In February 2022, when Nagaland Chief Minister Neiphiu Rio officially inaugurated Tseminyu, the 13th district of Nagaland, the then-new district was branded as the state’s “historical district”.
Home to the indigenous Rengma Naga community, Tseminyu was one of the oldest administrative headquarters in Nagaland which remained a sub-division under Kohima district till it was declared as a separate district in December 2021.
One among the first five recognized tribes of Nagaland which remained a sub-division, the Rengma Nagas had their fair share of struggle in their demand for a separate district. The demand for a district began in March 2016 when an appeal was made to the Additional Deputy Commissioner to upgrade Tseminyu to a district. Their demand intensified in 2021.
Less than a year after the 12th district of the state—Noklak—was inaugurated, the state government announced the creation of three new districts, namely Tseminyu, Niuland and Chumoukedima in mid-December 2021. At present, there are 17 districts in Nagaland, the latest being the recent upgrade of the Meluri subdivision in Phek district to that of a district.
With the creation and inauguration of Tseminyu as a district, the Rengma Nagas felt that their long-cherished dream came to fruition. However, almost three years on, the district grapples with a healthcare crisis that threatens the well-being of about 43 villages as their aspirations for a full-fledged hospital remain distant.
As a relatively new district, Tseminyu’s aspirations for progress are stifled by systemic neglect of healthcare infrastructure and resources. With only one Community Health Centre (CHC) and three Primary Health Centres (PHCs) serving the entire district, the healthcare challenges faced by this predominantly indigenous population highlight the need for urgent intervention.
What do numbers say?
As per the Health Dynamics of India (Infrastructure and Human Resources), Ministry of Health and Family Welfare 2022-23 report, statistics for the state of Nagaland indicated that there are 443 Sub Centres in rural areas and 22 in urban areas; 128 Primary Health Centres in rural areas and 8 in urban areas; eight Community Health Centres in rural areas and 15 in urban areas, with a total of 12 district hospitals.
This means that despite becoming a district, the health sector in Tseminyu and other new districts created continue to remain under the districts from which it was carved out, with no district hospital of its own.
A struggling lifeline for healthcare
According to data from the Rengma Selo Zi (RSZ), the apex youth body of the Rengma community, Tseminyu District spans 256 square kilometres. It is home to a population of 63,269 as per the 2011 Census. The RSZ has been vocal in demanding the upgradation of the lone Community Health Centre (CHC) to a district hospital, citing the urgent need for improved healthcare infrastructure to serve the growing population.
“The CHC in Tseminyu is in dire need of essential facilities and adequate staff. Right now, we have only one Medical Officer, and even that position is on a contractual basis. It’s not enough to meet the healthcare needs of our district. We need full-fledged Medical Officers, nurses, and technical experts to provide the care our people deserve,” Kegwayhun Tep, RSZ president told EastMojo.
Despite offering essential services like immunizations, outpatient care, dental services, AYUSH and national health programmes for tuberculosis (TB) and malaria, the CHC is severely under-resourced.
The CHC Tseminyu operates with a limited team of just four doctors—a Senior Medical Officer primarily handling administrative duties, along with a Medical Officer (medicine specialist), an AYUSH practitioner, and a dental doctor. They are supported by ten nurses including OST nurses who shoulder the immense responsibility of meeting the healthcare needs of the entire district.
Following the dismantling of the old CHC building after the COVID-19 pandemic, the facility is now left with only four operational beds, further straining its capacity to provide adequate care.
“Our current infrastructure at CHC Tseminyu is simply not enough to support the essential medical equipment and services we need. We urgently require progress of the under-constructed CHC and upgrades to our facilities so we can properly house critical healthcare resources and provide the quality medical care our community deserves,” Tep said.
The youth leader revealed that work at the under-construction building of the new CHC complex remains halted as funds were not released by the government.
A senior nurse at the hospital also revealed that essential medical equipment, including a portable x-ray, oxygen filling, ECG and ultrasound machines, remain unused due to space constraints and the absence of trained technicians.
“We have good machines, but with no space and no trained staff, they are just lying idle,” she lamented, highlighting the critical gap in healthcare delivery.
A doctor informed that to reach out to the masses, monthly Village Health Sanitation and Nutrition Days (VHSNDs) are conducted with the help of Accredited Social Health Activists (ASHAs) to provide preventive healthcare to remote villages.
Healthcare workers at the CHC Tseminyu face overwhelming responsibilities, with night shifts further stretching their capacity. The CHC records over 200 cases a month, with common illnesses like acute respiratory infections, hypertension, and typhoid dominating the caseload.
In August alone, the CHC recorded 11 child deliveries, pointing to the critical need for obstetric care.
However, for critical cases, patients are referred to the Naga Hospital Authority Authority Kohima (NHAK), or the Botsa CHC in Kohima district. Cases of pregnant women with complications, accident victims, and stroke patients are frequently referred to the Kohima district hospital.
According to Tep, the NH-2 stretch from Botsa to the Wokha district which cuts through the Tseminyu district is a high-risk, accident-prone zone. He emphasised that the absence of a well-equipped hospital in Tseminyu severely hinders emergency response efforts, often resulting in the loss of lives during critical situations.
Tep recounted how accident victims are typically provided only basic first aid before being referred to hospitals in Kohima, a delay that can prove fatal. Stressing the urgent need for a District Hospital in Tseminyu, he highlighted its importance for timely and effective emergency care.
Amid these challenges, the indigenous community has demanded a full-fledged district hospital. He further informed that a formal representation demanding the hospital’s upgrade has been submitted to the state government, but it has not yielded any results.
A doctor informed that the CHC Tseminyu’s healthcare system remains under Kohima’s Chief Medical Officer (CMO), despite an independent administration of the district.
Speaking on the condition of anonymity, the doctor revealed that a proposal has been put forward for a comprehensive district hospital with a minimum of 50 beds, acknowledging that a fully operational hospital may not be feasible immediately.
According to the doctor, establishing a full-fledged hospital is lengthy and complex, requiring the fulfilment of various criteria before it can be realised.
This story has been published as part of the AIPP-EastMojo Fellowship 2024
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