C-NES Newsletter (January – March 2015)

By the Brahmaputra (Vol: 29)

C-NES Newsletter
(For the Quarter January – March 2015)

 

Editorial

By the Brahmaputra 

 

Make a new ‘Assam type house’ our Icon for safety

On two successive days, the Government of India showered its benevolence on the North-eastern states.  On the first day, it declared that 15,000 crore rupees, which would be spent on building “road development projects”, in the region. Of this, not less than a staggering Rs 6,000 crore was ear-marked for Arunachal Pradesh and another Rs 2,000 crore  each for Meghalaya and Nagaland. This is a staggering amount and Transport Minister Nitin Gadkari said that the contracts would be awarded during the current financial year. The next day, an unnamed official in the Ministry of Urban Development was quoted as saying that the Centre’s largesse was also in the area of developing the existing capitals of the North-east, among others, as ‘smart cities’.

‘Smart cities’: Kohima, Aizawl and Gangtok not to mention Shillong and Imphal. A great and visionary statement for the future. But has anyone who is writing about these places or is planning for them even seen the condition in which they are in?

Gangtok and Aizawl seem to be having a competition for the largest number of casualties and damage to property they can inflict on their populations in the time of an earthquake or even a major cloudburst.  It won’t even take an earthquake to take those buildings of cement and brick down, built on soft soil: a cloudburst would do the job, said one of my friends, who is a climate and agriculture specialists and lives in Katmandu (providentially, he left the day before the quake).

The hills of Aizawl, Kohima and Gangtok are straddled by buildings.  These are settlements need first to be made safe before they can aspire to become ‘smart’. I am not surprised, however, that not a single major builder, architect, politician, government leader, technician, official or disaster expert worth his/her name has even said a word about what would happen to these cities if an earthquake measuring 7.9 on the Richter Scale hit them?

This is what a leading US disaster assessment organization has to say about the impact of a 7 Richter whammy on Aizawl, where buildings start at the base of a hill and snake all the way to the top; there are virtually no trees or green spaces in the city, everything is paved or cemented or appears to be built up on although it is also one of the cleanest hill towns in the country. The quote is from Geo Hazards International of California:

“The scenario paints a stark picture: collapse of 13,000 buildings, 1,000 landslides, 25,000 fatalities, and major damage to utilities and infrastructure…. The city’s many concrete buildings­–built up to ten stories tall, without earthquake-resistant features and on landslide-prone slopes–are especially vulnerable to collapse. Poor land use policies and poor construction practices exacerbate the hazards. Aizawl’s extremely high levels of risk have overwhelmed local mitigation capacity despite dedicated efforts by local technical professionals.”

Not just that, the article in The Hindustan Times declared in its opening paragraph that “the capitals of all North-eastern states –Agartala, Shillong, Aizawl, Imphal, Kohima, Itanagar and Gangtok – will be developed as smart cities under the government’s flagship programme.”  I was puzzled and looked at the list of cities.  That was seven states.  Guwahati was missing – did that mean that it wasn’t considered ‘smart’ enough or did not have the capacity to make that futuristic cut, what with the NRDF being summoned every monsoon to rescue people from their homes?

We’ve been expecting The Big One in the North-east – whether in Shillong or Assam – for years.  The media has been writing and gossiping and ‘experts’ have been filling the air waves with their gyan. But now that Nepal has shown what 7.9 on the Richter scale can do to a nation, not just a city, how prepared are we to cope with anything on that level or, as has been the case with Shillong in 1897 (8.5 on the Richter scale) and Assam (8.6 in 1950), with an even more severe earthquake? How many people would die and how many buildings would collapse (and where and who are the builders and owners of those buildings?) if it hit today or tomorrow or next week? How could they escape death by bludgeoning or pauperization?  What are the State Disaster Management Authority’s plans apart from holding a few drills at Digholi pukhori? What plans do the municipal committees and councils across the towns of Assam and in the hill states have? Shillong, of course, hasn’t for numerous reasons too complex to elaborate here, hasn’t had an elected council for over 40 years!

