Watch: The Long Walk To Healthcare In Jharkhand’s Latehar
Gwalkhar village, Latehar: Amarmuni Nagesia (26) was over seven months pregnant, and preparing for a four-hour journey for her antenatal check-up. Preparations had begun hours before. Her father Sukhdev, with help of neighbours put together a makeshift palanquin for Amarmuni using a wooden basket tied to a bamboo stick.
“The situation is common across Jharkhand, where health centres remain out of reach for forest-dwelling communities,” says Pyari Nageisa, a health worker.
Gwalkhar is about 178 km from state capital Ranchi. The majority of over 1,500 people in the village belong to the Kisan, Korwa and Birija tribes. “It’s bad here,” Sukhdev says. “The rain last night made the path even more slippery. If anyone slips, who knows what’ll happen to the mother and child.”
After about four hours of walking, Sukhdev, the villagers, and the health worker reached the nearest road, where an ambulance was waiting. Amarmuni’s blood pressure was checked, and the ambulance took the father-daughter duo to the hospital. The villagers continued walking--they couldn’t afford to hire an auto and were denied a seat in the ambulance.
Amarmuni needed an ultrasound, but the hospital lacked the equipment. A private hospital was charging Rs 1,000, which the family could not afford. So after basic checkups, they set about to return.
By 4 p.m., Sukhdev and four others from the village carried Amarmuni back in the bamboo palanquin, hoping to reach the village before nightfall. In their haste, they had forgotten to bring a torch—an oversight that could have made the journey even more treacherous.
”Forget about reaching healthcare facilities to get mandatory checkups,” said Pyari, “when it rains heavily, reaching the village with essential supplies for pregnant women like folic acid becomes a tough task. This can have an impact on the child in the womb.”
Six weeks later, Amarmuni gave birth to a girl child at home. There was no time to inform a health worker for assistance.
Every tenth child in India is born without care or assistance from doctors, nurses, midwives or other healthcare personnel. Among tribal Indians, this number is worse--nearly every sixth delivery happens in the absence of a skilled provider, according to data from the National Family Health Survey, 2019-21. Jharkhand--home to 32 tribes of which eight are categorised as Particularly Vulnerable Tribal Groups--has the fifth highest such births, data show.
India has approximately 650,000 villages, with 170,000 located near forests, the environment ministry told Parliament in December 2023. Around 300 million people depend on forests for their livelihood.
Of 117,064 villages with more than 25% tribal population for which data were available, one-third did not have access to an all-weather road and three in four did not have a health centre, the government told the Lok Sabha in November 2019. For nearly a third of the villages without a health centre, the distance to the nearest facility was more than 10 km, while another 28% villages were 5-10 km away from the nearest health centre.
“If people have to walk four hours to get to a hospital, that’s a catastrophic failure,” Thiagarajan Sundararaman, global coordinator of Jan Swasthya Abhiyaan, says. “It’s the responsibility of both central and state governments to ensure that every person has access to an all-weather road within a kilometre of their village.
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