The arrival of "AKHA" -- mobile boat clinic – brings hope to thousands of people living on the secluded islands in the majestic Brahmaputra in Assam.

The moment the mobile clinic anchors onshore, people start trickling towards the tents that function as makeshift clinics and pharmacies. The scene is no different at Chakia sapori or island, a good three-hour ride from Dibrugarh on a hot, sultry day. As the tents are being put up, the local accredited social health activist (ASHA) come running towards the boat, followed by the villagers. It is an unscheduled trip for the mobile clinic but the number of patients is no less than that on an announced visit.

“The patients come with common problems like skin rashes, ear infection, eye infection, diarrhoea and gastroenteritis and most of these are preventable diseases,” says Dr. R. Prasad, one of the two doctors on board. Apart from distributing free medicines, Dr. Prasad and his colleague Dr. B. C. Bora also give them a lesson or two on hygiene.

“Villagers here do not wear footwear and bathe in the river that leads to skin diseases and ear infection. We do not even give them antibiotics. Simple medicines help in curing them,” Dr. Prasad explains.But it is the women and children who have benefited most from the boat clinic. They come for ante-natal check-ups and bring their children for immunisation and vaccination. In fact, there have been three deliveries on the boat in the past six months though the floating clinic is not equipped for the purpose. No one is refused treatment, particularly if there is an emergency. The boat clinic was first started in 2005 by a non-government organisation, Centre for North-East Studies and Policy Research (C-NES), under public-private partnership with the State Govt. to provide health care facilities to geographically and socially excluded people living on these tiny islands. Beginning with just one boat, C-NES now has ten such floating clinics in Dibrugarh, Dhubri, Dhemaji, Morigaon, Tinsukia, Barpeta, Jorhat, Nalbari, Sibsagar and Sonitpur.

The concept received a boost after it entered into a partnership with the Government under the National Rural Health Mission (NRHM). The infrastructure is provided by C-NES and the technical support by the Government. Each boat has space for an out-patients department, doctor’s cabin, medicine chest, kitchen, toilet and a general store.

Walking all the way

Sometimes during floods when the river is in spate or when the water level is low, the boat clinic cannot enter less deep channels. In such cases, the 15-member team has to walk on foot for several hours to reach the villages. In some far-off islands, each trip can take three to four days without any communication with the outside world. Initially there was recommendation to provide referral transport facility for the patients but not much has been done due to the inaccessibility of the islands. The Centre is now considering supporting C-NES’s proposal to develop a floating hospital, designed as a referral hospital that could function between the lower districts of Assam and Meghalaya.

Tucked away in the north-eastern part of the country, Assam has 3,000 small river islands where 30 lakh people live in geographic isolation.

Keywords: AssamBoat Clinic