We haven’t woken up to the enormity of what could happen. And if  Nepal hasn’t opened our eyes, I doubt if anything will. And we’ll continue our selfish, blind, headless, heedless rush to death and destruction.  I would urge citizens of the states to file RTI applications in every city and town, flood the government and its departments with dak and demands, appeal to the courts and the Green Tribunals to issue orders and directions, establish resident welfare organizations that would work on these issues of safety. We must be relentless in our pursuit of this, just as the crooks and the lobbies are relentless in their pursuit of profit at the expense of lives.

The vision is horrendous.  And whom can we blame, apart from the builders lobby, bad architecture, government and politicians at all levels, and their insatiable greed for money, land and power? We would need to blame ourselves and the engineering institutes that turn out engineers who think that a four-lane highway is an ‘ultra smart’ idea in the soft terrain of our hills, vulnerable to shifting soil. They are deeply established in the technical departments of public and private sector companies, they sell these dreams and ideas to babus and politicians, little knowing that they easily turn into nightmares.

But I would underline one point: we need to blame ourselves because we have forsaken a form of architecture which has been proven as earthquake safe, dependable, green, locally buildable with local materials without ravaging our environment.  Look at the way rivers are being killed by builders and contractors in the name of sand and rock extraction, from Manipur’s Senapati district to the Brahmaputra and its tributaries.

Part of the technical answer to a major quake sits right in front of us – look at the traditional homes in Assam, in Guwahati and outside of it, in Jorhat, Dhubri, Tezpur and Dibrugarh where some of the most beautiful ones are.  Even in Shillong and Kohima. They’re called the Assam type house. Time tested for earthquake resilience, we dishonor our heritage, insult our intelligence by falling prey to the vast concrete dreams sold by builders and financiers and their partners in arms in politics and the bureaucracy. It is the Assam-type house, with new engineering, smarter and stronger, connected to the modern with cement foundations, that will save lives. It can become Assam’s USP at a time of crisis and disaster.  This must be built into law and regulations without delay.

I appeal to all chief ministers and their colleagues, chief secretaries and their colleagues, the IITG and IIM in Shillong and colleges of engineering and architecture and our powerful civil society groups – make the Assam type house, redesigned, reinforced and modern, elegant and spacious, an icon for safety and durability not the cubby holes of death trap flats. It can generate huge employment by encouraging local builders, labour and skills. We could push for plantations of ikora, which is fast vanishing and used in the walls of these vernacular houses.

Time is running out, for all of us.

by Sanjoy Hazarika

(From his regular column in the Assam Tribune )

 


Review Meet

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A three day C-NES Review meeting was held at Guwahati from the 2nd to 4th of March 2015. Fourteen District Programme Officers (DPOs)  from the fifteen Boat Clinic districts to take health services to unreached communities on the Brahmaputra were present at the meeting along with the Medical Officer of the Dibrugarh unit, Dr Deuri and Bhaskar Bhuyan, coordinator of C-NES’ Brahmaputra Community Radio Station. The meeting was attended by Managing Trustee Sanjoy Hazarika. Trustee Dr Jayanta Madhab, newly appointed Technical Consultant (Health) Dr CR Hira, PMU members and staff from C-NES,regional office, Guwahati were present. Participants shared their respective work plans, micro plans, experiences,problems faced and how best to overcome them, engaging in dialogues with the MT and with each other.

Mr. Hazarika said that while most of the team members worked hard in their own areas, but   sometimes they miss the larger picture- that they are here for a great journey and quoted C-NES’ Mission Statement “C-NES recognizes the right of every individual in the region to live in dignity, peace and safety because only under such conditions can the quality of their lives be improved and their deepest aspirations met” .He spoke about the  need to become “ a sentient being “that the district team should not only focus on health but should try and touch all aspects of the islanders lives. They should report any illegal activities harming the environment in their areas of operation including dolphin poaching.

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Rowing down the Kulsi in a country boat to view river dolphins at Kukurmara where a eco-tourism site with dolphin viewing was developed under the initiative of C-NES as part of a livelihood and conservation project supported by Ford Foundation in 2006. Dr Sanchita Baruah,Professor,Department of Zoology Kanoi College, Dibrugarh who has worked on this endangered mammal, now the national aquatic animal spoke about the river dolphins,their habit and threat to their existence.

