WELFARE DEPARTMENTS

PUBLIC HEALTH DEPARTMENT.

The public health of the district is looked after by three agencies viz. the State Government, local bodies and village panchayats. Public vaccination and execution of measures necessary for public health are obligatory duties of the District Local Board and the municipalities. The village panchayats, too have certain sanitary functions such as water supply, sanitation and preservation and improvement of public health. The Public Health Department of the State functions as an advisory body to the local bodies in respect of public health and sanitary problems.

Organisation.

The headquarters of the Director of Public Health (i.e., the head of the Department), Assistant Director of Public Health, Southern Registration District (i.e., the divisional officer) are at Poona. The Southern Registration District includes the districts of Sholapur, North Satara, South Satara and Kolhapur. The duties of the Assistant Director of Public Health in charge of this district include (a) vaccination (b) tendering of advice with regard to the sanitation of the various urban and rural areas his charge (c) inspection of birth and death registers when on tour (d) supervision of the general health of the district, ascertaining the movements and causes of the various epidemic diseases which may occur in the district, and advising revenue and local authorities as regards remedial and preventive measures, and (e) sanitary arrangements of fairs and festivals. The Kolhapur State was merged with Bombay State in August 1949 and the District Health Scheme was introduced into this district on a par with Bombay State by supplementing the staff.

Under this scheme, the District Health Officer is a subordinate officer under the administrative control of the Assistant Director of Public Health, Southern Registration District. Among his duties the following are important (a) to organise and control the sanitary, anti-epidemic and vaccination work of the area under his charge; (b) to advise the District Local Board, village panchayats, and municipalities that have no Medical Officers of Health, on all matters affecting the health of the residents in their area and on all points involved in the action of local bodies in this respect; and (c) to enforce orders, regulations and rules relating to public health which may be issued by any competent authority. He has powers to enquire into and report to the proper authorities upon the accommodation available in hospitals and dispensaries either maintained or aided by the District Local Board for the isolation of infectious cases occurring in the district and upon any need for the provision of further accommodation. He directs and superintendents the work of his, own subordinate public health nucleus staff and also of vaccinators, medical officers in charge of dispensaries and subsidised medical practitioners engaged by Or directly under the District Local Board so far as public health is concerned, and anti-epidemic workers appointed by the Board.

Government offers to pay the municipalities, classified as Class I and II, a grant to cover a part of the salary of the Medical Officers of Health and Sanitary Inspectors. In respect of Class III towns subsidy is offered only on the pay of a Medical Officer of Health, at their option, or a Sanitary Inspector, preferably a Chief Sanitary Inspector. Appointment of a Medical Officer of Health has to be approved of by the Divisional Officer in prior consultation with the Director of Public Health and of Sanitary Inspectors by the Assistant Director of Public Health concerned. The municipalities of Kolhapur and Ichalkaranji have taken advantage of this offer.

District Health Scheme.

Especially after the World War II, the activities of the Public Health Department were expanded in all districts. The health services maintained in rural areas in 1955 are as under:-

  Ministerial establishment including Senior Clerks, Junior Clerks, Officer Peons and Chowkidars has been included).

In Urban areas, there are in all- 1 Medical Officer of Health (Kolhapur town), 7 Sanitary Inspectors (6 Kolhapur plus 1 Ichalkaranji), 1 Chief Sanitary Inspector (1 Kolhapur), 2 Vaccinators (1 Kolhapur and 1 Ichalkaranji),

Vaccination.

In Kolhapur district, the vaccinators and their attendants are all Government servants.

No regular malaria control scheme exists for the district, but staff from other districts is deputed to this district for DDT spraying work.

As a part of B. C. G. Immunisation and T. B. Control programme, the BCG Units have covered the district and have carried out 635,414 testings, out of which 237,721 have been found positive, 254,186 negative and 143,507 have been vaccinated with BCG.

Mobile Hospital Unit.

For isolation and treatment of cases of infectious diseases in severely affected areas, a mobile hospital unit was formed in 1947 for the Southern Registration District as a whole with its headquarters at Belgaum. Due to Reorganisation of States in 1956, the headquarters of the unit have been located at Poona temporarily pending fixation of their revised jurisdiction. This hospital, equipped with staff, trucks, tents and furniture and other materials for 50 beds is kept ready to move to any affected place and start functioning at short notice. In non-epidemic period the hospital staff help the primary health centres in Poona district in its activities like rural medical relief, maternity and child health etc.

Chief Diseases.

The table below gives the figures of deaths due to different diseases in Kolhapur district from 1950 to 1955:-

KOLHAPUR DISTRICT.

DEATHS DUE TO CHIEF DISEASES FROM 1950-55.

The compilation of births and deaths for Kolhapur district is done in the office of the Director of Public Health along with that of other districts in the State. In the municipal areas, the municipalities concerned maintain registers of births and deaths and forward monthly extracts to the Director of Public Health. In the rural areas, the birth and death registers are maintained by the village officers and monthly extracts are sent by them to the taluka officers for transmission to the Director of Public Health.

Epidemics.

