By Sumit Kumar Ganguly*
In the matter of Jandurbhai Menshibhai Baladhiya v. Union of India & Ors. [W.P. (PIL) No. 89 of 2017], the Gujarat High Court has ordered that the concerned authorities of the Gujarat Government should see to it that one Medical Officer is made available between 10 am to 4 pm, 5 days a week at Sub-Health Centre, Shiyalbet. The bench comprising of Justice M.R. Shah and Justice B.N. Karia said that the Sub-Health Centre should be made available with all other full facilities/ equipments which should be available at other Primary Health Centre. Also, the same should be made available from 01.09.2017.At present, it is an interim arrangement, which was also stated by the Government Pleader as well as the State Government in its affidavit in reply.
Shiyalbet is an island in the Arabian Sea which comes under Jafrabad Taluka in Amreli District.
Jandurbhai Menshibhai Baladhiya, a fisherman from Shiyalbet, had filed a Public Interest Litigation for the emergency medical services required on the sea and the coastal areas of the State of Gujarat. In the Order dated 18/08/2017, the Gujarat Government was also directed to see that 110 new 108 ambulances are made operational within a period of 4 months from that day and out of those, 10 such 108 ambulances shall be earmarked and allocated exclusively for the coastal areas in the State of Gujarat. The High Court further directed, “All efforts shall be made by the State Government to purchase and provide 7 boat ambulances with full medical equipments etc. within a period of 6 months from today and which shall be made operational within a period of 6 months from today and shall be used for coastal areas.”
The main contention of the petitioner was that when the fishermen go inside the sea for fishing and other activities and if the medical emergency is required, because of lack of the facilities like boat ambulances, 108 ambulance services and lack of medical hospitals as well as Primary Health Centres, it is ultimately affecting the lives of such fishermen, etc. It is now a settled law through a catena of judgments of the Supreme Court of India that Right to Health is integral to Right to Life under Article 21 of the Constitution of India. Moreover, Article 39 of the Constitution directs the state to create policy in order to secure the health and strength of workers and that citizens have the right to an adequate means of livelihood. The petitioner also relied upon Articles 42 and 47 which direct the state to ensure just and humane work conditions and makes it a duty of the state to raise the levels of public health and safety of the workmen.
Apart from that, India is a signatory to the International Convention for the Safety of Life at Sea (1974) and the International Convention on the Law of the Sea (1982). The International Conventions obliges India to provide search and rescue services. The petitioner also cited Article 25 of the Universal Declaration of Human Rights. It begins as follows, “Everyone has a right to a standard of living adequate for health and wellbeing of himself and his family including food, clothing and medical care….”
The petition was filed in the interest of the villagers residing in the villages of Hirakot Bandar, Madhwad, Dhamlej, Prashnawada Bans, Madhwad, Madhavpur Bandar, Sheriyaj Bara, Shilbara, Sartanpar, Ghogha, Gadhula, Rajpara Bandar, Katpar, Mahuva Bandar, Dhara Bandar, Khera, Jafrabad and Simar Bandar, in the districts of Gir Somnath, Porbandar, Junagadh, Bhavnagar and Amreli. The main occupation of the villagers is fishing which is the main source of income, as around 80 to 90% of the population is engaged in the profession. The petitioner had collected data of the deaths occurring at the sea and has documentary evidence of 31 cases, of which 26 are deaths and 5 injuries, across these villages. The village residents had made applications to the Health and Family Welfare Department in July, August and September of 2014. The applications were either forwarded to private bodies or not replied to.
Gujarat has the longest coastline in India, which covers more than 1,600 km, with a large number of fishermen who have to go to the sea as part of their trade. The issue of an emergency medical service needed severe and urgent consideration not only for the abovementioned villages but also other villages along the coastline. The 108 Emergency Response Service is a free emergency service providing integrated medical, police and fire emergency services. The service is a public-private partnership between State Governments and private Emergency Medical Service providers.