Dr Hira said that during his initial visits to Morigaon and Kamrup he was impressed by the work of the health teams more so the quality of laboratory services given. Talking about the need of family planning in the river islands which was a is challenge given the religious and social taboo associated with it, he said that “education is the best contraception for family planning.” He said delay in receiving adequate care was one of the main  cause for the high maternal mortality rates in Assam, more so in the tea gardens and in the river islands where C-NES’ health teams work.

The meet also included a visit to Kukurmara where a eco-tourism site with dolphin viewing was developed under the initiative of C-NES as part of a livelihood and conservation project supported by Ford Foundation in 2006. Dr Sanchita Baruah, Professor, Department of Zoology Kanoi College, Dibrugarh who has worked on this endangered mammal, now the national aquatic animal spoke about the river dolphins, their habit and threat to their existence.


Field Visit

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Joint Director and DPM with the Kamrup Boat Clinic team

Dr. Amal Nath, Joint Director of Health Services, Kamrup (R) and Mr. Rajib Kr. Medhi, District Programme Manager, NHM, Kamrup (R) accompanied the Boat Clinic team to a health camp at  Uttar Matiram on 11th March 2015. The District Programme Officer Hiranya Deka introduced them with team member of Boat Clinic and gave a brief detail of C-NES and Boat Clinic, Kamrup. The camp which was held on the river bank pitching a tent continued for two and half hours. On the return journey Joint Director appreciated the hard work, Boat Clinic has been doing and stressed on the need of tracking high risk pregnant women.

 

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Boat Clinic, Kamrup team with students from TISS

Jyotismoy Deka and Zeenat Ahmed from the Tata Institute of Social Science (TISS),Guwahati campus accompanied the Kamrup team to the health camp at Nayapara on 24th January 2015. They conducted a study on menstrual hygiene, traditional practices followed by women, existing problems and taboos and developing an intervention plan. During the return journey the students told the team that they were satisfied with the responses from the villagers and this they believed was only because of the trust of the villagers in the boat clinic.

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With water subsiding during winter, the boat clinics cannot reach the destination, the targeted island villages. Subsequently walking distance to the camps become long and arduous. By the time the team reaches the villages they are tired and worn out walking. At times they get innovative and make alternate arrangements to cover such a long distance. The photograph shows the Kamrup Boat Clinic unit which had to walk through sand for over an hour to reach a health camp at Balagaon island village on 9th January 2015 returning back after camp in a horse-cart provided by a villager.


Awareness Camp 

The beneficiaries of the family planning initiative seen in the photograph with the district programme officer Tapan Borah (right)

The beneficiaries of the family planning initiative seen in the photograph with the district programme officer Tapan Borah (right)

A mega awareness camp was conducted by the Dhemaji Boat Clinic team at Laksmisuti Boro village on 14th March 2015. Health worker Kabita Banai helped the team in organizing the camp.

ANC checkups, immunization and family planning including medical termination of pregnancy (MTP) were some of the topics discussed. It needs mention that before conducting the camp, the team came to know through a survey that there were many cases of MTP which were not reported in the hospital and which often proved fatal.

There were about 80 participants in the camp which was attended by Dr. Ankur Phukon Medical Officer of Simenmukh state dispensary and Baneswar Boro, Head master of Laxmisutti L.P School. After an introduction by District Programme Officer (DPO) Tapan Borah, Dr. Phukon spoke about the importance of antenatal check-ups and benefits of immunization. Community worker Bhupen Taid spoke about the benefits of family planning and the financial aids given to the beneficiaries. Medical Officer Boat Clinic Dr. Rahul Mistri spoke about the consequences of an illegal MTP, the need to stay away from quacks and consult a registered gynecologist for the same.

There was good response from the participants who listened with rapt attention. Towards the end of the session they asked questions relating to MTP and other health issues.

On 26th March 2015 the Dhemaji boat clinic team conducted 28 laparoscopic surgeries as part of family planning initiatives in Jonai CHC.  Community workers Dharani Saikia, Puneswar Baruah and Bhupen Taid motivated the women from the most difficult to access areas- Mesaki and  Badalpur Barman .


