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Simplify ultrasound scan rules for timely help to moms-to-be: Experts

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When three-month pregnant Meena (name changed), 24, suffered abdominal bleeding for two days, diagnostic centres near her home in a remote village of Belagavi district refused to do an ultrasound sonography (USG) scan. For, they did not have a radiologist registered under the PreConception and Prenatal Diagnostic Techniques (PCPNDT) Act, 1994.

She had to travel to a district-level health centre to get a scan done by a PCPNDT-registered radiologist.”When local clinics refused to do the scan, I thought I would lose my wife and the baby. They said they did not have a PCPNDT-registered radiologist or a doctor to conduct the test for her,” said Meena’s husband.

Meena’s is not a rare case. The situation is similar in rural areas across the country as the PCPNDT Act prescribes a string of norms for USG screening of pregnant women. Now, the National Steering Committee on the PCPNDT Act, comprising experts from major national medical organizations, has suggested that ultrasound machines not used for obstetric purposes be exempted from the purview of the Act.

Suggesting several amendments to the existing Act, they have said this will ensure that poor and needy people from rural areas are not deprived of USG, a life-saving and cost-effective diagnostic tool.

Stressing that other avenues could be explored for promoting improvement of the sex ratio, the Indian Radiological and Imaging Association (IRIA), which part of the committee, has said criminal provisions of the Act should be applied only against those who do sex determination.

S Suresh, a prenatal scan specialist, said: “Such instances are common and several pregnant women from poor families are denied timely USG scans. Also, the existing Act does not allow a qualified, registered radiologist or a prenatal scan specialist to conduct USG screenings at more than two centres.This makes it difficult for rural patients to reach the few centres with registered radiologists which are mostly situated in urban areas and hat too with a few registered radiologists.” Dr OP Bansal, president, Indian Radiological and Imaging Association (IRIA), said: “We have to refuse USG screening to a pregnant woman even if she comes with some problems like appendicitis, arthritis or kidney ailment because we are not allowed to do so under the existing Act. Also, pa ients are required to produce voter ID or Aadhaar card to get a scan. Often patients come from rural areas with tremendous pain or vaginal bleeding and have to go back without diagnosis just because they don’t have government ID proof. This can be fatal for both mothers and babies.”

Dr Alex Thomas, executive director, Association of Healthcare Providers of India (AHPI), said: “It is not easy to open USG clinics in rural areas, nor can the machines be shifted from urban to rural regions without the government’s intervention. Accident victims who suffer abdominal bleeding can be immediately diagnosed with the help of USG. It is an efficient method to diagnose arthritis, cardio disputes and peritonitis. Due to unreasonable restrictions, patients in remote areas have to travel to the district health centres to get screening done.”

He said: “Radiologists are afraid to perform their duty as several doctors and radiologists have faced harassment due to restrictions under the Act. If they forget to fill up the forms containing details about a patient, which actually is a clerical task, they are sent to prison.

So, while suggesting several amendments to the Act, the steering committee has also said the medical community should not be harassed by misusing its provisions.

TIMES VIEW

The government has a chance to undo a great injustice meted out to pregnant women of rural areas for two decades. In an attempt to end pre-natal sex selection, stringent norms have deprived them of ultrasound sonography for non-obstetric purpose. Besides, medical practitioners were always under the scanner. While the intention is good, the government must realize that strict laws are not a solution to any problem, judicious enforcement is. There are many other ways to put an end to female foeticide. The government must look at experts’ suggestions and amend the straight-jacketed law for the benefit of women.