
Khamano |
|
12 |
Khamano |
-do- |
Urban |
Khamano |
|
(Source : Director,
Ayurveda, |
||||
Homeopathic Medical
Institutions.- As on
The Number of indoor and out door patients given treatment in the hospital
were 3,302 and 43,274 during the year
2000-2001.
The number of indoor and
outdoor patients given treatment in the hospital were 312 and 16,745
respectively during the year 2000-2001.
Civil Hospital, Bassi
Pathana. - This
hospital is a 25 bedded hospital
(15 for men and 10 for women). The hospital is manned by 1 Senior Medical
Officer, 1 Medical Officer, 1 Dental Surgeon, 1 Nursing Sister, 4 Staff Nurses
besides miscellaneous Class III and Class IV Staff.
The number of indoor and
outdoor patients given treatment in the hospital during the year2000-2001 were
279 and 9,219.
Civil Hospital,
Khamano. - This
hospital was established in 1978 and has 4 beds. This hospital is manned by 1
Medical Officer, 1 Pharmacist, beside miscellaneous Class III and Class IV
staff. The hospital provides facility of E.C.G., X Ray and Laboratory. The
Hospital also has doctors of Eye, E.N.T. and Medicine.
The number of indoor and
outdoor patients given treatment in the hospital during 2000-2001 were 77 and
16,900.
Blood Bank
One
blood bank has been functioning in the Fatehgarh Sahib District at
The number of blood units
collected and transfused in the district during 1999 to 2001 is given below:
|
Year |
Collected
Transfused |
|
|
1999 |
116 |
70 |
|
2000 |
50 |
41 |
|
2001 |
231 |
184 |
|
(Source: Civil Surgeon,
Fatehgarh Sahib) |
||
Disease Eradication and Control
Programmes
The
modern concept of good health lays great emphasis on prevention of diseases and
this necessitate various kinds of measures. Since Independence, several
measures have been undertaken by the Central Government to improve the health
of the people. Important among these
measures are: the National Health Programmes, which have been launched by the
Central Government for the control/eradication of various diseases, improvement
of environmental sanitation, raising the standard of nutrition, control of
population and improving rural health. Various international agencies like WHO,
UNICEF, UNFPA, World Bank, etc. have
also been providing technical and material assistance in the implementation
of these programmes, which are given below:
National Family Welfare Programme
Family
welfare Programme, as was called earlier as ‘Family Planning’ and renamed as
‘Family Welfare’ in 1976 by the Government of India, was launched in the country
in 1952. The Family Welfare Programme does not merely seek to limit the size of
the family. It also concerns on improving the health of mother and the existing
living children. The recognition of its welfare concept came only a decade and
half after its inception when it was
named Family Welfare Programme.
The
objective of the Family Welfare Programme is to adopt the 'small family norm'
to stabilize the population of the country. The programme initially adopted the
model of 3 child family. In view of the
seriousness of the situation, the 1980's campaign has advocated 2 children
norm. A significant achievement of the Family Welfare Programme in India has
been the decline in the fertility rate from 6.4 in the 1950's to 3.2 in 1998.
All efforts are being made through mass communication that the concept of small
family norm is accepted, adopted and woven into life style of the people. The
Family Welfare Programme aims at achieving a higher end that is to improve the
quality of life of the people.
The
Family Welfare Programme is a Centrally Sponsored Scheme and the Government of
India meats 100 percent expenditure incurred by the state Government. The
Family Welfare Programme may be said to have gained momentum in the State in
the beginning of Second Plan and got further boost by introduction of IUCD
(Intra-Uterine Contraceptive Device) popularly known as ‘loop’, in 1965.
The Secretary to the Government of India in the Ministry of Health and Family
Welfare is the overall in charge of the Department of Family Welfare, which was
created in 1966 and the programme became
target oriented. The National Institute
of Health and Family Welfare acts as an apex technical institute for promoting
health and family welfare in the country through education, training services,
research and evaluation.
