Sombari Hemrom gave birth to a premature baby boy in June 2010, in Kalaimuri village that comes under Salboni block in the Maoist-affected West Medinipur district of Bengal. “I thought I will die, my baby will die. Timely intervention from the doctor and nurse at the makeshift health centre in my village saved both of us,” says the thankful 27-year-old.
It’s another matter that the said health centre’s “doctor” was a quack and the “nurse”, an untrained attendant. “The people’s war started in this region around 2007-08 and built up in 2009-10. Government officials, including the health department staff, fled the area fearing for their lives. There was no one left to run the government offices, schools and health centres,” says Aarti Mahato, 55 of Kalaimuri village.
“Even otherwise, health facilities existed in name only. Neither the doctors nor nurses made regular appearances at the primary health clinics or the health sub-centres. Only a compounder could be seen sometimes selling medicines, meant for free distribution, to the villagers,” adds Pradyut Mahato, a member of the Maoist-backed People’s Committee Against Police Atrocities (PCPA).
West Medinipur, also known as West Midnapore, is one of the most backward areas of West Bengal and lack of development and basic amenities is often cited as the primary reason for the people’s uprising in the district.
For example, Salboni block, under which Kalaimuri village falls, has a population of about 165,000. For these rural residents, the state government has provided one hospital and just three primary health centres. There is one central government health undertaking and one privately run nursing home. Total number of beds under the block is 79 while there are only 12 attending doctors, according to the 2007 figures given on the district administration’s website.
“It’s wrong to say that the Maoist movement hampered health facilities in the district. They were negligible in any case,” says Mahato, adding, “The PCPA, in fact, started its own health centres to help the rural people and to distribute free medicines. We used the village women to run the centres.”
This is where the unqualified “doctors” and untrained “nurses” came into being. “The situation was terrible. Many of our men and women joined the movement voluntarily while others were forced to do so at gunpoint. In any case there was no work to be found. Our children could not go to school and there was hardly any food in the house. But worst of all, there was no one to care for pregnant women, deliver babies or even treat a snake bite. So I agreed to be a health attendant when the PCPA asked me,” says Aarti, who along with two other women took up nursing duties in her village.
The PCPA set up about 25-30 medical centres during 2009-10 in different villages under Salboni, Lalgarh, Medinipur and Jhargram. Local doctors and nursing attendants either served in these camps voluntarily or were forced to do so at gunpoint. Several untrained people were also asked to chip in. Each of these centres catered to about 100-150 patients daily.
“Money was at a premium. People had no food to eat. Ration shops were closed and there was no agriculture produce. The Maoists extorted Rs 10-20 and a kilo of rice from every household that could afford it. The family was often left with nothing. Malnutrition became one of the primary health concerns,” points out Jyotsna Tudu, 25, a trained nurse in Lalgarh, adding, “The PCPA had arranged for glucose and electral powder, which we distributed free of cost. But there were too many suffering and very little relief.”
In the Jangalmahal area, skin diseases like scabies are common, as is malnutrition caused due to abject poverty. “Tuberculosis and diarrhoea-related diseases also abound due to poor drinking water, bad hygiene and scanty diet. Malaria is also commonplace,” says Dr R. Dey, former block medical officer, Chandra Block, West Medinipur.
According to Dr Dey, the government tried its best to reach medical facilities to the remotest areas in the district but the threat from Maoists was too much for the government medical staff. In fact, they claimed that the health centres set up by PCPA were nothing but a front for Maoist operations. “When the joint para-military operations against the Maoists started in July 2009, the first target was the health centres started by the PCPA. The forces claimed that Maoists were given shelter here and treated. But how were we to differentiate between a common villager and a Maoist when someone came in with high fever, bouts of vomiting or a snake bite?” asks Tarulata Mahato, 38, who acted as a compounder at the health camp in Binpur.
By extending service at the PCPA-run medical camps, the poor villagers were only looking to help each other in times of adversity but even that effort had to be carried out under conditions that threatened life. “I am a trained nursing attendant. I worked at the government’s primary health clinic before the officials ran away. So, when the PCPA ordered me to work in their health camp, I agreed so that the people could avail at least some medical care. If I had refused the Maoists would have shot me,” says Kalpana Mahato, 45, of Bhulabera village.
With the para-military forces gaining ground in the insurgency-affected district, the PCPA-run medical camps have all closed down. However, the government primary health clinics, despite claims to the contrary, are not fully functional. This has caused untold suffering to a population in dire need of medical attention. “We are also being constantly harassed by the force personnel. They claim that we are Maoists just because we had worked under duress at the PCPA health centre. Was it a crime to help the people in need?” asks Krishna Mahato, 28, another trained nursing attendant.
“My daughter-in-law is six months pregnant. There is no staff at the nearest health clinic, which is 25 kilometres away. She has not seen a doctor in all these months. I am having sleepless nights worrying about her safety and the life of her unborn child,” says a frantic Srimati Mahato, 60, of Binpur.
West Bengal has a high infant mortality rate (IMR) of 35 per 1,000 live births. The state government claims to have as its priority health agenda, a reduction in the Infant Mortality Rate (IMR) and the Maternal Mortality Ratio (MMR). However, going by the experience of Srimati and her daughter-in-law, it seems unlikely that the government’s agenda would be met soon.
“The government is turning a blind eye to the needs of the people. If basic health care cannot be provided, how can one expect other infrastructural facilities? They are trying to curb this people’s movement by use of force but that’s not going to be a successful model. We realised the need of the people and tried to run the medical camps ourselves. But the government has closed them down and has not made other arrangements,” points out Mahato.
West Medinipore, with a total population of 51,93,411, as per the 2001 census, has 244 health facilities including government health clinics, rural hospitals, central government undertakings and private centres and 467 doctors. Presently, most of these health facilities are either closed or only partially operational. Of the total number of doctors supposed to be in attendance, only about 30 per cent are officially at work. There is scant access to health care for pregnant women and hardly any pre-natal, neo-natal or post-natal care in place.
Under these circumstances, the hapless people living in this conflict-ridden region have no option but to live with insufficient food, poor sanitation and illnesses. Their health has become a casualty of conflict. This is unacceptable and help must urgently reach them.