By the Brahmaputra (October – December 2015)
By the Brahmaputra (Vol: 32)
C-NES Newsletter
(For the Quarter October – December 2015)
Editorial / By the Brahmaputra
The Man on the Highway
The man lay crumpled on the highway, wearing a brown jacket and dark trousers. A checked handkerchief was next to his knee and he looked as if he was sleeping. Was he drunk? I wondered. in my mind, that moment remains frozen in time. We had just passed Amoni on the national highway between Nogaon and Guwahati on a crisp January morning. I can still imagine it vividly: the ‘line’ bus waiting on the right side of the road. A few white Tata mini-trucks on the left, at the top of a lane that went into the countryside. And a couple of men had started to move as the vehicle in which I was traveling sped by.
I had looked up after sending off an SMS where this scene appeared before me. What had happened? I asked the driver. There’s been an accident, he said. But what and where? I couldn’t see any other vehicle and felt terrible for having thought that the accident victim had been drunk. But where was the maut ka saudagar? The driver then told the story: the man had got off the bus and was walking across the road when a speeding motorbike with two men on it came screaming down the highway. The bike hit the man, who collapsed on the spot, careened off the road to the right and fell into a ditch with both riders. Neither man was wearing a helmet.
All this happened in the flash of a few seconds between the time I had my head down writing a brief SMS, sending it and then looking up to see the man sprawled on the ground. The driver said the victim had been ambling across the road without looking either side. The suddenness and finality of the event shook me. But forget who was to blame. It was not till much later than I got my swirl of thoughts under some control. That’s when the obvious question confronted me: why hadn’t I thought of calling 108, the emergency service? This was especially painful since I work in the health sector in Assam, an organization I founded (www.c-nes.org) helps run a boat clinic initiative over 13 districts that reaches three lakh people with regular health care, battling the deadly twins of high Maternal Mortality Ratio and Infant Mortality Ratio on the islands of the Brahmaputra.
Yet, as a first responder, I was a total failure. How many of us react in this manner? Was I more intent on reaching my destination and getting to my meetings? I have thought about this and have come to the conclusion that this was not the case. It was a matter of not being focused on what should be done and not going over what happened and the possible scenarios as they played out.
I recalled researching the scale of accidents in Assam a few years ago and was appalled at the number of incidents. That was before the four-lane highway between Guwahati and Nogaon and beyond became fully operational. This is what is touted as the AH 1 (Asian Highway 1) that is part of the Look East/Act East Policy of the past and present Central governments. New money means new vehicles, both the two-wheel and the four-wheel kind, of Indian make and international. Young people especially are getting a thrill out of speeding on city roads and highways, revving their engines and racing as if they were living a scene out of The Fast and the Furious or as if there was no tomorrow.
For some, there isn’t.
What’s needed are more rapid responders on land, more 108s at the ready in highway patches which are known to been especially dangerous. But apart from that, we have to embrace safety as a first principle – for ourselves and for each other. Thus, every rider of a motorized two-wheel vehicle should wear a helmet. It’s a law. It’s also about self-protection. We need highway patrols, hiding behind frees or in gullies next to the highway, to chase down those who are not. Insist on seat belts.
When I’m traveling in Assam and the North-east, I make it a point to tell those who drive cars or who are in the front passenger’s seat to put their seat belts on, if they haven’t done so within minutes of boarding the vehicle. Most drivers are smart and follow the law because they know what would happen if they were caught breaking traffic rules: they could lose their licenses or be forced to pay a fat fine or a large bribe or all of these. I find this is true across India and am glad to see some positive changes in driving attitudes in our region as well.
But to save lives on the highways we need to go much further.
A few years ago, a news report on the busiest highway in Assam and arguably of the region, said that not less than 5,742 persons were killed in 11,000 accidents in 10 years. Or more than 500 persons per year.
Around the same time, the then state transport minister Chandan Brahma said in a statement that “drunken driven, road conditions, haphazard parking of vehicles on the road, violation of traffic rules, overloading of vehicles, lack of awareness among pedestrians, lack of zebra crossings and mechanical failure” were some of the “main reasons” for the accident. He hardly left out any factor behind an accident.
