The Gazetteers Department

THE PUBLIC HEALTH OF SATARA DISTRICT is looked after by three agencies, viz. the Public Health Department of the State, local bodies and village panchayats.

At the Head of the Public Health Department is the Director of Public Health, who has his headquarters at Poona. Satara district comes under the Poona Division and the District Health Officer is directly under the control of the Deputy Director of Public Health Services, Poona Division, Poona. The Poona Division comprises six districts viz., Kolhapur, Sangli, Satara, Sholapur, Poona and Ahmadnagar. The District Health Officers in all the districts organise measures of public health, sanitation and hygiene in fairs, investigate the causes, origin and spread of both epidemics and endemics, and adopt preventive measures to control diseases' such as cholera, smallpox, plague, guinea-worm, malaria, poliomyelitis etc.; inspect and advise municipalities, village panchayats and village authorities about health, sanitation, drainage and water-supply; inspect child welfare and maternity work done by primary health centres and subsidised medical practitioners; look to industrial and school hygiene; recommend to the licensing authority the issue of licences for cinema theatres and other places o� public amusements, inspect sites of school buildings, burial grounds, village extensions etc. and give opinion regarding their suitability from the public health point of view; and inspect factories in the capacity of ex-officio factory inspectors. They also carry out public health propaganda with the help of subordinate staff. The Satara District Health Officer also does all these things according to requirements.

Satara district comprises nine talukas and two petas, having a population of 1,175,309 and an area of 4,034 sq. miles.

The following health staff worked in Satara district in the year 1959:―

Health Officer 1, Epidemic Medical Officers 2, Medical Officers in-charge, primary health centres 3, Sanitary Inspectors 8, Sanitary Sub-Inspectors 6, Compounders 3, Vaccinators 20, Health Visitors 5, Mid-wives 14, Social Worker (Family Planning Centre) 1, Field Worker (Family Planning Centre) 1, Subsidised Medical Practitioner (Public Health Unit) 1, and other subordinate staff of 75 persons.

The following staff of primary health centres in Community Development Blocks, Patan and Wai is working under the administrative control of Block Authorities and will be taken over by this department, as soon as the Block period is over: —

Medical Officers in-charge, Public Health Centres 3, Health Visitors 2, Mid-wives 11 and other subordinate staff of 19 persons.

Satara district is an hypo-endemic for malaria i.e. it is non-malarious and hence D.D.T. spraying work was not undertaken so far. But now under National Malaria Eradication Programme, the following staff has been sanctioned for Satara district: —

Malaria Medical Officer 1, Assistant Unit Officer 1, Malaria Supervisors 4, Malaria Inspectors 4, other subordinate staff of 35 and temporary staff engaged during some months of the year.

Functions of Public Health Officers.

Epidemic Medical Officers.

The main duty of the Epidemic Medical Officers is to control epidemics and in non-epidemic period to adopt measures for prevention of epidemics and also to render medical relief in rural areas. A Mobile Hygiene Unit in charge of a Sanitary Inspector is provided with a truck (Mobile Van) and necessary materials for the purpose. On the first report of an out-break of an epidemic, they rush to the place to carry out mass inoculation or vaccination and disinfection and protection of water supply and domiciliary treatment.

Sanitary Inspectors.

The district is divided into five divisions and five Divisional Sanitary Inspectors are in charge of them. One Sanitary Inspector is in charge of the Mobile Hygiene Unit and two Sanitary Inspectors are working under the Medical Officers in charge of Public Health Centres. The Sanitary Inspector is responsible for all public health matters in his charge including control of epidemics, public health propaganda, sanitation etc. He conducts regular inspection with the intention of improving the standard of vaccination and sanitation in rural areas. Government have appointed persons with suitable qualifications as Sanitary Sub-Inspectors. There are six such Sanitary Sub-Inspectors; one of them is under Primary Health Unit, Wathar-Kiroli and one under Primary Health Centre, Nagthane.

Vaccinators.

