To
His Excellency
Shri Nikhil Kumar
Governor of Nagaland, Raj Bhavan, Kohima
Sub: Memorandum on National Rural Health Mission Implementation in Nagaland
Your Excellency,
With due respect, the Naga Mothers’ Association once again seek to draw your kind attention to the NMA’s serious concerns on the functioning of the NRHM and its programs in the State and request for your immediate intervention. The reply and comments of the Department concerned on the NMA memorandum on NRHM is found to be vague, evasive and not satisfactory.
1. The NMA reiterates our demand for a High Level Inquiry on Implementation of the NRHM in Nagaland, submitted on the 21st March 2011 , based on the incriminating documents submitted by the Commissioner and Secretary, Health and Family Welfare and Chairman State Health Society to the Governor’s Secretariat. Copies of the same have been forwarded to the President, Naga Mothers Association, vide letter No.G-14/02—2/00/H & FW (Vol. 1) dated the 16th May 2011, by the Secretary to Governor. On perusal, the documents prove that the issues raised by the NMA as reference for Inquiry are justified, as there are glaring anomalies, financial irregularities and conflict of interest in spite of the comments from the Department of Health and Family Welfare. The Reply and comments from the Department concerned and the Supplementary Reply submitted by the Commissioner and Secretary, H&FW, to your esteemed office, are contradictory, as proven by the numerous documents attached as ANNEXURE by the Department.
2. According to the JSSK under NRHM, free referral transport is to be provided to the expectant mother before and after delivery from her home to the health unit and back. However it is learnt that transportation charges are being realized or claimed. The Department has also been silent on the detailed list of patients, who have been provided such facility, names of Health units, as such information is missing in the Annexures provided by the Department.
3. The NMA has received reports of preferential payments under JSY in Health units/district hospitals on delivery of babies, whereby mothers giving birth to male child were paid higher than those giving birth to the girl child. NMA’s concerns and objections on such preferential payments under JSY, NRHM were highlighted in a national seminar organized by the North East Network on the 14th December 2011 at Kohima in the presence of Planning Commission Member Dr. Syeda Hameed and the Secretary , National Commission for Women, New Delhi, Dr. Anita Agnihotri, IAS. When such anomalies were brought out by the media, the Department of H&FW, immediately threatened the NMA by serving a two days’ Show Cause on the 19th December 2011, to the Advisor, NMA who had critiqued “Laws and Policies of the State Government on Empowerment of Women” in her presentation as Resource person. Such threats and intimations to cover up illegal activities under NRHM has been viewed seriously by the NMA, as the Department has failed to Inquire into such violations of human rights of mothers and babies and instead has resorted to defamation of the NMA and threatening our freedom of speech. Details of preferential payments and names of hospitals have been verbally informed to the Principal Director, Department of H&FW but the NMA reserves the right to protect the identity of patients to avoid further harassment by the Department on mothers who have been discriminated with such payments.
4. That, Annexure 8 B submitted by the Commissioner & Secretary H&FW, lists the names of suppliers for drugs and equipments, however, it is silent on the amount of drugs/equipment that has been supplied and how much has been given to the different health units. The NMA’s initial monitoring reports from the Tribe units point to acute shortage of medicines in health units and even of damaged, broken delivery beds in hospitals.
5. It has been observed that the same names of suppliers are consistent in the lists provided. Whether open tenders have been floated, what are the credentials of these suppliers as manufacturers/ approved drug suppliers as per the NRHM purchase policies.
6. The NMA was given another list of suppliers which is not included in the Supplementary annexure submitted by the Department concerned. Whether the same procurement formalities and codal procedures have been followed and how much drugs have been supplied to the various health units from the procurement of drugs amounting to Rs.3.19 crores from M/s Eirene Traders, Dimapur.
7. Based on the Department’s reply to NMA queries, whether the GOI has agreed to the Purchase board and Verification board instead of the mandatory Purchase Cell set up in some states as per directives under the NRHM .
8. As per list of Contractors against civil works undertaken under NRHM over the years 2007-2008 /2009-2010 ANNEXURE Sl .no. 8A, the Department can provide the copies of completion certificates and photos of the said buildings, from serial No.1 -89 (2007-2008) and Serial no.1-11 (2009-2010) and serial 1 to 2 (2009-2010) in support of their claims.
