Securing the rural health practitioners

The latest verdict on Assam Rural Health Regulatory Authority Act, 2004 by the Supreme Court has made the 856 DMRHC (Diploma in Medicine & Rural Health Care) graduates apprehensive about their future. The Government of Assam had enacted this Act in the pre-NHM era, when the condition of health services in the state was very pathetic. The rural people were starved of medical practitioners and the health indicators were very poor in Assam. Due to the disastrous condition of health facilities, the doctors didn't show any intention to go to rural areas. At that juncture in 2004, the government of Assam had introduced this special Act to create a pool of medical practitioners to serve only in rural areas. For this the state government had established Medical Institute, Jorhat and started DMRHC course in 2005. A pool of meritorious students - only two from each district - had been admitted to the course. Many left Engineering, Ayurveda, Veterinary and other lucrative degree courses only with a dream to be allopathic medical practitioners. Till date, 856 students have passed out from this institute and they are popularly known as Rural Health Practitioners. They have proved their efficiency in managing the rural health services of Assam. Their service in eradicating malaria, decreasing home delivery and services during Covid-19 has been widely discussed in the national media and government platforms. But till date, despite passage of 18 long years of enacting the Act, the state government has not taken any step to regularize their services in the Health Department and left them facing an uncertain future.

Earlier, when the Gauhati High Court on a petition of the Indian Medical Association had declared this Act as unconstitutional, the government of Assam didn't prefer to file a special leave petition in the Supreme Court to save the future of Rural Health Practitioners. Since then, these meritorious students are suffering from a mental dilemma over an uncertain future. According to the judgment, while enacting this Act the state government had not followed important procedures such as prior permission from President etc. However, the students cannot be blamed for these procedural lapses of the state government. But unfortunately the 856 students have suffered a lot for the big lapses of state government of Assam in enacting this Act. Even the Supreme Court in its recent judgment has highlighted these procedural lapses but unfortunately all the courts are silent on the victims, i.e., Rural Health Practitioners. The passed-out students are serving under NHM with very limited remuneration without any scope of absorption in permanent posts. Even their degree is not suitable in any other post of any department of the Assam government.

These students are the biggest sufferers as most of them had obtained quite good marks in HSLC and HS (Science) exam and missed the MBBS course by only a fraction of marks due to fewer medical seats at that time. The Government of Assam should take immediate responsibility to secure the future of these students as they had taken admission in a government institute after wide advertisement. People come to college to secure their future, not to ruin it. Moreover, in the advertisement it was never written that a case is pending in the Gauhati High Court questioning the validity of the said course. So the students were unaware about the status of the course and at that time service of internet was too poor to learn these things.

Therefore, all the DMRHC passed-out students are requesting our great leader and Chief Minister of Assam Dr Himanta Biswa Sarma to take a kind step to secure the future of 856 Rural Health Practitioners immediately. Even in 2014, when the Gauhati high Court had declared the ARHA Act as unconstitutional, Himanta Biswa Sarma, the then Health Minister tweeted openly and desired that the future of these rural health practitioners should be protected. So we request him to take a big decision to secure the future of these hard-working professionals in upcoming Cabinet, thereby also benefiting two crore people in rural Assam by way of accessing healthcare services.

Some DMRHC practitioners.