Friday, 2 July 2010

No Doctor, No Medicines: Only God Can Save In Kalinganagar

The Hoo tribals in Kalinganagar are akin to David facing Goliath – as they resist the goons, the state machinery, the corporate giants, a local media hell-bent on branding them as Maoists, and a national shy of reporting their struggle. Yet, these men and women fight. However, there is one sceptre they are just unable to put up a resistance against – ill health, and the consequential death. A bored villager surveyed 15 villages and found out that in the last six years alone, 188 people had died due to various illnesses. This number excludes death due to aging and those killed in the ongoing repression; the 188 deaths are of people below the age of 45. 

In the last six months alone, 14 people from just about three villages have died since there was no medical aid to reach them, neither were they allowed to leave the area. And the illnesses are not lifestyle diseases – malaria, jaundice, tuberculosis, fever have been the culprits. Or at other times, several other illnesses piled together. I headed to Baligot village to track two such deaths.

Ghanshyam Kalundia (35) died on April 16 this year. He was ill since three years – the illness began with joint and back pains. Sometime in 2009, he was taken to Cuttack for treatment by his younger brother Madan, where he was treated for 20 days. But fate had other plans for his wife Mecho, 30, who narrated her tale to me. 

“We were a joint family – our family, as well as the families of my husband's two brothers. The wives of both his brothers abandoned the family, leaving behind three more children. My brother-in-law Madan was arrested on September 14, 2009, on charges of attempt to murder for the firing that had taken place on January 2, 2006. He was to be released on bail in March this year, but soon enough, charges of arson were slapped against him, for the same incident. By then, my husband's condition had deteriorated. I managed to contact some of my relatives in a distant village and then stealthily took my husband on the bike to Cuttack. That's when the doctor said that he wouldn't survive too long, as he was suffering from T.B., kidney failure and jaundice. We spent almost Rs 50,000 in the last three years to get him treated, but had made only two visits to Cuttack. I am the only person in the house now, taking care of five children. I cannot even go to the fields leaving them – that we have lost a considerable amount of our land to the steel plants is a another story,” Mecho sighed.

Mecho Kalundia sits at home with her two children, who no more go to school

Two days prior to his death, Ghanshyam had stopped eating and talking, and was only vomitting. Mecho saw that it wouldn't take too long for her to become a widow. Today, she whiles her time in her neighbour's houses.

Further down the road is where 40-year-old Bireng Kalundia now lives with her five children – two boys aged 22 and 20, and three girls aged 18, 15 and 12. Her husband Sikander (46) was ill for a month before he died on April 9 this year. Before the repression was further tightened following the March 30, 2010 – when the tribals opposed the construction of the Common Corridor project – two relatives managed to take Sikander on a bike to a certain point on the highway, from where they hired a car to Cuttack. “Those two relatives were employees at the Jindal Steel Plant and hence they could not stay back with my husband even when the doctor insisted that he should be admitted. My sons could not even go to Cuttack as the roads were blocked; the Common Corridor is very close to this village and my sons could have been easily nabbed if they had attempted to get out of here. There was no way that I could go and be with him. They hence brought back my husband,” explained Bireng to me, through her brother-in-law Dabar, who translated her slow, halted words to me.

Bireng added that if there was someone who could have stayed back in Cuttack with her husband, he could have been saved. Their house is huge, thanks to a larger family. Her daughters shy away upon seeing me. I ask Bireng about her sons. “One of my sons had a job at the steel plant of Rohit Ferro-Tech. But since we all were a part of the protest on March 30, he was fired from the job. Today, there is no earning member in the house. We have also lost an acre of our land to the Common Corridor. There has been no sign of any compensation for it. I only have some yield from the farm. Thanks to levelling, I don't understand what will happen to us,” sighed Bireng. 

I take leave of her and utter a few words in Hoo language, to convey that she ought to be strong. She smiled back, and let out a litany of words, no more in the demure way that she talking. “This is our struggle and we will continue our fight, come what may.”

There is a whiff of strength behind the calm and sad exterior of Bireng Kalundia

As I left her house, I saw several young children lined out on the tiny patch of road, playing. Some were chasing a bicycle tyre, some were lifting worms with sticks from a pond formed thanks to the rains, some others up on the trees. I asked Dabar about the presence of a school in the village. His answer was not a short one.