9. That there is evidence from the Department ANNEXURE sl.NO-11 that some of the Mother Non-governmental organization (MNGO’s) are related to the Field Non-Governmental organization(FNGO’s) having the same functionaries or related to the NRHM. That it is learned funds has been sanctioned to Mother Non-Government Organization (MNGO) for Mokokchung District but it has not been reflected in the list. Reasons for the same.
10. We are well aware that vehicles cannot be purchased from the NRHM funds except ambulances. However an RTI reply from the RTO Nagaland indicates huge purchase of vehicles. We have reason to believe NRHM funds are being misused to buy such vehicles without proper GOI sanction. The Department can provide justification and sanction orders for the same.
11. Recent advertisement on NRHM has claimed 66 ambulances as referral transport. The Department can provide whether such vehicles are being used as referral or attached to Doctors.
12. The NMA had raised concerns on lack of vehicles for Doctors, particularly in remote areas and districts, proper housing facilities and opportunities for further studies. Whether any action has been initiated on the same and if so, details on the same.
13. That as per NOTIFICATION No.MED/FW-4(B) 5/2005 Dated July 2005, the District Health Society under NRHM has to appoint in its governing body the District Unit of NMA as one of its representative members. However, till today no such Official information has been given to any Tribe Units of the NMA in the Districts. Reasons for the same.
14. Under the NRHM Nagaland, like in other parts of the country, village council and Panchayat functionaries are to be trained and educated on health/NRHM related matters. Names of villages where such trainings have been conducted and how much has been utilized for such training of PRI’s and outcome of the same.
15. That at the invitation of the State Program Officer, the NMA accepted the offer to conduct Community Monitoring in August 2011 and requested all its Tribe units as well as the Watsu Mongdang and ENWO to actively take part in the monitoring work. The NMA submitted a detailed proposal on the 12th September 2011 which is enclosed as Annexure. In spite of successive four representations to the Mission Director, NRHM and successive meetings held with the Hon’ble Minister H&FW, the Mission Director and State Program Officer and assurances given by them, no funds were released to the NMA and its tribal units for the community monitoring work which was begun by the NMA in August itself. Several tribe units had submitted initial monitoring reports to the NMA office , which indicates very serious irregularities in the NRHM.
Finally it was only on the 20th February 2012, seven months after the NMA accepted the offer for community monitoring and at the fag end of the financial year that the NMA was informed to collect a small amount of fund from the NRHM office for the community monitoring work on the 23rd February 2012. However, a decision was taken by the NMA Committee on NRHM issues in its emergency meeting on the 22nd Feb 2012, to reject the offer as it was too late to conduct a comprehensive Community Monitoring. Further, a highly irregular backdated letter of 12th December 2011 issued on the 23rd February 2012, addressed to the President NMA was received from the Mission Director, NRHM with a photocopied signature of the Mission Director, approving the NMA as implementing agency for community monitoring. All details of the highly irregular NRHM office procedures and NMA representations are enclosed in Annexures.
Excellency, may we draw Your attention to the fact that the report of the NRHM states that Community Monitoring, which is the most important and critical segment of NRHM, was not done in 2010-2011, as also now in 2011-2012, for reasons best known to the officials of the NRHM and State Health Society. NMA also has evidence of Community Monitoring funds being misused by the NRHM high ranking officials.
In the light of the above, and in continuation of the earlier NMA Memorandum dated 21st March 2011, we reiterate our stand and request Your Excellency to initiate a full fledged Inquiry on all issues raised, to root out the deficiencies, shortcomings and ensure a transparent and effective health delivery service under NRHM Nagaland. The Inquiry Committee must include at least two Expert members , nominated by the NMA. The President, NMA is supposed to be a Member of the State Health Mission. However, only one meeting was convened last year to obtain approval for partnerships, with no time given to discuss serious concerns. Till date, many district Tribe units of the NMA are unaware, that they are members of the District Health Society as they have not been invited for such meetings.
Therefore, the NMA demands for the immediate appointment of an effective and serious Chairman, State Health Society to ensure that due justice and services are delivered to mothers and children as envisaged in the NRHM. We demand the appointment of an efficient and effective Mission Director NRHM, with a proven good, clean track record, and without political interference, strictly in consonance with the MOU signed with the Government of India.
Yours sincerely,
Mrs.Abeiu Meru
President, NMA
Rosemary Dzuvichu
Convenor,
NMA Committee on NRHM
