(For the quarter July – September 2011)
Sikkim Quake is Wake Up call
The earthquake in Sikkim and the sheer terror and sense of helplessness that it inspired among the victims as well as those who have been trying to rescue them and document/report on event is a grim reminder of the power that nature can unleash without warning. I’m not talking about the ‘havoc’ that our natural world can strike but of the power it wields and the incapacity, inefficiency and seeming inability of our human systems, processes and ingenuity to ‘deal’ with this. Human folly, error, greed or a deadly mix of all three causes most of the ‘havoc’ that explodes during and after a natural calamity such as an earthquake or major flood. Because that ‘havoc’ in often meant to translate into loss of human life, human property, and the economy on which we depend.
Have you noticed that there is little or no reportage of the damage caused to wildlife or to the ecology of the place? That much of the damage, in Sikkim and elsewhere, is a result of bad planning of infrastructure expansion, especially roads and major hydro projects, of haphazard building of homes and offices, of not understanding and respecting mountain systems and of learning that our place in these systems is minor, not major.
We destroy and change without planning or concern for the future – at our own cost. The destruction of our species lies in its infinite capacity to malignantly harm its own kind – no other species on the face of the earth does that – and in our supreme arrogance thinking that we are right.
Our hearts go out to those who have suffered in the Sikkim earthquake and to those who have gone before them in calamities without number, unheeded, unreached and unhelped: Gujarat, Kashmir, Latur, Uttarkashi and the mother of them all – the Great Assam Earthquake of 1950, Aug. 15. And now the same voices will be heard – ‘we were not prepared’, ‘the buildings were unsafe’, help did not reach in time’, ‘the government doesn’t seem to know what it’s doing’ and ‘we helped each other, where were the disaster relief teams?’ etc.
There’s a new twist to the tale – as one news channel reported, members of the National Disaster Relief Force who arrived in Gangtok the day after the tragedy struck, were not going around their job but trying to get their food and rations. That is why the National Disaster Programme is often derided as a disaster itself. This is not to underplay the importance of the role of the NRDF and their courage but to underline the failure of those who plan for disasters; it is mired in bureaucratic mindsets, which see success in a few drills, training workshops and some action in the field.
I used to be a member of the Advisory Council of the National Disaster Management Board some time back; some of us raised issues time and again about preparedness especially at the state level, for urban planning and management and controls, of the need to use fast boats for rescue operations in river-dependent states. I would urge media training workshops etc. Nothing much happened – not surprisingly: we would meet but once a year. So why would anyone, in the ‘permanent executive’, i.e. the bureaucracy, take us seriously?
The earthquake in our small neighbouring state was felt in Tibet and Nepal; such events do not respect national boundaries no matter how our media plays it up as something located in India. The disaster underlines the urgent need to look at specific strategies to tackle the nightmarish growth that is killing our cities and the lands and ecosystems around them.
Take the relentless construction in places like Guwahati where concrete monsters of malls, homes and offices are occupying the natural flood management centres, the wetlands or beels. We are rushing to our own destruction for these are the very areas that an earthquake will first demolish.
We have some very articulate young leaders who seek permanency rights to those who have settled illegally, for example, in Guwahati, the heart of the North-east. It is the right of everyone to have a roof over their heads, food for nourishment, access to health and education. That is unquestionable. But this needs to be done, taking into account, the rights of others and the safety and sustainability of settlement. After all, who will mourn for those who have settled illegally when they become victims of landslides, quakes and floods? Will those who agitate for them also compensate them?
We hope such leaders will raise their voices against the land mafia which has have captured the lands of others. The land mafia is an international phenomenon, preying on human greed and distress. It operates in urban centres across the world, including Guwahati, enjoying protection by officials, the support of business, illegal land sharks but revenue staff. The latter are the kingpins and it is they who must be investigated and exposed as also their links to the higher echelons of power, including the police, bureaucracy and politics.
The Minister in Assam who handles Guwahati is Himanta Biswa Sarma. Many disagree with him on a wide range of issues. Yet, his no-nonsense approach has galvanized the Health Department over the years and he is turning his attention to Education, which needs a major clean up and push. But what are happening about Guwahati and other urban centres in Assam? There are few signs of efforts to control the land mafia and the haphazard growth disaster overtaking the city as forests, hills and agricultural lands are plundered. The mess at Khanapara and Jorabat is visible for all to see and experience, every day.
