“We are a few kms from the borders of Burma. We have to look at ourselves and how we look at C-NES the next 15 years.”These were the opening remarks of Sanjoy Hazarika, Managing Trustee C-NES in his welcome address at the three day C-NES Annual Review Meeting organized at the picturesque, serene Mount Tabor Retreat House, Kohima from 1st- 3rd June 2014. This beautiful capital of the North Eastern hill state of Nagaland which shares its borders with Myanmar, is the land of the Angami tribe. Kohima and other Naga settlements are built on the ridges of the high ranges here, which snake along the India-Burma border, standing like sentinels to keep an eye on foes and friends.
Over 40 C-NES staff comprising of senior Medical Officers, District Programme Officers from the 15 Boat Clinic Units along with the organization’s Family planning , Community Radio teams and staff from the Regional Office, Guwahati attended the meeting led by the Managing Trustee, Sanjoy Hazarika and the CEO, Dr Dipankar Das. Eminent Trustees of the organization including Dr VA Pai Panandiker, Chairman, Board of Trustees, Dr Jayanta Madhab, Economist, Mr GK Pillai, former Union Home Secretary, Patricia Mukhim, Editor Shillong Times, Preeti Gill, Consulting Editor, Zubaan and Mr Niketu Iralu, Peace Activist from Nagaland along with Advisory Council Member Jayanta Bhattacharya, PTI Bureau Chief, Agartala were present.
Hazarika said he was happy to be here in this beautiful state of Nagaland and thanked Trustee Niketu Iralu for all his support in holding the meet at Kohima. He said that “this was going to be more than a retreat but also a sharing of thoughts, experiences and ideas. It is also a review of the work we do as an organization, as separate units and as individuals, of our growth and our failures, our successes and shortcomings, our personal and organizational/process challenges and the ways we can and are overcoming them. I am sure all of us will go back more energized and committed to the work we are doing; when we come together, we realize the synergy and power of people working unitedly for a common purpose’
The road to Kohima from Dimapur through hilly terrain, bumpy roads and rough patches was a little tedious, this being a first visit for most which was however more than made up upon reaching the serene Retreat Centre and the smiling welcoming faces of nuns who have dedicated their lives to the service of God and humanity. For three whole days they took care of the staff, meals were home cooked, wholesome and delicious complete with fresh fruits from the orchard. The stay at the Retreat Centre provided opportunities to the team for internal discussions between members, sharing and learning and living together from washing dishes to preparing presentations welcomed by green, cool forests on lush hills, washed by monsoon rains, and a constant hum of cicadas which at times threatened to drown out the speakers.
The introductory session saw the Trustees being felicitated with hand woven gamochas (towels) and mementoes – a cane basket with organic tea and pepper from upper Assam’s famous Hatikhuli Tea Estateby District Programme Officers (DPOs) of the Boat Clinic Units- Swapna Das (Barpeta II), Moushumi Duwarah (Sonitpur), Riturekha Baruah (Jorhat), Zerifa Begum (Goalpara), Manisha Baishya (Tinsukia), Family Planning Counsellor Kabita Nath (Sonitpur ) and Moushumi Borah and Sangeeta Baruah from the regional office, Guwahati. A traditional Assamese Sarai (a brass platter) was gifted by the Managing Trustee to host Niketu Iralu after which there was a group photo session with the Trustees.
