URVASHI POPLI Vs. UOI

JUDGEMENT

(1.) THE petitioner Smt. Urvashi Popli, a practicing lawyer, has filed this petition in public interest seeking to challenge the instructions issued by Union of India through Secretary, Ministry of Health and Family Welfare vide D.O. No. M12015/22/2002-MCH dated 5.1.2006 and D.O. No. M.120115/22/ 2001-MCH dated 7.10.2005 for providing in-house / on the job training in Anesthesia to government doctors to be posted at First Referral Units (FRU) / Community Health Centres (CHC) at sub-district level in order to control the alarming high maternal deaths in the country. The petition appears to have been filed at the behest of Indian Society of Anesthesiologists (Respondent No.6 herein) who has been opposing Anesthesia Training Programme on the misplaced apprehension that the training to handle the emergency obstetric care at FRUs would be taken as an additional medical qualification in Anesthesia which is factually incorrect. The Government of India makes it very clear that this training programme, formulated in the national interest, is limited to the requirement of tackling emergency obstetric situations only and neither can be construed as an additional qualification / specialization nor entitles the person to practice anesthesiology generally except to tackle the emergency obstetric situations at FRU level while in Government service nor in any way replaces the specialist anesthetists who are working after pursuing degree/diploma in the subject.

(2.) THE issue of high 'Maternal Mortality Rate (MMR) ' in the country has been a matter of grave concern to the Government of India. As per World Health Organization Report, 2005, the MMR ratio per one lakh births in India was 450 against only 44 in Thailand, 56 in China and 92 in Sri Lanka and less than 10 in the developed countries. The non-availability of Emergency Obstetric Care (EmOC) at the FRUs due to lack of qualified personnel is the primary cause of high MMR. Sri Lanka, Thailand, Malaysia and Egypt are few examples which have drastically reduced the MMR below 100 by training in midwifery and variety of integrated skills. The 10th Five Year Plan recommended for a six month training course on Anesthesia for serving government doctors. The Government of India, in association with WHO, UNICEF, UNFA, DFID, AIIMS and the States, identified 21 States and 91 medical colleges to organize programmes to train Government MBBS doctors on Life Saving Anesthetic Skills (LSAS) for emergency obstetric care.

(3.) IN the rejoinder that has been filed by the Respondent No.6 Society, it is alleged that the doctors who have completed four and a half months training have not been posted in FRU and are posted to the City/District hospitals to work as full-fledged anesthetists and some others, posted back to their earlier designations, are doing general medical duties, postmortem work, emergency cover duties etc. It is further alleged that most of the FRUs/CHCs are yet to be equipped with anesthesia machines, monitors and blood storage units. Further, in paragraph 5 of the rejoinder, it is suggested that the period of training should be increased to minimum of 12 months in the medical college departments and certain other suggestions are also made.