These doctors in Naxal-hit areas get higher pay than physicians at AIIMS in Delhi


Shantanu Nandan Sharma    09 July 2018

When Dr. Aakriti Shukla joined a hospital in Bijapur in February, her family was thrilled. For the 29-year-old gynaecologist, who completed her masters in surgery just last year, getting a salary of Rs 2 lakh a month is no mean thing.

At the district hospital in Chhattisgarhs capital Raipur, where Shuklas parents live, the salary for a specialist doctor starts at Rs 56,000. Even in Delhis prestigious All India Institute of Medical Sciences, the entry-level salary is less than a lakh.

The big pay notwithstanding, the doctors parents are apprehensive. Bijapur is not just another rural district. About 500 km from Raipur, it is one of the areas worst affected by Maoist violence in the country. There were 172 Naxal-related incidents in the district in 2017, and 68 till June this year, according to data available with the Bastar Police, which commands over seven districts, including Bijapur.

"My parents are supportive, but my relatives ask them, Yeh ladki ki shaadi ki time hain, kahan bhej rahe h o (This is the time to get her married off. Where have you sent her)?"says Shukla. The young surgeon, though, loves her job and will apply for an extension after completing the one-year contract.

At least three districts --Bijapur and Dantewada in Chhattisgarh and Keonjhar in Odisha --are hiring on contract specialised doctors to work in far-flung and sometimes unsafe areas by paying them a hefty salary --of Rs 2-2.5 lakh a month. The big pay comes from district-level mining funds that are under the disposal of district magistrates.

It all started in 2015 when the Mines and Minerals (Development and Regulation) Act was amended, leading to the creation of District Mineral Foundation (DMF) in 12 mineral-rich states, including Odisha, Chhattisgarh, Madhya Pradesh and Jharkhand.

The formula is simple. Miners in a particular district contribute 10-30 per cent of the royalty of mining leases to a fund under the DMF.

The money is primarily used for environment preservation, healthcare, education, drinking water, welfare of women and children, skill development, sanitation etc. Recruitment of highly paid doctors is being initiated under the healthcare head.

Last week, for instance, there were walkin interviews for doctors in Keonjhar district in Odisha. District magistrate Ashish Thakare told ET Magazine over the phone that 22 specialists were shortlisted. An anaesthetic willing to work in the interiors is paid over Rs 2 lakh.

The selection list has yet to be finalised. Keonjhar has an annual mineral kitty of about Rs 700 cr, higher than most others, because of its location in an iron ore and manganese belt. The contribution to the district fund comes mostly from private miners such as Tata Steel, and stateowned entities like Steel Authority of India Limited (SAIL) and Odisha Mining Corporation (OMC).

A huge, extra-budgetary fund at the disposal of district magistrate means the district can experiment with new ideas; getting doctors to work on a higher salary being one such innovation.

The district administration also hires super specialists --oncologists, cardiologists and neurologists --from state capital Bhubaneswar, 200 km away. They come once or twice a week, for a daily fee of Rs 20,000. Districts such as Angul, Jharsuguda, Jashpur, too, have experimented with this model of hiring.

NITI Aayog, it is learnt, wants this model to be replicated in other districts as well, mainly to overcome the problem of one government doctor serving 11,082 people in India as against the WHO-prescribed ratio of 1 doctor for 1,000 people.

The mineral fund is helping Bijapur and Dantewada make perceptible changes in healthcare. On April 1, 2016, the entire district of Bijapur, with a population of 2.5 lakh, had just one specialist --a gynaecologist. By the end of 2017, the number of specialists in the district went up to 17.

Dantewada, meanwhile, has 46 medical officers and 17 specialists, many of whom are recruited on contract. The district has spent Rs 5.78 crore from the mineral fund in the current fiscal for hiring doctors and paramedical staff.

Now that the doctor is in, the traditional healer is on his way out. "Sirah guniyas (traditional healers) are losing their clout,¡¨ says Dr Shrikant Gedem, an ophthalmologist, who is on a Rs 2.2 lakh-permonth contract in Bijapur.

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