Touching the border of Birbhum in West Bengal , in this abjectly poor district of Sahebgunj in Jharkhand the story of despair is stark. In the black stone mines of Pakur and beyond, run the dark narratives of Kala Azar, silicosis, malaria, tuberculosis and rampant malnourishment. Poverty stares brazenly but there is not even the shadow of a government or relief for the people.
At Gumani (Sreekund) the local MLA has a sprawling mansion, shockingly huge. He is building another massive building with “Saudi Arabian money”, locals say. Across Pakur and Gumani, people have nothing – poor homes, thatched huts, most of them in the BPL category, undernourished, without schools, without doctors and hospitals, jobless, hopeless. Little girls make bidis, afflicted with TB. Miners are severely malnourished. Even the Jamaat-e-Islami with its formidable network, has just a one-room dilapidated ‘office’ with a blanket on the ground in a broken down building. Everyone speaks Bengali, but there are no red flags here, not even a CPI(M) office.
However, a ray of hope has arrived. In jam-packed medical camps, the young and old are sharing their angst, digging for change. “Let’s start with health first,” says Imtiaz, a science graduate, jobless. Agrees Mohsin and Ibrahim, and others, including girls: let’s begin with primary health care, and push this awareness into social transformation. That is how the Gram Swasthya Sewa Sansthan has found its contours of hope.
That is why Dr Punyabrata Gun from the Shramik Krishak Maitri Swastha Kendra of Chengail has arrived. He teaches the 100 odd ‘quacks’ and paramedics the nuances of medical philosophy, the importance of case histories and socio-economic backdrop of patients, how to define basic healthcare, how to avoid the ‘culture of indiscriminate drugs, including antibiotics’.
“Was the fever intense when it started, did it increase, what were the earlier ailments? Did the patient have diabetes, blood pressure or any other history, what are the ailments which can be cured by medicines and not surgery,” Dr Gun speaks softly, but they are listening in apt attention, taking notes.
Dr Swapan Jana, the life-force behind the Rural Medical Practitioner’s Association of West Bengal is the catalyst behind this movement of thousands of rural doctors in Bengal. He has charged up the meeting, cajoling every ‘student’, including an old man who has been ‘practising’ medicine for four decades.
“How do you look at patients in pain when you are the only ‘doctors’ for miles together? Are they not your friends and community members, are they not close to your hearts? Don’t you give them what they need most in a crisis, the healing touch, relief from suffering?” says Dr Jana. “You are already illegal by law. So what is the worry? If healing pain is illegal, so be it. That is why, organise, upgrade your skills, change the world.”
Everyone agrees. They have come from long distances to create a collective. They know their villages, their people. Most common ailments they can cure, and they follow the medical rules: complicated or specialised treatment only at the district hospital – which is in shambles anyway, while there is no official primary health care around.
“Hence, the need to train rural doctors. In the absence of government machinery and complete breakdown of the public health system, rural doctors are the lifeline of immediate hope. So they have to be professionally upgraded, trained, equipped with technical and research knowledge systems. They have to be provided higher medical support systems. They have to be legalised since health is a fundamental right,” says Dr Jana.
One of the first batches of young people at Chengail are from Gumani – training to be paramedics. Others have followed from Madhepura in Bihar , the Kosi flood-hit area, Jadugoda and Sahebgunj. The new batch has 10 girls, Muslims, Hindus, tribals.
Says Sharmistha, a tribal girl, “I want to become a health worker and help children and women. They have no one to even ask for basic health care.” Agree Raina Khatun, Anjali Devi, Zenaab – shy but stoic and determined. Those who have kids, their husbands and fathers cajole them to go. “Don’t worry, Dr Gun’s hospital is the best. And we will take care of the children.”
In this poor and conservative domain, all these girls just out of school, mark an optimistic rupture with the past. Women here are often left to their repetitive fate, there is lack of education, they have no right to their bodies or sexuality. Young girls are forced to become mothers. In this domain, a new empowerment is blooming, the ‘girl paramedic’ becoming a catalyst and role model of change, along with the boys.