The main duty of Vaccinators is to carry on vaccinations in the area under their respective charges. Some of these Vaccinators and the Sanitary Sub-Inspectors under whom the Sanitary Squads are working, assist in carrying out anti-epidemic measures and sanitary works in the villages. The main duty of these Sanitary Squads is to improve sanitation in villages which have no Panchayats. They construct soakage pits, manure pits, trench latrines and drains and fill pits and also clean the surroundings of schools, wells etc.

Primary Health Centres.

Organisation and Functions.

Six Primary Health Centres, have been established in the district at Vadgaon and Indoli in Karad, Nagthane in Satara, Patan and Dhebewadi in Patan and Kavathe in Wai. First three of these centres, are under Public Health Department and the remaining three will be taken over as soon as the block periods are over. Every Primary Health Centre is a unit providing medical care both curative and preventive to the areas covering a population of about 66,000.

Each Primary Health Centre has been staffed with a Medical Officer, a Health Visitor, four Mid-wives and other subordinate staff.

A Health Visitor and a mid-wife are attached to the Headquarter place of the Centre while the three mid-wives are attached to three sub-centres working under the administrative control of the Medical Officer.

Medical Officer.

The Medical Officer is responsible for both curative and preventive work in his centre's area. He attends dispensary in the morning and visits centres and a number of villages in the afternoon for rendering medical aid. He carries out health survey of the village and arranges for collection and maintenance of vital statistics and other record for his jurisdiction. He supervises and guides the Health Visitors and Mid-wives under him. He is also responsible for submitting all returns and information to the Health Officer. In times of epidemics, he has to adopt preventive measures and help the Public Health staff to control the epidemics. The Medical Officer is also responsible for development of school health programme and medical examination of school children.

(Lady Doctor).

Health Visitor.

The Health Visitor is responsible for the development of. maternal and child health services in the area. She conducts ante-natal clinics at the main centre and at sub-centres of the Primary Health Service and arranges to give health talks to expectant mothers. She has also to carry out home visits. She visits once a week on fixed day each of the Sub-Centres and advises people on family planning. She supervises the work of mid-wives and dais. She maintains necessary records, helps in training of indigenous dais; assists the Medical Officer in development of school health programme and medical examination of school children. She is responsible for giving report of the work done in the field of maternal and child health in the area.

Mid-Wife.

The mid-wife works under the supervision of the Health Visitor. She takes particular care in the training of indigenous dais and attends labour cases in houses. During home visits she contacts the expectant mothers and encourages them to come to the Centre. She helps the Health Visitor in conducting the clinics and keeps the necessary record.

Sanitary Inspector.

The Sanitary Inspector works under the general supervision of the Medical Officer. He assists the Medical Officer in carrying out the health survey of the villages and is responsible for execution of the plan chalked out by the Medical Officer on the basis of the survey. He collects and consolidates vital statistics. He is in charge of environmental sanitation programme. He helps in the supervision and construction of wells, rural latrines, urinals, magan chullas, soakage pits etc. and visits schools for environmental sanitation. He carries out public health propaganda in the area of Primary Health Centre, in schools etc. and takes preventive measures to control epidemics viz. control measures against fly and mosquito nuisance, health education, formation of village committees etc. He is also responsible for maintenance of stock registers concerning his section.

The Primary Health Unit, Wathar-Kiroli in Koregaon taluka under Subsidised Medical Practitioner, and having staff of one Health Visitor, one mid-wife, one Sanitarian and one Sanitary squad, serves a population of 20,000. Their duties are same as those undertaken by the Primary Health Centre.

Maternity And Child Health Centre.

In 1959, there were two Maternity and Child Health Centres, one at Aundh and the other at Patan. The staff of the Maternity and child Health Centre, Patan, is attached to the Public Health Centre, Patan. The staff of Maternity and Child Health Centre, Aundh, viz. two Nurses-cum-Mid-wives do maternity and child health work. The Nurse-Mid-wives are allotted a population of 5,000 for maternity and child health work, wherein they visit villages on specific days and give advice to expectant mothers and carry on maternity and child health work.

Family Planning Centres.

Two Family Planning Centres, one at Public Health Centre, Nagthana and the other at Public Health Centre, Indoli have been started. One Field Worker and one Social Worker have been appointed at each of the Centres, who work under the Medical Officer, in charge of the Public Health Centres, popularise the modern methods of family planning, emphasize the importance and need of family planning and organise vasectomy camps.

