By the Brahmaputra (Vol: 18)
(For the quarter April – June 2012)
By the Brahmaputra
A question of trust, equality – force Centre to share facts about water
Perhaps ‘In the Brahmaputra” or ‘On the Brahmaputra’ may be the more appropriate title for this week’s column and perhaps for the next months as well. As the river brushes aside embankments and feeble human efforts to control it, we are reminded again and again of the thunderous songs of Dr. Bhupen Hazarika in his endless tributes to the river, of ‘on either bank, the breath of so much hope and despair.’
And again we are reduced to wringing our hands, organizing the same set of seminars, workshops and inviting the same set of speakers and self-styled experts to talk about the flood ‘threat’, calling for ‘good ideas’ and better engineering solutions etc. Suddenly, the Government has realized that embankments are a curse; they are a palliative answer not a permanent solution, developed by British engineers and their Indian successors to protect the towns and let the flood plains where our main populations live be destroyed.
Can you think of a more cynical approach: study the pattern of embankments – they are built to protect towns and large, important villages (usually close to an urban centre or home to an influential official or politician). They are designed to keep the river out, not to let it flow.
And despite everything that we do, our fresh water sea dismisses our intervention with contempt. I wonder if our engineers, babus and politicians will ever learn anything from anywhere despite all the trips they make abroad and MOUs they sign. New theories are floated to suggest engineering solutions, whether by dams or braiding etc.
We can theorize and model all the way to heaven or hell but as others have said before, an ounce of practice is worth a million tons of theory. Well, all these theories are being buried under the weight of the water and sediment of the Brahmaputra and its tributaries of these past years.
As a river, the Brahmaputra is the greatest sediment carrier in the world after the Hwang he or Yellow River of China. The alluvial fans of the Brahmaputra stretch beyond the mangrove swamps of the Sundarbans, the ‘Mouths of the Ganges” in Bangladesh which should be renamed as the Mouths of the Brahmaptura for it is the greater river, past the Andamans and towards Indonesia, building land underwater in the Bay of Bengal even as its gouges soil from the Tibetan Plateau, the Assam Plains and Bangladesh.
Today, we are told that the Government has discovered that erosion is the major problem in the Brahmaputra. Well, scholars like Prof. Dulal Goswami of Gauhati University defined this as the key concern decades back. No one listened to them. The embankments we build, year after year, despite funding from international institutions like the Asian Development Bank are poorly made. Over 300 of them gave way in the last major deluge in 2006; or have we forgotten that disaster already? Governments count on short public memory. But we seem to be suffering from collective amnesia.
I’m prepared to wager that many of the 100+ embankments which have collapsed this time around were in that earlier list. And what did studies commissioned before that disaster and after it find: that the embankments were poorly designed, badly constructed and ill maintained. I’m running out of adjectives here. Some of the problems are very simple: the structures are weakened by infestation of rats, which burrow below the surface, weakening the stone and mud above, allowing water to seep in. When a flood comes – use your imagination and a little science to think of what happens. These embankments being the only seemingly safe high land, the refugees from the villages crowd upon them, using the tin sheets, bamboo poles, tents that government gives and other materials they ar3e able to salvage.
There are embankments on villages at the edge of Guwahati, abutting its pride and joy, the IIT of Uttar Guwahati. Go and visit them and see how wretched are the lives of those who toil in the fields at such times: hungry, sick, having lost their capital (homes, property, crops and most, of all, animals). They survive on the doles of a flood manual that hasn’t been revised in 30 years. That is an outrage by itself. Try living for a few hours, forget about a day like that and you will understand why millions of people are angry and desperate. The humiliation and lack of dignity is an affront to all of us.
The Government has waged a valiant fight at the district level, under its state leadership. The National Disaster Relief Force (NDRF) and state officials, political leaders, district authorities, have worked ceaselessly, with courage, energy and determination. As usual, the Indian Air Force and army has rushed to the help of the beleaguered garrisons of tens of thousands of people; yet the human toll has risen to over 120 as I write and hundreds of animals have been killed by floods in Kaziranga, not to speak of the evil poachers and reckless drivers).
