Koraput: Bad road connectivity, coupled with weak telecommunication, has hit the health care delivery mechanism in Malkangiri district.

The district, considered a hotbed for Maoist activity, shares its borders with Chhattisgarh, Andhra Pradesh and Telangana. It has an infant mortality rate of 48 per 1,000 live births, while the maternal mortality rate is 245 against one lakh live births.

Health officials relate the district's high infant mortality rate and low institutional delivery to its terrible road network that prevents patients from reaching the nearest hospital on time.

"Pregnant women are unable to come to the nearest hospitals owing to damaged roads. Ambulances also face difficulty in reaching the villages due to the absence of motorable roads," said additional district medical officer K.K. Sarkar.

An official said it took hours to attend to a patient when they got calls about labour pains, primarily because of bad roads. When health staff members reach there, the woman, in most cases, either would have delivered a child or the child or the mother would have succumbed due to some complications. Sources said one of the main reasons for the high infant mortality rate and low institutional delivery were because of apathy of ground-level staff members in generating awareness among pregnant women regarding safe motherhood.

They claimed that the district's infant mortality rate hovered around 100 and alleged that official reports could not be accepted as accurate because of improper recording of birth and death rates due to immobility of patients and non-recording of neo-natal deaths in the far-flung areas.

"How can we reach the patient quickly if the roads are not motorable? Even phone lines are down most of the time, creating problems in receiving calls from patients and disseminating the same to our field staff members," a health official said.

With a population of 6.5 lakh, 60 per cent of which are tribal people, Malkangiri has 36 health centres apart from the district headquarters hospital.

While the health department blames deplorable road conditions for faulty health care delivery, officials and people's representatives held the Maoists responsible for the condition. "Maoists understand that better road connectivity will not only bring development in the area, but also facilitate the movement of forces. They have successfully halted several projects worth crores for this reason. They don't want the roads to be either constructed or repaired," said an administration official.

"After the Maoists murdered a few contractors, people fear to even take part in the tender process," the official said. In three separate incidents, the Maoists set fire to over a dozen vehicles engaged in road construction.

Acknowledging the horrible road condition, former Nabarangapur MP Pradeep Majhi said: "It's a matter of concern. The state government should construct roads on a priority. Vital roads should be constructed with the deployment of security forces."