Buses and trucks drive at breakneck speed, challenging and racing each other; smaller vehicles are no less; some get smashed trying to stay out of the mayhem. The super highway coming up by the side of the old road has marked the price of its creation from time to time: it wounds me to see the stumps of hundreds of magnificent old flowering Krishna sura, groves of banana, areca nut and bamboo trees, piled up by the side of the road, lying mutely in their destruction. No one seems bothered. That’s what really hurts.
At a time when global warming is one of the greatest challenges facing our planet, here we are going about destroying the resources that protect our earth and our own patch of it. Every state is developing a Climate Change Action, Mitigation and Adaptation plan. Surely, growing more trees is part of the strategy, not destroying the resources we have.
All of us are familiar with the counter-argument – it’s a price we pay for development. I don’t think so. I think that we can manage pretty well and connect to each other, to the rest of India and to South-east Asia with well-built and well-maintained two lane highways in the hills and the existing four-lanes in the plains areas of Assam. The promise that Atal Bihari Vajpayee made over a decade ago to build four-lane highways in the hills overlooked one thing: the Patkai hills and the Eastern Himalaya are not the hills and vales of Europe and England. They are much more fragile.
Apart from that, we should not forget that roads and other infrastructure in our largest eastern neighbor, Myanmar, are far worse than in our own region. So where will our four-lanes, when built, lead us, if there isn’t seamless asymmetry across the border? It would save huge financial investment, reduce the harm to our forests and green cover and improve life on our planet, even a little.
Sanjoy Hazarika
Managing Trustee
(From his regular column in the Assam Tribune published on 3rd February 2016)
Italian Pathologist Visits Boat Clinics
Dr.Livia Bellina, a Pathologist from Italy, visited the Boat Clinic units of Kamrup, Dibrugarh and Dhubri district in September 2015. She has been following the C-NES website over the past 2 years till she was convinced that she must see this initiative for herself. From Palermo in South Italy, Dr Bellina has been working for Italy’s National Health System since 1987. She founded the Mobile Diagnosis, a not for profit association aimed at sharing knowledge and providing diagnostic support to health workers worldwide, by using mobile phone technology. Her constant endevour has been to see and solve local problems with appropriate, frugal, solutions for bridging the technological and educational gap.
Since 2009 she has been travelling and sharing her method in several rural underserved and poor villages of developing countries in Uganda, Bangladesh, Afghanistan, Madagascar, Democratic Republic of Congo and Thailand bordering Myanmar. In 2010 she visited Bangladesh, when she was invited by Professor Muhammad Yunus, the founder of the Nobel Peace Prize Winning Grameen Bank where she showed the feasibility of the MD Method for a low cost tele-transmission of images from rural to the central head quarter at Dhaka. In 2013 and 2014 during her time in Thailand, the Oxford-Mahidol University invited her to teach the staff at Shoklo Malaria Research Unit Staff working in the Karen refugee camps on Burma-Thai border.
During her stay at Guwahati she delivered a lecture and made a presentation at the National Health Mission (NHM), Assam and at the Department of Pathology, Guwahati Medical College where there was keen observation by the students on her methods along with an interactive session. She conducted trainings and demonstrations on her concept of mobile diagnosis on-board the vessels in the Boat Clinic laboratories. Techniques such as preparing and focussing on slides using the microscope, examination of slides and capturing of the exact image through a smart phone camera for diagnosis were demonstrated. Visiting, teaching and interacting with the teams and beneficiaries at health camps in Dibrugarh, Kamrup and Dhubri districts she observed how the dedicated health teams took health and healing to the many inhabitants, poor and marginalized living in the remote Brahmaputra river islands, carrying medicines and camp essentials for miles into interior villages beating hostile weather conditions. She was amazed at the perfect synchronization and harmony of the teams and their efficient operation with not a minute wasted. Apprehensive about the high rate of skin infection like scabies and worm infestation due to contaminated water she provided a few precaution tips. At all the field visits she interacted with the patients and villagers attending the health camps. She also provided tips to Medical Officers on medication and preventive health, minutely observing each and every component of the health camp activities. Interacting with Medical Officers, ANMs, Pharmacist and laboratory technician she appreciated the activities they performed. After observing the camps she said that regularly exposed to mud, soil and contaminated water, parasites may infect not only the villagers but also the Boat Clinic team members causing worm infestation, scabies, other skin diseases and so necessary precautions needed to be taken. Pregnant women may be more at risk. She stressed on ensuring purity of water and so chlorination of drinking water was essential along with encouraging people to buy modern water filters as almost all the drinking water sources in the river island villages are contaminated. She was impressed with the work of the Boat Clinics.