But despite this courage, this is not a situation that a state can control, as the Chief Minister has admitted with candour. It is even beyond the power of the Centre. But it requires as scholars such as Prof. Goswami, Prof. Chandan Mahanta of the IIT and others have been demanding for long – a regional approach that must bring in China, Bangladesh and Bhutan. We are sandwiched between all these countries, an island as it were marooned between receiving the waters of two nations (Tibet and Bhutan) and flushing those waters downstream to another lower riparian, Bangladesh, of whose suffering little has appeared in our media.
What is at stake here is not just the lives of millions of people. It is also the issue of equality and discrimination: the Government refuses to share information with even the Governments of its own party/allies in these border regions! What does that tell us: no number of statements from Prime Ministers or UPA chiefs or helicopter rides over the flood stricken areas can negate the actual message behind it all: we can’t trust you. Because “international;” rivers and “international borders” and security issues are “involved.” It’s as simple as that.
The Government of India refuses to share information on water: it treats water like a state secret, locked up in vaults, away from even the prying courage of RTI buccaneers. The reports of the Brahmaputra Board are not accessible to even state leaders. I know in one case where a Chief Minister asked for the report of the Board; it was brought to him by an official who stood in the room while the Chief Minister examined the report and then took the same away after the politician had completed his perusal. Of course, times have changed and perhaps information is more readily accessible.
But this is all part of the process and system of secrecy that dominates our region and our rulers. So it is not just the offensive and draconian Armed Forces Special Powers Act that we must mobilize against, it is also the lack of information on issues such as water and our natural resources where the state governments must battle with and for us, the people. How can you design policy or an embankment or a project or programme of any sort if you do not have access to the basic data. And we don’t.
This is the astonishing fact: and instead of merely fighting against big dams, I believe that all must come together to force the Centre share information on issues that make the difference between life and death for millions, between hunger and destitution for them and between governance and delivery of basic services by Governments. Scholars base everything on the river on estimates and presumptions not on raw data because they do not have access to this, barring what little they and their research teams generate! How can you plan for the future on such an ad hoc basis?
It is in the interests of the Chief Ministers of Assam, Arunachal Pradesh and Meghalaya as well as Sikkim especially as four states which are directly affected by the devastating floods, landslips and incessant rain to come together and press the Centre to give them the information they need and which the people require. It is their constitutional mandate and the basic human rights of those who are suffering today.
I write with concern about my boat clinic teams, one of which had to be rescued by an IAF helicopter sortie in Amarpur (Tinsukia district – I wonder how many of our school and college children even know of its existence), but who have, within days of being rescued returned to their efforts of reaching the most vulnerable on the islands with sustained medical help and succour. This is where our partnership with the National Rural Health Mission in Assam is an example of a triumph against all odds and why it is held up as an example, by the Central Planning Commission, of inclusive health care.
So even in desperation, lies hope. From despair can come courage. But let our Governments and all of those concerned about the vulnerable of Assam come together and demand with one voice of the Centre – open up, don’t just toss out a few hundred crores and think of palliative measures. These deny us justice and access to rights. Share the data, plan the present and future with us, not for us.
Aami jodi bharotor xontan, tene amar maat, amar kotha xunok. Will the Governments have the courage to lead this fight? Many eyes are on Tarun Gogoi; as the region’s most influential chief minister and political leader, he cannot let this slip away.
In all this, do not forget the river’s cry — it needs space to breathe, as it were, for our help in gouging out the millions of tons of silt and sand, pebbles and rocks that it brings down along its magnificent journey to the sea. Use dredgers continuously, use them scientifically not to raise sand that is used to build fancy apartments in Guwahati but to deepen channels and enable navigation to flow again, for the fish to spawn, for the xihus, the dolphins, to play again.
In the health of our rivers, lies our future. Not in damning and blocking them.
(From his regular column in the Assam Tribune published on 11 th July2012)
MT delivers talk at Boll headquarters
Sanjoy Hazarika, Managing Trustee, C-NES, was invited to give a series of talks in Germany and screen his latest film on conflicts and its impact on women in the North East. Hazarika, who also holds the Saifuddin Kitchlew Chair and is Director of the Centre for NE Studies at Jamia Millia Islamia, New Delhi, gave the first of the talks on Monday April 16, 2012 at the Heinrich Boll Foundation Headquarters in Berlin followed by a screening of his latest documentary, ´A Measure of Impunity: the impact of conflict on women in Nagaland and Assam.´ The film is directed by Maulee Senapati. The screening was preceded by the launch of a month-long exhibition of Kausiki Sarma´s powerful images of conflict and its repercussions; the photos formed a crucial part of the report released by former Home Secretary GK Pillai in Delhi last September. Later in the week, Hazarika traveled to make presentations of the film at the Martin Luther University at Halle, the University of Leipzig, the Society for Indo-German Cooperation at Frankfurt before concluding at the South Asia Institute at the University of Heidelberg. Each presentation was followed by an interactive session. This was the first time that such an extensive programme on the North-east was organized by the Boll Foundation in Germany.
