There is a concept called the "Disability Adjusted Life Years" which is a measure of the overall disease burden expressed as the cumulative number of years lost due to ill health, disability and early death. This concept tries to focus our attention to the hard fact that disease and disability which may arise due to various factors may severely restrict our chances of earning a livelihood and so hamper our productive lives. It is very difficult to quantify the aggregate economic loss to the nation or one of its provinces from this health burden but it is a well known fact that for most of the people of this country disease is the cause of continuous income loss and frequently major economic shocks. Especially for the Adivasis.
The Bhil Adivasis traditionally relied on their medicine men to cure them of diseases. These medicine men or "Burwa" as they are called, depended on a combination of invoking the spirits and dispensing with herbs to cure the ill. These methods were not always successful and so morbidity and mortality rates were high. Unfortunately modern medicine or other schools of medicine such as Ayurveda or Unani have not been able to improve matters much. Primarily because public health services in Madhya Pradesh, which are supposed to provide these other forms of treatment are close to non-existent. Consequently there is a huge tribe of quacks practising irrational medicine in rural areas and even in towns indiscriminately injecting anti-biotics and steroids and administering intravenous saline and other drugs. The patients get some temporary relief but they are ill again and sometimes they even die due to mis-prescription. Matters are compounded by the fact that most Bhil Adivasis are under nourished and so their auto-immune system does not function properly. So the Adivasis are mostly between the devil and the deep blue sea.
Its not as if the problem is faced only by the poor and illiterate Adivasis. Shankar, the General Secretary of the Khedut Mazdoor Chetna Sangath, who has a middle class income and a fair amount of education, too is not in a position to tackle diseases of a serious nature. He began complaining of pain in the small of his back and also in urination some time back. He first went to the Government District Hospital in Alirajpur. This hospital has doctors but very little else. The diagnostic facilities do not work because of lack of staff and reagents. The X-Ray and Sonography machines are also non-functional. The doctor prescribed some medicine which Shankar had to buy from the market as it was not available in the hospital dispensary. However, this medicine did not work and his pain increased. He was then advised by the doctor to go to the nearby town of Dahod in Gujarat and consult a private doctor. This private doctor had a slew of tests done and then prescribed some medicines. This too did not work. Then the doctor had a sonography done and that revealed that there was a small stone in the kidney that was causing the problem but he said that Shankar would have to go to Ahmedabad to get the stone removed. Shankar instead came to Indore where I reside. We deliberated whether he should go to the government run Maharaja Yashwantrao hospital but in the end we decided against it because another Adivasi colleague Shaitan from Dewas district told us that he had gone there for his own stone in the kidney problem and it hadn't been solved and so he had to go to a private doctor instead. Eventually we went to consult a private doctor who used lithotripsy, which is a procedure for the breaking up of kidney stones through concentrated sound wave hammering and does not require surgery, to break up the stone and cure Shankar of the problem. The treatment cost Rupees fifteen thousand in toto. However, that was because I went along with him and asked the doctor incisive questions about the problem and its treatment. There is every likelihood that if Shankar had gone alone he would have been fleeced because Shaitan who went alone ended up paying Rupees Thirty Thousand for a small stone removal through lithotripsy. For about five months Shankar has not been able to work properly suffering from excruciating pain at times and he has only now returned to normalcy.
Shankar's case reminded me of my own serious health problem of two decades back which in a way forced me to move out of Alirajpur onto a different track altogether. Alirajpur in those days was a malaria endemic area with deaths every year due to malaria. I too contracted malaria and began having repeated attacks of the disease. Every time I would take the course of chloroquine tablets and get well only to fall ill again after a month or two. Eventually I had to come to Indore and consult a private doctor there. The doctor said that I would have to take a prolonged course of treatment consisting of some other medicinces and distance myself from Alirajpur while I was taking these medicines. This was at a time when I had no resources at all and so I not only had to move out of Alirajpur but also give up activism for some time and start doing consultancies to earn money. Even if I did go back to activism after some time, I did not give up earning money from consultancies and that still sustains me even though it has meant that I cannot give full time to activism. Malaria has now been controlled in Alirajpur because over the last decade serious efforts were made to provide quick and proper treatment to those who were afflicted with the disease by the government health system. This just goes to show that when the government does decide to do something it succeeds in doing it but generally there is a lack of commitment.
