A team of doctors on September 4 flagged the abysmal living conditions in relief camps in Manipur that is in the grip of an ethnic conflict. Nearly 70,000 people displaced by the violence stay in 334 such camps.
A fact-finding team of five doctors from the non-profit Indian Doctors for Peace and Development (IDPD) visited relief camps in both Meitei and Kuki-dominated areas on September 1 and 2.
The team found 194 people from 45 families living in Khumanlankpak sports hostel in Imphal district, with a room to each family. There are just 20 toilets. “What was distressing was there was an acute shortage of piped water and the families had to carry buckets to and fro,” Shakeel Ur Rahman, general secretary, IDPD, said.
In relief camps under the Sapormeina Primary Health Centre in Kangpokpi district in the hills, up to 600 Kuki inmates were staying, with one room for up to three families, the team noted.
The medical infrastructure was also poor in Kangpokpi district, with no facilities for surgery at the District Hospital. The conflict had also left the superspecialty medical facilities in the Imphal Valley out of bounds for the Kukis. “There is no functional OT [operation theatre] in Kangpokpi District Hospital, neither are there any blood bank facilities. There are at least four pregnant women in the Kuki relief camp that we visited who are at the cusp of delivery, but may have to be rushed to Kohima or Dimapur [in Nagaland], which is a 24-hour journey, in case of any emergency,” Arun Mitra, president, IDPD, said.
With no leafy green vegetables, eggs or milk available, children at the relief camps are facing severe Vitamin A deficiency. “The capacity to restore Vitamin A in a child’s body is much less than that of an adult. We are expecting Vitamin A deficiency emerging in form of an endemic. Night blindness is a very common fallout of Vitamin A deficiency,” Dr. Rahman said.
“Inmates are only eating dal, rice and potatoes for three meals a day. The situation of food shortage in the camps is so bad that each inmate gets one egg every two weeks. Lactating mothers are not receiving enough nutrition to produce breast milk. A five-day-old baby was being fed diluted milk powder because of lack of mother’s milk or its nearest substitute — cow’s milk,” he said.
With connectivity between the Kuki and Meitei zones disrupted, there is also an acute shortage of vaccine supplies. No special immunisation drives, especially against measles, had been undertaken in the relief camps visited, the team noted.
“Measles Vaccine Immunisation drive in children above 9 months along with Vitamin A oral suspension is imperative for relief camps according to United Nations Commissioner For Relief SPHERE standards,” the team noted.
“Nurses we spoke to in the relief camps said that multiple barricades on Kuki and Meitei sides posed blockage on transport of vaccines,” Dr. Mitra said.
While there has been a dengue outbreak, fogging for mosquito control has not been conducted in and around relief camps. The team also reported a couple of Kuki patients who required haemodialysis but were unable to access it in the hills.
“We found patients of diabetes, high blood pressure, chronic kidney diseases in relief camps unable to access help,” Dr. Mitra said.
“Also there is an acute shortage of specialists in the hills where the Kuki-dominated areas are. Vast majority of specialist doctors and all medical college hospitals of the State are located in Imphal (three medical colleges) and Churachandpur (one medical college),” he added.
The team in its report, which will be submitted to State and Central officials, including the Prime Minister’s Office, noted that robust referral systems after triage from PHCs to higher relief centres both within Manipur and neighbouring States should be put in place. Fabricated OTs should be operational at district and sub-district level and blood storage units should be started around relief camps after cluster formation, it said.
Internet services should be restored in health facilities around relief camps for telemedicine services to be functional. “Basic doctors can be trained in performing peritoneal dialysis, use of ambu bags for children with breathing distress, counselling of mothers for breastfeeding children and so on,” it said.