Health stories from rural India

A PRIMER: “The book explains complex diseases and science in a simple fashion.” Picture shows a doctor examining a tribal boy Raju at a makeshift health centre, at Chinnagellur village in Chhattisgarh. — PHOTO: REUTERS   | Photo Credit: RUPAK DE CHOWDHURI

The rise of witch doctors, quacks and unregistered allopathic doctors as a result of an inadequate health infrastructure is not incidental is a point made by a Bilaspur-based non-governmental organisation using cartograms or maps on which statistical information is shown in diagrammatic form. Using 50 stories that are resonate with rural living, the ambitious project aims to spread awareness about socio-economic reasons for deaths, rather than just medical ones.

One such cartogram in a newly launched “Health Atlas”, is about snake bites. Here, Aghani Bai’s son, Dal Singh, who was bitten by a snake, is given a concotion made of plant root mixed with water to drink. Baiga tribals consider the herb an antidote to snake venom. The local ‘jholachhaap’ doctor administers a saline solution to Singh. In less than 24 hours, he dies, his body turning yellow and fingers swelling as a reaction to the venom. Most snake bites happen at night when transportation facilites are hard to come by. Understanding this, the book suggests numbing the bitten part before going to a health facility as a method of first intervention.

“An Atlas of Rural Health: Chronicles from Central India,” which is produced by the Chhattisgarh-based non profit Jan Swasthya Sahyog (JSS), is rich in narratives collected over many years, from Bilaspur district where the JSS operates. “This book is not only about Chhattisgarh but also the whole of India as we face [the] same problems everywhere. The book has tried to capture the socio-economic reasons for deaths, rather than just medical ones,” says Dr. Yogesh Jain, Secretary and founder of JSS.

Deaths due to snake bite are among the top 10 reasons for death, according to the Million Death Study by the Registrar General of India. Snake bites kill nearly 46,000 people annually in India with 97% of them occurring in rural areas. And this hardly makes news .

“Mostly, IEC [Information, Education and Communication] materials are very city-centric and have [a] top-down approach. But this book is written by people who work with poor and marginalised people. It explains complex diseases and science in a simple fashion. It will be used by health workers from rural setting,” says Manisha Gupte, co-convener of the Pune-based MASUM, a rural women’s organisation.

In another section, the book gives information on many common ailments in a simple language to help people understand their science and take informed decisions. It captures emerging issues such as antibiotic resistance in community.

The health maps

An interesting part are the health maps, titled “Maps of Inequity” and created with the help of the cartogram software tool, ScapeToad. The method is used to visualise intensity of a variable on a physical map. Apart from a strong visual impact of geographical patterns of diseases, the maps highlight State-wise inequities in India.

“The trend that emerges though the maps shows that resource-poor States have [a] higher burden of diseases than the others,” says Dr. Ajay Verma of the All India Institute of Medical Sciences, Delhi, who worked on the cartograms for JSS.

For example, the malaria map shows that eastern States, including Chhattisgarh, suffer far more than other parts of the country. For maternal mortality ratio, the map shows that even though it has been contained in many parts of India, the northeastern States continue to suffer badly.

The book provides a fresh way of looking at the health scenario in India. With a combination of narratives, science and data, and priced at ₹400, it is a much-needed intervention, especially in times when the buzzwords are privatisation and public-private-partnerships rather than public health.

Jyotsna Singh is a New Delhi-based freelance journalist, reporting on health policies.

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Printable version | Jan 20, 2021 11:14:13 PM |

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