HEALTH STATUS OF MUSLIM GHETTOS IN MUMBAI – A STUDY DONE BY BHARATIYA MUSLIM MAHILA ANDOLAN

HEALTH SURVEY OF MUSLIM SLUM COMMUNITIES
Bharatiya Muslim Mahilan Andolan

Behrampada , Bharatnagar, Garibnagar, Jogeshwari, Kalina, Mahim,  Navpada, Pipeline, Andheri Dongar, Gyaneshwar nagar

PART ONE
HEALTH CONCERNS OF THE COMMUNITY

Ø  MOST COMMON DISEASES IN THE COMMUNITY
CHILDREN
Cold, cough and fever are the diseases seen most frequently among children. Typhoid, dengue, chikangunya, malaria, tuberculosis, vomiting, jaundice, viral fevers are the most prevalent diseases detected among children. As the weather changes, more and more children fall sick with cough, cold, throat irritation and fever.
YOUTH
The most common diseases among the youth in the area include tuberculosis, jaundice, typhoid, pneumonia, malaria, chikangunya, diabetes, blood pressure, cancer. The youth are intoxicated and addicted to tobacco products (thambaku, gutka, cigarette) and medicines (freely available at the chemist) which leads to cancer, lung related diseases and kidney problems. Hand and joint pains, eye infection, back aches, elephantiasis, tonsillitis and tuberculosis are also common.
WOMEN
Women mostly complain of ovarian and breast cancer, blood clot, backaches, white discharge and weakness, irregular menstrual cycle, stomach ache, knee ache. Diabetes, heart diseases, blood pressure, elephantiasis, kidney stones, appendicitis, typhoid, tonsillitis and pneumonia are the diseases which are prevalent among women. Women also complain of eye problems, arthritis, joint pains, obesity, blood vessel blocks, acidity, anaemia and calcium deficiency.
ELDERLY
Frequent complaints made by the elderly are weakness, fever, diabetes, cancer, arthritis, eye diseases (glaucoma), heart diseases, tuberculosis, kidney failure, anaemia and calcium deficiency. Diseases most common among the elderly are, block in blood vessels, weak bones, knee pain, leg and hand pain, weak or loss of eyesight, cough and cold and insomnia.


Ø  CAUSE OF THESE DISEASES
A recurrent cause seen among all the groups mentioned above relates to dirty environment, presence of a big open drains, unclean public toilets, water contamination and stress/anxiety.
Lack of food, insufficient knowledge of a healthy diet, stress and anxiety and obesity are seen as the main reasons for the diseases among women. Stress is caused by lack of employment which leads to worries and tensions. Women meanwhile have erratic meal timings, consumption of unhealthy oil, adulterated food, calcium deficiency and lack of exercise.  Women’s diseases can also be attributed to use of tobacco products (thambaku, gutka and masher].
There are mobile towers of Reliance and Vodafone which along with unclean surroundings are seen to be the main reason for the diseases seen among the youth. Youth are highly affected by intoxicants like gutkha. They also consume unhealthy junk food, fast food, Chinese food which are also made in dirty and unclean surroundings.
Weakness, tension, lack of food, tobacco products (thambaku and gutka), betel nut (supari), betel leaf (paan), cigarettes and alcohol are the causes for the diseases among the old. Lack of food and sleep along with tension are the primary reasons for the spread of these diseases. Adulterated food, high oil content, calcium deficiency, rise of inflation and hence non-accessibility to basic food items is also the cause of diseases amongst the old.
Change in weather, lack of proper garbage disposal and breeding of mosquitoes are seen to be the main culprits for diseases seen among the population. Houses being small and no gardens nearby, fresh air doesn’t come in. Children also don’t have spaces to play. This affects the health of both the elderly and children.
Ø  NEW DISEASES WITNESSED IN THE PAST TWO YEARS
Dengue, chikengunya, malaria, thyroid, arthritis, jaundice, diabetes and swine flu are diseases reported to have come up in the past two years. Diseases which are most prevalent in the community include cancer, blood pressure, kidney failure, tuberculosis, thyroid, jaundice, heart diseases, diarrhoea, cold, cough and fever.


