Mewat in Haryana ranks among India’s most underdeveloped districts on several health parameters. Mewat has one of the highest infant mortality rates in Haryana, with as many as 43 deaths per 1,000 live births, which is higher than the state average. This is often attributed to inadequate healthcare facilities, low immunization rates, and poor maternal health services. The region has fewer healthcare facilities compared to other districts in Haryana. Many villages lack a proper maintenance of Primary Health Centers (PHCs), and there is a shortage of trained medical personnel.
A primary health center is the first point of contact between the community and the medical system. It provides as a first step to accessing basic healthcare facilities in rural India. According to Indian public health standards, a PHC is typically staffed by at least one medical officer supported by a number of nurses (usually three or four), a pharmacist, a lab technician, and other healthcare staff such as health assistants, a female health worker (ANM), and a male health worker. Each PHC is ideally meant to serve a population of 20,000-30,000 in plains and 10,000-20,000 in hilly, tribal, or difficult areas.
During the COVID-19 pandemic, the crucial role of Primary Health Centers in rural areas became even more pronounced. Despite the ongoing need for robust healthcare services, ‘Health on Air’ report from rural Mewat district of Haryana reveals that many of these centers remain dilapidated and non-functional.
Kahkasha, 24, sits alone at Ujina Primary Health Centre (PHC) in Mewat, with her visits now totaling ten in the past month. She gave birth a month ago and has been facing complications due to her anemic condition. Her struggle with anemia remains largely unaddressed due to persistent staff shortages. This center, crucial for local healthcare, is understaffed and exemplifies the systemic challenges prevalent in health services across one of Haryana’s least developed districts. Photo: Zoya Hussain/HoA
Savita, 22, holding her patient care card, narrated the gaps in prenatal care at her local PHC in Mewat. Essential tests such as ultrasound scans and glucose screenings, crucial for monitoring the health of both mother and fetus during pregnancy, remain inaccessible. The locals are frustrated because this lack of basic healthcare services not only endangers her well-being but also underscores the systemic neglect that pregnant women face in accessing timely medical interventions. Photo: Zoya Hussain/HoA
Savita highlights the dire state of maternal healthcare, sharing, “I don’t even know if my baby and I are healthy, or when my due date is. Every time I come here, they tell me to return next week. I’ve been running around this PHC for the last five months. Moreover, the roads leading here are so poor that it’s risky for pregnant women to commute on them.”
Women, who are among the most frequent visitors to the local PHCs, often endure lengthy waits due to inadequate electricity and water supply at these centers. Essential tests that require both water and power are delayed, compelling them to wait for hours. Miskena, a patient who has been waiting for over three hours, shares her ordeal, “In this extreme heat, the long wait becomes even more distressing without food. It only adds to our troubles rather than alleviating them.” Photo: Zoya Hussain/HoA
In the empty courtyard of this Mandikheda PHC, a lone wheelchair highlights the harsh realities of healthcare access in rural India. This center, stripped of consistent electricity, can only power its lights for one or two hours in the morning. In such conditions, medical staff often have to conduct deliveries and handle emergencies in the dark, underscoring severe neglect by government provisions. Patients, left with no choice, are frequently referred to distant hospitals, further complicating their access to essential care. Photo: Zoya Hussain/HoA
In the dimly lit confines of her office at the Ujina PHC in Mewat, a doctor sits idle, the stark lack of patients is a silent testimony to the center’s challenges. Despite being equipped with solar panels, the facility faces frequent power shortages, limiting its ability to provide consistent care. They depend on natural light through barred windows. Photo: Zoya Hussain/HoA
Prem Kumari, a staff nurse, shares, “Ever since I joined this PHC, we’ve faced constant electricity issues. There hasn’t been a single day with uninterrupted power. Mostly, we see pregnant women coming in for deliveries or tests. However, due to the frequent lack of water and electricity, we are only able to perform a very limited number of tests. Most of the time, we have to refer deliveries elsewhere, and in emergencies, we are forced to proceed without proper lighting.”