The implementation of Family Welfare Programme is done by the Medical and Health Department of the State Government through the Director Health Services (Family Welfare) at the State level and the District Family Welfare Officer at the district level. The Director, Health and Family Welfare , Punjab is assisted by and Assistant Director (MCH), Deputy Director (FW), Assistant Director (FW) and Assistant Director (IUD).
The District Family
Welfare Officer, Fatehgarh Sahib is responsible
for effective realization of objectives of this programme in the district. As
on 1 April 2001, there were 3 Family Welfare Centres functioning in the
district at Fatehgarh Sahib, Chanarthal Kalan and Nandpur Kalaur.
The present approach in
Family Welfare Programmes is to provide a 'Cafeteria Choice' viz. conventional
contraceptives, oral pills, IUD's and sterilization.
The Medical Termination of
Pregnancy, (MTP Act) was enacted in 1971 and later on, the Government of India
introduced MTP Rules,1975. The Punjab Government notified these Rules on 7
April 1976. Under these Rules, the government hospitals need not to require any
certification. These are considered approved places for MTP provided MTP
trained/qualified doctor is posted in the hospital and necessary medicines,
equipment, etc, are available there. The private hospitals are required to
procure the approval of the Government before functioning as MTP centres.
The progress of
sterilization operations, IUD insertions and MTP in Fatehgarh Sahib district
During 1993-94 and 1996-97 to 2000-2001
is shown in the table given below:
|
Year |
Sterilization |
IUD Insertions |
No. of Progressive
totals
Insertions |
|||
|
1993-94 |
10,771 |
39,359 |
142 |
12,641 |
47,610 |
179 |
|
1996-97 |
1,999 |
8,668 |
148 |
14,640 |
56,278 |
327 |
|
1997-98 |
1,773 |
6,724 |
119 |
16,413 |
63,002 |
446 |
|
1998-99 |
2,232 |
7,064 |
139 |
18,645 |
70,066 |
586 |
|
1999-2000 |
2,230 |
7,154 |
136 |
20,875 |
77,220 |
722 |
|
2000-2001 |
1,542 |
7,008 |
112 |
22417 |
84,228 |
834 |
(Statistical Abstract of Punjab 1992 and 1997 to
2000)
National Programme for Control of Blindness
This
programme was launched in 1976 and incorporates the earlier Trachoma Control,
Programme, which was started in 1968. The ultimate goal of this programme is to
reduce blindness in the country from 1.4 per cent to 0.3 percent, to provide
comprehensive eye care through primary health care. Each primary health centre
and district hospital is provided with Ophthalmic Assistant. Since cataract is
the main cause of blindness, targets have been laid down for cataract
operations. The cataract is curable by simple operation. Curable cases of blindness are treated by holding eye camps at
various institutions for cataract and glaucoma operations. Corneal blindness is
treated by corneal transplant operation at specialized institutions. The
cataract operations are done at the district and tahsil level hospitals.
The
voluntary organisations have been encouraged to organise eye camps in remote
rural and urban areas as per guidelines issued by the State authorities. A number
of such organizations are functioning in the district and are active in
providing eye health education, preventive, rehabilitative and surgical
services for control of blindness.
The
number of patients treated/operated under National Programme for Control of
Blindness from 1992-93 and 1996-97 to 1999-2000 in the Fatehgarh Sahib
District, is given below:
|
Year |
Number of patients |
|
|
1992-93 |
857 |
|
|
1996-97 |
1,687 |
|
|
1997-98 |
1,372 |
|
|
1998-99 |
1,543 |
|
|
1999-2000 |
1,617 |
|
|
2000-2001 |
557 |
|
|
(Source : Civil Surgeon,
Fatehgarh Sahib ) |
||
National AIDS Control Programme
AIDS
(Acquired Immune Deficiency Syndrome) was first classified as a disease in 1981
and in 1984 HIV (Human Immuno Deficiency Virus) was identified as the cause for
it. There is no cure for it when a person is infected with the disease. Hence
the measures are carried on by the Government to control and to prevent the
spread of the disease. AIDS is a dreaded
disease which spreads mainly due to hetro-sexual contract and unsafe blood
transfusion. Other routes of transmission like intravenous drug abuse or
perinatal spread. To control the spread of this dreaded disease, the Government
of India, in 1985 constituted a task force. It began by Pilot Screening
Programme of high-risk population. National AIDS Control Programme has been
launched under the aegis of Union Ministry of Health and Family Welfare in 1987
at central level. In 1991, a strategic plan for prevention and control of AIDS
was developed with the help of WHO and World Bank, it was implemented in 1992.
