Chattisgarh reels under poor health care system

ALL FOR CAUSE: The doctors here are daily dealing with malnutrition and food security.

          

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Keywords: Chattisgarh, Doctors

New Delhi: When you work in such conditions of abject poverty your ideological moorings are bound to be different, you are obviously going to be critical of the government and the health care system.

The doctors, working in the Naxal belts of Chattisgarh, are daily dealing with malnutrition and are wondering about food security. They have begun questioning. To them the rising Sensex doesn't make sense when they are looking for a proper village road or those who have never seen electricity in their lives.

Chattisgarh Chief Minister Raman Singh says, “SAIL and Jindals are already ready to work here. The companies with whom we have signed MOU are serious about this.”

But the state cannot hide its abysmally poor development data. It has a high infant mortality rate of 78 per thousand live births.

The rural infant mortality rate is even higher at 95 per thousand. It has only 42 lakh hectares under cultivation in a mono-crop state. The net irrigated area is not even 7 lakh hectares.

The entire state has only 6,000 middle schools and about 2,300 high schools. And the health care system is in a shambles.

The state has just six district hospitals and merely 512 primary health care centres. South of Bilaspur, districts like Dantewara and Bastar have been taken over by the armed revolutionaries.

In fact, the figures suggest that in the absence of these doctors, the lacunae in the system would have been even more glaring. The JSS doctors did a survey, which revealed how widespread the poverty is.

Dr Yogesh Jain says, “In fact we find medical poverty as a major issue. People getting poor due to the fact that people have to seek health care at exorbitant rates and this has also led to this that there are a large number of people who do not seek health care anywhere because they cannot afford to do.”

Therefore, it's only to be expected that the doctors will harbour strong views on claims being made that liberalization has achieved miracles.

“I do not see probably the urban middle class has benefited but the rural we have reasons to feel the nutrition level and the financial level of most of the rural Indian people have probably gone down in the last 10 years or so, “ Jain adds.

So, given this grim scenario, the doctors are chipping in with whatever they can. Like making drugs available at affordable rates. Cheaper medicines sold from the pharmacy bring people from far-flung areas to Ganyari.

And it is because he now has easier access to insulin shots that Sufal has managed to survive.

He is an acute diabetic and his helpless parents relied on fate alone before Sufal decided that a 30 km weekly journey to Ganyari is the best option.

And these three young people have heart problems, their valves are defective. Their condition explodes the myth that cardiovascular problems or blood sugar are always urban problems.

Dr Bhargav says, “It is about diseases being classified as as urban and rural. No schemes by the government to treat ailments like heart diseases and diabetics that can help the poor rural.”

This 13-bed ward is a fair indication of the kind of diseases they have to deal with in the countryside of the new millennium. This is a full-blown AIDS case. He is a migrant worker who has returned from a big city with the disease and may have passed on the virus to his wife.

And close by, this 15-year-old mother is nursing her infant. The doctors say the policy-planners don't understand that there is nothing called a rural or an urban ailment. They are one and the same.

Dr Anju Kataria says, “Well the problems are same everywhere it's not the problems in the rural areas are different from those in the urban areas almost same kind of problems are there plus malnutrition and infection."

The conditions are depressing but doctors have not given up hope. There are moments like this with a bonfire in the evening when the doctors and their staff come together to celebrate. Every day is a grim day.

Every day is fight to save lives. So they must celebrate their bonding, celebrate their staying together, celebrate that their others who are being inspired and joining their ranks.

This fire is not just about fun - it symbolises many others who have joined in. This fire is also about the will to carry on.

In fact, the doctors have turned creative. With help of colleagues from Delhi they are designing the poor man's medical equipment. This electrophoresis apparatus, which separates sickle cells, has been developed in the back of the beyond.

It has been developed because the branded separator available in the market is too expensive. This basic device without the frills cost ten times less. The Jan Swasthya Sahyog is not selling this device to other non-profit organisations.

Dr Chatterjee says, “The entire thing we have sold to many non-profit organization for 3,500 rupees market price for this electrophoresis equipment you won't get it for less than Rs 35,000.”

Not just that, the water testing kit, another of JSS's innovations costs 500 times less than the market price. The double stethoscope, which is put to wonderful use while training semi-literate health workers.

Of course, what really stands out is the community health scheme. Meet Kunwara Devi. Her one-room mud-hut doesn't even have a door. She earns nothing. She has been taught to read and write. And here in a remote village on the edges of the forest in Chattisgarh, she knows how to take a blood smear, wrap it hygienically and send it to Ganyari through a relay system. A local boy carries it to the bus stop.

The bus driver takes it to a dhaba close to the hospital. And there a hospital handpicks up the sample. The report is send back the same way.

Again the method has been perfected in JSS but it carries the indelible stamp of another great innovator. Dr Binayak Sen had developed the mitanin programme now lauded the world over. He had trained the community health workers and proved how medical care need not rely essentially on doctors.

Because he realized that it would be impossible to attract qualified doctors to come here because he was a maverick who came and he had a MBA in Pediatrics, yet he choose to work in this area but it was not possible to find more people like that.

So he undertook initially a long program of training health workers, and the idea of the Mitaini program, as he understood it, was born in that.

He picked up people from the village, people who had very little formal education some of them are sitting here in this room with us today, people who had may be class II, or may be class III education, yet he felt that technology and science were something that were things that ordinary people could master they could understand they could use, so there was long and very patient program of building up health workers.

And yet today Dr Binayak Sen is lodged in jail but his work is carried on by the doctors of the Jan Swasthya Sahiyog and there is no stopping them.

The Chattisgarh government has been keeping a tab on the activities of all the NGOs in Naxalite affected areas, all NGOs have been asked to shutdown, fortunately for the JSS.

They are not functioning in the Naxalite affected areas. Fortunately also for the JSS, they are also no longer associated with the man the government in Raipur, loves to hate most.