Mewat, despite its proximity to affluent areas like Gurugram and Faridabad, faces significant challenges with electricity access. The region experiences unreliable power supply, with some areas receiving electricity for only a few hours each day. This inconsistency in power availability affects daily life and economic activities, contributing to the overall sense of marginalization felt by its residents. The lack of reliable electricity is one of several infrastructure issues that exacerbate the area’s developmental delays. Photo: Zoya Hussain/HoA
Globally, nearly a billion people depend on healthcare facilities lacking reliable electricity, particularly in South Asia and sub-Saharan Africa where up to two-thirds of facilities face power instability. Unreliable power in many countries is preventing clinics from consistently delivering health care services at best-practice standards—and from expanding medical services on offer—according to the global nonprofit Sustainable Energy for All.
Dr. Sandeep Rajput, Additional SMO at CHC Nuh, expressed his frustrations, stating, “Many solar panels were installed here by the government, but they either malfunctioned upon arrival or we were not instructed on their maintenance. Moreover, the cost of maintaining them is so prohibitive that we can’t manage it. We have repeatedly discussed these repair issues with the government. Recently, some officials from Niti Aayog visited. We presented this electricity issue to them. Now, let’s see what happens next.”
A few PHCs have working solar panels, but according to the staff, solar power does not meet all the centers’ needs. Suman Kumari, a nurse midwife, mentions that electricity still frequently goes out in the on-site staff housing quarters, and the center’s solar panels cannot supply enough power for energy-intensive medical equipment or even basic water pumps. Maintaining the system smoothly is also a constant challenge, including issues like insufficient funding for repairs, overloading the solar panels, and batteries dying without replacements available. Photo: Zoya Hussain/HoA
Dr. Rajput explains, “We heavily rely on cold storage to preserve vaccines, medicines, and biological materials that require controlled temperatures. However, after a point, even our cold storages need electricity for the freezers inside the facility’s cold chain room. Mewat faces significant challenges in healthcare infrastructure due to chronic neglect and underinvestment, which slows the installation and maintenance of crucial technologies like solar panels, affecting the reliability and effectiveness of health services in this underserved region.”
In the sparse corridors of a Primary Health Center in Mewat, aging taps run dry, mirroring the severe water scarcity that plagues the region. With 78% of the district grappling with saline groundwater, these facilities struggle to maintain basic hygiene, exacerbating health challenges for the community. Photo: Zoya Hussain/HoA
A patient shared, “When we come here, the bathrooms are unusable due to the lack of water, which also means they can’t be cleaned. After my daughter-in-law gave birth, she asked for water, but even the patients’ water pots in the rooms were empty.”
This patient’s room in Ghasera PHC features a traditional water pot, highlighting a stark contrast to modern medical needs. Although PHC premises are expected to have adequate and safe drinking water, this facility faces critical shortages, impacting everything from drinking to various medical and hygiene purposes. The acute water crisis forces residents and health centers to spend Rs. 1000-1500 monthly on water tankers, due to high groundwater salinity and inadequate supplies, severely affecting both patient care and staff living conditions. Photo: Zoya Hussain/HoA
In a room at Mewat’s Ghasera PHC, without electricity or working fans, Sugaina Shareef, 24, lies in sweat after delivering her baby. She recounts her recent delivery during a power outage. Amidst severe labor pains and extreme heat, she was forced to wait several hours in the dark before the staff nurses proceeded with the delivery. Sugaina describes the experience as deeply distressing, given the lack of a gynecologist and the high temperatures, which soared to 48 degrees Celsius that day.
Photo: Zoya Hussain/HoA
“I came here in severe labor pain and there was no electricity. The doctor told me to wait 2-3 hours, but the lights never came back on. In an emergency, the doctor proceeded with the delivery in the intense heat, with temperatures that day reaching 48 degrees Celsius. Delivering in such pain and heat was terrifying. Afterwards, I was scared that something might go wrong in the darkness, especially since they don’t even have a gynecologist. The staff nurses handle the deliveries. It felt like a terrible nightmare,” shares Sugaina Shareef, recounting her harrowing experience at this PHC.
The Health on Air team visited several PHCs in Mewat and inspected their medicine repositories. They discovered issues with the distribution of near-expiry medicines at these centers. This is a bottle of Vitamin A pediatric oral solution, part of the Haryana Government’s health supplies like many other regular medicines that were nearing expiring their date. These problems were linked to supply chain management challenges within the public health system, including inadequate procurement planning, poor distribution, and monitoring systems. Such systemic issues result in the expiration of stocked medicines before they are distributed or used. Photo: Zoya Hussain/HoA
