Six-year-old Altaf and his companions were sitting adjacent to the river bank since morning, with their eyes locked on the distance. With just a glimpse of a vessel, they stand up and begin bouncing and yelling in bliss.
On the vessel, one of the crew members approaches the bow and checks the water level with a long bamboo. Within a few minutes, the boat reaches the bank of Uttar Bhatkhowadia—a river island situated in the mighty Brahmaputra. The mighty Brahmaputra is home to 2,500 Saporis (river island) as well as Chars (sand bar) in Assam. The only medical services for those island dwellers is their revered “vessel of hope”.
In the meantime, two of Altaf’s companion hurry back to the village to inform the older folks about the arrival of their long-awaited Doctor Nao, the local name for the Boat Clinic.
Every month, this boat visits Uttar Bhatkhowadia and the other twenty-six river islands in Kamrup district—a population of 16,140 out of which 8244 are males and 7896 are female.
The nearest boat clinic in Kamrup district is situated at a distance of almost 70 km away from Guwahati. “Boat clinic in Kamrup started in October 2010. We start at 10 am from the Jahirpur ferry ghat in Chaygaon,” said Hiranya Deka, District Program Officer, Kamrup C-NES.
Kaliyani, the name christened by the NRL (Numaligarh Refinery Limited) who donated the ferry boat for the noble mission, wait almost every morning for the team to take them to the regions which are vulnerable towards getting receiving medical facilities and essential health care.
These boats are equipped with a vaccine kit, necessary medicines for a basic health check, a laboratory kit to collect blood samples (whenever necessary), a small kitchen, life-saving jackets, few umbrellas, and a bicycle which is used to carry medicines.
The team includes two doctors, three nurses, a pharmacist and a laboratory technician—all employed through the National Rural Health Mission (NRHM), along with three crew members and two community workers.
On reaching the shore, the community workers, along with the help of local Accredited Social Health Activists (ASHAs) and Anganwadi (grassroots public health care) workers, try to mobilise the patients who are informed prior to their arrival.
Akin to the last time, the health camp took place in a venture school of Uttar Bhatkhowadia Char where 102 patients had turned up, most of them being women. A Char has a total of 12 villages in which almost 1,109 people dwell.
18-year-old Surjomala is one of the patients who, along with her three-and-a-half-year-old son, was waiting under the shade of the tree since morning to visit the doctor. After proper examination, Dr Gunajit Deka confirms conjunctivitis and prescribed medicine to her son.
“Every month, the boat clinic comes to cure us. It’s a great relief as we find it difficult to travel to the mainland and only do it when there is any emergency,” she said. “I know with the intake of the medicine my child will be healed.” It’s her belief that pulls her to these centres every time her family is sick.
“We belong to the minority group. Every year, the local MLA and ministers come to us to seek votes and in return, they promise us good health care, education and employment but nothing works in ‘chars’,” said Md Abdur Rahim, a local school teacher. “These people promise and forget. In such situation, boat clinics are the only source of medical care we are getting here.”
From health care facilities to schools, the power, the road; from the improper water supply to the sanitation problem, most of these islands lack all basic infrastructure and services.
The facilities offered by the Boat clinics are OPD, Access to antenatal care (ANC) and postnatal care (PNC) services, immunisation, laboratory, family planning services like distribution of OLE for Process Control (OPC) and condoms, and Intrauterine Contraceptive Device (IUCD) insertion in a few districts.
“These are not only secluded but also flood affected areas. Each year, the locals suffer from major waterborne disease after the flood dismisses. So, the boat clinic not only provides basic healthcare facilities, it also provides awareness camps to prevent these diseases,” said Dr Gunajit Deka of boat clinic.
Assam has a total of 2,251 Char villages. A large portion of these areas are transitory in nature, regularly inclined to serious surge and continuous displacements as their development rely upon the moving courses of the Brahmaputra. This infers impermanent, unstable presences for the general population who falls under BPL living in these ranges.
To address this problem, veteran journalist and managing trustee of Centre for Northeast studies and policy Research (C-NES) Dr Sanjay Hazarika dreamt of a project—driven by the tragedy of families who lost pregnant women, sick children due to lack of medical care facilities—which, later on got popularized by the name of boat clinic.
With the help of UNICEF, the boat clinic activity of C-NES began in 2005 with ‘Akha’ (meaning hope in Assamese). Energised by its prosperity, NRHM went into a concurrence with C-NES to give health support and therapeutic service to the ‘chars’. These units not just give access to fundamental administrations of human services, but also give crucial learning and data on the sort of administrations to the inhabitants of the island who have no access to basic healthcare.
There is a total of 15 units of Boat clinics functioning in the 13 districts of Assam.
“We are also planning to launch India’s first hospital ship which under construction and will soon be in service,” said Ashok Rao, Program Manager (Boat Clinic), C-NES. “This ship is supported by the North Eastern Council, Government of India. It will provide specialised healthcare services on the river to island communities, particularly for mother and children, including safe institutional deliveries, as well as will conduct an operation.”