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Some 4.5 lakh impoverished people in the state are reaping the benefits of the compulsory rural stint for doctors

By Rashme Sehgal


 

A rural posting is often shunned by India’s six lakh doctors. But Assam has decreed that MBBS doctors need to put in one year of rural service before they can apply for an MD degree. The official order has come as a godsend to rural communities there, ravaged by disease and hunger. And two young doctors in Assam have shown how their posting has energized these communities and improved their health.
Dr Bhumidhar Barman and Dr Nabakanta Das work with impoverished farming communities living in islands off the Brahmaputra, the world’s second largest river stretching from China to Bangladesh. During the monsoon season, the river, along with its tributaries, becomes so swollen that entire villages are known to have been washed away in a day.

On the move

In order to help those marooned in these islands, the Centre for North East Studies and Policy Research (C-NES) has helped set up 15 boat clinics, operating in 13 districts. These carry teams of doctors, pharmacists, lab technicians and auxiliary nurses, along with vaccines and medicines to the island villages. Both Barman and Das have, over the last six months, ridden over these turbulent waters daily in their attempt to alleviate the suffering of people. India Legal recently joined the team to gauge the selfless work done by them.

“The first time I had to travel on one of these boat clinics, I was very uncomfortable. I could have never imagined a doctor’s job meant going by boat to treat patients living far away. Travelling to all these distant, inaccessible villages is an arduous task,” Barman told this correspondent.

One morning, the boat clinic travelled from Mukulmura Ghat, 60 kilometers from Guwahati, to Balachar village in a remote island, 50 kilometers downstream. The village is mainly inhabited by an illiterate farming community, which grows rice and jute. Girls continue to be married off by the age of 13-14 and are plagued by malnutrition and anaemia. Fever and skin infections are the other common health problems.

Reaching this remote village was an adventure in itself. After a boat ride of 90 minutes, the clinic personnel walked in the hot sun through jute fields to reach a rivulet. Then, in a wobbly, leaky boat, they disembarked at Balachar. Another long walk led the team to the village center, where they set up a makeshift clinic under the shade of two towering jamuna trees. And, then, began the actual job of healing the sick.

Effective treatment

There was already a serpentine queue of 200 people waiting patiently for the clinic to begin. Women in assorted cotton saris, most haggard, waited with a motley group of bedraggled children. As an auxiliary nurse and a medic immunized the younger children, the doctors checked the adults.

“We deal with 180 to 250 patients every day, providing them with drugs for basic ailments. We also have a simple kit to test HIV, plasmodium falciparum (for malaria), blood groups, urine and hemoglobin levels,” infor-med Barman.
Begum Tahira, a mother of five, is deli-ghted to see the doctor. “I have been suffering from an eye ailment for the last eight days. My husband works as a daily wager and recently got a job in distant Dibrugarh,” she said.

Most of the patients clamored for “liquid” medicines rather than capsules. The reason is that the village quacks had been giving them syrups in colored bottles and they believe that medicines come out of these bottles.
The doctors battle against all odds. Besides the difficulty of reaching remote locations, they also have to ensure that the vaccines are kept at the right temperature, given that there is no electricity in these villages. They have managed to recently solve this problem at Balachar by installing a refrigerator run on solar power.

BALACHAR BOAT CLINIC  (49)
Boat clinics have brought succor to rural communities in Assam hit by disease and hunger.

Their work has paid off. The boat clinics have already reached out to 4.5 lakh people, said Parvez Ahmed, head of C-NES in Nalbari district under which Balachar falls. Some 98 percent of children between 0-5 years in Nalbari have been immunized. The district with a population of eight lakh also has a high birth rate of 1,200 live births every year.

However, Assam has among the highest maternal mortality figures, with 480 deaths per 1,00,000 live births. One of the main reasons is that around three million people live in socially and geographically isolated villages along the Brahmaputra.
As for Barman and Das, working with these farming communities has been a transforming experience. “For one, we have understood how a small intervention like ours can make a difference of life and death in these village communities,” said Das.

It is time for the return journey to Mukulmura Ghat. Another adventure awaited us. This time, weeds got caught in the propeller, bringing the boat to a halt twice. Removing them was simple.

Nonetheless, there was a sigh of relief when everyone finally disembarked.

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