Every year, millions of people are displaced and extensive property, crops and livestock are destroyed in annual floods in Assam. Health problems are acute. Many are affected by water-borne diseases. A major problem is access to medicines and sustained health care. Periodic devastating floods and consequent erosion has not just reduced or degraded the amount of available arable land, but also resulted in large scale destruction of infrastructure. This year’s floods destroyed lives, property and agricultural produce, and brought about pest epidemics which have further lessened production. People living on the Brahmaputra islands or the chars are especially vulnerable to annual floods.
C-NES has been providing health care services to the island communities at their door steps through its innovative Boat Clinic services since 2008 in 13 districts of Assam with a total of 15 units in association with NHM, Govt. of Assam. It covers a population of about 3 lakh in 373 char villages under 25 BPHCs. Apart from its regular scheduled health camps, Boat Clinics are also involved in emergency situations such as rescue operation, relief distribution to treatment and extending cooperation to the administration to help the needy as an when required. Through its regular awareness generation programmes, Boat Clinic teams always stresses upon preventive measures to be taken at personal, family and community level to protect themselves from communicable as well as non-communicable diseases and also about the do’s and don’ts to be followed during and post floods
Like earlier years, C-NES’ 15 Boat Clinic units put in their best efforts while providing health care services to the marooned people in the chars or in the make shift camps initiated by the district administration. Many units were unable to provide services immediately during floods especially in Upper Assam as the Brahmaputra is more turbulent in this region and the district administrations put a ban on ferry movement till the river subsided to safety levels. Post floods is very crucial as diseases become more prevalent especially water borne diseases. While conducting the health camps among the flood affected community, the boat clinic teams distributed halogen tablets as water purifier and ORS/Zinc tablets for the diarrheal patients. The team also spent ample time to generate awareness on the need to drink pure water, maintain personal hygiene, preventive measures for water borne diseases and remedial measures even through street plays and holding meetings. There are plenty of challenges as it becomes difficult and even dangerous for the teams to reach the areas/villages during floods with water surging but they somehow manage to reach the people. All units continuously provided health care services till date, tirelessly.
Following are glimpses of the services provided by different Boat Clinics :
Barpeta Unit-II conducted 8 flood emergency health camps from the 5th to 14th July, 2017. Although normal camps were carried out from 3rd July but the river became suddenly turbulent and submerged the char villages. So the team could conduct health camps only on the highlands available where the boat could be anchored and people could come to the camp. The raised platforms constructed by the government were fully occupied by the local people to be used as makeshift camps, where both men and livestock took shelter together. Safe drinking water and sanitation and maintaining hygiene were the highest challenges to the people. Plastic sheets which were using as the roof became more troublesome for them when rain stopped and weather became hot. Following are some of the affected char villages where health camps were organized.
|Sl.No||Char Name||Date of Camp|
|1||Ramapara Gaon||5th July|
|2||Chapuri Pathar||6th July|
|6||Balikuri Pathar||12th July|
1) Fever- 70
2) Loose motion- 75
3) Weakness- 89
4) UTI- 8
5) Resp Tr.inf-111
6) Muscular pain-68
7) Dyspepsia- 58
8) Injury (cut) – 31
9) Skin infection (fungal, scabies, allergy) – 55
10) Eye infection- 24
11) Ear infection- 23
12) STI/- 15
13) Helmenthiasis- 19
14) Oral diseases -3
15) Demenohoreah – 1
Barpeta Unit-I conducted 13 flood emergency health camps in 14 of the worst affected char villages. After receiving the warning from the boat clinics operating upstream, the unit started generating awareness on preparedness measures to be taken by the people living in the chars for minimizing the risks and preventive health care. Officials from the DHS also accompanied the team in few such camps. The Joint Director of the Health Services and the Deputy Commissioner were regularly updated about flood situation by the team. 1085 patients were treated by the boat clinic team and the disease pattern was as follows;1. Diarrhoeal cases- 182. Dysentery- 373. Fever- 864. RTI- 1195. General Health Checkups- 8256. ORS distributed- 1260 packets7. Halogen tab distributed- 1600 .