“About 10 years ago, I had begun to teach some children in my own courtyard. Later, some youths from the village erected a mud house and taught the children. Two years had passed and we appealed to the authorities to send in a teacher. One was sent in, and later another. By 2007, we collected Rs 2.5 lakh from the 100 families in this village and erected a concrete structure for a school of 120 children. But the children never returned to school after the summer vacation in 2007. Neither did the teachers turn up. When our Sarpanch enquired, he was told that since all the families in this village had left the village after having accepted the rehab package by Tata for its steel plant on their land, there isn't anybody residing in the village anymore. So the teacher stopped coming. On April 29 this year, the school building we had erected was razed down by the police and the goons. We were a village of 100 families; now the figure is 80. The 20 families who have taken the rehab package from Tata are killing their own kin in various ways – they have razed down the school, they do not let the sick and ailing get treated, they are leveling our fields, and when we protest they do not shy away from using the gun which they have been forced and paid to carry,” explained Dabar. 

The children leave behind their games with stones and sticks, and are delighted to see the camera

Here are the names of the 14 deceased in the last six months. This list is not comprehensive; it is only from few of the nine villages within Chandia panchayat. These nine villages are the ones affected directly by Tata. There are 18 villages in the panchayat, with a population of over 5,000 and 2,400 voters. Gobarghati is another panchayat. I got this data from Rabi Jarika, who noted these as and when he would get information about the deaths. This list is only indicative of the number of dead from all the villages across Kalinganagar.

  1. Leena Soy (60) from Bamiagotha village – died of fever
  2. Sudarshan Samad (32) from Chandia village – died of malaria
  3. Buduni Jamunda (20) from Chandia village – died of malaria
  4. Besi Jamunda (30) from Chandia village – died during delivery; the child died after birth
  5. Sidiu Jarika (28) from Bellahori village – died of malaria and typhoid
  6. Shmabari Jarika (40) from Kankrajhar village – died of malaria
  7. A three-year-old girl from Baligot village – died of malaria
  8. Bhandai Bankira (8) from Baligot village – died of malaria
  9. Sikander Kalundia (46) from Baligot village – died of T.B., malaria, jaundice, etc.
  10. Ghanshyam Kalundia (34) from Baligot village – died of T.B., malaria, jaundice, etc.
  11. Nakoi Deogam (38) from Baligot village – died of jaundice
  12. Ladu Kalundia (60) from Baligot village – cause of death is unknown
  13. Jemma Honnaga (37) from Chandia village – several ailments together
  14. Balema Goipai (57) from Gobarghati village – cause of death is unknown

But there surely had to be a medical centre. It was impossible that the government would not try to render a facade of governance. I am told that just 500 metres after the main gate of Kalinganagar was the Dhangadi Medical Centre. It had a huge concrete gate, painted white with some red carvings. I entered the huge complex; to the right was a space for the staff quarters. To the left was a medium-sized building. I entered and saw a torn bed, with an old woman lying on it. This was the supposed waiting area of the hospital. A younger man sat next to her; he said that she was suffering from diarrhoea. I walk near her bed – there was no bedsheet on the mattress, the lady slept with her legs crouched up to her chest, and tried to cover her whole body with her thin saree. A saline drip stood next to her bed. The syringe was left open: a fly sat on it while a Band-aid was stuck on it. 

Stench, grime, bugs: this medical had it all

Paan stains had coloured the corridors. I noticed an old man; somebody told me that he had fractured his leg but had nowhere to go. He lived in the premises of the hospital. I walked further through the gloomy, stinky corridor to see the ward. The coir was falling off through the torn mattresses; saline drips stood next to these empty beds. One journalist – whose stories about the struggle of the people of Kalinganagar were no more accepted by his newspaper, and had hence opened a photocopy store near the medical centre – told me that the medical centre was empty as no patient would visit there. “There are no doctors here. Just one medical in-charge, who sits in the OPD till 12 noon and doesn't wait a minute more even if there are patients lined outside. He runs to his private clinic which he operates from his quarters. He just holds a post-graduate degree in Medicine, but he handles all sorts of cases because there is no other doctor here. He will check a patient coming in, and will promptly refer him to Cuttack.”