In urban areas, it is the statutory duty of the municipalities to provide special medical aid and accommodation for the sick in times of epidemic diseases and to take such measures as may be required to prevent the outbreak or to suppress and prevent the recurrence of the disease. In rural areas the primary responsibilities for dealing with outbreaks of epidemics rests with the District Local Boards. According to Government Resolution, General Department, No. 1773/33, dated 23rd April 1945, every District Local Board is required to set apart annually a lump sum equal to the average of the amount spent during the preceding three years for expenditure on epidemics. A grant is also placed at the disposal of the Director of Public Health for emergency measures. The Collector is empowered to take action in consultation with the District Health Officer and the Assistant Director of Public Health if he finds the measures taken by the Board are inadequate. The District Local Board will be helped in its task by the District Health Officer and his nucleus staff under him and the Mobile Hospital Units. The services of dispensary medical officers and subsidised medical practitioners are also utilised.

Government also pays 50 per cent, grant-in-aid to local bodies on their expenditure on anti-epidemic measures provided the local bodies have spent 10 per cent, in the case of District Local Boards and 4 per cent, in the case of municipalities of their annual income on medical and public health measures excluding anti-epidemic ones.

Small- pox.

From the number of deaths due to small-pox it will be seen that the severity of this disease has been considerably reduced during recent years. Government policy regarding small-pox control is to protect the population by vaccination which is offered free to the public by Government and local bodies. Segregation of the patients is attempted only in large towns where hospital facilities are available. Disinfection of infected houses and clothes, etc. is also carried out to educate the people as to how to protect themselves against small-pox. Since 1954, mass vaccination drive has been started according to which three months in each year mass revaccination programme is undertaken in one-fifth of the. population and during the remaining nine months of the year, primary vaccination work is done in the same one-fifth of the population. In Kolhapur district there are twenty-three vaccinators appointed by Government but their pay and allowances are partly paid by the Board in the form of fixed contributions. There are also two Government vaccinators in the Kolhapur municipal area.

Plague.

The entire State including Kolhapur district has been free from plague for the last six-seven years.

Cholera.

Kolhapur is one of the districts in the State where severe cholera epidemics break out at intervals. During the last five years, the incidence was low except in 1953 during which year it was widespread and severe. Due to the establishment of the District Health Scheme in the district, anti-cholera measures are now carried out on a large scale immediately there is an outbreak of the disease. Protection of water supplies, mass immunisation of people by anti-cholera inoculations and isolation and treatment of cholera cases in temporary isolation hospitals in the affected areas are the measures employed to combat cholera epidemics. On the occurrence of an outbreak of cholera in a village, the nearest dispensary medical officer is deputed by the Mamlatdar to adopt preliminary measures and send a report to the District Health Officer who sends the public health staff to continue measures if the situation so demands and also visits the affected villages himself. Temporary Medical Officers or trained inoculators are appointed, if the epidemic assumes a severe form, to assist the local public health staff and the District Local Board staff.

Malaria.

Kolhapur is one of the hypoendemic district for malaria in Bombay State and consequently the district was excluded from the DDT spraying till 1956. During 1956, the district was taken-up in entirety for malaria control work. The DDT spraying work was directly controlled by the District Health Officer, Kolhapur. All areas receive one round of DDT spraying only. The season of spraying is generally from June to August. About 64,000 lbs of DDT 75 per cent, wettable powder are consumed in the rural areas of the district and about 7,000 lbs. of DDT (Technical) are consumed in Kolhapur town.

FAIRS.

There are certain important fairs held in Kolhapur district which attract people from outside. The following table gives some particulars about these fairs:-

As the above fairs are major ones, elaborate sanitary arrangements are generally made. Fairs at Kagal-Samangad and Khidrapur are managed by Government with the co-operation of local bodies and the remaining by the local bodies concerned with the help of the Public Health Department. In order to meet the expenditure on sanitary arrangements a pilgrim fee is levied. Other fairs which are of minor importance i.e., attracting less than 10,000 pilgrims, are managed by revenue authorities with the help of the Public Health Department. At such fairs no pilgrim fee is levied.

Famine Relief.

When famine and scarcity conditions are declared to exist in the district, the District Health Officer is under the general orders of the Collector in so far as medical and sanitary arrangements on scarcity and famine relief works are concerned.

MATERNITY AND CHILD WELFARE.

These activities have been started in Community Develop- ment and National Extension Service Blocks, vide paragraph following.

Under the Community Development Programme, twelve primary health units, as shown below, have been established in the Kolhapur district during 1956-57:-

These primary health units provide integrated curative and preventive medical services in the areas served, viz. 20,000 population each. Special emphasis is given on maternity and child health activities. A maternity home is provided at the headquarters of each unit.

Maternity and Child Health Centres were established at Gargoti and Kurundwad during the years 1955-56 and 1956-57 respectively. A staff of two nurse midwives is provided. They are attached to the existing dispensaries. They serve a population of 20,000 each in connection with maternity and child health activities. No maternity home is provided.

Health propaganda.

For Kolhapur district no separate organisation is maintained. The propaganda van at headquarters and the Sanitary Inspectors, Sanitary Sub-Inspectors and Vaccinators during the course of their tour carry out health propaganda.

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