The Ministry of Health and Family Welfare has set up a National AIDS Control
Organisation as a separate wing to implement and closely monitor the various
components of the programme.
AIDS Control Programme was launched in Punjab
State during 1992-93 as a 100 percent Centrally Sponsored Scheme. AIDS control
cell has been created in the Directorate headed by Deputy Director AIDS. Civil Surgeons
have been directed to designate one of their District Officers as Nodal
Officers. Information about AIDS has been disseminated to the people through
Health Education Camps.
The
Government of India has established Surveillance Centres at different places
for screening persons practicing high risk
behaviour and Zonal Blood Testing Centres in large cities for screening
all pooled plasma for HIV infection and screening blood samples received from
blood banks.
One State level Surveillance Centre along with Sentinel Cenre has been established at Medical College, Amritsar. Three Zonal Blood Testing Centres have been established in the State one each in College of Amritsar and Patiala and at Civil Hospital, Ludhiana. Number of cases reported in the Fatehgarh Sahib was 20 till 2000-2001.
National Leprosy Eradication Programme
Leprosy is the oldest
disease which is neither hereditary nor contagious. About 95 people are
naturally immune to the leprosy germs. The problem of combating this deadly
disease attracted the attention of the rulers of the erstwhile Princely State
of Patiala. A Leper Asylum was established by Maharaja Karam Singh in Sambat
1883 at Patiala near Moti Bagh which supported 16 lepers and 13 blind paupers
at that time1. National Leprosy Control Programme has been launched
in the country during 1955-56. With the availability of highly effective
treatment of leprosy, the programme was re-designated as National Leprosy
Eradication Programme in 1983 with the objective to eliminate the leprosy in
the country. Punjab is a low prevalence State so far the leprosy is concerned.
In
Punjab, at the State headquarters, there are Zonal Leprosy units to supervise
and review the achievements under National Leprosy Eradication Programme. At
each district headquarters there is one Urban Leprosy Centre. One Urban Leprosy
Centre is functioning at Fatehgarh Sahib under the supervision, guidance and
control of District Tuberculosis-cum-Leprosy Officer.
The number of persons
given treatment under the programme during the years 1994-95 to 1999-2000 is
given below:
Year Persons given
treatment
1994-95
4
1996-97
16
1997-98
17
1998-99
45
1999-2000
37
2000-2001 32
(Source :Civil Surgeon, Fatehgarh Sahib)
1 Punjab
States Gazetteer Volume XVIII-A, Phulkian States (Patiala,Nabha and Zind),1904,P183
Child Survival and
Safe Motherhood Programme
This programme has been introduced as a
part of the overall strategy for reduction of infant mortality rate, child
mortality rate, natural mortality and
reduction in low birth-weight babies. To achieve these objectives, Child
Survival and Safe Motherhood Programme was started in the State in August 1992
with financial assistance of World Bank and UNICEF. The health measures
relating to women and children, prior the launching of this scheme, has been
included in it besides widening its scope in this respect. The important
schemes run under this programme are detailed below:
Universal Immunization
Programme.-After the
success of Small Pox Eradication Programme, immunization was considered as the most
powerful and cost effective weapon against vaccine preventable diseases. In
1974 the World Health Organisation (WHO) launched its "Expanded Programme
on Immunization" (EPI) against six most common preventable childhood
diseases viz. diphtheria, pertussis (whooping cough), tetanus, poliomyelitis,
tuberculosis and measles. The Government of India launched its EPI in 1978 with
the objective of reducing the mortality and morbidity resulting from
vaccine-preventable diseases of childhood and to achieve self-sufficiency in
the production of vaccines. EPI was renamed as 'Universal Child Immunization '
(UCI) during the same year. In India, Universal Immunization Programme was
started in 1985. It has two vital components, immunization of pregnant women
against tetanus and immunization of children in their first year of life
against six EPI target diseases. The whole of the Punjab State has been covered
under the programme upto 1989.