She is an experienced teacher with excellent networking and communication skills. Over the years she has developed good competence in establishing motivated teams and working groups. She has established a good human relation with patients, as well as students, teams and colleagues, as documented by several letters from her students in Bangladesh and elsewhere. Her constant endevour has been to see and solve local problems with appropriate, frugal , solutions for bridging the technological and educational gap. In 2011the World Health Orgaization published her work “ Mobilephone image transmission for diagnosis. The same year she was selected as one of the top 30 finalists of the Ashoka Challenge Global health Innovators 2011
She is now in her Mission Journey to India, from here she will travel onwards to Nepal to share her methodology and to do a training to local work force. Her goal remains the same: applying the Mobile Diagnosis Method together with social entrepreneurship education, to improve rural development and community life.
CRM team visits Dibrugarh Boat Clinic
A nine member CRM team visited the Dibrugarh Boat Clinic unit. The team consisted of Dr. Partho Jyoti Gogoi, Regional Director MH&FW, Guwahati, Mr.Atul Basumutary, Director DoNER , SumitPriyadarshi, Asst.Adv (PHE) Ministry of DWS, Dr.Narayan Gaonkar, UNICEF, Dr.PR Sodani, Prof. PH& Health Eco. IIHMR, Ms.Seema Upadhyay, Program Manager, PFI, Dr. Ashish Banerjee, MH,Mr.Arindam Saha, State Facilitator Tripura, RRC-NE and Dr.R.K.Lakhani, consultant NHM, MoHFW. The team was assisted by state, district, block health and NHM officials. C-NES Programme Manager Ashok Rao was present. The water level of the river near Maijan Ghat, Dibrugarh had receded and the boat had to be docked at Balijan ghat which is almost 40 kms from town. There were 8 vehicles carrying the team. The 1st vehicle, a Bolero made it through the stream but two other vehicles which followed got stuck in the mud and had to be pushed out by the people around, assisted by few members of the CRM team.
The team members on reaching the Boat Clinic was welcomed by the staff with traditional Assamese hand woven towels called “Gamochas”. After the health team was introduced, Dr. B.C. Borah, MO, Boat Clinic made a presentation on the Dibrugarh Boat Clinic which was followed by interactions and questions by the members. The Program Manager assisted Dr.Borah.
The members were interested to know about the services being provided, the difficulties faced, funding system of BC, livelihood, education, drinking water, solar lighting etc. and steps taken by the villagers during floods.
The health camp was arranged at Sarisuti Sapori. It took around 1hr 20 minutes to reach the island after which the team had to walk through paddy fields before reaching the LP school ground where the Community Workers and Boat crew members immediately pitched the tent. The 2 ASHA workers attired in uniforms and patients were eagerly waiting for the team. The members of the team interacted with the patients and villagers and observed the working of different sections in the camp. They were impressed to see the systematic way the camp was set up and appreciated the manner in which the laboratory investigations were done, the way the pharmacist explained to the patients while dispensing the drugs prescribed by the doctors. On the whole the CRM team was happy to see the uniqueness of the concept and applauded the dedicated service provided to the difficult to reach island communities.
Visitors to Kamrup Boat Clinic
Accompanied by C-NES Programme Manager Ashok Rao and Technical Consultant Dr C R Hira, Dr.Anuj Kapilashrami, Faculty, University of Edinburgh, UK and Director for Global Health and Public Policy along with Prof. Ramila Bisht, Associate Professor at JNU and Dr.Sunil Deepak Head, Mobility India (North East) which works in the disability, development and rehabilitation sector, visited a health camp at Kamrup on 25th November 2015. Dr. Kapilashrami’s area of interest lies in public-private mix models and their potential for achieving universal coverage and access. Prof. Bisht and Dr.Kapilashrami were keen to document and better understand the organisation and delivery of models such as the Boat Clinics that are being implemented to expand coverage and reach out to remote and geographically isolated populations in the north eastern states. The health camp was held at Dureduba char which took around an hour to reach. As the village was near the bank the camp was arranged in the courtyard of the nearest house where there were 92 general check-ups, 10 ANCs and 15 RI s conducted. Dr.Deepak suggested initiating a pilot project between C-NES and Mobility India (in one district initially) to do a survey and analysis on incidences and detection of the disabled for which his organization would provide training. Appreciating the program, Dr.Anuj expressed her interest of sending her students for internship to C-NES.
