The Tribune - Spectrum

Sunday, May 21, 2000

Of darkness & disease
By Chanchal Sarkar

IN the late seventies I had, gone to Calcutta as part of Government of India committee and one morning we met Jyoti Basu in his office. In the evening we were flying back to Delhi and jouncing alongwith us in the rattling Indian Airlines bus on way to the plane we met Jyoti Babu again. We were greatly impressed. But things change. A few days ago on a empty highway next to paddy fields near Jhargram (in Midnapore) a couple of jeeps approached us from the other side. On one was mounted a red light and, under it, a sign saying ‘Pilot’. My two companions called out in mock-excitement, "Mantri, Mantri" and sure enough there was a West Bengal minister hunkered down in the rear seat. There was not a person in sight.

What the CPI (M) set out to do in West Bengal hasn’t disappeared completely. By no means. The mobilisation of the landless and the low castes, the phasing out of social inequality, the redistribution of land and decentralisation of local government, have indeed done something lasting for the state and its people, something which an ideology-shorn Congress party could never have done. But over the years some of the shine has worn off. At the same time, some of the ideological stiffness has also become flexible. Corruption over real estate, for instance, has tarnished the party. In the districts of the state which is sixth in urbanisation (mainly, of course, because of Calcutta) most people believe that all advancement, all taking out of glitches, all chances of employment or grants are through the party and its henchmen.

  There is too much of the depressive apathy of unemployment. In a primarily Santhal village, not far from Jhargram we were told, to our pleasant surprise, that there were practically no illiterate people. This was unusual in villages where the high illiteracy rate came primarily from the heavy concentration of scheduled castes and tribes. In Midnapore district, for instance, the proportion of scheduled castes and tribes is 26 per cent of the population. But in the village we met several young men who had studied upto B.A. and failed. They could find no work and agriculture was not enough to sustain them. An elderly lady, Priyabala Tudu, universally called Masti said she had studied upto Class X, gone in for a nursing course and then given it up when she married and this was maybe 40 years ago. What a waste of talent and energy that was. She had no hope that any of her children or nephews and nieces would find work except, of course, as occasional casual labourers and raiders of the fast vanishing forests. What is called Common Property Reserves, accounts for 12 per cent of the income of the rural people mainly in fuel and fodder but they are increasingly being denied access to these reserves. Land redistribution over, there are IRDP loans which can rarely be had without the party’s sponsorship. Bengali colonisation has penetrated deep into the tribes who are invariably bilingual in Bengali and their traditional (usually spoken) tongue. There we found some scattershot attempts by NGOs to revive old cultural heritages in song and dance, but mostly these are a lost cause. According to Priyabala, there had been little visible improvements in her village between 1975 and 2000. Soon, I learnt, the state government might enable sharecroppers to buy the land they till (now with a secure tenure) and loans from public funds might be available for buying the land.

The image of the tribal is still that of a happy-go-lucky child of nature, unaware of the value of money and open to exploitation. Given the chance and the opportunity of living in a settled society, they are cooperative and socially conscious, eager to be literate and happy to keep their environment clean. As children of the forest they know their environment as no one else does. In the village of Kundaldihi we found that a German organisation had given money for a number of tiled (not brick but pressed cement) houses with three rooms and an attached toilet. Cheap enough for the donors at Rs 18,000 to 20,000 (less than $500) they came very expensive for rural people. Those who got the first lot were happy but those left out had not much hope of acquiring a house through the Self Help Scheme, which was slow. The Self Help Scheme of the UCO Bank (as in Bangladesh’s Grameen Bank) for groups of 5 to 20 women has, in the Jhargram subdivision, mobilised Rs 5.16 lakh for 189 groups for enterprises like poultry, goat rearing, shallow tube wells, small business etc, but a housing loan is large and not easy to get. Unfortunately loans were also given for "crisis management" which ate up the money. The Santhals still don’t have dowry among them but the others do and the only asset they can part with to raise money is land. There are, apparently, 40 million of them in India and it is clear that in most cases, there can be little crafts without electricity and electricity in a place like Midnapore district is a myth. Patharnala near Jhargram, is an attractive tribal village served by an NGO, Women in Voluntary Action,set in sal forests with neat houses, a small clinic (set up by an NGO) for the sick, a young woman health visitor, Shrota Nayak, and a singing-dancing troupe. The village leader, Vimala Shobor was a highly intelligent, dignified woman. Indeed it is a great pityto see how such intelligent women are put to little use. We saw all this in darkness because the only source of light was the "hurricane" lantern and a shortage of kerosene was evident from the restless queues outside shops in the towns. Men had jobs in Jhargram town where they went by cycle if they could or by bus part of the way and then walked. A middle-aged man leaning on our fourwheel-drive car seemed most pessimistic about the future of the village and its people. Perhaps he was a medically depressive person. While that village in the forest clearing was attractive by lantern-light and the women sang tuneful songs about health and nutrition, while they knew about ORS and other remedies for common illnesses, while they, as usual, were more forward looking than men, I would not make any predictions of a quick march to a better life. Primary Health Centres are often five or more kilometers away and rural hospitals much further. The villagers have no access to an ambulance or car. The doctors get no allowance for motor cycles. Such villages are