The immunization services have been provided in the
State through the existing health care delivery system i.e. maternity and child
health centres, primary health centres, subsidiary health centres, hospitals
and dispensaries.
The
achievement under the 'Universal Immunization Programme’ in the Fatehgarh
Sahib District, during
the years 1992-93 and
1996-97 to 2000-2001 is given in
the following table:
|
Achievement Under The 'Universal
Immunization Programme’ in the Fatehgarh Sahib District |
||||||
|
|
1992- 93 |
1996- 97 |
1997-98 |
1998- 99 |
1999-2000 |
2000-2001 |
|
TT (Pregnant women) |
10,442 |
13,514 |
12,509 |
11,915 |
10,056 |
8,283 |
|
DPT (Infants) |
11,698 |
13,242 |
12,528 |
13,290 |
11,369 |
8,823 |
|
Polio (Infants) |
11,698 |
13,242 |
12,528 |
13,290 |
11,305 |
8,823 |
|
BCG (Infants) |
11,057 |
13,695 |
12,548 |
13,702 |
12,453 |
12,646 |
|
Measles |
10,385 |
13,392 |
10,711 |
12,415 |
12,742 |
11,065 |
|
DT (5 years) |
9,223 |
13,858 |
13,254 |
13,320 |
15,167 |
12,065 |
|
TT (10 years) |
8,847 |
12,427 |
9,121 |
12,702 |
11,887 |
10,698 |
|
TT (16 years) |
8,871 |
8,894 |
8,103 |
11,013 |
9,610 |
8,407 |
( Source: Civil Surgeon Fatehgarh Sahib)
Prophylaxis against Nutritional Anemia Amongst
Mothers and Children.- Anemia is quite common
during pregnancy, because the existing nutritional deficiencies are aggravated
by demand of pregnancy and nursing of children and prevalence of high incidence
of worm infestation. To prevent and counter the adverse effects of these deficiencies.
Iron and Folic Acid tablets are given to the mothers and children for 100 days.
The achievement under the programme during the years 1992-93 and 1996-97 to 2000-2001 is given hereunder:
|
Year Iron and Folic Acid tablets given
|
||
|
1992-93 |
15,882 |
16,539 |
|
1996-97 |
11,435 |
7,606 |
|
1997-98 |
13,231 |
11,897 |
|
1998-99 |
12,742 |
18,857 |
|
1999-2000 |
17,030 |
27,520 |
|
2000-2001 |
20,921 |
30,433 |
(Source: Civil Surgeon, Fatehgarh Sahib)
Prophylaxis against Blindness
caused due to Vitamin 'A" Deficiency.- Xerophealimia (nutritional blindness) is
attributed to nutritional deficiency of Vitamin 'A'. Keratomaliacia has been
the major cause of nutritional blindness in children usually between 1-3 years
of age. To prevent blindness among the children caused due to Vitamin 'A'
deficiency, highly concentrated solution of Vitamin ‘A’ is given to children at
an interval of 6 months till the age of
3 years.
The achievement under the
programme during the years 1992-93 and 1996-97 to 2000-2001 is given here under:
|
Year |
No. of children given the dose of
Vitamin ‘A’ |
|
|
1992-93 |
10,052 |
|
|
1996-97 |
14,272 |
|
|
1997-98 |
11,348 |
|
|
1998-99 |
12,938 |
|
|
1999-2000 |
11,393 |
|
|
2000-2001 |
10,494 |
|
(Source: Civil Surgeon, Fatehgarh Sahib )
School Health
Programme
The
aim of the School Health Programme is to provide comprehensive health care to
the school children. It comprises medical examination, treatment and
correctional remedies. The school children are also guided in forming habits
and practices that are necessary to promote their best growth. The entire State
of Punjab was brought under the School Health Programme by the year 1986. In
the Fatehgarh Sahib District, one School Health Clinic is functioning at Civil
Hospital, Fatehgarh Sahib.