Action must be taken urgently; the Sikkim earthquake is a wake up call and media, rights activists and scientists should put pressure on state governments in quake-prone regions to publicly come out with their disaster preparedness programs, starting from the district and panchayat level to the state level. The key challenge is construction design and the need to build earthquake-proof or resistant and resilient buildings; this in turn depends on location and soil quality as much as on what materials should be used.
There need to be trauma and counseling centres because people have been struck by distress and fear. This is an issue that is often forgotten: physical damage, in terms of injuries and property and loss of funds, can be repaired or healed. No so trauma, which needs treatment and counseling, similar to victims of violence and oppression.
The Centre must push the States on this and ‘civil society’ and media must be unrelenting. The Sikkim quake cannot be treated as another event that is forgotten in a week and then remembered when the next disaster strikes. That is what governments would love us to do. We cannot afford to be complacent.
The same can be said for Aizawl, Shillong and Kohima, at the very least in our region, and all hill stations across the Himalayan belt, in and outside India.
After a major earthquake as this, it is natural for people in the entire region to be worried and for a spate of uninformed writing to assault readers as well as breathless, pontificating and reporting by news channels to overwhelm viewers, adding to their concern and panic. But that’s the subject of another column.
However, this is a matter to be seriously reviewed – how should news media, visual and print as well as radio and new media (internet, Face Book, Twitter etc) report on such major events? It is all very well to report the facts– but when journalists start broadcasting opinions without understanding basic issues, that’s when major problem arise and they end up by spreading confusion, panic and misinformation.
(From his regular column in the Assam Tribune, 21 September, 2011)
Assam MMR highest
Against a national average of 212, the MMR in Assam is 390, the highest in the country, according to the MMR bulletin released by the Home Ministry on July 7th, 2011 along with IMR (Infant Mortality rate) and TFR (Total Fertility Rates). MMR is the rate of women who die in child birth as a proportion of the population. However MMR in Assam has considerably declined from 480(during 2004- 2006) period to 390(2007- 2009) and Assam has seen significant efforts by the state government in the health field to bring down MMR, IMR and TFR.
C-NES’ Boat Clinic health outreach programme works specifically in these three areas in 13 districts of Assam, in a huge task partnership with NRHM , crucial to reach the vulnerable areas of the sapori and char population across the Brahmaputra Valley.
MT meets NRHM officials
Managing Trustee Sanjoy Hazarika held a meeting with senior officials of the National Rural Health Mission in New Delhi to discuss the ongoing partnership between C-NES and NRHM in Assam. The meeting, on 5 July, between Mr. Hazarika, Mr. Pradhan, head and Executive Director of the NRHM, and Mr. Naved Masood, Special Secretary was held at the Ministry of Health. At the discussion, issues relating to the C-NES- NRHM Public Private Partnership model being followed for the Boat Clinics as well as other aspects of health including the significant improvement of Assam’s MMR statistics, a 90 point drop from 480 in 2005-06 to 390 figured. They agreed that much work remains to be done as Assam is still the worst performer in the MMR sector, ranking at the bottom, below Uttar Pradesh, Bihar and Madhya Pradesh which had an MMR rate of 308.
Mr. Pradhan spoke with appreciation of the work of C-NES’ 15 boat clinics, having seen it in action at Morigaon, central Assam, and how the work was reaching the most vulnerable groups.
Family planning at Bongaigaon chars
As part of World Population Day, (observed throughout the globe on 7th July) the Bongaigaon Boat Clinic in collaboration with the District NRHM and District Health Society, Bongaigaon, performed IUCD insertions in the Boat Clinic. 16 beneficiaries (in the child bearing age) were successfully provided IUCD. 4 women from Srijangram and one from Boitamari BPHC underwent Laparoscopic operation at the special camps held at Abhayapuri CHC and Chalantapara MPHC respectively after being motivated by the Boat clinic camps and the regular awareness sessions conducted by the health team in the camps.
