To make that happen, the hospital workers rise with the sun. Doctor Gun makes the commute to the hospital starting at 6:30 AM from his humble home in Kolkata, about 49 Km away from Chengil. I met him there along with his affectionate wife, who is a teacher and an education advocate in Kolkata, and from there we travelled to Chengil. When he arrives at the hospital a group of dedicated women have already prepared the hospital and opened the doors. In the lobby of the building, two young women are attentively sitting opposite of incoming patients and questioning them about not just their physical ailments but also their personal lives and mental wellbeing. “Integral to our practice is the case history, in which we will record a patient’s biographical information: the languages they are comfortable in, their physical ailments, their mental health, previous treatments received, family conditions and socioeconomic conditions. This way we can understand what treatments and services the patient will be able to afford, and how we can best communicate with them." He adds... "If a patient doesn’t understand how and when to properly consume their medicine, what’s the point in seeing them at all?”

Female health workers as they record case histories of the morning patients.

And affordability, it seems, grows out of rationality. The World Health Organization maintains a concise 354-item Essential Medicines List (EML), explains Dr. Gun. But the recommendations of the list are hardly executed. And although simple, single-ingredient medicines for these illnesses are extremely cheap, these drugs are not always available. Instead, poor consumers are cajoled into buying all kinds of tonics, cough syrups, steroids and multi-ingredient drugs—or in other words ‘irrational’ drugs.

As the age old story goes, the process of neo-liberalization brought in a deluge of costly and dangerous drugs that are now rigorously pawned off to India’s poor. In fact, according to a report by Pharm Tech (2005) the formulations market in India grew by a whopping 118 percent in 1990-1991, the year that India opened its doors to the global market. Resultantly, the 4.5 billion dollar pharmaceutical industry currently boasts over 60,000 formulations, 80% of which are sold domestically. In the Shramik Krishak Maitri Swasthya Kendra (Worker Peasant Friendship Health Centre), they believe that most of these drugs can be totally done away with. If India treated its sick scientifically (using principles of rationality), many deaths could be avoided and billions of rupees could be saved.

Rational medicines shop at Shramik Krishak Maitri Swasthya Kendra.

Thus, all of the medicines that are found in the Shramik Krishak Maitri Swasthya Kendra pharmacy have been tested and can be found on the Essential Medicines List. They are supplied to the hospital by an ngo at an affordable cost, and are sold to the patient at equally low rates. Thus, even though a patient’s registration fee is slightly higher than the government rate, he or she will end up spending far less because they aren’t charged for a long bill of unnecessary drugs.

Dr. Gun is not only giving treatment to poor patients who have been neglected by the state, but also the Worker Peasant Friendship Health Centre goes on to challenge the imperialist, neo-liberal model of medicine which, along with a deluge of costly drugs, resulted in a dramatic push towards the privatization of hospitals, whose exorbitant prices left behind the grand majority of the nation’s poor. “The hospital is entirely cooperatively run”, explains Dr. Gun. The health workers collectively manage the hospital and make all of the decisions. If somebody is getting a pay raise, everyone gets to vote on it. They also root themselves in the broader struggle against globalization by providing support to displaced peoples movements across Bengal and its neighboring states.

During the Nandigram land struggle of 2007, Dr. Gun and his band of workers put their lives on the line, sending teams to assist the farmers who were being brutalized by the CPI(M) goons. Now they are organizing “health camps” across Bengal in the name of Binayak Sen, a dedicated human rights defender and world renowned doctor (and old colleague of Dr. Gun’s). With the egregious use of false evidence linking Sen to Maoist groups the Chhattisgarhi Sessions Court recently charged the Doctor with sedition landing him a life sentence behind bars. “It is crazy that anyone has tried to paint Sen as a terrorist,” cries a chorus of his supporters across the globe... “He is such a gentle man!” In the PowerPoint presentation that Dr. Gun is showing as he campaigns, he describes a friend’s first encounter with Sen… Prabir Chatterji said, “I met Dr Sen first in August 1984. He was examining a child in the verandah of the Shaheed Hospital when the child passed stools. Binayak went and fetched a mop and cleaned up the mess….He told me that he was as qualified as anybody else to handle a mop- so why not?”

In his early twenties, Dr. Gun left his home in search for his life’s meaning. After a short stint in Bhopal, he landed up in Chhattisgarh, where he met Shankar Guha Niyogi. They were working with workers in a vibrant an anti-steel mining struggle driven by perhaps one of India’s most revolutionary mining workers’ unions, the Chhattisgarh Mines Shramik Sangh. “It was unprecedented in the way unions operate”, says Gun. "Most unions fight unilaterally for the welfare of the workers, but this union was raising critical issues involving land and livelihood in the mining affected areas." In other words, the “picket line workers verses front lined communities” dichotomy was absent from the struggle. And this was because the two groups in many ways were inseparable. The people who were employed by the company were living in impoverished conditions, losing their ancestral land, their health was deteriorating, and their long standing community foundation was being demolished.