Workshop on Disaster Risk Reduction
Managing Trustee Sanjoy Hazarika spoke on understanding Disaster Risk Reduction(DRR) issues and the different roles of media in DRR at a workshop on “Main streaming media into disaster risk reduction” organized by the Assam State Disaster Management Authority on 9th April 2012 at the Assam Secretariat, Dispur. The Chief Minister of Assam, Shri Tarun Gogoi, the state Revenue and Disaster Management Minister Shri Prithvi Majhi was present at the workshop along with Shri Shashidhar Reddy, vice chairman, NDMA, Delhi. Over 90 media professional from both print and electronic were present.
The workshop emphasized on the role of media in covering disaster events, recovery and mitigation initiatives and establishing effective interface between disaster management agencies and communities at risk. The role of media in informing the people and the authorities during emergencies becomes critical, especially the ways in which media can play a vital role in public awareness and preparedness through educating the public about disasters, warning of hazards, alerting Government officials, helping relief organizations and public towards specific needs.
Highlighting the role of the media Hazarika said “As journalists, we are in the business of public information; we should give information to people about which the government does not want to give people.” He said that in all disaster natural or human induced, humans have had the worst role to play and that those who are vulnerable and poor are more affected by natural disasters. He suggested offering media fellowships to journalists to study disaster management which found good response among the participants and the organizers.
Training for Laboratory Technicians
A five day induction training for Boat Clinic laboratory technicians on Human Immuno Deficiency Virus Infection/ Acquired ImmunoDeficiency Virus (HIV/AIDS) was held at the seminar hall of Gauhati Medical College and Hospital (GMCH) organized by the Department of Microbiology, GMCH from 12th to 16th March 2012. Fifteen laboratory technicians from the Boat Clinic units participated in the training held to give basic awareness, detection and control of HIV, a disease of the human immune system caused by the human immunodeficiency virus. The illness interferes with the immune system making people with AIDS much more likely to get infection, that do not usually affect people with working immune systems. This susceptibility increases as the disease worsens. HIV/AID is a major health problem in many parts of the world and is considered a pandemic. As of 2010, there are 33 million HIV patients globally. Of these approx 2.3 to 2.5 million are Indian patients.
Dr P Talukdar, Additional Director of Assam State Aids Control Society (ASACS) welcomed the participants and summarized the basic objective of the training. Dr NK Hazarika (HOD microbiology, GMCH) Mr Mahmood (Quality Manager ASACS) and Ms Kanika Das (Technical Officer) were present as resource persons. In the introductory session Dr Hazarika spoke on HIV and the role of medical staff to create awareness, control and detect HIV adding that after counseling, every HIV case should be registered with full address, age, sex and occupation. After the introductory session virology and pathogenesis of HIV infection and its detection was demonstrated in the laboratory. On the final day of the training, a recap of the past days was done along with past training evaluation test at GMCH.
It need mention that all Boats Clinics are equipped with a full fledged laboratory and provide basic laboratory services with a full time laboratory technician carrying out routine tests like Hemoglobin, Urine for sugar and albumin and Malaria – RDK, Pregnancy Test, Blood grouping, ESR as part of providing basic health services to the deprived communities inhabiting the river islands of the Brahmaputra.
HIV prevention in Boat Clinics
Earlier on 2nd February, 2012 a meeting was organized by ASACS with the members of Boat Clinic for correlating the activities of Boat Clinic in HIV/AIDS prevention. Dr D Das, CEO, C-NES and Programme Manager Ashok Rao were present. The meeting was presided over by Dr PN Talukdar ,Additional Project Director ASACS. In his speech he exhorted the participants to strengthen the activities of boat Clinics in HIV/AIDS prevention service. Programme Manager Ashok Rao spoke about the services to pregnant mothers provided through boat clinics. ASACS assured the C-NES team about providing kits / logistics and to organize trainings for laboratory technicians, GNMs and community workers who can subsequently counsel patients.
