Lal Jan, an ASHA worker in Hapatnard Gogaldar village in Anantnag district, has helped out with at least 500 deliveries since she was appointed to the health department.
In 2005, Lal Jan (45) was appointed to the health department as an ASHA worker before her appointment. She has helped out with at least 250 deliveries at their homes. Lal Jan’s mother, Zaina Begam, was also doing this job and has helped out with at least 700 deliveries at their homes in normal delivery when there were no health facilities in their area.
Speaking to the reporter, Lal Jan said, “I have learnt from my mother. My mother was very well known in the area for helping pregnant ladies with home delivery.” Her mother died 30 years ago.
Lal Jan has had experience in deliveries for the last 30 years. She goes from house to house raising awareness about family planning.
In 2007, Lal Jan got an appreciation award from the office of block medical officer Bijbehara for her motivation to a number of beneficiaries for family planning and female sterilisation during the years 2007-2008 and 2009. Her performance, character, and conduct remained satisfactory for the said period, she said.
According to her, in the Hapatnard area and nearby villages, at least 300 women have done sterilisation and taken procedures after the birth of their 3rd and 4th children; some of them have their 6th and 7th children.
The Hapatnard village, which is located on the foothills of the Khovripora block, is about 35 km from the district headquarters in Anantnag.
In 2008, a PHC was established in the village, which was functional in 2018. Before the functionality of the PHC, the patients of the area either visited sub-district hospitals or MCCH hospitals in Anantnag.
The PHC of Hapatnard village caters to about seven thousand people in eight villages that are around the hospital. The hospital lacks basic facilities, including X-ray and diagnostic testing facilities, forcing patients to visit the See Sub District Hospital or MCCH Hospital Anantnag.
Due to the non-availability of a gynaecologist, pregnancy care has also been hit badly, and women in the area face severe hardships.
According to official data in Anantnag District, more women than men were opting for sterilisation in Anantnag District. Official data provided by the Chief Medical Officer of Anantnag reveals that from 2019 to date, 1369 women were operated upon for various permanent birth control methods, including laparoscopic sterilisation and mini-laparotomy, while only one man opted for permanent sterilisation in the period.
The same is true for spontaneous miscarriages in District Anantnag, where at least 3144 cases have been reported since 2019.
However, the only maternity and child care hospital in Anantnag district, which serves the entire south Kashmir region as well as Chenab and Pir Panjal Valley of Kashmir, has also provided data to this reporter, revealing that 913 women have been operated on in hospitals for permanent birth control methods through laparoscopic sterilisation and mini-laparotomy since 2019.
The hospital is presently housed in an old, worn and unsafe building in the congested Sherbagh locality of the old town in the Anantnag district.
The 40-bed hospital gets an average of 40,000 patients in the outpatient department (OPD) and about 7,000 indoor patients every month.
According to official sources, the ratio will be high in South Kashmir as most of the patients prefer to do sterilisation and miscarriages in private hospitals.
While talking to the reporter, Dr. Nawaz, HOD Gynecology in MCCH hospital Anantnag, while talking to the reporter, said that female sterilisation is the most preferred family planning choice here in south Kashmir›s Anantnag district.
The department witnesses hundreds of women undergoing sterilisation procedures for permanent birth control each year. Misconceptions and lack of awareness are the main factors in the urban as well as rural population›s poor uptake of family planning services in the Anantnag district. Other responsible factors include cultural and religious beliefs. He added that men generally don›t undergo vasectomy for sterilisation because they believe that it affects their manhood.
Anaemia is another problem in the country. According to a study conducted by the Department of Obstetrics and Gynecology at GMC Anantnag, almost 83% of pregnant and lactating women in South Kashmir were anaemic due to poor nutrition.
Anaemia can lead to multiple complications during pregnancy, labour, and the postpartum period, which include foetal growth restriction, abruption of the placenta, cardiac failure, and even death of mother and baby, Nawaz says. Women don›t take the recommended iron and folic acid supplements in adolescence and pregnancy. Short birth intervals and multiparity further add to the problem.
ASHA workers and primary care physicians should be involved in rural areas to address the issue. Another issue that is under-addressed in this part of the world is the emotional and mental well-being of pregnant women. Poor social support, bad pregnancy experiences and outcomes in the past are some of the few responsible reasons.
There are a number of women in hospitals in south Kashmir who suffer from mental health issues during their pregnancies, especially those expecting moms who have had a negative experience in the past.