the key to India’s future but are ignored by our political sages who are now slaves to consumerism and to lining their pockets. With so many airconditioned nursing homes what do we care for rural health care?

Health and illness? I visited a rural hospital at Mohanpur,some 25 kms from Jhargram. Set in very attractive surroundings around sal trees and gravel paths, it is full of surprises.One such is that the hospital of 10 beds had no patients, though some 3000 people a year came to the out patient department. Of the three doctors (one on deputation) the two regulars came for a short while in the mornings and then hared off to their private clinics in the town. The operating theatre had two medical trolleys and an ordinary bright light which could be pulled closer by hand. There was no anaesthetist, no ambulance or car, not even a sucking machine to clear the breathing passage for a newborn babe. Instruments were few. The doctor present said that he could attempt a simple case like a hydrocelea but not much more, certainly not an appendectomy. Doctors in such rural hospitals jostled for transfer to popular towns for obvious reasons and such transfers had usually to be bought. I noticed several UNICEF gifted refrigerators and deep freezers for immunization vaccines lying out of order or use because the electricity was unpredictable; sometimes it shut down for 10 hours at a time. Just outside the operating theatre, a few steps down to the grounds there was an accumulation of garbage. Rubber gloves for operations were drying on benches.One store room seemed full of abandoned cartons. Such is a rural hospital.

The doctors and nurses have their own problems. There are no good schools nearby to educate the children and no infrastructure for social life. Doctors today are being appointed on one-year contracts at Rs 6000 a month. Nurses start on Rs 1100 and in time reach Rs 6000. What sort of service are such hospitals able to give the public? No wonder there were no patients in the beds. We met a young man with acute backache under a tree, with his wife sitting helplessly beside him in the expectation that a doctor would come.

The story of the 200-bed sub-divisional hospital at Jhargram is worth recounting. We walked a corridor there and a friend accompanying me, a distinguished FRCS surgeon, said that he had not seen in England a three-unit operating theatre as well conceived as the one in the hospital. But in England, he said, 17 or 18 operations, of them eight or nine serious ones, were done daily. In Jhargram only three or four were attempted.

Outside on open land next to the corridor I saw heaps of cotton wool on the ground. It seemed as if they had blown there from a cotton tree. But no, this was soiled cotton wool discarded from the hospital and two young boys were collecting them in sacks, presumably to sell. In a district starved of water two overhead tanks were overflowing without any check. Because of a WHO grant which had not being utilised in time, a hurried extension to the building was under construction. On account of this 18 stately sal trees, the pride of the region, had been cut without properly examinating if a way could not be found to save them, but that is another story.

Yet another story is of the Panirsola primary schools where a 50 per cent dropout rate is not uncommon and where 90 per cent of the parents are illiterate. In towns private schools are coming up charging Rs 175-200 a month for fees. The Holy Trinity School run by Catholic nuns near Jhargram (with some lay teachers) charges its 250 students Rs 10 a month and only about 100 families pay. It is probably not true to say that all government institutions are rundown and the private ones all good. There are questionable NGOs in plenty but when someone like Sarada Kalyan Bhandar and the Ramakrishna Mission take things at their hands, there is more than a ray of hope.