Australian visitors at Radio Brahmaputra
A seven member team from Australia were at Dibrugarh on 29th November 2015 to visit C-NES’ Community Radio Station, Radio Brahmaputra, a platform for marginalized communities to raise issues of their concerns and the Boat Clinic Akha operating in the Dibrugarh river islands. Led by John Zubrzycki, an award-winning journalist whose long association with India has included stints as a Hindi student, diplomat, consultant and foreign correspondent besides authoring two books on India, the team which included teachers, photojournalists and health professionals, was humbled by the river, by the work done by the dedicated health team. Welcomed with gamochas by C-NES’ lady reporters and nurses at the office, Bhaswati Goswami, Communications Officer who accompanied the team presented a background of C-NES’ work including the Boat Clinics and the Radio Station. Bhaskar Bhuyan, coordinator of the station and Medical Officer Dr B Borah made presentations on the BCRS and Boat Clinic programmes at Dibrugarh respectively. Bhaswati Goswami took a short interview of John Zybrisky at the studio where he highly appreciated the work done. The team donated a cheque of Rs 56,580 to the Radio Station. The visitors were given a ride in Boat Clinic Akha where they interacted with the health team Each of the seven members wrote beautiful comments on the visitors book.
Team from Singapore National University
A team from the National University of Singapore visited Dibrugarh, Tinsukia and Dhemaji from the 4th December 2015 to conduct a study on the Brahmaputra and see the work done by C-NES. ManikBoruah, Associate Programme Manager,C-NES accompanied the team. Field visits were made to finalize sites to conduct survey and to meet local people, officials and academicians. The team visitedRohmoria, the most erosion prone area and Bali Chapori in Dibrugarh; Guijan in Tinsukia and Rekhachapori and Laxmishuti Bodo in Dhemaji District. On 6th December they visited Bali Chapori with community worker Ramakant Yadav and spent the day there to study the geomorphological character of the river. The team visited C-NES’ Community Radio station at Dibrugarh and interacted with the radio team, appreciating the programmes and activities of BCRS.
Journalists from UK at health camps
Journalists Catherine and John Davidson visited health camps to document health status of women living in the islands of mighty Brahmaputra River at Morigaon and Jorhat districts on 30th October and 31stOctober 2015 respectively. At Morigaon they visited Meetmari char village along with the health team and interacted with team members and villagers visiting them in their homes. They visited Jorhat’sBhekeli sapori village focussing more on anemia and anaemic women in the island village. During the health camp, they interacted with the villagers and Asha Bina Pegu and asked questions such as ‘Is there any health services at the village beyond Boat Clinic?’ ‘What do you think about Boat Clinic, is it beneficial?’ ‘Can you remember the first day of health camp of Boat Clinic at 2no Bhekeli sapori?’ ‘Is there any changes you have seen at the village?’ ‘How many children do you have?’ ‘Do you adopt family planning method?’
Villagers responded to their questions and said that they benefitted a lot from the health services provided by Boat Clinic. They also said that it is the only health service that comes to the village every month and has made people aware about the need for timely health check ups including ANC check ups, immunization, importance and need for institutional delivery and family planning methods.
Workshop on National Forest Policy
Indian Institute of Forest Management (IIFM) Bhopal in association with the Ministry of Environment & Forests (MoEF), Govt. of India and United Nations Development Programme (UNDP) organized a two day Regional Consultation Workshop for the North Eastern States and West Bengal to review the National Forest Policy 1988 at the North Eastern Hill University (Shillong) on 13th and 14th October 2015. The consultation was a part of the series of such region specific workshops to finalize the new national forest policy on the basis of the Indian Forest Policy 1988. The objective of the workshop was to set the preamble for the new forest policy and the essentials of the forest management and strategy. The workshop was able to conduct a number of group discussions and exercises to bring out the points and recommendations for the upcoming forest policy. Senior officials from the Forest Department of North Eastern States (Excluding Tripura) participated at the workshop along with representatives from the WWF, India (Assam Region); Aaranyak, Assam; Nature’s Backon; South Asian Forum for Environment (SAFE), Assam and West Bengal and C-NES.