PART TWO
STATUS OF HEALTH FACILITIES IN THE COMMUNITIES
Ø  CONDITION OF HEALTH CENTRES
In Behrampada Kherwadi and Bhabha hospital are the two health centres nearby. Medicines and injection for tetanus are available here. These facilities aren’t sufficient. Facilities like x-ray, sonography and treatment for big diseases are required. Doctors visit regularly and since it is new, they come on time as well. A lot of people come here for treatment.
In Bharatnagar, government health centres are present nearby. However, they do not have any facilities. Treatment for cough, cold, rat bites, antiseptic medicines and injections are provided. Polio vaccine is also administered here. No other facilities are given and if at all they are given, they are sent to Sion or Bhabha hospital. Not a single doctor is available and even when he comes, he leaves quickly. Also, Rs.5 is charged by the government hospital every time they visit the hospital.
In Garibnagar, there are no government health centres nearby and hence a huge lack of all medical services.
In Jogeshwari government health centres are present nearby, but they do not have any facilities. Medicines are not available and they are asked to be bought from outside. Neither does the doctor come on time, nor does he give enough time to discuss problems. Medicines aren’t administered well either. A laboratory and x-ray machine is a necessity here. The hospitals charge Rs.250 from the pregnant women in the first month of their pregnancy itself. Medicines are available in only one medical shop. The things bought for the pregnant women are siphoned off at the BMC as well as the anganwadis.
In Kalina, no government health centres are present nearby in Shastri Nagar and hence there are no facilities. This is not acceptable and facilities are required.
In Mahim, Mori Road, there are no facilities in the government medical shop. Check up isn’t done and medicines are asked to be bought from outside. From the side of the government, there are no facilities. Blood test, x-ray and sonography are all available at Bhabha hospital, but not in Mahim. In case of any emergency, patients are sent to Bhabha hospital. Such facilities are lacking in Mahim and are a necessity. The facilities are insufficient and services that are available in private hospitals like sophisticated machines are required here as well. Doctor isn’t available round the clock and especially aren’t available during hartals.
In Navpada, no government health centres are present nearby. There are only private ones. BCG, TB, cough and cold medicines are the facilities available. All other medicines are asked to be bought from outside. The facilities at the health centre are grossly insufficient. The doctor doesn’t visit the health centre on a regular basis either. There are about 2-3 government health centres present nearby. Medicines for cold, cough, leprosy, jaundice, polio and iron capsules are available here. These facilities aren’t enough.  The doctor visits the health centre regularly.
In Andheri too there is no facility available. They get only medicines for cough and cold, vaccination for polio and antiseptics. That clearly is not enough. Many more facilities need to be provided by the state. The doctors come very late and leave early.
In  Jyaneshwar nagar the  health centre has  medicines  for   cold  and   cough,  ointment for   leprosy  and  treatment  for  TB. Those facilities are not   enough.  More medicines are also required.  The doctors also come daily.
Ø  CONDITION OF GOVERNMENT HOSPITALS
People in Behrampada, Navpada and Garibnagar and Pipeline go to KEM, Sion hospital in case of big diseases and in case of jaundice, they go to Kasturba hospital. The closest government hospital is 1 km away from Behrampada. Medicines for TB, worms and polio and injections for tetanus are available. They were aware of only Kherwadi hospital and they felt that the behaviour of the doctors there were good. The behaviour of nurses is also satisfactory and they don’t get irritated. While the aya bai in Kherwadi were well behaved, the ones in Bhabha hospital weren’t. They squander away money and if they aren’t given money, they don’t pay attention to the patients.
Kherwadi hospital and Bhabha hospital are at a minimum distance of 2 kms and 5 kms respectively from Navpada. Private or trust run hospitals like Lilavati and Millat are preferred over government hospitals as the latter don’t have the necessary facilities. Only the check up by the doctors is free of cost. Medicines have to be bought from outside. CT scans aren’t available. X-ray and sonography are available at Bhabha hospital. But none of these machines are there in Kherwadi hospital. The behaviour of doctors at both the hospitals mentioned above is satisfactory. Nurses behave very rudely to the patients. In case of any emergency or help, they do not come to the aid of the patients and don’t provide them with good facilities. They refuse to respond to patients. Injections are also given with no proper care. The behaviour of the aya bai is the worst of the lot. They make a lot of fuss, behave very rudely and steal from the ward. They also slap pregnant ladies and don’t let people enter the wards.
In Bharatnagar, in case of big diseases, the hospitals preferred are Kasturba, Cooper, Nair, Tata, Sion and Bhabha. The two nearest government hospitals are at a distance of one and five kilometres. Facilities for diseases like cold, cough, tuberculosis, polio and also facilities for pregnant ladies are available here. The behaviour of doctors, nurses and aya bai is good. It is only the doctors in Bhabha hospital who behave well. The aya bai in Bhabha hospital however don’t treat the patients well. The behaviour of doctors, nurses and ward bai at both the hospitals mentioned above is satisfactory. Burkha clad women are especially treated badly. Nurses make a lot of fuss while the aya bai behaves as if the hospital belongs to them.
