Medical and public health services
Medical facilities in early times
Before the advent of the British rule,
Ayurvedic and Unani systems of medicine were practised by the vaids and hakims in the
district. The British introduced the allopathic system of treatment and government
dispensaries were opened. Lack of government patronage of the indigenous Ayurvedic and
Unani systems resulted in their decay. In the due course, the homeopathic system of
medicine also entered the field and, because of its inexpensiveness, it has provided
relief particularly to the sick from the less-affluent sections of the population.
In The
beginning of the twentieth century where were two hospitals, one for men and other for
women at the headquarters of the district. In addition there were outlying dispensaries
each under a hospital assistant at Bhongaon, Karhal, Shikohabad and Jasrana. These
dispensaries belonged to the district board. A dispensary at Gopalpur was maintained by
the irrigation department.
Vital
Statistics:
The registration of deaths and births was attempted for the first time in 1865 ,
but the results were not dependable and the procedure had to be modified.
The following table provides a
glimpse of the average birth and death rates per thousand over a number of decades:
| Decades |
Birth Rate |
Death Rate |
1901-10 |
31.43 |
38.06 |
1911-20 |
30.69 |
35.28 |
1921-30 |
38.43 |
33.84 |
1931-40 |
29.40 |
16.70 |
1941-50 |
20.80 |
11.90 |
1951-60 |
- |
- |
1961-71 |
12.11 |
6.12 |
While it transpires that there were marked fluctuations from the decennial averages
given above in some of the years of the various decades, there has been over the years, a
gradual but marked decrease in both the firth and death rates ,m the exceptions, in
respect of death-rates being provided by the first two decades of the current century, and
in respect of birth-rates in the decade 1921-30. In the first decade (1901-10) the
death-rate shot up as high as over 41 per mile in the opening years on account of scarcity
conditions and the out-break of plague in an epidemic form. The death-rate mounted to
53.70 per mile in 1908 due to the combined result of high prices and scarcity and the
visitation of an extremely virulent form of malaria fever. In the decade 1911-20 , the
death rate rose due to the out-break of malaria and influenza in an epidemic form as well
as the
occurrence of plague . The high birth-rate in the decade 1921-30 is partly
explained by the low birth-rate in the decade. It will be also noticed that, in general ,
the birth-rate has been ahead of the death-rate and also that the death-rate has shown a
very marked tendency to fall during half
mainly on account of better
sanitary and health measures and medical facilities provided by the government, and the
eradication of epidemics like, plague and cholera. Family planning consciousness may well
have also contributed to the markedly low birth-rate in the decade 1961-71.
Diseases Common to District
The diseases which
accounted for a large number of deaths in the district during the three decades ending
1940 were fevers of all type, respiratory disorders, diarrhea, dysentery, cholera and
smallpox . They held the district periodically in their grip and were endemic in the past,
but now how a marded decline. Since the enforcement of a district health scheme in 1936,
regular anti-epidemic measure have been taken by the State medical and health departments.
plague has almost disappeared (two deaths in 1952 were ascribed to it ) and there has been
no reported case of cholera since 1954. This comparative relief from the
onslaught of these and several other diseases has been brought about largely through
control measures adopted by the state Government and the extension of medical and health
facilities in the rural areas.
Fevers- They
are, perhaps, the biggest teasers and tormentors and not only include malaria and typhoid
but many others . The following statement gives the number of deaths caused by fever
during the recent years:
| Year |
Number of Deaths |
| 1971 |
86 |
| 1972 |
105 |
| 1973 |
108 |
| 1974 |
60 |
Respiratory
Diseases
These diseases were
included in the category of fever before 1941. Such diseases are not an immediate cause of
death but they often result in permanent or temporary infirmity and, in some cases, even
premature death, e.g., pneumonia, pleurisy and bronchitis.
The following statement will show
the number of deaths on account of respiratory disorders during the recent years:
| Year |
Number of Deaths |
| 1971 |
70 |
| 1972 |
55 |
| 1973 |
80 |
| 1974 |
56 |
Epidemics:
Epidemics of cholera, plague and smallpox usually accounted for a high
incidence of deaths in the past.
Plague -
Plague first appeared in the district in 1903 claiming 5 lives only, while in 1905 and
1911 it appeared in an epidemic form, claiming 10,886 and 70,277 lives respectively . In
latter years it subsided as in certain years of the decade 1921-30 it claimed less than
two lives and finally disappeared in 1955 . Since then no case has been reported from the
district. Inoculations, evacuation and destruction of rats were the principle preventive
measures taken in the district to check plague.