From C-NES, Manik Boruah, Associate Programme Manager was present at the workshop and he shared issues related to forests and environment bringing in community perspectives. He spoke about the current status of poor forest coverage in Assam for which the Forest Department of Assam was broadly blamed for their failure in protecting the forests and wildlife. Encroachment, poaching, man- animal conflict, proper demarcation of forest boundaries, inter-state disputes were some of the key issues which came out as serious threaten to the forestry sector in Assam. Elephant corridors in Assam was recognized but not yet legalized by the Department.
The consultation was facilitated by Dr. G. A. Kinhal, Director, IIFM Bhopal. Dr. Anil Kumar, Additional Director General of MoEF, Govt. of India, present as the Guest of Honour expressed serious concern about the degradation of forests and environmental status in the country and stressed on the need for urgent measures to formulate strong forest policies to keep the balance of the nature as well as to make the planet earth healthy for the future generations. He was happy with the current forest coverage of the North East. The recommendations gathered through the regional consultations will be compiled and final draft policy will be presented at the national consultation workshop to be held in February 2016.
From the Field:
Awareness sessions at Dhemaji
An awareness camp on hand washing was conducted at Dhemaji’s Laxmisuti village on 13th October, 2015. The meeting at the camp site of Laxmisuti village was attended by about seventy people. Bhupen Taid, Community worker Dhemaji explained the objectives of the session. Dr. Vivek Kumar Sahu, Medical Officer, Dhemaji Boat Clinic, spoke on hand washing, demonstrating different steps of hand washing in the presence of ASHA, AWW and the staff of boat clinic Dhemaji.
Awareness sessions at Sonitpur
An awareness camp was conducted at Sonitpur’s Dubai char on family planning. DME Ms Sangeeta Das attended the meeting from district. Rasida Khatoon who had undergone LS operation few days ago and her husband were requested to share their experience with the people. She was also told to play a role model for other village women and motivate them. They were felicitated with gamosas. Family planning is given prime importance in the awareness sessions in the health camps. As a result of prolonged motivation on family planning by the team, 4 women have adopted LS as a permanent method from different chars during the month.
Bongaigaon
The Bongaigaon Boat Clinic organized an awareness camp on family planning at the KheluaparaL.P.School on 30th September 2015 with the help of Population Foundation of India (PFI). ASHAs, AWWs, local leaders, school teachers and eligible couple were the stakeholders of the programme. Various issues related to family planning was focused like methods of family planning, incentives given, advantages of a small family including better physical and mental development of the children in a small family.
Goalpara
Boat clinic Goalpara conducted an awareness programme on family planning at Noonkhuwa-II village on 18th November 2015. The local ASHAs helped in conducting the session along with the AWW, local leaders and school teachers. The target groups or stakeholders of the program were eligible couples of child bearing years. Various issues relating to family planning, incentives related, advantages of a small family, different methods of family planning- IUCD, Laparoscopy, using contraceptives were discussed. About 120 people attended the program. Medical Officer Boat Clinic Dr Eunus Salim delivered a talk on the advantages of having a small family while Dr. Arafat Abdullah spoke on usage of condoms and OCP. The community workers spoke about the importance of regular ANC checkup. ANMs from the boat clinic team tried to make the targeted women aware about IUCD and laparoscopy. Pharmacist and Lab technician also spoke about importance of family planning. All spoke in the Bhatia language, understood by the beneficiaries. Concluding the session, DPO Mitrajyoti Konwar interacted with the community and thanked them for attending the session.
Sensitization meeting at Dhubri
A sensitization meeting was held at Dhubri’s Tindubi Chalakura on 14th November 2015 at the LP school. The resource person was Abhijit Sharma, Block Programme Officer ,NHM,Dhubri . PanchayatHead Tamasuddin Ahmed was present. The introductory speech was given by Mehebub Alom Hazarika, DPO,Dhubri Unit II where he emphasised on women’s health and how a small family can lead to a healthy mother and family. Abhijit Sharma explained about the various methods of family planning. He said that if population keeps on increasing, it will increase the rate of unemployment and that with more children they cannot take proper care and will not able to give proper education to them. Medical Officer Boat Clinic Dhubri II Dr Nabokanta Das explained the methods of family planning methods and displayed the temporary devices of family planning. He said that both temporary and permanent methods are safe and can be used without any hesitation.Vicky Das, Project Assistant, PFI Project explained to the crowd about the importance of a child’s education for his/her better future that every child has right to study and play. He appreciated the parents who sent their girl child to school.