I saw the game myself. I was visiting the medical centre after lunch and while strolling through, one man was brought in. I couldn't believe my eyes – all I saw was a skeleton covered with a thin layer of skin. The man was accompanied by his parents who were too old to hold their 35-year-old son. I learnt that they had come from nearby Jakhpura village, along with a cousin who was dressed rather well. I had seen images of malnutritioned children from Africa, but never anything like this. I stood by, looking at him. His eyes, cheekbones and jaws were popping out. His nails were black. Every joint in his body stood out from the thin vest that hung on his body. I could count his ribs. He yelled out that he stomach was paining. His mother laid out a rug and held her son gently to lay him down on it. His feet were swollen, and so was his stomach. The cousin told me that he had stopped eating since five days, but was ill since 6 months.

Will he survive?

The doctor rushed in and cold metal of the stethoscope hurt the patient. He was screaming; the doctor hit the stomach several times to gauge what was wrong. The next moment shook me – the doctor pulled the patient from his thin arms like he would yank a log of wood towards him. This young man of 35 yelled. After he was done with checking his respiration on his back with the stethoscope, the doctor let loose the man. His shoulder hit the hard mattress.

The doctor ruffled the medical papers that the cousin handed to him. He summoned the cousin and said that the patient should be taken to Cuttack. I later bumped into the doctor. He said, “Severe anaemia. Hypoglycemia. Renal failure. Jaundice. T.B.” I asked the cousin what was to be done next. “Five days ago, we gave up. We knew that death was near anytime now. But his parents insisted on bringing him here since he suddenly was having diarhoea.”

“So you will take him to Cuttack now?” I asked.

“I don't know if that would help. The doctor could administer some fluids to hydrate him, but he didn't. His parents still believe that their only son will be fine,” he said. I remember how the man's mother smiled back at me innocently when I was standing next to her son. 

I walked out with a heavy heart and headed to the administration office on the top floor. It was spartan clean. On the wall was a huge board mentioning the various 'health days'. There were about 30 dates; but none on malnutrition. I walked back down to the medical centre. I though I had seen enough, but more was to come.

A beautiful lie

I met Mena Mohanty who was an 'Asha Madam'. The Orissa state government had roped in midwives from villages to be Asha Madams who would be responsible for all the pregnant women in the village. She was responsible for bringing in the women in labour to medical centres. On doing so, she would receive Rs 250. “So you must be travelling to other villages too, to see if there are more pregnant women..” I ask Mena didi. She smiled widely to reveal her paan-stained teeth. “I am responsible only for the women in my village. In a year, there are just about 10 pregnancies. So I can earn only that much,” she replied. Mena didi said that she had been working as a midwife in her village since 30 years and was an expert in her work.

She was more than happy to show me the labour room. There were two steel tables for the women in labour to lie on. On one of its edge was a huge dirty bin, which I assumed was to let the blood flow out of the bleeding woman. Across the tables was a concrete slab and a basin. I walked up to it. On a kidney tray were several forceps and scissors. And a string, with a curved needle. I asked her what was it. “This is the needle and the string used to stitch up the vagina of the woman after the delivery.”

I was shocked that it lay in the open. “Aren't these instruments sterilised?” I asked.

Mena Mohanty shows me the labour room; the kidney tray is full of instruments which are far from clean, let alone sterilised

“Of course they are. Look at that machine for sterilising. When a woman comes in, and as she is prepared for labour, it is during that time that these instruments are sterilised. There is no point in sterilising them well in advance as there is no place to keep them clean.”

Just at that moment, a petite woman in labour walked in with two other women. I stepped out. She was somehow made to jump up onto the high table. She cried in pain. I stood in a corner with Mena didi. “That lady in the blue saree is the Asha Madam for that pregnant woman. This lady in red and white saree is the sweeper. She does most of the deliveries.” I looked at her in disbelief.

A nurse in a white saree walked in. She looked at me and I somehow managed to convince her to let me see the process of the birth of a child. Mena didi chipped in to say something in Oriya, after which the nurse relaxed a bit and they all laughed. Few minutes later, another tribal woman walked in with a packet full of small vials of liquids, gloves, sanitary napkins sold loose, syringes and IV administration sets. The entire pack costed Rs 500.