Obligatory Duties of Local Bodies.

Public vaccination and execution of measures necessary for the public health are the obligatory duties of the municipalities in urban area and the District Local Board in rural areas. The District Health Officer advises them in respect of public health and sanitary problems.

Municipalities.

There are in all nine municipalities in Satara district of which two are borough municipalities and the rest are district municipalities. The borough municipalities of Satara and Karad have not yet appointed Medical Officers of Health (July 1959). There are two Sanitary Inspectors with each of these municipalities. The other municipalities have one Sanitary Inspector each. The municipalities receive grant-in-aid towards payment of the Sanitary Inspectors. The Sanitary Inspectors bring to the notice of the Chief Officer defects noticed by them during the rounds and the Chief Officer takes action according to the powers vested in him under the by laws. There is one Government Vaccinator for Satara. Government recovers fixed contribution and the cost of pay and allowances of peon to the vaccinator from the municipality. The municipalities where Government Vaccinators perform vaccination pay contribution annually to Government. The municipalities in whose areas District Local Board Vaccinators perform vaccination pay fixed contribution to the District Local Board, Satara.

Local Boards.

There is no Health Officer or Sanitary Inspector in the. employ of District Local Board, Satara but there are 17 Vaccinators. The District Local Board receives fixed grant-in-aid from Government. Besides these there are two more vaccinators for Phaltan Taluka (formerly a State) absorbed in Government Service. The District Local Board pays fixed contribution of Rs. 1,770 and salaries of peons to the vaccinators. In villages having Panchayats, sanitation is looked after by them and they appoint conservancy staff under the supervision of the District Local Board. The Sanitary arrangements made by village panchayats are inspected by the officers of the Public Health Department and defects are brought to the notice of the President, District Local Board, Satara. The village panchayats are empowered to levy taxes to enable them to meet the expenses towards sanitation, improvement of the villages, purchase of medicines, disinfectants, lighting, water supply etc. In the area where there are no village panchayats, the District Local Board deals with the complaints directly.

The District Local Board has to meet all expenses regarding appointment of extra staff and purchase of medicines during epidemics.

Chief Diseases.

The following table gives the number of deaths due to chief diseases in Satara district from 1954 to 1958:—

The chief diseases in the district are leprosy, malaria, tuberculosis and epidemic diseases like cholera and small-pox.

Leprosy.

From enquiries made through the Sanitary Inspectors and other agencies, it is seen that more than 2,000 persons suffer from this disease. Recently a Leprosy Subsidiary Centre has been established at Karad.

The Non-Medical Assistants at the Centre are doing survey work and treatment of patients in selected areas in Karad taluka covering a population of 60,000. Leprosy Subsidiary Centre is provided with a jeep.

One Leprosy Clinic is also conducted at Satara. A Medical Officer and a dresser from Medical Department and Non-Medical Assistant conduct the clinic on fixed days every week. The Non-Medical Assistant, Satara has also to do survey work for detection of leprosy cases and direct them to the Clinic at Satara. The American Maratha Mission is also working in the district in this connection and receives grant-in-aid from Government.

Malaria.

In the year 1959, a new Malaria unit with its Head-quarters at Satara, was started for Satara district under the National Malaria Eradication Programme. The district has been divided into four sub-units and for each sub-unit one Malaria Supervisor and one Malaria Inspector is appointed to conduct day-to-day spraying operations. The district consists of 11 talukas out of which four talukas viz. Javli, Phaltan, Khandala and Man will get two rounds of D.D.T. spray in a year. The remaining seven talukas being hypoendemic will get only one round of spray every year.

During 1958, in all 1,015 cases were treated in the dispensaries in this district. Few talukas in the district are taken for B.C.G. Vaccination every year.

Tuberculosis. Guineaworm.

The disease is prevalent in some talukas as the water supply is from step wells and tanks and infected persons due to ignorance freely contaminate the water. ' Steps are being taken to convert the Step wells and tanks wells. Arrangements to disinfect the water supply through the sanitary squads are made every year.

Epidemics.

