DESPITE EVERY year thousands of patients from Assam and other states of the North-East throng the hospitals of Kolkata and Delhi for proper treatment due to lack of quality medical facilities in the region. The gradual decline in Assam’s health expenditure in the recent years has aggravated the situation further. According to the Assam Human Development Report the growing revenue expenditure and committed expenditure has hampered the state’s ability to outreach the delivery of health services. According to the report, first of its kind in Assam, the expenditure on health as a proportion of total public expenditure was 5.23 per cent in 1980-81 and remained more or less unchanged at 5.04 to 1090-91 but it declined sharply to 4.65 per cent in 1998-99. The expenditure on the sector as a proportion of gross domestic product has been lower in contrast to expenditure on education, says the report adding that from being a little less than half the expenditure on education in the early 80s, the share of health has increased to about a fifth in 1998-99. The proportion declined from 1.48 per cent in 1980-81 to 1.005 percent in 1998-99.

The report says there has not been marked improvement in the eradication of malaria, diarrhea, acute respiratory infection, anemia in women and children, tuberculosis, AIDS, cancer, cataract blindness, cardio vascular diseases and diabetes. While the expenditure on health services in Assam as percentage of total state domestic product is higher than that in most other states, the revenue expenditure on health in the state is lower than the average of all states. In the last few years, there has been increased investment on the health front both from the state resources and from other sources, the report says. The report says the state has 26,335 hospital beds, of them, 12,179 are in public sector while other 14,156 belong to private sector. Average rural population covered by primary health centre is 32,200 while bed population ratio is 1:855 besides doctor population is 1:1195. The prevalence of cancer in the North-Eastern states is reported to be as high as 127 per 100,000 people, which is about three times as much as the all India figure of 43 per 100,000 population. Similarly, the state registered 710 tuberculosis cases per 100,000 people higher than the national estimate of 544 per 100,000 people.

The scene is no different in insurgency affected Manipur. Only 24 ambulances out of the total 42 available with the state health department are currently in working condition. These have given a big blow to referral services and emergency needs. Shortages of staff at various health centres have also added to the misery of the patients. Presently the department needs a whopping 424 new employees to put the health services back on the rails.

New community health centres and primary health centres were set up without any post being created. Similarly 160 beds were added at JN hospital, Porompat in the 8th plan without any new employees. The state health department plans to establish 90 PHSCs, 10 PHCs, 4 CHCs, 5 homeopathy clinics, 2 nature cure clinics and 5 ayurvedic clinics.  The proposed scheme is to be exclusively funded with additional Central assistance. The non-lifting of the existing ban on new job creation is a impediment to all these plans. Half of the 16 community health centres do not have X-Ray facilities.

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