In his opening address, CEO Dr Dipankar Das appreciated the challenging work performed by the field teams and spoke about how enriching this entire “boat clinic experience” has been for him. He said that strategies and policies initiated have been streamlined now and revised but with the changing health policy there is need for further improvement. The primary object of reducing MMR, IMR and TFR is slowly being achieved but what is more important is that it has to be a people’s movement. I had to be tough also with the teams since I also in my initial days battered all odds including isolation in the mountains of Arunachal Pradesh while discharging my duty. The reason is to see for oneself the local problems, solve them and guide them for which I must say that many a national Health Program has not taken off steadily because of this reason of not attending to the ground reality of resolving local issues”
“I am so glad all of you are here and thank you for the same” said Trustee Niketu Iralu. Paying rich tribute to the Assamese culture and language he said “The strongest impact of Assamese culture in Nagaland is the birth of the Nagamese dialect, akin to Assamese. I leant it from my mother as a child. Everyone in Nagaland speaks itand itis an amazing cultural phenomenon. It is the only language of communication between tribes including the underground and a wonderful gift from Assam to us” He lauded C-NES’ experience of dealing with people’s problems, more so, as according to him as “ the state today is just a salary distributing agency . Too many of our people have become leaches and that is why nothing is happening’ he lamented.
In his speech Dr Pai Panandiker, Chairman of the Trust emphasized on the need for reaching out to the community and creating a bond for a better interaction and participation with reference to his home state of Goa having a better statistics on MMR and IMR. He spoke about the importance of HEE (Health, Education and Employment) as a major tool for development in the region and encouraged C-NES to contribute within its own resource ensuring that every efforts do not go to waste. “We as Trustees will ensure that you get all possible help. Our main effort should be to enable you to have every capability to be able to offer the best you have to the people you serve”
Appreciating the Boat Clinic teams, Trustee GK Pillai said “You all have done outstanding work, however there should be more delegation at the grassroots level. Boats should be regularly maintained. You should be able to say that you will not run the boat when it is not repaired on time and should also look at the standard operating procedure (SOP). Many of the developed countries have control at the grass root level and are not top heavy, you should develop that culture. We have to keep on thinking. All suggestions should come up and experience from the field put into our perspective.”
The first session : C-NES Strategic Vision 2020: Reflecting, reinvention, reviving was chaired by Trustee Patricia Mukhim where Managing Trustee Sanjoy Hazarika put forth few critical things based on the current situation of C-NES to reflect upon.
- Issues of communication and neglect of following up. The need to take corrective actions.
- The need to have a three month balance of fund and the need for greater accountability. Better understanding between PMU and DPOs and the gaps should be filled. Persistent following ups needed.
- Do we continue on the Boat Clinic programme on this scale? Do we reduce and concentrate on just those districts where we have our own boats and make it more efficient.
- C-NES is a larger organization of which the various units are a part. No one can work as they wish but wok together.
The Managing Trustee stressed particularly on the need to monitor the weather and check with the local meteorological department before the teams set out for health camps.“We are responsible for each one of us, we cannot put anyone’s life at risk and crew members are very important for the boat” he said. “The work we do with NRHM will continue. But we must multiply our work with our limited resources of manpower, and resources at both the grass root and policy level and need to expand our knowledge base” he added. He spoke about the C-NES study on sanitation and drinking water as part of the project “Poverty and funding in the North east: States of Assam and Mizoram” supported by the Heinrich Boll Foundation, Germany. The study examines the relationship between central funds flow to the North East states and poverty. The challenge of funds faced by C-NES’ Brahmaputra Community Radio Station (BCRS) was also highlighted as UNICEF which has been supporting it so far will soon stop funding. The need to screen the films on the Boat Clinic and the shorter film on Family Planning supported by the Population Foundation of India (PFI) in all districts as part of IEC was emphasized.
On a positive note Hazarika mentioned that the New Delhi based Public Health Foundation of India (PHFI) has designed a course on the Masters Programme based on the Boat Clinics. He also informed that he had met Dr. Amitabh De, Director, IIM Shillong, on 29 May 2014 at his office where the following were discussed
- A rural health management training programme for students of IIM through a course of internship (summer) in Assam with the Boat Clinic teams to be conducted regularly
Collaboration at conferences, seminars and climate change issues
Chairing the session Patricia Mukhim said that “We are not a Government department so those at the field do not have working hours. The people we serve are a priority. Accountability is important as the buck stops somewhere. We need to evaluate ourselves” She spoke about the need to show leadership qualities and that the greatest disservice we can do to ourselves is to blame someone else” The need to innovate constantly was stressed as only when one innovates that “our USP will come out- we have to prove ourselves”. She spoke also about the need for proper reporting and documentation was important as funding agencies also look at it.
