The arrival of Akha, a mobile boat clinic, brings hope to thousands living in the secluded islands on majestic Brahmaputra in Assam. The northeastern State has 3,000 small river islands, where almost 30 lakh people live in geographic and social exclusion and lack basic services.
The moment the mobile clinic anchors in, people start trickling towards the tents that function as makeshift clinics and pharmacies. The scene was no different at Chakia sapori or island, a good three hour ride from Dibrugarh, on a hot, sultry day.
As the tents were being put up, the local accredited social health activist (ASHA) came running towards the boat, followed by the villagers. It was an unscheduled trip for the mobile clinic, but the number of patients was no less than that on a scheduled visit.
The patients come with common problems like skin rashes, ear infection, eye infection, diarrhoea and gastroenteritis. Most of these are preventable diseases, says R. Prasad, one of the two doctors on board. Dr. Prasad and his colleague B.C. Bora give the villagers a lesson or two in hygiene, apart from distributing free medicines.
The villagers here do not wear footwear and bathe in the river. That leads to skin diseases and ear infections. We do not even need to give them antibiotics as simple medicines do the job, Dr. Prasad explains.
Women, children benefit most
It is women and children who have benefited most from the boat clinic. The women come for ante-natal check-ups and bring their children for 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-governmental organisation, the Centre for North East Studies and Policy Research (C-NES), under public-private partnership with the State government providing health care facilities to geographically and socially excluded people living on these tiny islands.
Starting off with just one boat, the C-NES now boasts 10 such floating clinics in Dibrugarh, Dhubri, Dhemaji, Morigaon, Tinsukia, Barpeta, Jorhat, Nalbari, Sibsagar and Sonitpur.
The concept received a boost after the NGO entered into a partnership with the government under the National Rural Health Mission. The infrastructure is provided by the C-NES, while support is given by the government.
Each boat has space for an out-patient department, a doctors cabin, a medicine chest, a kitchen, toilets and a general store. A generator set and a 200-litre water reservoir have also been installed.
When the water levels are low, the boat clinic cannot enter into shallow channels. In such cases, the 15-member team has to walk on foot for several hours to reach villages. In some far-off islands, each trip can take three or four days without any communication with the outside world. Initially, there was a recommendation to provide referral transport facility for patients, but not much has been done due to inaccessibility of the islands.
Proposal for referral hospital
The Centre is now considering supporting the C-NES proposal to build a floating referral hospital that could function between the lower districts of Assam and Meghalaya. There is also a proposal to start community radio facility between the clinics.
It has OP department, medicine chest, kitchen, toilets, general store, a generator set
Assam has 3,000 small river islands where almost 30 lakh people live without basic facilities