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How the Pandemic Revealed Nagaland’s Poor Health Infrastructure

How the Pandemic Revealed Nagaland’s Poor Health Infrastructure

A view of an area in Kohima, Nagaland. Photo: The Anonymous Earthling/Wikimedia Commons, CC BY-SA 4.0

  • Nagaland doesn’t have a medical college – the sole state in India with this dubious distinction, which is also emblematic of the state’s people’s difficulties.
  • Even as medical care has improved in the state over the years, there is still low uptake: people have developed a habit of leaving the state in search of care.
  • In addition, these improvements are localised to a few facilities in Kohima, Dimapur and Mokokchung. Rural healthcare has continued to languish.

“I would see a young mother in her early twenties and her infant getting into a truck, a motorbike or any other means of transportation she could find, just to get a ride from Old Thewati village to Meluri, so she can get her new-born child vaccinated. Such is the condition of healthcare in our state.”

Rekha Rose Dukru, an entrepreneur who frequents Thewati, a remote village in Nagaland, near its border with Myanmar, was appalled to see how the state’s rural population struggle even to access basic healthcare.

“It’s a long and a tedious journey from Old Thewati to Meluri and I can’t imagine travelling that far for vaccination alone,” Dukru said. “Their health could get more affected by the journey.”

The nearest primary health centre (PHC) is in New Thewati Village, some 10 km away, but “there is usually no nurse available at the PHC to even administer a TT injection.”

In her own hometown, Pfütsero, located about 70 km away from the state capital of Kohima, “I have seen people going out of the town just for childbirth delivery. The facility is there, but the problem is when and if any complication arises.”

Dukru has also become used to being a caregiver whenever a sick family member needs to be taken outside the state for medical care. For any major health issue, she said, her family had to go to the Regional Institute of Medical Sciences in Imphal, in the neighbouring state of Manipur.

“Of course, we have much better facilities in the state now, but it’s a lot easier outside. For instance, if you are taking a number of tests, you still get the results on the same day and it saves you a lot of trouble, time and money, which is usually not the case in Nagaland,” Dukru said.

The only state in India without a medical college

Nagaland doesn’t have a medical college – the sole state in India with this dubious distinction, which is also emblematic of the state’s people’s difficulties.

The foundation stone for the first medical college was laid by Chief Minister Neiphiu Rio at Phriebagei under Kohima District in 2014 In February 2021, then Union health minister Harsh Vardhan laid a foundation stone for the Mon Medical College. Both of them have been under construction, even as the COVID-19 epidemic wore on.

Nagaland attained statehood in 1963, and its existence since sans a medical college has been a matter of great concern.

Entrance to the Kohima medical college under construction. Photo: Vishü Rita Krocha

An official from the state’s health department told The Wire Science that “without a medical college, the state will always fumble.” The official also said that good-quality tertiary care services within the state could have saved lives lost to COVID-19 as well as helped manage the state’s response to the virus better.

Thus far, Nagaland has officially reported 35,372 COVID-19 cases and 749 deaths.

“If we had had a medical college, health manpower, infrastructure, tertiary healthcare… All these would have been much better. A medical college [brings] in a lot of added facilities,” Dr Sao Tunyi, who worked in the health sector for over a decade and was part of the state’s COVID-19 ‘control room’ in Kohima, said.

“We are talking about handling complicated cases that require ICU care and high-end technology. Many of those who require home isolation or quarantine recover without any medication, but of the lives that we have lost, had we got better facilities, who knows, we could have saved more lives…”

This said, Dr Tunyi also said that medical care facilities in the state are “good enough” now – but it comes with a different problem: low uptake. According to him, many Nagas have become accustomed to the habit of travelling outside the state for medical treatment – even when equivalent care is available within the state itself.

This is partly because healthcare facilities that have improved are located mostly in  a few towns, like Kohima, Dimapur and Mokokchung, and in a few nursing hospitals. “The rural healthcare set-up remains largely unchanged,” Dr Tunyi said. “Except for preventive and basic primary care, there is no tertiary and secondary care in the rural areas.”

He added that this would be okay if each district provided tertiary care at its headquarters, in addition to the “secondary level of care” – including routine surgeries and “a little bit of ICU care” – that is already being provided.

Another doctor and health official, posted in a remote district, said there have been no exceptional changes as far as health centres are concerned, except for a few units that received oxygen cylinders and concentrators during the pandemic.

This doctor also observed that, “with special focus” on district hospitals, there hasn’t been much of an impact on the state’s rural health centres apart from the fact that there is now “additional basic equipment like masks, gloves, etc.”

This reporting was supported by an independent journalism grant from the Thakur Family Foundation. The foundation has not exercised any editorial control over the contents of this article.

Vishü Rita Krocha is an independent journalist based in Kohima, Nagaland.

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