Neglected Basti Dawakana Rusts Telangana’s Public Healthcare

Hyderabad: Locals of Mangar Basti, Mallepally, have been struggling to access healthcare at their basti dawakana. The entrance is strewn with garbage, and sewage water stagnates in front of the facility, with constant stench in the air making it difficult for patients and medical staff to enter. The building is in dilapidated condition with a patchy ceiling and damp walls.

“I have been working here for two years, and in the rainy season, the condition is worse as the water enters the building," said the medical officer at the dawakhana. The facility functions in a portion of the community hall, also partly used as a government school.

Basti dawakhanas and primary healthcare centres are the foundation of public healthcare. These clinics are the first point of contact for healthcare for most people.

Political leaders utilise the launch of these clinics to brandish their public image. However, after the inauguration, the clinics go out of the public glare without any periodic assessments.

A group of journalists from Deccan Chronicle visited basti dawakhanas across the city to find out how their condition and their functioning. Most clinics were either closed or were facing multiple challenges. Their functioning was also highly localised, which means their work timings and services differ across the city depending on the number of patients and nature of health problems.

Apart from the one at Mallepally, basti dawakhanas in Gachibowli, Madhuranagar Colony and Gopanpally were closed for over 30 days. The surroundings have become dumping grounds for trash. Garbage, plastic waste, and rotting food are thrown near the units.

In Dabeerpura, Balketh Ground, and Guddibowli, the basti dawakhanas were functioning satisfactorily.

Dr G. Yashasvi at the Balketh Ground Basti Dawakhana said she faced a challenge in handling records as the data of the 80 patients who turn up daily needs to be entered in the Ayushman Arogya Mandir app.

"When there is a large patient turnout, updating records becomes difficult as I am supposed to take care of patients and the nurse is busy taking test samples. If we had data entry operators like the PHCs do, it would have made the process a lot easier,” she added.

The staff members need to update their attendance online as well. "We upload the picture of staff with GPS location in our cluster group on arrival and while leaving for attendance. It is mandatory,” she said. When a staff member or doctor is on leave, they submit a letter to the senior health public officer, and arrange a replacement from the PHC.

According to Niranjan Yadav, a Guddibowli resident, the new attendance system has made the doctors more punctual.

However, he complained that the staff asked people to buy medicines from pharmacies outside, even when it was available in-house. Dr A. Manasa, medical supervisor, however, said told Deccan Chronicle that they inform the pharmacist at the PHC and ensure the supply within two days in case of shortage.

At the Chintalkunta Basti Dawakhana in LB Nagar, Dr Keerthi Priya pointed to the absence of separate washrooms for men and women. “There are no male staff members as of now but it would have been problematic. A recent survey by the district medical and health office (DMHO) included questions about washroom facilities, so we’re hopeful of the improvements,” she said.

Lack of separate washrooms is a common issue across old basti dawakhanas. The newly-constructed Basti Dawakhanas, however, have separate washrooms for men and women.

Tetanus (TT) injections, which are essential for treating injuries caused by accidents or dog bites, are unavailable in the Chintalkunta facility.

Funding is another challenge, as each basti dawakhana is supposed to receive Rs 10,000 per month through its account. However, no funds have been provided so far, reportedly because the DMHO has not received funding from the government.

Multiple centres in Secunderabad revealed a worrying situation — some were shut entirely, while others were running with minimal staff and only basic emergency facilities. The basti dawakhana in Chapalabi was functional but difficult to locate, requiring multiple enquiries with locals before it was finally found. Though emergency equipment was on standby, there was no visible expiry date on the medicines, raising concerns about their safety.

The PHC in Mettuguda was shut on Saturday and Sunday, leaving no option for those in the area who might have needed medical attention. At the PHC in Pan Bazaar, Bhoiguda, only a nurse and two ayahs were present on Sunday, while no doctor was on duty. The unit was only ready to cater to pregnancy-related emergencies, meaning anyone with other medical concerns would have to look elsewhere.

“Emergencies do not follow a Monday-to-Friday schedule. While major hospitals remain open, not everyone has the means or ability to travel long distances for minor but urgent health concerns,” said Anjaiah, who was waiting outside the Chapalabai Basti Dawakhana in Monda Market, Secunderabad, for the nurse to take his data.

The situation was not so grim at Gunfoundry Basti Dawakhana, as it was functioning in a comparatively better building with easy access from the main road. After this unit opened, the locals explained, they have stopped going to private clinics. However, they say availability of doctor at the clinic was the most important for them to visit the clinic.

The district hospital at King Koti caters to the most densely populated areas in the heart of the city. The hospital's in-patient wards and special wards are well maintained. When it comes to the outpatient department, which opens from 9 am to 2 pm, patients found language as a major barrier. A proper help desk should be set up for the locals. While the interns and junior doctors were trying their best, senior doctors were largely disinterested, the locals mentioned.

Visitors and doctors also asked the government to appoint specialists in cardiology, neurology and urology, as several patients come to the clinic with problems related to these ailments. "Cardiology should be brought in immediately," said one visitor.

The emergency services, functioning well, are enhanced at the time of accidents or medical emergencies. Vinod Kumar, a student, said, “My hostel mate who had seizures from epilepsy was brought to this hospital. He was attended well by the doctors and the services were good.”

With inputs from Shrimansi Kaushik, Shivani Reddy, Aishwarya Gandeed, Sanjay Samuel Paul, Prathyush Nallella and Rachel Dammala

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A basti dawakhana (BD) or a palle dawakhana functions as a subset of a primary healthcare centre.

It will have a medical doctor, a staff nurse and a support staff, providing basic medicines and first aid.

Urban primary healthcare centres (UPHCs) function on a larger scale, catering to a population of about 30,000 to 40,000.

UPHCs provide an out-patient unit, lab testing, pharmacies, and immunisation and maternity services.

Functioning of basti dawakhanas highly localized; their work timings and services differ across the city depending on the number of patients and nature of health problems.

Lack of separate washrooms is a common issue across old basti dawakhanas.