Under
this programme, school children are being immunised against horrified diseases.
Medical check-up of all students belonging to primary and middle schools (both
government and recognized private schools) is done twice a year. A team of
doctors visits all the schools to examine the students and provides them
curative, referral and follow-up services.
Health
education on various health topics is given to students and teachers. The doctors
also advise the school authorities about proper water supply, good sanitation,
cleanliness and help them to observe health fortnights. Under this scheme,
about 23,000 students examined in the Fatehgarh Sahib District during the year
2000-2001.
Prevention of Food
Adulteration Programme
Adulteration
in food stuff is checked under the prevention of the Food Adulteration Act 1954 in the state. The Food Adulteration
Programme is implemented in the State under the supervision of Director, Health
Services (Family Welfare), Punjab who has been notified as State Food (Health)
Authority. He is assisted by Additional Director, Health (Food & Drugs). At
the district level Civil Surgeon has been notified as Local (Health) Authority
and is responsible for the implementation of prevention of adulteration
programme in the district. He is assisted by 1 District Health Officer, 1
Whole-time Food Inspector and a number of designated Food Inspectors.
The licenses for selling foodstuffs
are issued by the Municipal Corporations/ Municipal Councils/Nagar Panchayats.
All concerns dealing in sale, stock and preparation of edible articles are
subject to inspection by the team of Food Inspectors. In order to ensure
preparation of sale of genuine and pure foodstuffs, edibles and drinks, special
powers have been entrusted to the inspecting staff to seize samples. These
samples are sent to the State Food Laboratory, Chandigarh for chemical
examination and analysis. Those found guilty of adulteration are prosecuted.
The
number of samples found adulterated and prosecutions launched in the Fatehgarh
Sahib District during 1992-93 and 1996-97 to 2000-2001 are given below:
|
Year |
Samples seized
|
Samples found adulterated |
Prosecutions
launched |
|
1992-93 |
25 |
1 |
1 |
|
1996-97 |
198 |
71 |
71 |
|
1997-98 |
181 |
32 |
32 |
|
1998-99 |
79 |
17 |
17 |
|
1999-2000 |
135 |
37 |
37 |
|
2000-2001 |
113 |
15 |
15 |
|
(Source: Civil Surgeon, Fatehgarh
Sahib ) |
|||
(e) Sanitation
After personal hygiene and domestic cleanliness environmental hygiene is
equally important. The use of polluted water, soil pollution by indiscriminate
defecation an lack of proper drainage system gave rise to various diseases. To
solve these problems and save the people from diseases, the Government pays
much attention for the sanitation and conservancy of the cities/towns and
villages. The Government of India commissioned a number of schemes for this
purpose, such as National Water Supply and Sanitation Programme. It envisages
to prevent spread of water-borne communicable diseases such as cholera,
diarrhoea and typhoid to check contamination of food, water and milk due to
insanitary disposal of human excreta; to provide tapped water supply and
replacement of dry latrines with flush latrines and to free the sweepers
engaged in sub human system of collection, handling and transporting human
excreta from this unhygienic and humiliating practice. Apart from these
measures, the state Government have taken steps to establish a well-organized
department of Public Health.
(i) Public Health and
Sanitation in Urban Areas.- In the urban areas, sanitation work is looked
after by the Municipal Councils/Nagar Panchayats. These have been entrusted with
the work of providing various civil and other amenities. In the Fatehgarh Sahib District, all the Municipal
Councils/Nagar Panchayats have made arrangements for cleanliness of the towns
by employing a number of scavengers. The sweepers are deployed by the Municipal
Councils/Nagar Panchayats to collect the rubbish, etc; with the help of hand
driven rehris and tractor trolleys from the streets, lanes and roads before
dumping it into main compost grounds of the towns. The sewerage system has been
introduced in the Mandi Gobindgarh, Khamano
and Sirhind towns of the district. The total number of
sewerage connections provided in these towns upto 31 March 2001, were 7,731.