Workshop on Documentation and IPCC
A three day workshop from 30th April to 2nd May, 2012 on documentation and Inter personal Communication (IPC) was organized by C-NES at the State Institute of Health and Family Welfare(SIHFW),Guwahati as part of the Population Foundation of India(PFI) project with C-NES which supports the ongoing partnership with NRHM focusing on propagating family planning methods. The family planning intervention includes developing a programme for family planning in Dibrugarh, Dhemaji, Tinsukia, North Lakhimpur and Sonitpur districts of assam along with promotion of modern methods of contraceptives.
The district FP Counsellors for the project Rinkymoni Shil(Lakhimpur), Rhitiz Gogoi (Tinsukia), Bonobithi Das (Sonitpur), Jugananda Dutta (Dibrugarh) and Deva Kakaty (Dhemaji) were present at the workshop with Chandana Borah, State Advocacy & Family Planning Coordinator. The DPOs of the 15 Boat Clinic districts- Amrit Kumar Borah, (Dibrugarh), Dulu Buragohain, (Dhemaji),Arup Saikia, (Tinsukia), Tapon Borah.(Lakhimpur) and Mousumi Duwarah (Sonitpur), Mehebub Alom Hazarika (Dhubri Unit-1),Abdul Halim(Dhubri Unit-2), Shymjit Pashi (Barpeta Unit-1),Swapna Das (Barpeta Unit-2) Hiranya Deka (Kamrup), Hingulas Khakhalary (Goalpara), Muktinath Basumotari (Bongaigaon) Parvis Ahmed(Nalbari ),Riturekha Baruah (Jorhat),Abul Kalam Azad (Morigaon) also attended the workshop. The PFI team from Delhi who facilitated the programme included Sona Sharma, Joint Director (Advocacy & Communications) and Ms Shree Venkataram, Consultant PFI Resource persons for the documentation training.
The participants were welcomed by Dr Dipankar Das, CEO, C-NES and Mr. Manik Baruah, Associate Programme Manager, C-NES spoke about the proposed scalling up of the PFI prgramme to more districts. Mr Ashok Rao Programme Manager,C-NES spoke about the importance of documentation and IPCC .Ms. Sharma discussed the Communication process and IPCC including observation and establishing rapport, encouraging dialogue, listening and questioning. An impromptu play was staged on the need for adopting family planning by FP counselors Deva Kakati, Bonobithi Das ans DPO Swapna Das.A mock session on counselling was also held as part of IPCC where the focus was on communication, the different types of communications and Inter personal Communication (IPC) and Counselling.
In the documentation training the focus was on different tools- print, audio,video and kinds of documentation – reports and narrative writing. An analysis of the reports was made, errors shown.
PFI Sensitization meeting
A sensitization workshop as part of the PFI workshop was held at Sonitpur District’s Bootmari char in the Parthomik Bidyalaya (School) on 23rd May 2012. Twenty-two participants took part in the programme. The resource persons for the meeting were Dr.Vikram Doley, SDMO, Bihoguri BPHC. The State Advocacy & FP coordinator (SAFPC) C-NES, District Programe Officer, Sonitpur and other boat clinic staffs were present in the meeting. Child marriage, a bane on modern society still prevalent in the char areas where the Boat Clinics operates and which among others also severely affects the health of the mother and child was the issue on focus.
Chandana Bora, SAFPC focused on the religious challenges which caused barriers in adopting family planning methods among the minority community. Abdul Salam, a local teacher spoke on religious obstacles to family planning, mentioning that nowhere in the Quran is family planning condemned. Hasina Khakun, ASHA Mekar-Tapu char and Tahura Khatun, ASHA Ashigarh char were given incentives for active participation in family planning and their pro activeness by Mousumi Duwara,DPO and Bonobithi Das FP Counselor, Sonitpur District.