Cholera- Cholera is not as common in this district as in many
other districts of the State, though the disease was always more or less prevalent during
the five dacade ending 1950 . A large number of deaths were reported in 1937, 1945 and
1948. Incidence of the disease has been considerably less in the decade ending 1960. The
district has been free from cholera since 1971 due to adoption of preventive measures as
anti-cholera inoculation, the purification of well water and sanitary measures and other
precautionary steps.
Smallpox -
The district was never free from this disease in the past but no severe epidemic of
smallpox has been reported during the later half of the present century, due to the
preventive measures taken, such as vaccination and the provisions of better medical
facilities in both the rural and urban areas. A special programme was launched in the
State to eradicate smallpox and not a single case has been reported from the district
since May, 1975.
The following
statement gives the number of death due to smallpox during the recent years:
| Year |
Number of Deaths |
| 1971 |
112 |
| 1972 |
50 |
| 1973 |
1 |
| 1974 |
10 |
ORGANISATIONAL SETUP
Prior to 1948 there were separate
departments for medical and public health activities but were amalgamated in that year
under a directorate for better cohesion and control over the allopathic, Ayurvedic and the
Unani institutions and services. In July, 1961, a separate directorate was established at
Lucknow for the development and effective supervision of Ayurvedic and Unani institutions
and services. Local administration of these institutions, however, remained in the charge
of the district medical officer of health, now designated deputy chief medical officer
(health).
Formerly the civil surgeon and the
district medical officer of health respectively headed the medical and public health
organisations in the district . In July 1973, the departments of medical and public health
were again reorganized in the State, abolishing the posts of the civil surgeon and
the district medical officer of health. In the district from the same year,under the new
set-up, a chief medical officer has-been appointed who heads the entire medical, public
health, and family planning institutions in The district. He is assisted by three deputy
chief medical officers. In the urban circle at the district headquarters, the
superintendent of the district hospital
(male) and the women hospital control the medical health and family planning activities in
their respective institutions. The whole supervision of health and family planning
activities is under the control of the chief
medical officer.
At the district headquarters the
municipal medical officer of health is responsible for public health activities. The rural
area has been divided amongst the three deputy chief medical officers for all medical,
health and family planning work .
The public health centres in the
rural areas are equally distributed among the deputy chief medical officers. The rural
State dispensaries fall under the primary health centres and are also under the deputy
chief medical officer concerned.
At the level of primary health
centre a medical officer is in over all charge of the medical, health and family planning
activities. The medical officer is assisted by another medical officer in family planning
and maternity and child welfare centres.
Hospitals
and Dispensaries
About 1900 the district had only
two hospitals- the general hospital and the Dufferin hospital- and only six dispensaries,
one each at Mainpuri, Brogan, Karhal, Shikohabad, jasrana and Gopalpur. The daily average
attendance in these hospitals and dispensaries was about 430 including 29 indoor patients.
The number of hospitals and dispensaries has now increased to 8 and 20. Some particulars
about these hospitals and dispensaries are given in Statements A and B at the end of the
chapter.
Primary
Health Centres
There are 15 primary health
centres, each having a dispensary, a maternity and child health centre (with 3
subcentres), staffed by a medical officer, a compounder, 2 other employees, a health
visitor, 4 midwives (one for the headquarters and one each for the subcentres ) and a
sanitary inspector to look after the curative and preventive activities. All the primary
health centres are under the administrative control of the deputy chief medical officer
(health). Relevant information regarding primary health centres functioning in the
district is given in Statement C .
Maternity
and Child Welfare
The maternity and child welfare centres
were established to reduce the high rate of mortality among women, and infants during the
ante and post-natal periods. In the past the maternity services were rendered in the
district by the Red Cross Society ,now they are centres. Each primary health centre has a
maternity and a child welfare centres at its headquarters and 3 subcentres at other
places. There are 15 maternity centres and 45 subcentres functioning the district . Each
maternity centre is usually staffed with an auxiliary (midwife ) and a Dai but here
are a medical officer and a health visitor in addition, at the primary health centres of
the block. The trained staff of these centres offers advice and aid at the centres and
also pays domiciliary visits. Particulars of the maternity centres and subcentres in the
district are given in Statement D.