There is good provision for water supply in the municipal towns Amloh, Mandi
Gobindgarh , Bassi Pathana and Sirhind of the district. The total number of
connections provided in these towns except Khamano upto 31 March 2001 were
14,009.
(ii) Rural Sanitation and Water Supply.- In the past the well, hand pumps and
village ponds (for cattle) were the only source of drinking water in the rural
areas of the district. Under the present set up, arrangement for
sanitation are looked after by gram
panchayats. The block development staff takes up the responsibility in respect
of the area under their jurisdiction. The primary health centres established in
the block area, are the chief centre of these activities. The main functions of
the Public Health Department (RWS) are to provide tapped drinking water in the
villages besides installing hand pumps. The installation of tubewells in the
villages has taken the place of open wells for the use of drinking water
purposes. Gram panchayats also look after the sanitation of villages. For
providing better and hygienic living conditions in the villages, the Model
Village Scheme has been started. Under this scheme a few villages are selected
as model villages, where the streets are paved, drains are constructed and
arrangements are made for the sullage water. As on 31 March 2001, out of 455
inhabited villages, 410 have been identified as water scarcity villages, in the
Fatehgarh Sahib District and out of
these, in 164 water scarcity villages,
water supply scheme have been commissioned in the district.
(iii) Punjab
Pollution Control Board.-
The main objective of the Board is to prevent, control or abate water and air
pollution, maintain and restore the wholesomeness of water and the quality of
air. In conformity with the objective, the Board is vested with the authority
to oversee, within the State of Punjab, the application of the laws and rules
relating to pollution control are: Water (Prevention and Control of
Pollution) Act, 1974 as amended in 1988;
Water (Prevention and Control of Pollution) Cess Act, 1977; Air (Prevention and
Control of Pollution ), Act1981 as amended in 1987; Environment (Protection) Act, 1986; Hazardous Wastes
(Management and Handling) Rules, 1989 as amended in 2000; Manufacturing,
Storage and Import of Hazardous Chemicals, Amendment, 2000; Public Liability
Insurance Act, 1991; Bio-Medical Wastes (Management and Handling) Rules, 1998;
Recycled Plastics Manufacture and Usage Rules, 1999 and Municipal Solid Wastes
(Management and Handling) Rules, 2000.
The
main functions of the Board are: Pollution Control-Regulatory Functions;
Pollution Assessment; Laying down of Standards for Effluent and Emissions;
Research and Development including Setting up of Demonstration Plants;
Environment Awareness Programme; Advisory Role; Establishment of Laboratories
and Implementation of above mentioned Acts.
In
order to achieve the above functions, the general approach of the Board is: to
control pollution at the source with due regard to techno-economic feasibility
for liquid effluents as well as gaseous emissions; to ensure that natural
waters are not polluted by discharge of untreated effluents; reuse/recycling of wastes and to use the
treated effluent on land for irrigation and for industrial purpose after
appropriate treatment and to minimize pollution control requirements by judicious
location of new industries and relocation of existing industries wherever
necessary.
The
strategy of the Board is to take up highly polluting large and medium
industries grossly polluted areas of the State and grossly polluted river
stretches on priority basis for control of pollution; promotional measures and
assistance through incentives, guidelines, development of cost effective
technologies and putting up of demonstration plants are also the parts of the
strategy. Efforts have also been made for creation of awareness about
environmental pollution by educating the industries and local authorities to
take preventive measures for the control of pollution.
In
the Fatehgarh Sahib District for Ambient Air Quality Test, 3,905 samples were
taken during 2000-2001 and 14 units were detected as Red Category units.