ABITA supports C-NES
The Assam Branch of Indian Tea Association (ABITA) has supported C-NES with a donation amount of Rs 1.20 lakh as part of its Corporate Social Responsibility(CSR) for C-NES’ Brahmaputra Community Radio Station(BCRS) being set up at Maijan, Dibrugarh. The amount is being used to purchase essential equipments such as computers and recorders for the upcoming station. The programmes of BCRS which is now fully equipped, staffed and expected to broadcast later this year will be broadcast in five languages like Bhojpuri, Assamese,Mishing, Bodo and Shadri, the dialect of the tea tribe community prominent in the nearby areas of the station and will thereby reach a large number of tea garden community members on diverse issues extremely relevant to them including health, education and entertainment leading to overall development of the community. The community reporters are also drawn from the tea community and would be recording music, showcasing their culture, tapping local talent and interviewing people on their interests.
Swedish midwife visits Boat Clinics
Swedish midwife, Christina Pedersen collaborating with Ipas- an organization headquartered in North Carolina, US and working around the world to increase women’s ability to exercise their sexual and reproductive rights, especially the right to safe abortion visited the Tinsukia and Dibrugarh Boat Clinic Units from 17 th- 20th April 2012. She shared information on safe abortions with the team along with recent developments in mother and child care sector at the international level.
Following is her impression of the Boat Clinics along with photographs of the camp she had taken:
THE BOAT CLINICS IN ASSAM
I am a Swedish midwife and master student from Uppsala University in Sweden visiting Assam to do research on safe abortion care in relation to the high numbers of maternal mortality in Assam. The context is fascinating and complex in this region and there are so many reasons contributing to the high numbers of maternal mortality. I have been doing an interview study with doctors and general nurse midwives involved in abortion care working in government facilities both in rural and urban areas.
When I was visiting Upper Assam I got the opportunity to visit the Boat clinics in Tinsukia and Dibrugarh, I went with the boat located on the Dibru river outside of Tinsukia and could follow the teams work close up. We went upstream to one island that had a village with a population of approximately 350 persons. A health camp was quickly built close to the shore with a small tent roof and a table and some chairs under the roof for the doctor to sit and meet his patients. A never ending line of people with various health problems came to see the young doctor who patiently gave them advice and treatment. If the patients needed they could also go and meet the pharmacist, take some lab.tests, receive family planning or ante- and postnatal care, also children’s checkups and vaccination was available.
I am very impressed by their work and the enthusiasm the team showed. They seemed to enjoy their work and all had important tasks to do and therefore I felt they performed very well. After the health clinic we had lunch together and discussed about health issues concerning reproductive health and the specific problems found in the area where the boat clinics work.
The next day, after my interviews at Tinsukia civil hospital, I went to meet with the boat clinic team in Dibrugarh. We also had an interesting discussion about reproductive heath issues, contraceptive counselling and women’s health.
I found the boat clinics to be an extremely important provider of health care to people who otherwise would have a very limited access to health care at all. I am very impressed and inspired of what I saw.
Keep up the good work!
Camp at Sarikholia
A patient with severe respiratory problems was brought to the Dibrugarh Boat Clinic Akha on 8th April 2012 while the boat was anchored at Sarikholoia ghat for a night halt. The patient who was barely able to breathe and in distress was brought to the health team at eight in the evening. He was given emergency drugs and put under oxygen mask for over four hours. He was released at about midnight when his condition improved only to be replaced by his daughter suffering from the same problem. She was brought to the boat at two in the morning. She was treated till eight in the morning and released after recovery. The team spent a sleepless night.
It was a hectic day for the team earlier in the day as the Boat Clinic ANMs and Community Workers conducted a door to door visit to administer polio drops to children in Sarikholia, Sarpatwali and Bishnupur with the help of a country boat. They covered 115 children in three saporis and came back to the boat clinic late in the evening. 59 patients were treated in the regular follow up camp held at the ghat under the tents pitched by the team.
The Morigaon Boat Clinic crew and community workers were imparted training on basic repairing, fixing, ensuring safety measures and maintenance of Speed Boat “Joanna” on 20th June 2012. The boat, named after its donor from Switzerland, operates in Morigaon district supporting the local Boat Clinic-enabling patients from the char/saporis to be carried swiftly to boat clinic or hospitals in emergencies.
It may be mentioned that Swiss river expert Andy Leeman and his Switzerland based company, RIB (Rigid Inflatable Boats) Expeditions and Adventures extended a helping hand to C-NES towards emergency medical care in the river islands of Assam by donating the inflatable speed boat, “Joanna” in 2010. Earlier in November 2010, Leemann’s team, traversing the Brahmaputra from Tibet through North-east India into Bangladesh linked up with C-NES, in the sector of community health. The focus of the collaboration was to explore initial support for rapid emergency evacuation of patients from remote inaccessible habitations in Brahmaputra with fast-moving motorized inflatable boats.