Capacity building training for ASHAs
A two day capacity building training program on family planning and reproductive health was held on 23rd and 24th of November 2015 at the ANM training centre, Bongaigaon where 13 ASHA workers, 10Anganwadi workers, 2 ANMs and 2 link workers from different char villages took part along with the Bongaigaon Boat Clinic team members. The inaugural session was attended by Dr. Abhijit Basu, Joint Director Health services, Bangaigaon and Esmita Roy , District programme officer, NHM Bongaigaon along with State Family Planning Advocacy Chandana Bora, C-NES.
Jyotirmoy Mozumder, District Community Mobilizer, NHM, Dr. C.R. Hazarika, Specialist in RTI/STI, Joydev Kole, Administrator Civil Hospital and Dinanath Goswami, District Data Manager were the resource persons. The district officials were happy to take part in the program where they got a rare opportunity to interact with health workers from remote inaccessible islands serviced by the Boat Clinic and appreciated the effort of the organization for offering such a platform.
Another two days capacity building training was organized at the NHM training hall in Barpeta district on 1st and 2nd of December 2015. Dr. Subrata Sharma, Joint Director of Health services, Barpeta,Dr.Ishaqu Saikia,district programme officer, NHM Barpeta, Tirtha Nath Sharma, Chief Medical and Hospital Officer , Chandana Bora, State Advocacy and Family Planning coordinator, C-NES and DPOs of both the Barpeta Boat Clinic units also participated in the inaugural session. 32 ASHAs, 3 ANMs from both units along with some other members from district PMU of NRHM took part in the two dayprogram.Aminul Hasan, District Media Expert, NHM and Mr. Partha Pratim Das, District Community Mobilizer, NHM were the resource persons.
The objective of the training including importance of family planning, methods, challenges and govt. facilities for family planning were discussed in details. Group discussions were also conducted on different aspects of family planning for enhancement of knowledge. The groups later made their own presentations. On the second day the role of ASHA in mobilizing community was discussed. District Community Mobilizer, NHM in the respective districts helped with the sessions.
Radio Brahmaputra: Popular Support
C-NES’ Brahmaputra Community Radio Station, popularly called Radio Brahmaputra is based at Dibrugarh, very close to where the mighty river flows by at Maijan ghat. The station is unique in the sense that it caters to the needs and aspirations of people belonging to as many as five communities residing around the area in as many local languages – Shadri (dialect of the tea tribe community), Assamese, Bhojpuri, Bodo, and Mishing. While BCRS seeks to reach the most marginalised groups in 14 islands and 30 tea plantations and more than 180 villages in Dibrugarh district, its footprint reaches across the Brahmaputra to other districts as well. Today it broadcasts for eight hours every day on FM 90.4 from Dibrugarh and can be heard in three districts along and across the Brahmaputra. Till November 2015 the station has received near about 4250 SMS’ from listeners. Some of the feedback follows :
I am a regular listener of Radio Brahmaputra and I really enjoy its programmes. I can’t explain my anguish if I miss Radio Brahmaputra even for one day. I carry my radio with me all the time while going for harvesting and day to day work in the field. I have to change the battery of my radio three times a month, which I do not mind. What a wonderful radio it is!
Sujit Nath, Silapathar, No.3 Sivnagar, Dhemaji
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Namaskar! Please accept my Pranam and also wish a very happy Durga Puja to all the members of Radio Brahmaputra. I am very fond of listening to the programmes of Radio Brahmaputra. We could learn many new things through your station, especially the programmes aired on last Sunday on the need to send children to school. There are so many parents in our society, who allow their children to work for the officials of tea garden management like bonded labourers which is very wrong indeed. Is there someone to think about the future of those poor children? I will be very happy, if Radio Brahmaputra will broadcast programmes about the adverse impact of illiteracy?
Ram Prasad Munda, Nilokh Holokhani, Silapathar, Dhemaji
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