Punjab Health Systems Corporation
The
Corporation has been incorporated under the Punjab Health Systems Corporation
Act, 1996 ( The Punjab Act No. 6 of 1996) to bring more administrative flexibility
for implementation of The “Second State Health System Development Project” with
the World Bank assistance to upgrade health services in the State. The main
functions of the Corporation are: to formulate and implement the schemes for
the comprehensive development of the dispensaries and hospitals; to construct
and maintain dispensaries and hospitals and maintenance of cleanliness therein;
to implement National Health Programmes as per the directions of the State; to
purchase, maintain and allocate quality equipment to various dispensaries and
hospitals; to procure stock and distribute drugs, diet, linen and other
consumables among the dispensaries and hospitals; to provide services of
specialists and super-specialists in various hospitals; to enter into collaboration
for super-specialists with health institutions both within the country or
abroad to provide better medical care; to receive donations, funds and the like
from the general public and institutions from both within and outside India; to
receive grants or contributions which may be made by the Government on such
conditions as it may impose, to provide for construction of houses to the
employees of the dispensaries and hospitals and maintenance thereof by
mobilizing resources for financing institutions; to plan, construct and
maintain commercial complexes, paying wards and providing diagnostic services
and treatment on payment basis and to utilise the receipts for the improvement
of the hospitals and dispensaries; to run public utility service and undertake
any other activity of commercial nature for the delivery of health care within
or without the hospital premises directly or in collaboration with private or
voluntary agency on contract basis; to engage specialized agencies or
individuals in the relevant disciplines directly or from external sources for
the efficient and expeditious conduct of any of the functions detailed above
and to provide immediate treatment in case of emergency and for unaccompanied
patients.
To
provide better health services in the Fatehgarh Sahib District, the Punjab
Health Systems Corporation has taken over 5 institutions viz. Fatehgarh Sahib,
Bassi Pathana, Amloh, Khamano and Mandi Gobindgarh.
APPENDIX I
(vide page 345) Deaths Registered from
various Diseases in the Fathgarh Sahib District during the year 1996 to 2001
|
||||||
Total Deaths
|
1996
|
1997
|
1998
|
1999
|
2000
|
2001
|
Male
|
1992
|
1609
|
1846
|
1897
|
1926
|
1924
|
Female
|
1236
|
1338
|
1552
|
1522
|
1238
|
1155
|
Persons
|
2728
|
2947
|
3398
|
3419
|
3164
|
3079
|
(Source: Civil Surgeon Fatehgarh Sahib)
|
||||||
APPENDIX II (Vide page 352)
List of Hospitals/Primary Health Centres/ Community Health
Centres/Subsidiary Health Centres/Dispensaries/Clinics in the Fatehgarh Sahib
District as on
|
Serial No |
Name of the Institution |
Number of Beds Male female |
