Anarcho-environmentalism allegorised

The name Anaarkali in the present context has many meanings - Anaar symbolises the anarchism of the Bhils and kali which means flower bud in Hindi stands for their traditional environmentalism. Anaar in Hindi can also mean the fruit pomegranate which is said to be a panacea for many ills as in the Hindi idiom - "Ek anar sou bimar - One pomegranate for a hundred ill people"! - which describes a situation in which there is only one remedy available for giving to a hundred ill people and so the problem is who to give it to. Thus this name indicates that anarcho-environmentalism is the only cure for the many diseases of modern development! Similarly kali can also imply a budding anarcho-environmentalist movement. Finally according to a legend that is considered to be apocryphal by historians Anarkali was the lover of Prince Salim who was later to become the Mughal emperor Jehangir. Emperor Akbar did not approve of this romance of his son and ordered Anarkali to be bricked in alive into a wall in Lahore in Pakistan but she escaped. Allegorically this means that anarcho-environmentalists can succeed in bringing about the escape of humankind from the self-destructive love of modern development that it is enamoured of at the moment and they will do this by simultaneously supporting women's struggles for their rights.

Tuesday, May 1, 2018

Whither Public Health

One of my Adivasi colleagues in the mass organisation Adivasi Morcha Sangathan in Dewas, Saligram of Pandutalav village, was suffering from pain in his stomach for a few days and so he decided to go to the Government run Community Health Centre in the nearby Tehsil village of Udainagar. The doctor there diagnosed his problem as acidity and a mild hypertension and prescribed medicines for both. The pharmacy at the CHC did not have the medicine prescribed for acidity - omeprazole and so Saligram came away only with the medicine for hypertension. Late in the night the pain in Saligram's stomach began to increase and by dawn it was excruciating and he was finding it difficult to breathe. A local quack in Pandutalav said that the matter was serious and he would not be able to do anything and Saligram should go to Indore. So he called me up and said he was coming to Indore. When he arrived in two hours along with others in a jeep he was doubled up with pain. I immediately gave him two tablets of omeprazole and hopped on to the jeep and we went to a hospital. By the time we reached the hospital fifteen minutes later Saligram's pain had already eased and he was able to walk to the out patient department instead of the emergency department that we had thought of earlier. The doctors in the hospital found his blood pressure to be normal and an electrocardiogram revealed that his heart also was alright. Several other blood and urine tests were done but nothing emerged. Acidity it appeared was the only problem and so he was prescribed omeprazole. Saligram is now fine and regularly taking omeprazole to keep his acidity under control.
For quite some time before this Ravin the grandson of another old warhorse of the Sangathan in Dewas, Rukhria, had been laid low with pus emanating from his shin in two places where a rod had been inserted after he broke his leg by falling from a motorcycle. I had told him that it was probably due to the rod having been infected and would require its removal. However, Rukhria and others demurred and instead said that it was due to someone having done some black magic against Ravin!! So they engaged a venerable medicine man, another stalwart of the organisation, Deepsingh, to counter this black magic by chanting some good magic. Obviously this didn't work and finally Rukhria called me saying that something needed to be done. So  I brought Ravin to Indore and had his leg x-rayed. This revealed that there was indeed severe infection around the rod that had been inserted into his shin bone. So once again Ravin went on the operation table and the rod was removed and now he is fine.
In both these cases the problems were quite straight forward ones but the public health system could not solve them and so private help had to be sought. Luckily for these poor people I am around and so even if they had to spend some money it was not much as the doctors couldn't fleece them with unnecessary procedures as is their wont with people who do not know much about medicine.
A few days after this Subhadra and I went to Kolkata to hold a reproductive health camp there for women who are sex workers. The surveys and later the clinical examination and laboratory tests revealed that there is serious lack of awareness among the women about their gynaecological health and many of them are suffering from severe problems. Almost none of them had approached the public health system. The doctors who came to the camp said that in the government hospitals they do not get to do the kind of in depth history taking and examinations that were done in the camps because of the rush of patients and so they prescribe on cursory examination. During this visit, Subhadra conducted reproductive health workshops in two other localities near Kolkata with women and adolescent girls and the story was the same - little awareness of their gynaecological problems and the solutions required for them and lack of access to good public health services.
Innumerable studies have shown that investment in good public health services by Governments are recovered many times through taxes paid by a healthy working population. Yet right from the time of independence there has been a singular under investment in public health and now even what is there is dwindling. Hospitals are without doctors and medicines and people have to rely on private health services, mostly on quacks.
 The World Health Organisation has developed a tool called Disability Adjusted Life Years or DALY to measure the life years lost due to disability and death caused by disease. The map below shows the situation with regard to burden of disease across the world. The colour coding is from light yellow which are the countries with least burden of disease to deep red and brown which are the countries with a high burden of disease.

The country with the least burden of disease is Iceland which has an excellent and completely free public health system with a DALY of 18,265 per 100,000 population while the Central African Republic which has a DALY of 95,543 per 100,000 population has the highest burden of disease. India is unflatteringly situated with a DALY of 42,358 per 100,000 population. This means that for the whole population of the country, every year India loses a staggering 550,654,000 life years. This is an unconscionable loss but while we are concerned about rapes, genocides and mayhem we don't seem to be at all bothered about this much more horrific loss arising out of the lack of a good and free public health system.


Anonymous said...

if u ever come to delhi, visit such one such mohalla clinic ...

Rahul Banerjee said...

not only the mohalla clinics but the general functioning of the hospitals also has improved in Delhi. But this is a drop in the ocean compared to what is needed.