The Morigaon boat crew and community workers were trained by Apal Singh, a river expert and an active member of Leeman’s team who said that the team was learning fast and will be able to handle the boat well. Each participant was given the experience of driving and maneuvering the boat. The inflatable dinghy with a fiberglass bottom can carry half a dozen people and move at speed of 30km to 40km per hour.
Radio Netherlands covers Boat Clinics
Gayatri Parameswaran from Radio Netherlands visited a health camp at Tinsukia’s Amarpur sapori on 24th April 2014. The broadcast report:
The state of Assam in northeast India has the highest maternal mortality rate (MMR) in the country. One of the reasons for the abysmal record is that over three million people live on tiny islands along the Brahmaputra River without proper health infrastructure.
Boat clinics on the river, an initiative of the Centre for North East Studies and Policy Research (C-NES), have been working to lower the alarming figures. But the latest challenge they face is climate change.
Healthcare for islanders
Murari Yadav is paddling his boat on the Brahmaputra River. He navigates through the early morning traffic on the river. Boats pass by with people eager to get across to the land for their day’s work. Yadav is also helping people get to work.
He’s ferrying a team of doctors and supporting medics from the C-NES to an island about 40 kilometres from Tinsukia, a commercial town in upper Assam. They are heading upstream on the river to get to a remote island called Amalpur. Today, they will be setting up a camp there for villagers of the Missing tribe.
Sanjoy Hazarika, founder of C-NES, came up with the idea of delivering medical aid to the needy along the Brahmaputra River. Once while he was travelling on the river, he heard a story about a pregnant woman on an island who died while waiting for transport.
“This is really unacceptable in this day and age that people have to die for lack of care. So I thought, instead of people going for the service, why not take the service to them?” Hazarika says. Today the boat clinics, which began in 2005, work in 13 districts in Assam along with the government organisation, the National Rural Health Mission (NRHM).
Back on the river, the C-NES boat has reached the bank. It’s taken two hours on two boats. But the journey isn’t over yet. The team has to endure an arduous tractor ride to reach Napun village, where they will be setting up camp.
Villagers, most of them women and children, are already queuing up at the clinic. Narintari Chantalya is eight months pregnant. She remembers the last time she gave birth. “I was in labour for four days. It was very difficult. They finally took me to a hospital far away,” she says.
Narintari is still scared by her experiences and so are many others. They have all heard of women dying while giving birth. Assam has the highest maternal mortality rate in the country, at 393. The doctor presiding over the camp, Dr Ritesh Kalwar, says Narintari’s haemoglobin levels are very low. “She is anaemic,” he says. “I’ve prescribed her iron tablets and hopefully they should do the work. She is due to deliver the baby in a few weeks, so she should be careful,” Dr Kalwar adds.
Once the patient leaves, he says, awareness among villagers about their health is very low. “They have myths about some things. For instance, they believe that taking iron tablets will make the baby too big causing complications during delivery,” he says. On that day, Dr Kalwar treats 110 patients at one go.
But illiteracy and logistics are not the only problems faced by the boat clinics. Their growing concern now is climate change. In the past couple of years, the boats have not been able to reach many islands due to lowering water levels on the Brahmaputra River.
As he ferries the medical team across the river on land, Murari Yadav, the captain of the boat, says he’s seen the river change a lot. “I’ve been sailing boats since I was 13. But I can tell you the river is not the same these past years. The water levels have gone down and the river has grown wider,” he says.
He’s right. The Brahmaputra is widening at an alarming rate of five metres every year. If the trend continues, saving lives on the islands will become more and more difficult for the boat clinics.
Radio Netherlands at CRS
Dheera Sujan from Radio Netherlands visited C-NES’ Community Radio Station – Brahmaputra Community Radio Station (BCRS) at Dibrugarh’s Maijan on 24th May 2012 and interacted with the coordinator Bhaskar Bhuyan, the reporters and staff of BCRS. She shared her ideas on radio programming -the need for a good script, how to write a good script, the need to start a programme with a story and following it up with information and analysis. Tips on good presentation, conducting an interview, presenting an issue with the right emotion and expression were also given for programmes to have maximum impact on the community. These were valuable information for the young team.