In urban areas it is the statutory duty of the municipalities to provide special medical aid, accommodation for sick and to meet all expenses during epidemic time and take such measures as may be necessary to prevent out-break or to supress and prevent the recurrence of an epidemic. In rural areas the primary responsibility of fighting epidemics rests with the District Local Board, Satara. As per Government orders the District Local Board, has to set apart annually a lump sum equal to average of amounts spent during the preceding three years. During epidemics this grant is placed at the disposal of the Health Authorities for emergency measures. The Collector of the District is empowered to take action in consultation with the District Health Officer, the Deputy Director of Public Health Services, and the Director of Public Health, Poona, if he finds that the measures taken by the Board are inadequate. Similarly powers have also been conferred on the Collector in respect of the urban areas. The control measures in times of epidemics are organised by health department and the services of all the Medical Officers, and Subsidised Medical Practitioners are also utilised.

Cholera.

The main season for the out-break of cholera is rainy season, but occasionally it crops up in summer also, when there is scarcity of water. The spread of infection takes place through rivers, and water sources. As a routine, the Health Department staff is directed to take up disinfection of water supplies and anti-cholera inoculations in their respective areas. The Epidemic Medical Officers and the Mobile Hygiene Unit Staff are directed to take preventive measures. Segregation and treatment of cases is also undertaken by the Epidemic Medical Officers with the help of dispensary Medical Officers. Temporary Hospitals for cholera patients are also opened wherever the epidemic is prevalent.

Small-pox.

Small-pox prevails sometimes in mild form and the disease is fought mainly by means of vaccination.

Plague.

The disease has been completely absent in this district since 1950. As Satara district was endemic for plague in the past and also as plague infection has a tendency to remain dormant for a number of years in an area rather than disappear from that area, the plague organisation of Maharashtra State has been temporarily stationed at Satara and it is carrying out systematic investigation to locate the possible focus of lingering plague infection in this area.

Fairs.

In respect of the fairs managed by Government, the District Health Officer, Satara undertakes to organise (with the help of Revenue Authorities and District Local Board) the sanitary arrangements in the fairs. Pilgrim tax is collected by the Revenue Department and the amount collected is credited to Public Health Department. With regard to the fairs managed by the local bodies, the sanitary arrangements are organised by the respective village panchayats or the municipalities under the supervision of the Public Health Department. Pilgrim tax is levied to meet the expenses in connection with sanitary arrangements. In all fairs, anti-cholera inoculations are made compulsory. If there is small-pox epidemic, mass vaccination is also made compulsory.

Propaganda.

Public health propaganda is done by the Sanitary Inspectors, Staff of the Primary Health Centres and Sanitary Sub-Inspectors through magic lanterns, lectures, health talks on all subjects of public health importance such as cholera, small-pox, nutritious food, prevention of blindness, school and personal hygiene, antenatal and postnatal care, smokeless chullas, latrines, hirakhat urinals, family planning etc. At fairs, exhibitions are arranged where posters and models on public health subjects are exhibited.

Medical Inspection of School children.

The Epidemic Medical Officers and the Medical Officers in charge, Primary Health Centres carry on medical examination of school children during course of their tour and distribute drugs for minor ailments and vitamin tablets to children suffering from deficiency diseases.

Vital Statistics.

The compilation of statistics of births and deaths for Satara district, is done in the office of the Assistant Director of Public Health, Vital Statistics and Epidemiology, Poona. In the municipal areas, the municipalities concerned maintain registers of births and deaths and forward monthly extracts to the Assistant Director of Public Health, Vital Statistics and Epidemiology, Poona. In rural areas the register-is maintained by the village officer, and monthly extracts are sent by the village officers to the Taluka Officers for onward transmission to the Assistant Director of Public Health, Vital Statistics and Epidemiology, Poona. The Public Health Staff during course of their tour inspect the birth and death registers and omissions noted are brought to the notice of the mamlatdars of the talukas concerned.

Water Supply.

There are only four towns in Satara district which have piped water supply viz., Satara, Karad, Phaltan and Satara Suburban. Piped water supply scheme for Nagathana village has been undertaken from Block funds. In other areas the main source of drinking water is wells, rivers and nallas. Schemes for sinking new wells are in progress.

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