Health Camp at Kaltali
The camp at Kaltali in July 2011 was held under challenging conditions with flood waters submerging most of the village. The camp was held in a raised area inside the village because the regular venue, the Kaltali M.E. School and L.P. School was under water. After reaching the venue after a lot of difficulty, the team thought that beneficiaries would be unable to attend the camp due to floods, but was elated to find people coming to attend the camp on small hand boats. After two and half hours 99 patients were registered for heath checkups and treatment. As the team members were about to wind up camp, a few people carrying a man, severely injured approached the team for assistance. A bad fall had injured the man who was in excruciating pain. The team was informed that he was physically weak as he was observing Roja, the Muslim religious fast,this being a Ramzan month. The Medical officers immediately treated the man with IV fluids and multivitamin injection and after an hour the patient was back to normal. His family members and the villagers expressed their gratitude to the team members who resumed their return journey soon after.
Awareness Program at Cholakura Char
An Awareness program was conducted for the villagers of Cholakura Char, under Lakhipur BPHC by the Goalpara Boat Clinic on 14 July, 2011. Over 175 people were present in the program conducted to make the villagers aware about the importance of IMR, MMR and TFR .Sahidul Islam, the community worker, explained the same in the local dialect to the people. The importance of immunization for infants and pregnant women and the protection it provides from several fatal diseases were highlighted by the team members. The people were also encouraged to take up social issues in their locality to bring in a positive change in society .The program was participatory and interactive. ASHA facilitator Hasina Khatun played an important role in gathering people for the session. She said “small changes can bring a bigger change. I will play my role in bringing about this change”
On 8th August 2011, Medical Officer, Jorhat Boat Clinic, Dr Aaron Momin successfully conducted a delivery. A healthy girl child (a birth weight of 3.30 kg) was born at 8.48 a.m in Bhakeli sapori under his supervision.The team had to walk through mud and slush to the house of the woman, Jashoda Pegu, wife of Diganto Pegu, a local villager, carrying necessary equipments needed for the delivery. MO, Dr Nitumoni Deka could not attend the delivery as he was indisposed and could not walk the long distance to the home of the mother who delivered. This was the tenth successful, safe delivery conducted by the Boat Clinic heath teams till date – Five in Dibrugarh, two in Dhemaji, one in Barpeta and two in Jorhat (February 2011).
Providing ANC, PNC checkups along with advocating institutional deliveries has been priority with all Boat Clinic health teams especially crucial for a state like Assam which has India’s worst Maternal Mortality rate at 390.
Awareness session on prevention of early marriage
An awareness session on the effects of early marriage was held at Barpeta’s Aligaon village by the Boat Clinic Barpeta Unit II at the village L.P. school premises. Block health educator, Block Programme Manager along with a group of stage performers from Mandia BPHC accompanied the team for this special awareness session. It needs mention here that in most char village’s early marriage is a common practice. Often young girls are married off even before they attain puberty. Along with bearing a large number of children and increasing the problem of population boom, it takes its toll on the health of the young mother, in most cases anemic after repeated childbirth.
About 300 villagers attended the camp. The street play was performed for one and half hours depicting the adverse affects of early marriage and the associated health and socio- economic problems it poses. Since majority of the char inhabitants are illiterate such plays along with regular awareness sessions are expected to have a positive impact on them.
The fourth technical training on studio recording and editing for Community Reporters was held from 5th to 7th July 2011 at the training hall of CRS, Dibrugarh. 20 trainees participated in the training including Community Reporters, Field Coordinators, CRS Coordinator and the Assistant Programme Manager, C-NES. Mr. N. Ramakrishnan and Ms. Kriti Dheer from the Ideosync Media Combine, New Delhi were the resource persons for the training which started with a feedback session on the components and techniques taught to the participants in earlier trainings. The Resource Persons were happy to see the improvement of Community Reporters in terms of recording, editing and script writing assigned to them in earlier trainings. This training concentrated on studio recording and editing, discussion on different radio format sheets, conducting research, radio script and hands on practice on programme recording and editing.