Family Welfare Planning
In order to propagate the concept of a small family commensurate with the ideal of
planned parenthood , a family planning unit was established in the district . Now there is
a family planning centre. attached to every primary health centre . The family welfare
centres are supervised by the medical officer in charge of the primary health
centres. A mobile team functioning under the care of a male doctor who performs vasectomy
and a lady doctor who inserts I.U.C.D. (Intra Uterine Contraceptive Device) and performs
tubectomy operations has been provided in the district . Some details of work done in this
respect are given in the following statement:
| Year |
No. of Sterilization |
No. of Loops inserted |
No. of Contraceptive distributed |
| 1970-71 |
581 |
1,166 |
1,53,606 |
| 1971-72 |
690 |
1,748 |
1,54,495 |
| 1972-73 |
3,494 |
1,581 |
1,16,419 |
| 1973-74 |
117 |
1,886 |
1,67,260 |
| 1974-75 |
250 |
2,666 |
1,66,160 |
Vaccination-
In the early times the rate of mortality from smallpox was high in the district as people
were averse to vaccination. Vaccination through government agency was not introduced till
after the freedom struggle of 1857 and was at first undertaken through such agency in 1871
but with little success . It is now compulsory only within the municipal limit, Parents
are usually advised to have their children vaccinated within six months of their birth.
There are 2 government and 19 Zila
Parishad vaccinators to carry out vaccination work in the rural areas. Besides, there is a
team of 5 vaccinators with one public health assistant and two assistant superintendents
of vaccination at the district level. The deputy chief medical officer (health) is in
overall charge of the vaccination programme.
The following statement gives the
number of persons vaccinated during the recent years:
| Year |
Total No. of Person vaccinated |
No. of primary vaccination (Successful) |
No. of re-vaccination |
| 1971 |
2,12,128 |
81,238 |
1,30,890 |
| 1972 |
2,11,401 |
81,251 |
1,30,144 |
| 1973 |
1,44,227 |
56,346 |
87,881 |
| 1974 |
1,40,265 |
43,622 |
96,643 |
National Malaria Eradication Programme
The national malaria eradication
programme was launched in this district during 1958-59. Under this programme the district
was divided into two parts, one consisting of hyper- endemic areas and the other
consisting of hypo-endemic areas. Two subunits each were spread over in hyper-endemic and
in hypo-endemic areas . During 1958-59 the hyper-endemic area of the district, was covered
by a unit , under the programme with headquarters at Etawah and in 1959-60 , the remaining
area, categorized as hypo-endemic, was controlled by another unit under the programme, stationed at Mainpuri.
Thus the entire district was covered under the programme by 1959-60 and thereafter its
follow-up was undertaken.
This programme is operated in the
district under the supervision of the anti-malaria officer. He is assisted by 2 senior
malaria inspectors, 2 malaria inspectors , 13 surveillance inspectors and 25 house
visitors.
The following statement gives the
number of blood slides of suspected malaria patients collected and the number of positive
cases found in the district during the years between 1970-74:
| Year |
No. of Blood slides Examined |
No. of Malaria cases detected |
| 1970 |
68298 |
11 |
| 1971 |
72560 |
10 |
| 1972 |
67160 |
31 |
| 1973 |
74312 |
150 |
| 1974 |
72212 |
3330 |
Prevention of Food And Drug Adulteration
The district
medical officer of health, now the deputy chief medical officer (health), is the licensing
authority for food and drug distribution in the rural areas. The municipal officer of
health is responsible for this work in the
municipal areas.
The following statement gives the
numbers of samples collected, of those found adulterated and cases prosecuted in the
recent years:
| Year |
No. of Samples Collected |
No. of Samples found adulterated |
No. of Cases prosecuted |
| 1973 |
328 |
65 |
99 |
| 1974 |
294 |
53 |
85 |
In each tahsil there is one sanitary inspector who looks after environmental
sanitation and prevents food adulteration.
Diet and Nutrition- The main
cereals used in the district are rice and wheat
in equal quantity. A diet consisting of chapaties and boiled rice is usually preferred. Coarse grains like maize, Kakun,
bajra, kodon and jowar, which are produced
in small quantities in the district, are also con consumed by poor people. the usual method of rinsing rice
several times with water before cooking it deprives it of vitamin B. Wheat is now commonly
milled by the mechanically driven flour
mills. About 40 gm. of bran in each kilogram of flour is
wasted during milling and sieving.
Among pulses Urd, Arhar,Masur and
moong are largely used. A mixture of pulses
is sometimes preferred. Soybean dishes have not become popular.
The
common vegetables consumed in the district are, pumpkin, brinjal, cabbage, cauliflower and gourd. Among leafy
vegetables sarson ( mustard leaf) , palak
(spinach), cholai(amaranthus )and podina (mint) are commonly used. Bhasinda and singhara
grown in ponds and lakes are also eaten.common fruits used by the people of the district
are papaya, guava, banana, mango, water-melon,
musk-melon, apples, oranges and grapes. The last mentioned three fruits are common only
among the richer people . Dry fruits which have become costly
are favoured by well-to-do people only.