Interaction with the Binns at Dhubri
Earlier the same week Sujan travelled to Dhubri district in west Assam, bordering Bangladesh, where she met with members of the Binn community, a fishing community originally from Bihar. The Binns were earlier active river dolphin hunters. The dolphin blubber was used by the Binns as fish bait for which the endangered species were ruthlessly killed till C-NES intervened and converted the hunters into protectors through a Ford Foundation supported project on river dolphins linked to livelihood. The conservation, through participatory efforts and weaning poachers away from hunting was one of the major successes of the project. The Binns adopted conservation because they found a benefit in conservation: their catch improved nearly three times, so have their incomes with an alternative developed for dolphin oil: the fish gut oil. The river dolphins, xihu in the local language has since been declared the National Aquatic Animal of India. Sujan interviewed members of the community.
A corrective cleft lip surgery was performed on one year old, Mamoni Khatun, from Islampur village in Barpeta district in June 2012.The District Programme Officer, Barpeta Unit noticed the child’s condition when she was brought to a health camp at as a nine month infant. The DPO noticed how worried the mother was and informed her about Operation Smile,the corrective surgery performed free of cost at Guwahati’s Mohendra Mohan Hospital. After getting relevant information and motivated by the DPO the parents took the child for surgery helped by the Asha and Asha facilitator. Her happy parents expressed gratitude to the health team.
Family Planning initiative
The Barpeta Boat Clinic Unit II was successful in conducting 3 IUCDs insertion on 19th June 2012 as part of family planning initiative. The Boat Clinics in each district have been giving awareness on family planning. The beneficiaries- Sarala Begum (28 yrs) with three children Amela Nessa( 30 yrs) and Lal Bhanu (28 yrs) with five children each are residents of Uttar Sukherjar village in the district.
Along with reducing the high Maternal Mortality Rate (MMR- 390 per 1,00,000 live birth) Infant Mortality Rate (IMR- 61 per 1000) in Assam, reducing the high Total Fertility Rate (TFR- 2.6) in the state is an important focus area of C-NES’ Boat Clinic health initiatives under NRHM. After constant awareness sessions by the health teams in thirteen districts across Assam, the people are becoming aware of the importance of FP (family planning) and have started using different methods, observed the health team members. Many women show interest in inserting IUCD to prevent unwanted pregnancies. Awareness campaigns on health and hygiene, family planning, safe drinking water and sanitation are regularly organized. Motivating isolated communities under the influence of superstition and religions which do not encourage family planning is not an easy task for the health teams working, as they are, under challenging conditions.
AMC doctors assist Tinsukia Boat Clinic
The NRHM Tinsukia district unit collaborated with Juniors Doctor’s Association (JDA) of AMC Dibrugarh to assist the Tinsukia Boat Clinic in organizing two joint health camps at Laika sapori and observed the Mother and Child Protection week on 16th and 17th March 2012. The team reached Phasidiya river bank at 2 PM and loaded the medicines and other logistics in a bicycle and walked from the boat to Phasidiya village. The camp started at 2.45 PM and continued till 4.20 PM where 124 patients were treated.
Intern from Germany
Josephine Goldner, a student from Bielefeld School of Public Health, Germany visited the Boat Clinic camps at Morigaon and Tinsukia in April 2012 to get an insight of the health outreach programme. She visited Nepal and India to observe outstanding Public Health Programs in these countries, as part of an internship programme in a public health. She also attended a Summer School on “Contextualizing Social Determinants of Health“at Jawaharlal Nehru University, New Delhi in March 2012. While her stay at Nepal and India was promoted by the DAAD (German Academic Exchange Service) and “International Public Health Partnership” between universities in India, Turkey, Nigeria and Germany she would be writing a report about these field trips by focusing on the aspects of social and geographical determinants of health. At Morigaon’s. Pithakhaity char Josephine interacted with the community as well as ASHA and AWW of the char village and enquired about the kind of services people have utilized from the boat clinic.