Trustee Preeti Gill highlighted the importance of connecting data with ground reality for a larger perspective and spoke about the need for more training for DPOs at both the national and state levels. There was need to organize training and reporting workshop and also on power point communication as the presentations from the field at the meeting showed the need for a lot of fine tuning and crispness.
During the session: Challenges before Boat Clinic Programmes: PMU perspectives chaired by GK Pillai , there was a presentation on the district wise Boat Clinic performance by Programme Manager Ashok Rao where correct data entry was highlighted and PMU members answered to queries from the district staff and the Trustees. A critical part of the discussion was on boat repairs and the need for immediate repair on priority basisas part of efforts to take responsibility and for greater transparency. It needs mention that C-NES’ Boat “Shahnaz” operating in Dhemaji district and donated by eminent economist Swaminathan Aiyar (named after his wife ) has been damaged beyond repair within just six years of its existence due to negligence.. A few other boats including hired and referral boats also need repairs. Pillai stressed on the importance of maintenance of boats andsaid that since boats were the organizations main asset without which the health programme cannot run, they should not have mechanical breakdowns.
He asked the districts where C-NES has its own boats to pick up authorized boat builders ready so that they can go to the approved repair shop for immediate repairs for which there should be a 15 day tender period. The DPOS were asked to stop camps if the boats were not fit to ply. He asked the district health teams to maintain a checklist for boats in consultation with the boat master and that there should be promptness in action and swift response to the same. Where there are hired boats he asked the teams to make the boat owners responsible. End of each year the districts would be assessed by how many “down” times the boat had and look at the efficiency in each district. Manik Boruah, Associate Programme Manager, in charge of Boat maintenance added that where boats are being shared between districts both teams should be equally responsible for maintaining it. He also informed that those crew members who do not have a license will be given training for the same in Guwahati by IWT in July 2014.
About the problem of short supply of medicines which was raised by the DPOs, Pillai asked the DPOs for actual facts and figures and to provide proper details, data wise which will be submitted to higher health functionaries at Delhi.“We should have a system where we inform state and centre about non-availability of medicines” he added. Another point raised by the DPOs was the non cooperation of district officials. While officials in some districts do not invite the Boat Clinic staff to their monthly Health Society meetings, some others were reluctant to undergo the boat journey and the long walk to reach health camps to see how the camps operate. Pillai said that issues of non cooperation by district officials, short supply of medicines and other such issues should be sent to the PMU by the 10thJune, 2014with the last one year’s data which could then be immediately followed up at a higher level. He also asked the DPOs to develop a structure, a common format.
Presentations were made from individual boat clinic districts in the session “ Challenges from the field” broken up into two sessions chaired by Preeti Gill and Dr Madhab respectively where the teams highlighted their work, concerns, gaps and issues. Compared to the first day, there was improved power point presentations on second day following suggestions on briefer and sharper focus by Trustees. Based on the first days observations a check list for the hired boats before they took off for camps was prepared overnight by DPOS Hiranya Deka , Shyamjit Pashi . Swapna Das , Tapan Borah Monjur Mondal, Zerifa Begum and Parviz Ahmed while responding to MT and GKP including carrying extra tools, fuels and propeller in case of an emergency breakdown.
In her presentation Sonitpur DPO Moushumi Dowerah said that in her district dominated by the religious minority there was so much taboo with regards to family planning that a family had to even leave the village as the wife was using contraceptive pills. Interestingly before the Boat Clinic intervention a lot of people were procuringa Bangladeshi contraceptive tablet called Sukhi, which was highly unreliable and accounted for a lot of unplanned pregnancies which has come down with the BC intervention, she informed.