While the nurse injected some antibiotics into the saline, the sweeper inserted a pipe into the pregnant woman's vagina – she wore no gloves. Much liquid passed out. The nurse went away. Mena didi walked upto the patient – her name was Phula Mahakud was from Siyaria village, 1.5 km away – and showed her how to hold up her legs. Phula cried out. The other Asha Madam – who was much younger than Mena didi – just followed Mena didi's instructions. The sweeper called out to the woman accompanying the patient for some cloth. She passed on to her a moist rag stained with blood – I realised this was the cloth that must have been used during the menstrual cycle. The rag was slid under Phula behind, while she began to bleed slowly. Mena didi kept on urging her to pull her legs towards her chest. Phula cried on while she held the other Asha Madam's hand tight. Five minutes later, the head was visible. The nurse walked in languidly. She wore her gloves and an apron. Slowly she pulled out the child – it wasn't crying. The sweeper passed on a porcelain tray and the nurse kept the minute-old child on it with a thud. The child's eyes were shut but it was breathing. Phula's stomach had slumped down while she was breathing heavily. 

A new life

Meanwhile, the sweeper began to cut the umbilical cord in the middle. Blood splashed out in all directions, and my feet was covered with that red which had nourished the child for 9 months. Mena didi called me next to her, near the basin where she was washing her hands. There was no soap nearby. Before I could protest, she took one of the sanitary napkins and wiped the blood from my feet. I saw the child on that tray, who was being pumped by the nurse. All was not well. The nurse yelled at me to get out of the room as the doctor would be coming in. I thanked Mena didi and ran out. It was a weird feeling – amid the poverty, amid the loss of hope in the most unhygienic conditions, amid the lack of basic facilities, God's creation in the highest form was born. 

The doctor did not go into the labour room till a long time, but I later learnt that both the mother and child were doing fine and were sent home. I went Rabi's home that evening before sunset with a heavy heart. But the day was not to end so soon. I heard that a baby goat had died during the day. I went to see it inside the dark stable. Its face was very tiny but the stomach was huge. A small girl working at Rabi's house began to pull it. I stepped out immediately.

“Was it ill? How did it die?” I asked, trying to sound not too prying at such a time of grief.

But Rabi's sister-in-law only laughed. “Would you believe it – the goat ate hay all evening yesterday. By late night, it began to groan weirdly. We saw that its stomach was enlarged but how could we take it to the doctor? The night passed and late in the morning, it passed away.”

Sometime later, I saw that the goat was butchered and the meat ready for distribution, while a girl fanned off the insects that could crawl in with a branch of leaves. In a tub nearby lay the transparent bloated intestine. In the land of the poor and the hungry, a goat died of overeating. For a moment I felt we were in a 'developed' nation.

Glimpse of a developed country

7 comments:

  1. disturbing realities...what a shame that we still call ourselves a democratic nation where every citizen has a right to equality...or should we say that the democracy has died over the years as the state kept boasting about growth, development, prosperity and what not...when will all this come to an end...how many more lives will need to be sacrificed??????????
    very well written Priyanka...keep it up.

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  2. “The Hoo tribals in Kalinganagar are akin to David facing Goliath – as they resist the goons, the state machinery, the corporate giants, a local media hell-bent on branding them as Maoists, and a national shy of reporting their struggle. Yet, these men and women fight. However, there is one sceptre they are just unable to put up a resistance against – ill health, and the consequential death.”
    It is true that the tribals of Kalinganagar are continuously facing a fight for their survival and their existence. But it is also true that their struggle is rendered a lot difficult by the fact that these innocent people are being exploited by several other communities and interest groups who are just misleading them and using them for their own benefits.
    Has anyone really wondered in what way we, the so-called well-wishers of these people are responsible in aggravating their problems? Why are they are really unable to put up a resistance against ill health, and consequential death when it is an actual fact that several attempts are being taken to improve the healthcare facilities in the State? Is it the fear of local, agitation creators, who are nothing but goons in disguise? Is it lack of education? Or is somewhat due to us, and our urbane stylish contributions in blogs that lead these people astray. Some of the posts give an entirely lopsided, somewhat unfair and one-eyed perspective to the real happenings at Kalinganagar.
    People who claim to be friends of the villagers should help them to grow and survive peacefully and with dignity instead of discouraging them with incorrect information. What we are afraid of loosing? We are the poorest of the poor. It would be great if we can have collective effort to help them grow, get education and provide them a better lifestyle.
    When I visited Kalinganagar I had an open mind and I may as well add that I have collected information that goes on to prove the kind of dedicated efforts that are being taken at places to improve the condition of the villagers. Others need to know these facts and weigh it against some of the other things that are said.
    Significant Healthcare Initiatives that have been implemented by a respected Corporate House -
    1) Medical cover for project affected people and 100% immunisation for children.
    2) Treatment of critical cases at a hospital at Bhubaneswar, absolutely free of cost.
    3) Ensuring 100% institutionalized delivery. Health of every child below six years is constantly monitored.
    4) Regular health clinics and medical counseling sessions.
    5) Concrete steps to eliminate malaria completely.
    The State Health and Family Welfare Department of Orissa too is trying every measure to ensure adequate health care services to the people in line with the National Health Policy. New steps are being implemented on a regular basis to bring improvement in the existing healthcare system in the State.