In Jogeshwari, on going to BMC hospital, Sector Colony which is 15 kms away from Jogeshwari, patients are sent to KEM hospital. Only labour facilities and TB medicines are available here. The doctors in the hospital make a lot of fuss and don’t talk properly to the patients. The nurses, on the other hand, make them run around like dogs. The services rendered by them depend on the social standing of the person or otherwise based on personal bias. The behaviour meted out by the aya bai is the worst and they trouble the patients a lot.
In Kalina, Santacruz east, JJ hospital, KEM hospital, Bhabha hospital, VN Desai hospital, Sion hospital, Wadia hospital are approached in case of big diseases. The closest government hospital is at a distance of about 5 kms. The facilities available in the government hospital include x-ray and medicines for minor diseases. The behaviour of doctors at these hospitals is satisfactory when they are known to the doctors. Those doctors who speak in Marathi don’t behave well. Nurses behave very offensively. They ask the women not to wear the burkha as they feel that it leads to diseases and body pain. The aya bai’s behaviour on the other hand was reported to be good.
KEM, Sion, Nair, Cooper and other big hospitals are approached in case of major diseases for people in Mahim. The closest government health centres are at a distance of 5-10kms and hence one can say that there is none nearby. KEM hospital has all facilities. But medicines aren’t available and they need to be bought from elsewhere. The behaviour of doctors in these hospitals depend on their mood and isn’t consistent. The nurses and aya bai on the other hand mete out very bad behaviour and are domineering. On asking the aya bai to clean, they would rudely ask the patients to get someone from their home itself. They also ask for food expenses in order to take care of the new born babies.
In Andheri too people go to Cooper, Nair, Sion, Tata and Kamgar hospital for treatment. The closest public hospital is 3-5 kms. away from the community. The behaviour of doctors, nurses and wardboys is good and basic health care is given properly.
People in Gyaneshwar nagar go to Sion, KEM and Kurla Bhabha hospital.
Ø  Condition of Anganwadis
In Behrampada pregnant and lactating women are given adequate health facilities. Immunization camps happen and injections/vaccinations are also done here.
In Bharatnagar, all pregnant and lactating women are called and given health facilities. Food, calcium capsules and medicines are provided and weights of children are also recorded. Information about immunization is provided once in a while. Polio vaccine is administered here.
In Garibnagar, pregnant and lactating women are given adequate health facilities and food at the anganwadi present nearby. Immunization camps are undertaken by the anganwadi and polio vaccination is also done. Pregnant and lactating women are given adequate health facilities. Immunization camps are conducted and injections/vaccinations are also done in Navpada.
But in Jogeshwari, pregnant and lactating women don’t get any health facilities. Not even iron capsules are given. Children aren’t given food. The teachers fill everything in their bag and take it along with them. No information about immunization is given. Injections/vaccinations are done. Polio vaccine is administered here. There are no facilities. The children and their mothers aren’t given food or medicines.
Same in Kalina. Pregnant and lactating women are not given any health facilities. Immunization camps aren’t held by them neither is vaccinations done regularly.
Even in Mahim, neither is pregnant and lactating women given adequate health facilities nor are immunization camps held. However, polio vaccine is administered.
In Pipeline too, no facilities are given to pregnant and lactating women. Khichdi is given to small children. Immunization camps aren’t organised here. Only polio vaccination is done.
In Andheri the anganwadis function properly. They give medicines and calcium and immunization is also done regularly.
In Gyaneshwar nagar, the mothers do not get  any services, children get khichdi. No immunization camps are held. Only children are given polio dose.
Ø  Condition of Public Toilets
In Bharatnagar, there are 8 public toilets of the BMC in the entire basti. This is sufficient and there is a person entrusted to clean them. Basera society maintains it which is private and money is paid to them. The BMC officials refuse to respond and maintain that they have sold it to the builders.
Behrampadahas ten public toilets. They are sufficient and clean. BMC takes the responsibility for the cleanliness and they send people for the same.
There are no public toilets in Garibnagar. Since the ones available are private and one pays to use them, they are generally kept clean by the private agency itself.
In Jogeshwari, there are about 10-12 public toilets of the BMC. They have become private and one has to pay to use them. Private people clean them and extract money in the name of BMC.
Public toilets are present in Kalina but they aren’t clean and they charge money for its usage. Makadwale sit outside, but don’t keep it clean. They are enough, but need to be renovated. Women throw sanitary napkin which also sticks to the feet.
Mahimhas ten public toilets, but they are used by people from three areas. No one comes to clean them. Though private people have been assigned to clean them, they don’t do it either.  Not only are they dirty, but don’t have doors, lights or even water.