There were concerns raised by DPOs about disruption of programme due to frequent bandh calls and at times natural disasters. While nothing much could be done about the latter,ways to tackle the former was discussed. DPO Bongaigaon Boat Clinic, Monjur Mondal cited his own example of tactfully dealing such local challenges by convincing the pro bandh groups to avoid disrupting the health camps as this was a essential service being delivered to the needy.
The presentation on C-NES’ family planning initiatives under the PFI programme was made by Chandana Borah, the Coordinator. On the Family Planning initiative Patricia Mukhim said that it is important to have a fertility data to know how much it has come down after the programme intervention and whether the initiative has made a difference. Borah spoke about the visible changes in the new districts where the PFI project was implemented and how people are readily accepting family planning measures. She further said that the earlier districts were the project was implemented had trained teams on family planning who can continue the work.The requirement of documentation training was highlighted in the discussion. And that as per PFI the training on Documentation can be held in the month of June 2014 for which a budget of RS, 1,00,000 /- was available. All DPOs can be included along with the FPC. The presentation and audio clipping from the Community Radio Station by Coordinator. Bhakar Bhuyan and Reporter Minto Baruah was much appreciated. It is worth mentioning that the radio station reporter’s profiles are quite unique. They are mostly all school dropouts, milkmen and local hidden talents who have been given capacity building training and recruited from the community.Communications Officer Bhaswati Goswami spoke about the need for proper documentation and timely reporting. She requested the teams to regularly go through the quarterly e newsletters and the website so that they get the bigger picture of the work the organization does and the need to have a visitor’s book ready in the boat clinic units for valuable feedback. A workshop on documentation and power point presentation would soon be held at Guwahati, she informed.
The Managing Trustee added “think of interesting developments/events that you have witnessed which may be unrelated to the BC programme but which have relevance and bearing on the lives and livelihoods of people in your district, record them, photograph them if possible and send them to our PMU and they will convey to me. We can put it on our website, on our news letter and even in the book that Bhaswati Goswami is putting together”.
In between sessions quick trips and sightseeing visits were organized including a visit to the Kisama village near Kohima, well known for the Hornbill festival which attracts tourists from the world over during winters and a visit to the famous Kohima cemetery.Mr. Kekhriye Sema, former IAS, who is leading the One Tax, One Govt. campaign in Nagaland and a leader of ACAUT (Members of Against Corruption and Unabated Taxation )gave a briefing to the Trust on the civil society movement in Nagaland seeking unity of various armed factions and ceasefire groups and a political settlement of the Naga imbroglio. The session was chaired by Mr Iralu on the the 1st of June followed by a special dinner hosted by the Nagaland Chief Secretary Ms Bano Jamir and Mr. Alemtemshi Jamir, former Chief Secretary, at their residence in Kohima for Trustees and Invitees.
The final evening of music and songs was delightful: team members put up a wonderful presentation of song and dance, mostly impromptu. The Trustees and the CEO joined in too. The Angami song by Niketu Iralu and his wife Christine, a trained singer and pianist was highly appreciated. Sangeeta Baruah’s Bihu was a big hit with most members joining in. The programme was beautifully compared by Chandana Bora and Programme Manager Ashok Rao was the main person behind the show. He played the key board nonstop displaying his musical talent and versatility. The evening ended with a beautifully rendered number” Till we meet again” by Trustee Patricia Mukhim.
Concluding the report with a thoughtful message from Jayanta Bhattacharya, Advisory Council member C-NES to Sanjoy Hazarika ‘This was a wonderful experience of staying in Mt Tabor for three days. I went to understand how the boat clinic functions. To me it was a life time experience. It may be like an adventure to go to chars or saporis for three four days, but to work over the years in those areas is really tough and challenging and our colleagues on the ground have accepted the challenge. ‘This innovative project became so useful to them who were deprived of health care and health consciousness. I had interacted with many of our colleagues critically and all of them told me that they found the works interesting and challenging”.
Report prepared by: Bhaswati Goswami