The petitioner, Jandurbhai Menshibhai Baladhiya, is the Vice-President of Shiyalbet Swayamsevak Sangh, which is an unregistered body working for the betterment and proper development of the village Shiyalbet. The word “Bet” in Gujarati means the island. During the arguments, on behalf of the petitioner it was pointed out that earlier in the year 2012, a policy decision was taken to establish a Primary Health Centre (PHC) at Shiyalbet. However, no further action was taken to establish the PHC at Shiyalbet. In the absence of a PHC, the residents of the island have to cross the sea to reach the coast by boat which is approximately 10 to 12 kms and then travel 15 to 20 kms to reach the nearest hospital which is at Jafrabad. As a result, the people residing at Shiyalbet are suffering as such medical services are not being provided to them.
The Government Pleader, Ms. Manisha Lavkumar, conceded that the non-establishment of the Primary Health Centre is due to non-availability of the full-time doctor. She submitted that the State Government had constructed the Sub-Health Centre at Shiyalbet which comprises a Female Health Worker, who handles the basic requirement of vaccination and medical illness, normal deliveries, etc. She stated in the affidavit in reply that Medical Officers, who are qualified doctors, would be deputed from in and around the District on daily basis. The Medical Officers will be available between 10 am to 4 pm, 5 days a week at Shiyalbet. This arrangement will meet the medical aid requirements of the island and other fishermen around the area. The Government Pleader further stated, “Medical Officer at the Sub-Health Centre, Shiyalbet shall be available with all facilities which shall be required for a Primary Health Centre, Shiyalbet”.
In the last affidavit in reply, the State Government submitted that it was conscious about the rights of the fishermen and the persons who are residing in the coastal areas. The Government Pleader stated, “the State Administration considered the grievances raised in the petition regarding requirement of emergency medical services when out at sea and in the villages around coastal areas in the State of Gujarat positively and not as an adversarial litigation.”
On behalf of the respondent State Authorities, she stated that as of that day 96 government’s 108 ambulances were earmarked for the coastal areas, and 10 more would be required which would be made within a period of 4 months from that day. On the possibility of boat ambulances, she stated that the State Government had in fact taken a policy decision to purchase the boat ambulances. The boat ambulances would be fully equipped to handle any kind of emergency situation. She submitted that the State Government would propose to deploy approximately Rs. 2.5 crores for the procurement of 7 boat ambulances.
Additionally, the Government has already taken a policy decision and proposed to establish and operate the emergency helpline service through boat ambulances for the fishermen community living in the coastal fishing harbour areas in the State of Gujarat.
This Order by the Gujarat High Court has far-reaching consequences. It is a shot in the arm for fisherfolk rights. The petitioner and his organisation must ensure the implementation of the Order in the stipulated time period. The biggest takeaway from the Order is that one Medical Officer is made available between 10 am to 4 pm, 5 days a week at Sub-Health Centre, Shiyalbet. However, it is highly unlikely that the Medical Officers will be eager to visit Shiyalbet by crossing the Arabian Sea. Hence, the Sub-Health Centre will be non-functional even if it has all the facilities/ equipments that are available in a PHC. In that case, the agony of the inhabitants of the island will continue to exist.
Secondly, if 10 new 108 ambulances are added within 4 months in coastal Gujarat, it may evoke a faster response on the part of emergency medical services in those areas. Lastly, the 7 boat ambulances across the 1600 km of the Gujarat coast could be a game changer in the next 6 months. But, it can only happen if the boat ambulances respond promptly to the distress calls of the fisherfolk. They must be capable enough to deal with emergency cases with the available medical equipments and also transport the ailing patients on shore in the shortest possible time, so that they could be taken to the nearest hospital. The matter has been scheduled to be heard on 09/01/2018 by the Gujarat High Court for the compliance report.
*Research associate, Centre for Social Justice, Ahmedabad