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  3. Few significant and successful measures:
    Hospital at Gobarghati: About 10,000 people in the Vicinity will be Benefited: Information collected from trusted sources: The hospital building is under construction on a land of 4 acres. When completed it would have round-the-clock service, pathology lab and outdoor complex. Initially it would have 8 beds and in phase-wise manner the number of beds in the hospital would increase to 200. Also to begin with, the hospital would have 4 to 5 doctors and required number of para-medical staff. Apart from members of Kalinganagar project affected families, the hospital would cater to around 10,000 people from the nearby villages. Various health services related activities like, rural health check-up programmes, emergency health camps during epidemics and awareness building activities for people on health issues would also be planned through the hospital.
    Healthcare Programme in Tribal Residential Schools: Several children in the rural and tribal areas of the state are found malnourished due to a number of factors. In the Kalinganagar area a specific programme has taken up five tribal residential schools under the school healthcare programme with the objective of taking care of children through regular health check-ups and free medicines distribution. Corporate doctors along with trained para-medical staff visit each of the schools once a month for this purpose. Besides, students in the tribal residential schools are also taught about basic healthcare and hygiene.
    Attaining Zero Infant Mortality Rate: During the antenatal period a minimum of three antenatal checkups are done by O&G specialist with additional one checkup during the last 15 days of EDD is ensured in most of the cases. Two doses of TT, 100 tablets of IFA tablets and calcium tablets each are given. Hemoglobin levels, blood grouping and typing are done on a routine basis. In case of detection of anemia additional IFA tablets and nutritional advices are given. In case of any anticipation of complication ultra sonography is carried out with the advice of O&G specialist. As most of the displaced families belong to the tribal communities and literacy levels are low additional care is taken to remind them about their EDD (expected date of delivery) 15 days before the EDD to facilitate institutional delivery in time.
    Therefore it is high time that people who are actually affected be made aware of the facilities and benefits that are being arranged especially for them. It is the only way that they will be able to come out of the problems that they have endured for a long time. Let us be more responsible in our blog posts than what some people have been in recent times.

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  4. I'm not sure how much longer I can continue reading your articles. These exposés are now beginning to induce a deep sense of nausea accompanied by even a stronger sense of anger at the ‘Greedy Goons & Co.” of Orissa. It is about time some kind of action is taken, say an appeal, a petition, anything that could give these plundered and downtrodden their due birthrights. -SR

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  5. "One journalist, whose stories on Kalnganagar were no longer accepted by his newspaper" ... for me, this one line says it all.

    I continue to follow this blog some of your work is going to be mandatory readi8ng for my studets of journalism.

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  6. Riki, couple of queries and clarifications:
    1. Please define the 'other communities and misleading groups'
    2. You are constantly contradicting your own self, so I really cannot help it.
    3. Your words about the hospital are in the future tense. Let's wait and watch for that future to come by. This was promised even 60 years ago - nothing has changed yet. When there are no gloves in the hospital, then do not even talk about things like 'outdoor complex'. Please get your priorities right.
    4. "Corporate doctors along with trained para-medical staff visit each of the schools once a month for this purpose." MY dear friend, schools have been razed down.

    I guess you need to go to Kalinganagar either once more, or perhaps you need to open your eyes really wide.

    SR, umpteen number of petitions have been written. It is about time the middle class does something more - it should WAKE UP AND SMELL THE FASCISM!

    Scorpio and Mamata, thanks for the kind words. Please feel free to circulate the mails around.

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  7. @priyanka : its not HOO , by the way it is HO tribe .

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