Rural/Urban |
Types of Management |
||
|
1 |
2 |
3 4 |
5 |
6 |
||
Tahsil Fatehgarh Sahib |
||||||
|
1 |
Civil Hospital /CHC
Fatehgrh Sahib |
25 |
25 |
Rural |
State Public |
|
|
2 |
Rural Hospital, Nandpur
Kalaur |
15 |
15 |
-do- |
-do- |
|
|
3 |
Civil Dispensary Sirhind |
2 |
2 |
Urban |
-do- |
|
|
4 |
PHC Chinarthal Kalan |
4 |
4 |
Rural |
-do- |
|
|
5 |
PHC Mulepur |
2 |
2 |
-do- |
-do- |
|
|
6 |
PHC Bhamarsi Bulund |
2 |
2 |
-do- |
-do- |
|
|
7 |
PHC Nabipur |
2 |
2 |
-do- |
-do- |
|
|
8 |
PHC Sangatpur Sodhian |
2 |
2 |
-do- |
-do- |
|
|
9 |
SHC Chheleri Khurd |
2 |
2 |
-do- |
-do- |
|
|
10 |
SHC Badhauchi Kalan |
2 |
2 |
-do- |
-do- |
|
|
11 |
SHC Kharaura |
2 |
2 |
-do- |
-do- |
|
|
12 |
SHC Saundha Head |
2 |
2 |
-do- |
-do- |
|
|
13 |
SHC Jalha |
2 |
2 |
-do- |
-do- |
|
|
14 |
SHC Dhargherin |
2 |
2 |
-do- |
-do- |
|
|
15 |
SHC Tandha Badha |
2 |
2 |
-do- |
-do- |
|
|
16 |
SHC Jhabala |
2 |
2 |
-do- |
-do- |
|
|
17 |
PHC Ladpur |
2 |
2 |
-do- |
-do- |
|
|
18 |
PHC Nandpur Kalan |
0 |
0 |
-do- |
-do- |
|
|
19 |
PHC Balheri Kalan |
2 |
2 |
-do- |
-do- |
|
|
20 |
PHC Nogawan |
2 |
2 |
-do- |
-do- |
|
|
21 |
SHC Burass |
2 |
2 |
-do- |
-do- |
|
|
22 |
SHC Ghumand Garh |
2 |
2 |
-do- |
-do- |
|
|
23 |
SHC Jhampur |
2 |
2 |
-do- |
-do- |
|
|
24 |
SHC Badwala |
2 |
2 |
-do- |
-do- |
|
|
25 |
SHC Randhawa |
2 |
2 |
-do- |
-do- |
|
|
26 |
CHC Khera |
15 |
15 |
-do- |
-do- |
|
|
27 |
SHC Rupal Heri |
2 |
2 |
-do- |
-do- |
|
|
28 |
SHC Talania |
2 |
2 |
-do- |
-do- |
|
|
29 |
SHC Sangatpura |
2 |
2 |
Urban |
-do- |
|
|
30 |
ESI Dispensary Sirhind |
0 |
0 |
-do- |
State Special |
|
|
31 |
Municipal Dispensary,
Sirhind |
0 |
0 |
-do- |
State Public |
|
|
32 |
USAD Sirhind (Bara) |
2 |
2 |
-do- |
-do- |
|
|
|
|
|
|
|
|
|
|
1 |
2 |
3 |
4 |
5 |
6 |
|
Tahsil Amloh
|
||||||
|
33 |
Civil Hospital, Amloh |
15 |
10 |
Urban |
State Public |
|
|
34 |
CHC Mandi Gobindgarh |
25 |
25 |
-do- |
-do- |
|
|
35 |
ESI Dispensary Mandi
Gobindgarh -I |
0 |
0 |
-do- |
State Special |
|
|
36 |
ESI Dispensary Mandi
Gobindgarh -II |
0 |
0 |
-do- |
-do- |
|
|
37 |
Rural Hospital, Malowal |
15 |
10 |
Rural |
State Public |
|
|
38 |
PHC Barni |
2 |
2 |
-do- |
-do- |
|
|
39 |
USAD Nasrali (Mandi Gobindgarh) |
2 |
2 |
Urban |
-do- |
|
Tahsil Khamano
|
||||||
|
40 |
PHC Nanowal |
2 |
2 |
Rural |
-do- |
|
|
41 |
PHC Sanghol |
2 |
2 |
-do- |
-do- |
|
|
42 |
SHC Raipur Majri |
2 |
2 |
-do- |
-do- |
|
|
43 |
SHC Ajner |
2 |
2 |
-do- |
-do- |
|
|
44 |
SHC Khamano Kamali |
2 |
2 |
-do- |
-do- |
|
|
45 |
SHC Lohar Majra Khurd |
2 |
2 |
-do- |
-do- |
|
|
46 |
SHC Raya |
2 |
2 |
-do- |
-do- |
|
|
47 |
SHC Khant Manpur |
2 |
2 |
-do- |
-do- |
|
|
48 |
SHC Dhoonda |
2 |
2 |
-do- |
-do- |
|
|
49 |
SHC Dhanola |
2 |
2 |
-do- |
-do- |
|
|
50 |
SHC Jatana Kalan |
2 |
2 |
-do- |
-do- |
|
|
51 |
SHC Barwali Khurd |
2 |
2 |
-do- |
-do- |
|
|
Tahsil Bassi Pathana |
||||||
|
52 |
Civil Hospital Bassi Pathana |
15 |
10 |
Urban |
-do- |
|
|
53 |
SHC Bhagrana |
2 |
2 |
Rural |
-do- |
|
|
(Source: Director
Public Health and Family Welfare, Punjab, Chandigarh) |
||||||