Awareness Camp at Bhakuwamari, Kamrup
An awareness camp was conducted in the Bhakuwamari L.P. School premises on 29th June, 2011. ASHA and community worker had informed the villagers about the camp. Although it was a rainy day people were waiting eagerly in the school premises for the camp. A baby show was also held on the occasion for infants (0-1 year) with the Medical Officers, GNM and ANM as judges. Tips for keeping a baby healthy were given to the new mothers. A public meeting was held in the school premises attended by over 100 people including village headmen, PRI member and Dewan. DPO Hiranya Deka briefed about the Boat Clinic mission, its objectives and details about various schemes of NRHM. The medical Officers spoke about Family planning ,details about ANC, PNC and RI. ANM Rashida Begam took part in discussion on health and hygiene speaking in the local dialect with villagers.
C-NES particpation in “Chandrakant Patil Memorial Eastern India Regional Health Assembly”
The Chandrakant Patil Memorial Eastern India Regional Health Assembly was held on 9 July 2011 at the Eastern Zonal Cultural Centre, Kolkata. Nobel Laureate Amartya Sen and Sir Michael Marmot (professor of Epidemiology and Public Health at University College London) were the distinguished speakers. Others were Mr Kumar Rana, Project Director, Patrichi Institute, David Mcloughlin, Deputy Representative, UNICEF, India and Mr P.P.Ghosh, Director, Asian Development Research Institute (ADRI). Sanjay Sharma represented C-NES and spoke on the process of the spread of the boat clinics taking active part in the panel discussion on “Rethinking Health systems”.
Speaking on the health and education scenario of the region, Professor Amartya Sen said that both these crucial areas of development indicators were neglected. He stressed on the need for quality healthcare which reaches the poorest in remote areas of the region. Professor Michael Marmot highlighted on the global health aspects and showed slides on health, nutrition, average life expectancy, average growth weight, and the need to focus on key areas with research findings to have significant achievements.
The panel discussion under the theme, “Equity in Health” saw Dr Sunil Kaul from the ant, Chirang district of Assam speaking on the issues on immunisation coverage and non availability of Medical officers in the remote areas of Assam. He also spoke highly on the performance of NRHM in Assam. The speakers in the panel discussions stressed mostly on the need for healthcare delivery at the grassroots.
Towards the conclusion of the assembly, a minutes silence was observed in the memory of the late Dr Chandrakanta Patil, who was pursuing his post graduate studies in Community Medicine and Public Health at the KEM Medical College, Mumbai during his tragic accidental death on September 21, 2008, by lightening while he was providing medical relief to flood victims, at a relief camp in Bihar’s nondescript Katariya, Supaul. Dr Patil was just 24.
Visitors at Rowmari Char
A two member team comprising of Ms D. Daniel from the Centre for Disease Control and Prevention, Atlanta, US and Mr Santosh, UNICEF Consultant, visited the Barpeta Unit II Boat Clinic in lower Assam on July 14, 2011. The team joined the health team on the Boat Clinic during their trip to conduct a health camp at Rowmari char, located behind the picturesque Baghbar hills. The SDM & HO of Mandia BPHC, Block Extension Educator (BEE) and Block Programme Manager (BPM ) accompanied the team. The hour long boat journey from Manikpur ghat to the char started at 11am
The health team informed the local ASHA (Accredited Social Health Activist) ahead of the teams visit so that necessary arrangements for the camp were made. The Community workers of the health team were sent earlier to the char to inform villagers about the camp, held on the banks of the Brahmaputra . There were 117 general check ups, 6 ante natal check ups conducted and 16 children immunized. As part of family planning measures, oral contraceptive pills and condoms were distributed among eligible couples. An awareness session on the importance of breast feeding was also conducted by the team.
The visitors were impressed by the way the camp was organized and the outreach of health services to these isolated people obvious from the comment left behind by Daniel in the Visitors book “The experience of seeing the Boat clinic camp is life changing. The staff at the clinic is doing wonderful work. They care for the very young to the very old. So many different areas are covered- general check ups, laboratory tests, distribution of medicine, family planning and immunization. The team is providing care to the people who would not have access to these services otherwise. Wonderful work!” she wrote.