Art Contest for sapori children
The Jorhat Boat Clinic has started organizing art contests for children dwelling around the islands- Baruah Chuk, Ghuria and Subidha sapori. The first such competition was held on 26th March at Baruah Chuk where 21 children took part. Local school teacher Dipa Pegu helped the team. In May 2012 they were held at Ghuria and Subudha sapori .Excited at getting drawing papers and color pencils, the initially hesitant and secluded children, open up to their creative best. They also perform traditional dances and sings at the group’s request. Most regret not being able to attend regular schools, given their physical isolation. Even where schools exist, they are in dilapidated conditions, teachers seldom take classes. That has not however deterred them from aspiring; most aspire to become doctors naturally, the boat clinic doctors being the perfect role models to serve their community.
Intern from UC Berkeley, California
Arunava Sarma, pursuing undergraduate degrees in Molecular and Cell Biology and Public Health with a focus on infectious disease at the University of California Berkeley interned at C-NES during May- June 2012. Through her studies of Molecular and Cellular Biology she learnt about the biological aspect of disease, the underlying causes of malaise. Public Health has given her a human perspective on disease: the importance of making care available to people in the most convenient manner to them, the importance of primary care in preventing disease, and the incredible need for education to prevent the spread of disease.
After her visits to and observation of health camps at Nalbari, Bongaigaon, Kamrup and Jorhat she feels that the Boat Clinic program is the epitome of public health as they go to isolated area, provide health services, and most importantly provide information about disease and how to prevent their incidence. Arunava in addition her studies, also volunteers at the long established Berkeley Free Clinic. The clinic provides free care especially with regards to general care, tuberculosis screening, and STI/HIV testing. She was impressed with how the Boat clinic teams were able to create a trusting bond in rural populations in a short period of time that provides them the ability to better outreach to the community. Also, as a hopeful future physician, she learnt about the diseases prevalent in specific areas and the methods of care adopted by the Boat clinics.
Boat Clinics in rescue operations
Dhubri : Medartary
The Dhubri Boat Clinic Unit I took active part in the rescue operation of the tragic boat mishap that took place at Dhubri’s Medartary, on 30th April 2012. Medartary lies in the border of two districts- Goalpara and Dhubri with regular ferry service between the two. The ill-fated vessel carrying people and goods between Medartary ghat and Dhubri ghat was overcrowded even as it started journey in the afternoon. Nearing Medertary ghat, the vessel faced a strong storm, lost balance and capsized. Over 200 lives were lost. As the incident happened in the evening and the weather was bad, the boat clinic team could not take part in the rescue operation the same day, but the next day (1-5-2012), the team sailed on vessel SB Rustam early morning to the site and took active part in search and rescue operations. The team also carried medicine from the District Health department and transported them to the nearest State Dispensary for providing necessary aid to survivors. The health team treated some of the survivors too.
The Bongaigaon Boat Clinic team took active part in the rescue operation of a boat packed with passengers which capsized at Oudubi in the Champawati, a tributary of the Brahmaputra on 15th of June 2012. On village haat (fair) days many people travel to and fro from the Chapar bazaar through the route.The DPO received a call from one of the Community workers in the evening about the incident After getting instruction from the C-NES regional office and district authorities the Bongaigaon Boat Clinic team reached the incident site the next morning to take part in the rescue operation. The boat clinic MO and paramedics helped the Block PHC authorities at Boitamari BPHC. 15 passengers were admitted at the Block PHC out of which 2 critical injured were referred to the civil hospital Bongaigaon. After the boat reached the incident site the Deputy Commissioner asked the boat clinic staff to make a night halt as medical standby and help the rescue operation team the next day.
The army personal reached the spot at 7.30 am. After searching for over 2 hours the capsized boat was recovered by the National Disaster Response Force, few kilometers away from the accident site. Fortunately no casualties were recorded by the end of the search operation.
Water Resources Minster at Bongaigaon Boat Clinic
Rajib Lochan Pegu, the State Minister for Water Resources accompanied by local MLA Chandan Kumar Sarkar and media persons boarded the Bongaigaon Boat Clinic on 25th June, 2012 for a nearly two hour survey of erosion affected char areas around Dogasipara, Kheluapara pt I & II, and Gaspara starting from Oudubi, under Boitamari Block PHC, Bongaigaon. The Boat Clinic team led by the DPO and the MO discussed about the functioning of the Boat Clinic and the char areas covered with the Minister and the local MLA who assured the health team of all support while conducting camps.