One of the early turning points of the struggle was when Chhattisgarh Mines Shramik Sangh’s vice president Kusumbai died during child birth in the Bhilai Steel plant hospital in Dalli Rajhara because the doctors neglected to give her proper treatment. The workers vowed to create a proper maternity home for the community. SIx years later, under the leadership and inspiration of the fierce labor union leader, Shankar Guha Niyogi, the workers created “a program of the toilers by the toilers”. Doctors Gun, Sen, and others like Dr. Asis Kumar Kundu, Dr. Saibal Jana and Dr. Chanchala Samajdar worked tirelessly to build Shaheed Hospital, which was done entirely through the wages of the company workers and without any external funding. The workers participated in the decision making and the day to day functioning of the hospital. It was fought a long and hard battle. The struggle was multifaceted—it addressed the health needs of the workers and the social issues of the community like alcoholism and domestic violence. The union began imposing small fines on those who drank, and even returned the amount to the alcoholics’ wives in secret!

The organisation posed such a massive threat to the liquor mafia and the steel company and other politicians/industrialists that on September 27, 1991 their leader, Niyogi, was shot dead in the middle of the night by a mafia linked to the BJP.

When Dr. Gun left Chattisgargh, he was so inspired by his experience with the revolutionaries of Dalli Rajhara that he decided to take up his own health venture in rural West Bengal, a state that has historically been mired in corruption and chronically lacking in proper health facilities for its poorest. It is this vision, to provide a foundation for revolutionary movements, as the CMM once did, that drives him forward.

Amazingly, this man who is both a revolutionary, social reformer and full time doctor has not a post-graduate medical training. At the age of 22 Dr. Gun completed his undergraduate degree in medical sciences, but the real bulk of his learning happened at a residency experience where he learned all medical operations including complex surgeries. Yet, today he is not eager to cut people open, as he once was. “Surgery is a really romantic thing. You get to go into the operating theater and come out a hero. But this isn’t what I want to do anymore. There is so much one can do with a rational system of modern medicine….But this is a long and continuing process, that requires continuous dialogue and a lot of patience.”

And patience is clearly not something Gun needs a (rational) dose of. At the inception of the hospital, Dr. Gun was virtually alone, treating patients out of an abandoned poultry shed. He slowly built the clinic and one by one he trained the health workers, who were largely poor women from around the village. This required building relationships with their families and slowly gaining the trust of the community. It is because of his perseverance and willingness to build from the bottom up that these women have stuck with him for so long, some of them joining the hospital as health workers. He has totally avoided taking any incredulous funding and prefers to stay out of the public limelight. Although he has formed a network of sympathetic comrades to from time to time donate equipment or perform cheap surgeries for his patients, the money to run the hospital and has come from the nominal patient registration fees (In 1994 it was 1 Rs, then it was raised to 2 after a couple years…Then in 1999 it was 4 Rs and it has been 5 Rs for the past 9 years). Those who cannot even afford to pay these basic fees are seen for free. In fact, it is said that Dr. Gun never turns a patient away, which means he often remains at the hospital into the evening past the closing hours, seeing that every patient is cared for.

Waiting to see the doctor! Not a single patient will get turned away.

Years into this endeavor, the hospital had enough funds to build the two story hospital, which now constitutes Shramik Krishak Maitri Swastha Kendra. Enthusiastic friends donated some microscopes and test tubes. Although they were originally using a manual ECG system, they now have an automatic one, along with an x-ray chamber, eye equipment, a full test laboratory, and several specialists in ENT, skin, reproductive health, dentistry, eye care, psychiatry and physiotherapy. All of these services are given to the people at most nominal prices—“We will perform an x-ray for 70 Rs, whereas in Kolkata they will charge almost double that. This is on top of a patient registration fee that could reach up to 500 Rs” says one of their workers.

The waiting room curls up and down the three story stair well. It is a bustling atmosphere but not chaotic. Beckoning from the upper corridor comes a smell of the puris and aloo subje thali from the laps of patients who recently had their blood tested. At the bottom of the stairwell is a line of framed photos of various revolutionary doctors including Dr Dwarkanath Kotnis and Dhiranjan Sen. The Worker Peasant Friendship Health Centre seems to be not just a medical institution but a home and a kind of refuge for the oppressed. He rather calmly sums up his sentiment, "if what doctors are doing does not radically challenge the status quo, what is the point in practicing medicine?"

When I arrived back home in Ranchi from a 2 week venture across India, I was greeted by the following warm words from Punyabrata Gun: “….I am more than double your age, I was quite adventurous in my early life, still I found you inspiring. You have left your home at a younger age to integrate yourself with peoples' struggles. I salute you. Whenever you need please call me. It will be a pleasure for me and my organisation if you accept my offer for a fortnight crash health worker training course. I think you may learn some useful things from us to serve the people.”