Health Camp at Kadamtola Kopahtoli char: A report by Sanjay Sharma, Associate Programme Manager, C-NES
A visit was made to Kadamtola Kopahtoli char, Mondia Block on 15 July 2011 with the Barpeta Boat Clinic Unit II. The team reached the Manikpur ghat at 930 hours. At Manikpur ghat the road was muddy and slippery. We had to cross a small stream near the ghat to reach the boat holding their shoes and slippers in hand.
During the journey there were discussions on the visit of the representative of CDC, Atlanta the previous day. After about one and half hours the boat reached Kodamtola Kopahtoli ghat and the camp was organized at the Kodamtola M E School. A large crowd had already gathered at the school when we reached. The temporary health unit was set up immediately inside the school. The school was having summer holidays and the team could use it for conducting the health camp. Pharmacy was setup in the boat as the boat was anchored close to the school. During monsoons the boat reaches inside the villages.
Medical officers Dr Soleman Khan and Dr Shah Alom checked up the patients in the temporary OPD setup inside the school building assisted by the laboratory technician and nurses. Community Workers Reyhan Ali, Montaz Ali Khan and Wahabur Rahman were busy organizing the crowd and distributing advice slips to the patients. At times they were seen to be in difficulty controlling the large crowd. The DPO and the Community workers called on ASHA workers to organize the crowd .Later an awareness meeting was organized wherein there were discussions on IMR and MMR , their extremely poor figures for Assam and why care of the young mothers was important. The importance of Family Planning was also highlighted.
The community workers spoke on the six killer diseases which proves fatal for infants and how the process of routine immunization helps in reducing IMR. People were told about the schemes of NRHM where the mothers, men and women could take benefits. At the health camp there were 18 ANCs, 24 RIs, and 191 general Health Checkups. The camp which started at 1130 hours ended at 1530 hours. We reached the ghat at 1700 hours and started the return journey to Guwahati. The Pharmacist, laboratory technician and an ANM Jilima Begum accompanied in our car.
Bearing witness- Boll report released
Former Home Secretary Gopal Pillai launched a three-day programme of C-NES in New Delhi on September 7, 2011, saying that it was crucial for governments and non-government groups to reach out to groups and communities in the North-east which felt distanced and alienated.
Mr. Pillai, who released the report, ‘Bearing Witness: the impact of conflict on women in Nagaland and Assam,’ based on research by C-nes teams in the two states, said that he had been moved by the accounts in the reports of the reality of the pain and trauma that women especially had suffered over decades.. Sanjoy Hazarika, Managing Trustee of C-nes, who was co-author and project director, delivered opening remarks, spoke of the project and how it had taken shape. He paid tribute to the hard work of the research teams of Charles Chasie, Dr. Lungshang Zeliang and Dr. Buno Ligase in Nagalad as well as Mirza Zulfikar Rehman and Riturekha Baruah of Assam and their networks that enabled such a powerful document to emerge.
The Project Report was edited by Ms. Preeti Gill, the editor of Zubaan, also an associate director of the Conflict project. Senior figures from government, media, scholars, non-government groups as well as diplomats and representatives of international organizations took part in the inaugural, which was held at the India International Centre Annexe where Kausiki Sarma’s graphic photographs of the project and women victims was also opened by Mr. Pillai. The project was funded by the Heinrich Boll Foundation of Germany and the IIC was also a partner.
The premiere of the documentary, ‘A Measure of Impunity,’ directed by Maulee Senapati and produced and scripted by Sanjoy Hazarika was also screened during the three day event . The final event was a surcharged evening of discussions led by a panel comprising of the respected scholar Prof. Udayon Misra, Dr. P. Ngully, psychiatrist from Nagaland, Ms. Meenakshi Ganguly, representative of Human Rights Watch, Ms. Monalisa Chankija, editor of the Nagaland Page, Mr. Mirza Rahman, researcher for the Assam segment of the project, and Mr. Hazarika. The discussion was chaired by Ms. Gill, who spoke of how her understanding of issues and people had grown over the years through travel there and extensive meetings and conversations with a wide range of individuals and groups.
Closing the three-day event, Mr. Hazarika spoke of how the issues raised in the report and the interactions could be developed in the National Steering Committee on Health of which he was a member; it would be important to include these issues through a prescriptive framework into a policy structure involving the stakeholders.