On our quest to find a place for our new clinic in Sitapur or Mainpat block of Surguja, we decided to visit 3 villages located between Sitapur to Mainpat. Dhiraj had received a call from one of the villagers, a Kotwal from Kot, expressing his interest to know what our purpose is and in renting a place for our clinic. So we decided to visit the village Kot and some other places around.
We had contacted a Mitanin Trainer (MT) of Bandhana village- Sarita Singh, through SHRC contact to show us the village and facilitate our visit with the villagers. We met Sarita Singh, MT at house of one of the mitanins – Basanti Paikra. Sarita, having recognized Dhiraj, having trained her on how to use the pulse oximeter, welcomed us with a pleasant smile. I was hoping to visit the village or their follow-up patient with her; but she told us that we would not find anyone at home in this season, people were busy with “dhaan ropai”. We went inside Basanti’s home,it was a beautiful classic village house with central opening/ clearing; we could enjoy the rain fall, the clouds hovering over while we were sitting at home and even see some birds making themselves at home..
Basanti & Sarita got their follow up books and readied themselves up for the conversation. We started with a question on what health problems do they encounter in villages, when do villagers approach hospitals? Which health facility does this population visit?, etc., etc. The immediate answer to our questions was Sab thik hai, we don’t have many problems here, people access the nearest Primary health center where MCH services, fever treatment, Malaria treatments are provided quite well. We then again introduced ourselves and explained our motive in coming to Bandhana- their village. Then both of them opened up a bit more; Sarita explained that Bandhana is a long, longitudinally set village on the mountain with the head at the base and tail midway around mainpat plateau. The para– Hamlets around base have better access to PHC, which is situated right in the Bandhana-Khaas, but for the ones in the mountains where mostly Manjhi, Manjhwars, and sparsely situated Pahadi Korwas live, do not have access to the health services much, they believe in faith healing with Ojha. She was also worried about the huge issue of Alcohol addiction in this community. On asking what kind of medical conditions were seen in the village, she said “There were 13 Hypertension patients and 8 patients with Diabetes on regular medicine” while producing her follow-up book. Again on probing we asked what medical conditions you see, she did not say much. But when asked about Stroke_ Lakwa ki pareshani, Sarita had some questions about whether Lakwa patients ever recover well and why Lakwa occurs, and why they need hypertension medicines. We explained as much as we could, being satisfied with the same; she further enquired if we could help half-mind patients– patients with Mental health issues. We were even more surprised when she informed us of having a significant number of Mental Patients in the village, mostly young adults. On asking about women’s health, Basanti informed most of the women do not seek health care unless it is very necessary, Chhoti Chhoti pareshaniyon ke liye kaha hospital jaye?
Our meeting lasted well over an hour or so, and both the amazing women bid us off with a cup of tea. Also, urged us to build a clinic for people in the mountains.
Sumantri, with the rest of the Mitanin staff of 14 women and Health & Wellness Centre_ HWC’s Community Health Officer_ CHO Savita Sinha, had arranged a meeting with us in HWC itself. This HWC is situated at the entrance of the village, with the woods and greenery around. The Mitanins here were misinformed that we were from the Family and welfare department, so Savita – the CHO had prepared (?) them for questions on MCH, like how do they encourage women on contraceptives? How many pregnant women are taking services from them? How frequently are they visiting the newborns of their para?, etc.
But this time we first introduced ourselves as people who are conducting a weekly Primary Clinic in Lakhanpur block and expressed our willingness to do the same in Mainpat block as well. We also clarified our intentions on having a community owned clinic. Following the same, similar discussion was started on what health problems they see in the community. Again here, we did receive the usual feedback of Sab thik hai. Then we started asking specific questions on various divisions of health. On women health, all these Mitanins agreed that Women issues are not looked after at all and they do need clinic where privacy is maintained. On probing about NCDs, all of them said that their patients are on regular follow up. What opened these Mitanins up was questions on mental health- they informed that all the 6 paras of Udumkela had at least one patient with Severe Mental illness. They connected Metal Health issues to severe psychosis and they were explaining the symptoms of running amok, excessive violence or smiling, untidy conditions in such patients. They also told us that the families of such patients have spent a lot on them but no result was seen and that’s how they could not continue the medicines that were prescribed to them. The main reasons for non-compliance being poor access and cost. One of the Mitanins also told us that she had discussed the mental health issue of her village in one of the Para meetings.
We also asked them to help us out_ do sahyog in finding the place for the clinic; one of the experienced_ Siyan Mitanin asked promptly what kind of Sahyog are you asking for? We realized how specific we should be while expressing our interests and commitments. She also said that you all are spreading the word_ Prachaar-prasaar for your clinic while you are asking what problems you see here. Overall the meeting was very relieving, where Mitanins were sharing their village issues easily and they were also relieved to not be evaluated by anyone. Most of the mitanins were wearing the same kind of sarees as if it was a uniform; which we got to know later that Mintanin has a uniform for every type of meeting, pink for Saturday meeting with MT, violet one for Bi.Chi.Si. Meeting AKA para meeting!
After meeting in Udumkela for almost an hour or so, we went to Kot, a village which we had visited in October. We decided to visit Janki Paikra, MT of Kot but she was finishing off medicine distribution with the Baigapara- one of the paras of Kot. We were wandering in the village looking for a Mitanin house, when we noticed a ration store had just opened. The villagers- mostly the older population gathered around it and were dealing with their various cards- Aadhar, Ration cards, etc. There was so much hustle around the ration shop area; no one noticed us which is a new experience, as we were mostly viewed with scrutinizing looks in some of the villages, maybe due to our appearance or due to our mighty four-wheeler vehicle, Thar. I remember in one of the village meetings, where we had taken appointment with the villagers, they started running off in the fields when they saw Thar approaching. They had mistaken us for an official forest vehicle, but they also commented later that such a frail young woman and such a short man _ Bhagirathi Bhaiya, our driver, didn’t look like Sarkari Aadmi, so eventually they gathered around.
We met Parmila Singh, a Mitanin of Kot-Khaas. This was her ration day too; her rest of the house was busy looking for everyone’s Aadhar card. She was already occupied in her daily chores, but still informed us about the problems that were there in the village. Her para, approximately 40-45 houses, had only a single patient of Hypertension and no other issues that she could see. On asking specific questions, she told about a house where 2 of the young women, both siblings, had mental illness; she also said that despite spending a lot, approx. fifty thousand rupees, which they arranged by selling their land and their postal savings, on their illness in the city with a doctor or in a village with Ojha, the family is still suffering. As their savings have all been used up, the family is no longer treating the girls and the girls are usually found roaming in the village or are tied up at home. Parmila was not able to comment if our clinic would help the village in any way, so she gave us a neutral reply_ Haa, kar lijiye aise koi clinic. Also, Kot had a HWC which was an empty new building next to the Ration shop. We also met a young man, Amit Soni, a Lab technician by training and a MSSVP volunteer, who could not understand why a primary clinic was needed here in his village Kot, if there is already a HWC and why should specialist doctors visit a village. After this small informal talk with him we realized that Kot may not be the base for our clinic for sure.
And thus, the quest for our clinic continues..…