Decaying Manipur Health Care Delivery System - I
How JNIMS, Porompat, was established!
Suggested treatment lines for improvement
- Part :: 1 -

Dr Th Suresh Singh *

Central Library Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Porompat Imphal :: Pix - Rakesh Khwairakpam

When I joined as Director of Health Services(DHS), Manipur, at the end of February 2006, I paid a courtesy call to Hon’ble CM, Manipur immediately. The CM is also the head responsible for appointing various heads of Department. After exchange of various preliminaries, CM expressed his desire to establish a medical college for the state and asked me to explore the feasibility of converting Porompat General Hospital for the same. I gave a firm reply that I will do. Coming back to the office, and with my background of M.D.(Health Adm.), I knew that it is an uphill task. I also knew that, with the present infrastructure, it is not possible to convert it into a medical Collage. The Indian Medical Council (IMC) will never give the needed permission. We require a lot to do for the same.

However, I am firmly of the opinion that we can do this, and with the negative attitude of RIMS, Lamphel in every field, a separate Medical College for the State is a must. RIMS during those periods, and even now, behaved like an extra constitutional body with negative attitude all around. They even shown callous attitude during the fight against Birth Flue Epidemic in the state. As a result, I have to call many times to the than Superintendent Dr. Mohen who happen to be my friend for the needed additional support during the Bird Flu epidemic.

The Director was also my friend, but his idea was otherwise. It is condemnable that those holding higher position at RIMS had forgotten the sacrifices the State did for its establishment. Everybody at RIMS should remember that besides sacrificing the then General Hospital, the state has contributed all the available manpower including specialist doctors who were sent for P.G. to various branches at the state’s exchequer. This has led to unavailability of many specialists in the state. The situation is still continuing even now.

Accordingly, I am willing to do that extra mile for this medical college. Moreover, on my inner mind, I have that desire and urge to establish a Medical Collage during my DHS period. The 1st thing is the infrastructure and Manpower (especially doctors and nurses). In respect of infrastructure - a lot of construction works were going on. These were however tardy and unsatisfactory and requires close monitoring. In respect of manpower – I knew that it is a time consuming process and has to deliver on a time bound road map.

The month of March was consumed on the nitty-gritty of financial year and encasement procedure of the various money allotted to the department Chief Secretary (CS) Janail Singh repeatedly mocked the department for its failure of not encashing Rs 6 crores or so during my predecessor’s period in all the cabinet meetings held in March 2006. I was determined to show that there would be no such failure during my period. A team of about 30 staff, including doctors dealing with various sections, are trained and motivated since I joined. With clear demarcation of duty and daily monitoring, this team was able to encash all the money allotted to the department It was an achievement worth remembering.

In this said encashment, various components of the JN Porompat hospital are also included. I had started monitoring minutely keeping in mind the coming up medical college. In respect of the more important Manpower recruitment, 877 posts of various categories of health institutions, including Porompat hospital, were approved in April 2006. It includes 150 staff nurses and other paramedics of Porompat hospital i.e. the proposed medical college. Hence, inwardly I was happy while thinking that this will enhance our proposed medical college.

Coming months were full of extra duty and burthen - conduction of written exam of recruitment of the above posts, the same for MBBS training, another one for selection of different categories of paramedical staff etc. I must mention here that recruitment procedure, including viva voce of more than 8000 candidates was a difficult nut to crack. These were easier written than the actual stuff. In spite of many handicaps, the department. was able to recruit 900 regular posts of various categories by march 2007. Not only that, various crores for the infrastructure development of Porompat hospital were enchased and deposited to the concerned construction departments. The stage is now set for the development of a new medical college in our state.

April 2007 was spent as relaxation month as everybody was tired of the financial year hot spots. Starting May 2007, my mind was fully devoted to the establishment of this medical college. Here, I must mention the role of our Hon’ble CM Shree Ibobi. It is he who was responsible for giving cabinet approval for new recruitment to 3 departments. viz- medical, education and home relaxing the restriction norm. I am fortunate that I have a Chief Minister who is always encouraging the department to do the best.

Whatever asked for additional fund for the improvement of health department the CM is always willing to oblige and frequently overruled other departmental Secretaries. It is rare to find that our CM was asking this small fray Director to come to him anytime and whenever required. He even gave me his personal mobile no. and gave permission to call him anytime. That I never disturbed him by calling is another matter. I also happen to be the most frequently called upon Head of Department to attend his almost weekly Cabinet Meeting. On extreme tiresome weekend period, when I was relaxing by hiding, he used to send the Commandos to find me. Perhaps he is satisfied with my work, I don’t know. I am really thankful to our CM. Chief Secretary Jarnail Singh basically also supports our department very much.

From May, I had been asking our planning section to prepare a project report for the converting JN Hospital Porompat to a medical college. I have told the section the component needed for that Project formulation and the rough outline. In spite of that, our department of planning section is unable to put up one. Perhaps they knew I will reject a substandard one. In the meantime, CM was asking me frequently about the progress of the proposed Medical College. In every occasion, I briefed him the various progresses made during the last 1 yr. and assured him that I will prepare a medical Collage project which cannot be rejected by the centre. I am as confident as a rock, and why not? Project formulations were a part of my MD (Community Health Adm.) course at Delhi.

In the meantime, a senior IAS, Principal Secretary (PS) D.S. Punia was appointed as health secretary i/c. It is a boon to have a senior IAS officer as our head at the secretariat. It gave credibility to the department Dr. Ibomcha Singh, additional Director (Manpower Development.) was also appointed as coordinator for the proposed medical college. It was, however, done without my knowledge/ approval. Though it was a good move and Dr. Ibomcha also contributed to a certain extent in the speedy function, I knew it would lead to frictions with the other branch i.e. planning and finance under another Add. Director and who was dealing with other project formulations and infrastructural development. As feared, mutual avoidance has started between the 2 sections and I had to frequently interfere in my busy schedule to get maximum output.

Meanwhile, uninterrupted power supply and uninterrupted water supply had already been accomplished by sanctioning additional 50 and 15 lakhs respectively in the financial year 2006-07. It is sere same that these had not been undertaken previously for this only state level hospital. Both health as well as other related two departments had to be blamed for this. It is again emphasized that a lot of running here and there and jee-hujur had to be done in many departments from our side, including myself, to accomplish the same.

Various activities were also ongoing - land acquisition of 14.05 acre of the neighboring area to bring to 30 acre IMC norm + another 30 acre acquisition proposal for future expansion, various infrastructural development like ground floor of the new OPD block/construction of private ward/eye OT/ improvement of premises/up gradation of 100 bedded ward/ accident and trauma centre etc. etc.

Other formalities like no-objection certificate and affiliation consent from the Manipur University, Registration under Society’s Act, identification of consultancy firm etc. were under process or in advanced stage. However, suddenly in one morning of early November 2007, I found in my office room that the project proposal was not ready from our section. I also felt nervous in that all my hard labour and desire to set up one medical college during my time may go in vain. My objective was clear - to take approval from the Union Health Ministry and finish the ground work as much as possible so that it can start in the next 1/2 years after I left office in May 2008. Not only that, I will be doing injustice to the Hon’ble CM, who had so much faith in me, for my negligent and inability. He was always after this college. Hence, in one week (Saturday & Sunday at home) I prepared the project proposal, revised it 2 times, and submitted the same to the Principal Secretary with copies endorsed to the Hon,ble CM and Chief Secretary.

To be continued.....