There are many instances of Adivasis suffering from simple to serious diseases and losing time to work for their livelihoods or even dying only because they do not have free or cheap quality medical services. This is in fact a nationwide problem leading to considerable productivity loss throughout the country. Like in the case of education so also in the case of health, government investment in setting up and running a free or cheap quality public health system yields huge gains for the economy and society as a whole which far outstrip the costs incurred. Yet like the public education system, the public health system in this country is in a shambles and we are as a nation losing hugely in terms of productivity and individually many families are getting wrecked.
The Bhil Adivasis traditionally relied on their medicine men to cure them of diseases. These medicine men or "Burwa" as they are called, depended on a combination of invoking the spirits and dispensing with herbs to cure the ill. These methods were not always successful and so morbidity and mortality rates were high. Unfortunately modern medicine or other schools of medicine such as Ayurveda or Unani have not been able to improve matters much. Primarily because public health services in Madhya Pradesh, which are supposed to provide these other forms of treatment are close to non-existent. Consequently there is a huge tribe of quacks practising irrational medicine in rural areas and even in towns indiscriminately injecting anti-biotics and steroids and administering intravenous saline and other drugs. The patients get some temporary relief but they are ill again and sometimes they even die due to mis-prescription. Matters are compounded by the fact that most Bhil Adivasis are under nourished and so their auto-immune system does not function properly. So the Adivasis are mostly between the devil and the deep blue sea.
Its not as if the problem is faced only by the poor and illiterate Adivasis. Shankar, the General Secretary of the Khedut Mazdoor Chetna Sangath, who has a middle class income and a fair amount of education, too is not in a position to tackle diseases of a serious nature. He began complaining of pain in the small of his back and also in urination some time back. He first went to the Government District Hospital in Alirajpur. This hospital has doctors but very little else. The diagnostic facilities do not work because of lack of staff and reagents. The X-Ray and Sonography machines are also non-functional. The doctor prescribed some medicine which Shankar had to buy from the market as it was not available in the hospital dispensary. However, this medicine did not work and his pain increased. He was then advised by the doctor to go to the nearby town of Dahod in Gujarat and consult a private doctor. This private doctor had a slew of tests done and then prescribed some medicines. This too did not work. Then the doctor had a sonography done and that revealed that there was a small stone in the kidney that was causing the problem but he said that Shankar would have to go to Ahmedabad to get the stone removed. Shankar instead came to Indore where I reside. We deliberated whether he should go to the government run Maharaja Yashwantrao hospital but in the end we decided against it because another Adivasi colleague Shaitan from Dewas district told us that he had gone there for his own stone in the kidney problem and it hadn't been solved and so he had to go to a private doctor instead. Eventually we went to consult a private doctor who used lithotripsy, which is a procedure for the breaking up of kidney stones through concentrated sound wave hammering and does not require surgery, to break up the stone and cure Shankar of the problem. The treatment cost Rupees fifteen thousand in toto. However, that was because I went along with him and asked the doctor incisive questions about the problem and its treatment. There is every likelihood that if Shankar had gone alone he would have been fleeced because Shaitan who went alone ended up paying Rupees Thirty Thousand for a small stone removal through lithotripsy. For about five months Shankar has not been able to work properly suffering from excruciating pain at times and he has only now returned to normalcy.
Shankar's case reminded me of my own serious health problem of two decades back which in a way forced me to move out of Alirajpur onto a different track altogether. Alirajpur in those days was a malaria endemic area with deaths every year due to malaria. I too contracted malaria and began having repeated attacks of the disease. Every time I would take the course of chloroquine tablets and get well only to fall ill again after a month or two. Eventually I had to come to Indore and consult a private doctor there. The doctor said that I would have to take a prolonged course of treatment consisting of some other medicinces and distance myself from Alirajpur while I was taking these medicines. This was at a time when I had no resources at all and so I not only had to move out of Alirajpur but also give up activism for some time and start doing consultancies to earn money. Even if I did go back to activism after some time, I did not give up earning money from consultancies and that still sustains me even though it has meant that I cannot give full time to activism. Malaria has now been controlled in Alirajpur because over the last decade serious efforts were made to provide quick and proper treatment to those who were afflicted with the disease by the government health system. This just goes to show that when the government does decide to do something it succeeds in doing it but generally there is a lack of commitment.
There are many instances of Adivasis suffering from simple to serious diseases and losing time to work for their livelihoods or even dying only because they do not have free or cheap quality medical services. This is in fact a nationwide problem leading to considerable productivity loss throughout the country. Like in the case of education so also in the case of health, government investment in setting up and running a free or cheap quality public health system yields huge gains for the economy and society as a whole which far outstrip the costs incurred. Yet like the public education system, the public health system in this country is in a shambles and we are as a nation losing hugely in terms of productivity and individually many families are getting wrecked.
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