Like previous years, this year also the Joint Director of Health Services, Dhubri and DPM, NHM Dhubri requested both the Boat Clinic units to conduct flood relief camps in some badly affected char villages of Dhubri district. Accordingly the Boat clinic unit-II Dhubri took active part in conducting both flood relief as well as heath camps under its targeted char villages.w.e.f 5-7-2017 to 22-7-2017. Five flood relief camps and 13 general health camps were conducted during these 12 days where 1085 patient were treated. Moreover, both the unit of Dhubri district jointly organized one mega awareness cum health camp with multi sectoral approach from Public Health Engineering Deptt., Veterinary, Health and family welfare and the District administration. Boat Clinic units got assistance from District Health Society in terms of medicine. Support for better coordination and effective working was received from both district administration and health society. Some glimpses from Dhubri Unit-II:
Dhubri Unit-I conducted a total of 8 flood emergency health camps from 10th July,2017 and ended on 21st July, 2017. Due to high flood situation and turbulent weather condition camps had to stopped from 13th July, 2017 to 16th July, 2017. During this period 645 patients were treated along with other regular activities. It was seen that most of the char villages were submerged under flood water.. Most of the diseases were related to exposure to contaminated water. Chalakura part-I, II and III, Pach Peer, Boldiar Alga East, Kuntir char, Birshing Part-III were covered under flood emergency health service. Some glimpses from Dhubri Boat Clinic-I:
Goalpara Boat Clinic
Goalpara Boat Clinic conducted 9 flood emergency health camps among highly flood affected areas i.e. Thailapara, Cholar char, Lotibari-I & II, Helenga, Noonkhowa-I & II and Patakata under Lakhipur BPHC. 571 patients were treated during this period along with other regular activities. It was observed that all the drinking water sources i.e. the hand pumps were submerged under flood water and sanitation was a concern. Considering the situation Boat Clinic team arranged awareness generation on water and sanitation and distributed halogen tablets for water purification and distributed ORS. Some glimpses from Goalpara:
Bongaigaon Boat Clinic
The unit conducted Relief Camp during flood from 11th to 17th august 017 for 7 days and “Post Flood Management camp” after flood from 18th to 24th August 2017 for 8 days in association with the district’s PHED and Veterinary deptt. The team conducted 13 flood medical camps during this period and most of the camps were performed in very high flood prone areas; some of these villages are in mid of the Brahmaputra river under two block PHC’s Boitmari and Srijangram. All flood camps started from morning hour before 8:00 am, where an average of 70-80 patient were treated per day for various ailments. On reaching the flood prone areas the Boat Clinic community workers announced through loudspeakers informing the people regarding various services which will be provided. The team had good coordination, support and appreciation from district and sub-divisional administration and submitted reports and photograph on daily basis. There were some measurable activities performed like general health camps, medicine distribution, awareness and counseling on flood preparedness and precautions, safe drinking water, sanitation and hygiene. ORS, Zinc and Halazone tablets were distributed.
Major Challenges Faced during Flood by Boat Clinic, Bongaigaon
- It became very difficult for us to reach the areas/villages during flood due to strong current of the river but taking all risks, we managed to reach these difficult to reach villages.
- In some islands it was difficult for us to dock the Boat as it was flooded and the banks had erosion. Country boats were used to reach homes for vaccination and ANC.
- The district administration provided additional manpower on some days but still it was difficult to serve when flood waters submerged the entire island.
- People were demanding phenyl, bleaching powder, animal fodder etc. These issues were communicated to civil SDO Abhyapuri, who immediately made arrangements for distribution among the flood affected villagers.
Flood medical relief camp during flood at Chatpara NC near Jogighopa on 16th August 2017; the whole area was under water:
Sonitpur Boat Clinic
14 flood relief camps were conducted during July 2017 in which 1773 patients (male- 646 and Female-1127) were given general health checkups along other regular camp activities i.e. ANC, PNC, RI, Laboratory investigation and health awareness etc. All camps were conducted in collaboration with district health society. Sufficient medicines and other logistics had been provided by them for each camp. Following are the details about the kind of patients treated;
- Diarrhoea- 262
- Fever- 276
- Cough- 217
- Skin infection- 186
- Worm infestation- 78
- Allergy- 99
- Scabies- 888.
- Fungal infection- 252
- Itching- 234
- General weakness- 81
Glimpses from Sonitpur Boat Clinic
Tinsukia Boat Clinic: Villages under Amarpur panchayat of Sadiya Sub Division under Tinsukia district are getting affected first by the flood in Assam as these villages are located just along the foot hills of Arunachal and all the major tributaries of Brahmaputra i.e. Siang, Dibang and Lohit flows by these villages. Due to high elevation the current of the rivers are very strong and so damages also take place within a very short of time. Erosion and sand deposition is a very common here. During floods ferry movement cannot be done here due to strong currents and timber logs which are carried by the flood waters. During the current flood Boat Clinic conducted 13 camps in all 13 flood affected villages and treated a total of 751 patients along with other regular activities normally done in health camps. Most of the diseases found were bacterial and fungal skin infections, respiratory tract infections, viral fever, diarrhea, gastrointestinal tract infections, ear and wound infections. Boat Clinic team also conducted awareness sessions on prevention of water borne diseases during and post flood period.