The consumption of edible oils is adequate. They are derived from ground-nut and mustard seed. Vanaspati Ghee
(hydrogenated oil) is a popular medium of cooking in the urban areas of the district.
The consumption of sugar is
adequate. In rural areas people use gur(jaggery)and
khandsari (coarse sugar) Crystal sugar is mostly used by urban people.
Use of meat, milk, fish and egg is
not very common in the district
Statement-A
Hospitals
| Name of the
Hospitals |
Staff |
No. of beds |
No. of Persons
Treated |
| Doctors |
Others |
Male |
Female |
Indoor |
Outdoor |
| District hospital, Mainpuri |
5 |
41 |
48 |
30 |
3,565 |
1,53,634 |
| District Women's hospital, Mainpuri |
2 |
14 |
- |
30 |
4,239 |
13,472 |
| Police hospital Mainpuri |
1 |
5 |
20 |
- |
524 |
3,472 |
| Jail hospital Mainpuri |
1 |
3 |
6 |
- |
25 |
2,665 |
| T.B. Clinic, Mainpuri |
2 |
18 |
- |
- |
- |
5,472 |
| Dental Clinic, Mainpuri |
1 |
2 |
- |
- |
- |
6,732 |
Statement-B1 Allopathic Dispensaries
| Name of the
Dispensaries |
Staff |
No. of beds |
Patient Treated |
| Doctors |
Others |
Male |
Female |
Outdoor |
Indoor |
| Bewar dispensary |
1 |
3 |
2 |
2 |
42,920 |
248 |
| Bhongaon dispensary (male) |
1 |
3 |
6 |
2 |
26,400 |
145 |
| Bhongaon dispensary (female) |
- |
4 |
- |
6 |
6,048 |
50 |
| Naviganj dispensary |
1 |
3 |
2 |
2 |
8,052 |
23 |
| Ram Nagger dispensary |
1 |
3 |
2 |
2 |
9,828 |
21 |
| Samoan dispensary |
1 |
3 |
2 |
2 |
174 |
15 |
| Sahai dispensary |
1 |
3 |
2 |
2 |
2,790 |
35 |
| Bamkapur dispensary |
1 |
3 |
2 |
2 |
39,063 |
22 |
| Pratapur dispensary |
- |
3 |
2 |
2 |
12 |
2,256 |
| Saadatpur dispensary |
- |
3 |
2 |
2 |
2,673 |
14 |
| Beontikhurd dispensary |
1 |
3 |
2 |
2 |
3,232 |
15 |
Statement-B2 Homeopathic Dispensaries
| Name of Dispensaries |
Year of Opening |
Staff Posted |
| Doctors |
Others |
| Urawar Dispensary |
1973 |
1 |
3 |
| Rachan Dispensary |
1974 |
1 |
3 |
| Bhongaon Dispensary |
1973 |
1 |
3 |
| Maleadpur Dispensary |
1975 |
1 |
- |
Statement-C Primary Health Centre
| Name of Primary Health Centre |
Year of Openings |
Staff |
No. of Beds |
| Doctors |
Others |
| Kuchela |
1959 |
1 |
19 |
4 |
| Kuraoli |
1969 |
2 |
20 |
4 |
| Ghiror |
1961 |
2 |
18 |
4 |
| Sultanganj |
1961 |
1 |
19 |
4 |
| Manpur Hari |
1959 |
1 |
17 |
4 |
| Kishni |
1963 |
1 |
16 |
4 |
| Sagamau |
1968 |
2 |
18 |
4 |
| Karhal |
1969 |
2 |
17 |
4 |
| Barnahal |
1967 |
1 |
18 |
4 |
Statement-D Maternity Centres and Sub Centres
| No. of Maternity Centres |
Sub Centres |
| Kuchela |
Nauber, Kamkan, Karimganj |
| Kuraoli |
Nagla Ind, Achalpur, Nagla Kalan |
| Ghiror |
Naugaon, Midrauli, Kirna, Ganeshpur |
| Sultanganj |
Rakari, Ruismaura, Alipurpatti |
| Manpur Hari |
Kundi, Berar, Nairganj |
| Kishni |
Kumlaraul, Chitani, Manigama |
| Sagamau |
Pandari, Ratanpurbads, Ailan |
| Karhal |
Andani, Naikpur, Sauj |
| Barnahal |
Gotapur, Khera Bhau, Radapur |