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Be patient, they’re told

One of Aam Aadmi Party’s flagship schemes – Mohalla Clinics – has proved so popular with the public that it is already groaning under the overload of patients

“My daughter is suffering from high fever. We have been sitting here for the last two-and-a half hours, but I know my turn will come,” says Rubaiya, whose eight-year old daughter had dozed off in the seemingly endless wait in Mohalla Clinic of Shaheen Bagh. She is all praises for the efforts of Delhi CM Arvind Kejriwal.

Deemed to be the pilot project of the Aam Aadmi Party, the Mohalla (Neighbourhood) Clinics have been instrumental in plugging a gap in Delhi’s health services. Free consultation by a private doctor is provided under the scheme to every household with free medicines and tests. The AAP government launched the scheme in 2015 but it met a lot of hurdles in its implementation. One by one, the clinics started functioning and brought a revolutionary change in the health sector.

The idea behind the Aam Aadmi Mohalla Clinics was to strengthen the primary healthcare system. The AAP’s flagship project was launched with a target of 1,000 clinics but even after passage of 4.5 years, only 201 clinics have become operational.

In its manifesto of 2015, the Aam Aadmi Party said to provide 900 new Primary Health Centres (PHCs). After attaining a massive mandate, CM Arvind Kejriwal promised a thousand clinics in Delhi in July 2016. The scheme hit a roadblock when the Lieutenant Governor gave his nod only in September 2017.

Mohalla Clinics serve around 110 patients every day and are functional from 8 am until 1 pm. Doctors seem to arrive only after 9:30 am to face the daunting task of seeing around a hundred patients in less than four hours. That’s about 3 minutes per patient.

At the Mohalla Clinic in Jasola Vihar, patients started to line up from 7:30 am itself in order to get an early number, as the policy of first come first serve functions at every clinic. Also, as claimed by the clinic assistant, the numbers are given until 9 am and patients who come at around 11 am are asked to report the next day.

An intriguing notice is pasted inside the premises of the clinic which reads, “Patients are required to carry their Aadhaar card to the clinic.” When this reporter asked the in-house nurse/clinic assistant about this, she said, “I don’t know anything, it’s a rule which we follow.”

When patients presented their Aadhaar, an entry was being made by the nurse in a register based on their slip and Aadhaar number. In the midst of the required papers, a man probably in his thirties enters the clinic and interacts with the staff about a girl who is nine years old and is suffering from viral fever for two days but doesn’t have the Aadhaar card. The clinic staff insists it’s required. The man replies, “We have her school identity card. Aadhaar is under process.” The clinic staff now looks tense but asks the man to bring the girl to the clinic.

When Patriot approached the doctor for his statement on various issues, he declined to speak to media. Dr Khan at Shaheen Bagh said, “Kindly don’t ask questions. It’s already election time and although we are neutral persons, it has become Mohalla Clinic vs BJP.”

Dr Khan did provide some details about the patients, saying, “Usually the number hovers around 90-100 each day but it has also touched 200 at times.” When asked whether this clinic is open until 5 pm as displayed on the Internet, Dr Khan said, “No, this clinic functions until 1 pm.”

Saad, who works at a welding shop in front of the clinic, said that the clinic is supposed to be open till 5 pm but it shuts down every day by 1 or 1:30 pm. Saad adds, “A complaint has been filed regarding this to the administration and inspection has been made a few days ago, although no action has been taken yet.”

Patients at the clinic had a common complaint over the long waiting period and everyone had their tale of suffering to narrate. One such patient was Mohammed Badlee, who was at the clinic with his son. Both were suffering from fever, while the elder man also had body ache. “The services are good and the medicines/tests are provided immediately but the problem is the waiting time. I came at 8 am but at 11:30 am, I am still waiting for my number to be called,” said  Badlee.

He added that “I am not aware about other clinics but this one certainly requires at least two doctors — or the time period should be increased.”

A woman came with her son at around 11 am, claiming that the case was “serious” as the nerves of her son’s neck had got ‘entangled’, causing pain and fever. But her requests were turned down by the clinic assistant who said, “No new case will be entertained after 9 am.” The nurse added, “Everyone’s case is serious out here. I can’t allow new patients at 11 am.”

When Patriot contacted the Delhi Health Ministry, an official on condition of anonymity said that “The journey of Mohalla Clinics has not been easy as the biggest hurdle was land-owning agencies like the DDA and even the MCD. Only after the Lieutenant Governor gave his go ahead in 2017, we were able to approach the DDA for a no-objection certificate for the setting up of primary healthcare centers or as we call it, the Mohalla Clinics.”

When asked about failure to meet the target of 1,000 clinics, the official said, “A lot of hindrances have occurred while setting up of the Mohalla Clinics but currently we have 201 operational clinics and CM Arvind Kejriwal is scheduled to inaugurate another 100 on October 19 while 100 clinics each will be opened up in the coming months until January. Hence we will be able to set up around 500-600 operational clinics in this tenure.”

Another achievement is that around 34 clinics are now functioning for 12 hours a day. The official claimed, “This facility is one of its kind in the entire country. It was decided as the number of patients visiting these clinics was above 120 per day. Two separate OPDs — one morning and another evening — are functional at these centres with two doctors overseeing the operations.”

When this reporter inquired about the mandatory Aadhaar card at the Mohalla Clinics, the official of the health department said, “Aadhaar card is not mandatory. In an inspection done by Health Minister Satyendra Jain in East Delhi, we found around 6-7 clinics with such notices. We immediately advised them not to deny any free medical services if someone isn’t carrying his/her Aadhaar card. It’s more of a voluntary service as it helps us in making things more transparent.”

However, the officer also said that some identity proof is required if someone is undergoing tests prescribed by the doctor. The AAP government had allocated a heavy amount for this pet project. The official elaborated, “Rs 209 crore has been allocated by the government for the construction and maintenance of the Mohalla Clinics. However, the medicines are procured through a central system and hence the budget of medicines is not included in this.”

Explaining the goals set for Mohalla Clinics, the official said, “Each and every clinic is to function completely paper-free. More transparency will be on the agenda; each patient’s detail will be recorded on the tablet and if required a slip will be printed for the patient only for medico-legal purposes. We are trying to integrate technology with smart steps to make our steps simpler and transparent.”

Meanwhile, the budget report of the Delhi government says that in the previous year, the number of patients who visited the Mohalla Clinics stood at 80 lakh in 164 centres. However, the number is at 40 lakh this year upto September this year. Impressive by any standards.