Navpadahas two public toilets. They are not sufficient and many more are required. The public toilets are all very dirty and there is no one around to clean them.
Pipelinehas three public toilets, but one has to pay (Rs.2-3) to use them. They are sufficient. However they are very dirty and need to be cleaned. Authorised people from BMC don’t come at all.
In Andheri the total area has only 6 toilets which is not enough. They are also not cleaned regularly.
There are 3 public toilets in Gyaneshwar nagar. But they are all paid toilets.  The number of toilets are enough but they need to be cleaned. 
Ø  Condition of Drains
In Behrampada, the drains are cleaned regularly and it is undertaken by the BMC itself. People from BMC come to clean the drains once in 15 days and the roads are cleaned every day. Fumigation is done regularly, so are medical camps organised once in a month.
In Bharatnagar drains aren’t cleaned at regular intervals. Private people clean it when given money and do it once in two or six months. No one from BMC /comes to clean these drains and the people have kept individuals to clean the drains. Fumigation is done every 15 days or a month. Medical camp isn’t undertaken by the municipality. 
In Garib Nagar the drains are not at all clean. The person appointed by the BMC does come, but demands money for the services. They feel that the BMC is just namesake and private contractors are assigned to clean them. Fumigation is done once in fifteen days. However medical camps aren’t organized By BMC.
In Jogeshwari, drains aren’t cleaned. People save money and get it cleaned by private people. To clean one chamber, Rs. 150 is demanded. It is people like beggars and waste pickers who are made to clean the drains. No one from BMC come to clean these drains. Fumigation is done every month. Medical camp is however not conducted by the BMC. Drains are open with dirty water, so are the pipelines which are on the streets. Public toilets of the BMC and water facilities need to be made available in the basti.
In Kalina, the BMC comes, but do not take away the waste and yet ask for money. They are cleaned privately through contracts. No one from the BMC comes to clean. Makadwale and contractors come only once in a month to clean. Fumigation is done 15 days in a month and then in the next month only. Medical camps aren’t organised here by BMC. Only road visits are done by them.
In Mahim, neither are the drains clean nor does anyone come to clean it. No one from BMC come to clean the drains regularly. Fumigation is done once in a month. Medical camps are however not organised here by BMC.
In Navpada, neither are the drains cleaned nor does anyone come to clean it regularly. Privately, people come and clean the drains and no effort is taken by the municipality for the same. No one from Brihanmumbai Mahanagarpalika come to clean the drains unless they are called and an application is filed. They come to clean only when some leader comes to visit the area. Neither is fumigation done during the monsoon season nor is medical camp undertaken by BMC.
In Pipeline, there is only one big drain. People from BMC come to clean it. Pipeline has been laid from under the road which is cleaned regularly by the people themselves. The entire drain is cleaned before the monsoons and fumigation is done once in 15 days. Medical camp is organised by BMC.
In Andheri the drains are not cleaned regularly. People have employed private persons to do the cleaning. The BMC is absent completely. Fumigation is done regularly. No health camps are held.
In Gyaneshwar nagar the Mithi river flows along which is cleaned regularly. There is another pipe running through it. But that is cleaned by public only. BMC does not clean it.
PART THREE
DEMANDS TOWARDS THE GOVERNMENT
Ø  FOR CLEAN SURROUNDINGS
·         In all the communities the women interviewed demanded that:
·         Drains and public toilets be cleaned regularly by the BMC.
·         There should also be waste bins at regular intervals. These bins must be cleared regularly by the BMC.
·         Waste should be put only in the bins and they acknowledge that it is the people’s fault for not doing so always.
Ø  FOR BETTER HEALTH CARE
Everyone felt that free medicines and tests should definitely be available in hospitals. Respect and good behaviour is also expected from the staff of the hospitals.
There should be a fully functional health centre in each slum community.
The health centre must have the following facilities:
·         General body check up
·         Treatment for minor illnesses
·         Medicines [tablets, ointments and injections]
·         Machines like x-ray and sonography
·         Facility for blood test, ECG, tetanus shots
·         Gynaecology services like regular check up, sonography etc.
·         Basic health care in case of sudden illnesses and emergencies
They believe that hospitals should be state run and not be privatised. Doctors, medicines and machines must be available round the clock so that the poor does not have to run from pillar to post. The poor depend on the state run hospitals and state must not run away from its responsibility. The state must spend on medicines, machines and total health care facility for the poor.
Earlier the roads in Bharatnagar used to be good, but once they have been handed over to the builder, everything has gone haywire. The builder along with the general atmosphere of greed that has been created has brought a bad name to the community. The state must monitor the work of the builders.
The mobile phone companies must also be monitored and if they are causing health problems then they should be removed.

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