Lakhimpur Boat Clinic
Subansiri and Ranganadi are two major tributaries of the district and this time Lakhimpur has been the worst affected especially Nowboicha and Bihpuria block due to flash flood. Lakhimpur boat Clinic in association with District Administration, DHS and DDMA conducted health cum relief camps in worse affected areas and treated 1904 patients in 23 camps.Following diseases were found in flood time for the month July 2017.
Following diseases were found in flood time for the month July 2017
|13||Soft tissue injury||150|
Jorhat Boat Clinic
Jorhat Boat Clinic conducted 4 emergency health camps among the flood affected communities in 4 island villages from 7th to 10th July 2017. Due to heavy water current and continuous rise in water level Majuli District Administration announced ban on ferry movement until the river was calm, Boat Clinic team had to postpone its services and return to Kamalabari on 10th July, 2017. Majuli is being chronically affected by floods and erosion every year. The northern side of Majuli is mostly affected by Subansiri and Ranganadi and southern side by the Brahmaputra. The geographical area of the island is reducing considerably and has shrunk to around 400 sq km from 1250 sq km in 1950. During this flood emergency a total of 683 patients were treated in Bilotia, Huttar, Sesuguri and Kathgaon along with other regular camp activities i.e. ANC, PNC, RI, laboratory tests etc. People were mostly suffering from fever, cough, diarrhea and skin infection. Due to high water level, it was very difficult to anchor the boat and also to find out a suitable highland to conduct camps.
Nalbari Boat Clinic
Island villages in Nalbari district are highly vulnerable to erosion than flood. Many islands have disappeared due to erosion and people had to migrate to Mukaluah, Nalbari and Guwahati is search of job and shelter. During the current flood, one big char, Sahabuddin Suba nearly disappearing due to rapid erosion. People of this char as well as from others have migrated temporarily, some even permanently to the mainland, i.e. Mukalmua, Kaplabori, Keken, Chowalkhowa, Bullut, Boriliarpar, ete. Most people are staying in make shift camps initiated by the local people. Further receiving instruction from the District Health Society about conducting health camps in flood affected areas, Boat Clinic Nalbari started emergency health camps from 4th July 2017 and continued till 18th July 2017. A total of 17 health camps were conducted and a total of 1391 patients were treated. Besides health check up, other regular activities were also conducted. Most of the patients came with complain of fever, skin infection, fungal infection, RTI, diarrhea, dysentery and Helminthesis. Halogen tablets were also distributed among the affected people for water purification.
Details of patients are as follows:
|Sl. No||Date||Name of Char Villages||General Health|
|6||08-07-2017||North Soyed Ali char||76|
|8||12-07-2017||North Hanif Ali Char||68|
Dhemaji : Boat Clinic in Rescue Mission
During the recent floods in Dhemaji district, residents of few river islands locally called sapories were trapped in their homes due to sudden surge and rise of water level in the Lali, a tributary of the Brahmaputra. The Dhemaji Boat Clinic swung into action were and successfully rescued them supported by a Jonai based organization, Mising Mimag Kebang (MMK) and local authorities. On 11th of August 2017, at 12.15 P.M, after consulting C-NES’ Programme Management Unit at Guwahati and informing the Joint Director, Dhemaji and District Programme Manager, National Health Mission, a team of 10 members went to the following sapories: Badalpur Barman, Kangkan, Lamba Missing, Lamba Millon, Apsara and Chengajan Koibatra and began the rescue operation. 518 people were rescued before dusk. The Boat reached Majorbari Ghat at 5.30 P.M. The rescued people were shifted to Somkong high School for further care. Again during the first wave of floods in Lakhimpur district with Subansiri and Ranganadi the two major tributaries overflowing the Lakhimpur Boat Clinic in association with District Administration, DHS and DDMA conducted health cum relief camps in worse affected areas and treated 1904 patients in 23 camps.
Apart from regular scheduled health camps, C-NES’ Boat Clinics are also involved in emergency situations such as rescue operation, relief distribution, treatment and extending cooperation to the administration to help the needy dwelling in the Brahmaputra River Islands as and when required. Like earlier years, the 15 Boat Clinic units put in their best efforts while providing health care services to the marooned people in the river islands or in the make shift camps initiated by the district administration. Many units were unable to provide services immediately during floods especially in Upper Assam as the Brahmaputra is more turbulent here and the district administrations put a ban on ferry movement till the river subsided to safety levels. Post floods is very crucial as diseases become more prevalent especially water borne diseases. All units have been continuously provided health care services, tirelessly, till date.
It needs mention that through its regular awareness generation programmes, Boat Clinic teams always stress upon preventive measures to be taken for protection against communicable or non communicable diseases along with imparting lessons on the do’s and don’ts to be followed during floods, post floods or any such disaster situations. Such a holistic effort has contributed to minimizing risks to lives of people.