Awareness Camp at Goalpara

Left: The resource persons led by DPO Goalpara Begum Zareefa walking to the awareness camp. Right: The Goalpara District T.B. Officer, Dr. R. D. Kakoti giving an informative talk on Tuberculosis in the local Bhatia dialect.

Left: The resource persons led by DPO Goalpara Begum Zareefa walking to the awareness camp. Right: The Goalpara District T.B. Officer, Dr. R. D. Kakoti giving an informative talk on Tuberculosis in the local Bhatia dialect.

On 18th March 2015 the Goalpara Boat Clinic unit organized an awareness camp along with a health camp in Bamuniralga III as part of the “Safe Drinking Water & Sanitation Week” from 16th to 22nd March, 2015 declared by Govt. of Assam. The District T.B. Officer, Dr. R. D. Kakoti present at the camp gave an informative talk on Tuberculosis. His talk had a popular appeal as he spoke in the local Bhatia dialect. He said that Boat Clinic coverage area should be declared as difficult area in Goalpara. Declaring the unit as Sputum collection Centre, Dr. Kakati announced that the Boat Clinic will have to collect the sputum of suspected T.B. cases. Under Revised National T.B. Control Program (RNTCP) the Laboratory Technician of the unit will be paid Rs. 50 for per case and he will have to give the sputum to Lakhipur T.B. Centre on the same day.


Basix team visits health camp

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Dr Vijay Mahajan Founder and CEO BASIX accompanied the Jorhat Boat Clinic on 23 February, 2015 to a health camp. BASIX is a Social Enterprise Group engaged in livelihood promotion of low income households in over 20 states in India and six developing countries. Dr Mahajan and his group interacted with the villagers and shared their thoughts about livehihood prospects of the people at Majuli. The health team and villagers of Majuli shared their feelings with Dr Mahajan.

Dr. Vijay Mahajan(sitting left) with the  Boat Clinic staff, villagers of Besamora and members from BASIX

Dr. Vijay Mahajan(sitting left) with the Boat Clinic staff, villagers of Besamora and members from BASIX

Follows his message to the Managing Trustee C-NES, Sanjoy Hazarika:

Sanjoy,

Thanks to you and Riturekha’s persistent help we finally found the Boat Clinic in Majuli, two hours after we thought we would. But it was worth our while to go there and see only one of your 15 boat clinics catering to the forgotten lakhs living in Brahmputra river islands.
Very good work and a wonderful, motivated team.

Best wishes

Vijay Mahajan

 

 


Pulse Polio Immunization Program

The Nalbari Boat Clinic conducted an Intensive Pulse Polio Immunization Program at Nopara and Paptamari villages in January 2015 where 131 children were covered. This was part of the Govt. of India decision to conduct the first ‘National immunization Days’ round of Intensive Pulse Polio Immunization (IPPI) on 18th January 2015 and 2nd round on 22rd Feb. 2015 where children in the age group of 0-5 years would be administered two drops of Oral Polio Vaccine (OPV) at IPPI centres followed by house to house visit by the staff in the next two days to search and vaccinate the missed/ unimmunized children.

 


Training on Nutrition and Adolescent Health Care

The DPO Shyamjit Pashi explaining the objectives of the  program at Morishali Char village.

The DPO Shyamjit Pashi explaining the objectives of the program at Morishali Char village.

A series of training programmes on nutrition and adolescent health care were organized by the Morigaon Boat Clinic during February and March 2015 supported by Population Foundation of India in collaboration with district health society. Konkona Borah, Dietician from the Nutrition Rehabilitation Centre, Morigaon was present as resource person along with diet counsellor Bhopali Kalita from Lahorighat Block PHC.  Chandana Borah, State Advocacy & Family Planning Coordinator and Dr. C.R. Hira, Technical Consultant, Health C-NES was present at Morishali char.

The introductory training on Nutrition and Adolescent health care was organized in the L.P.School of Bhangkoura char village. The ASHA & Anganwadi worker organized the camp with the help of community workers where 65 young mother and adolescence girls were present. The DPO of the unit Shyamjit Pashi explained the objectives of the training. The dietician from NRC spoke about anemia, its impact and simples measures with a corrective diet habit to overcome the situation and promoted the use of iodized salt in their food. Mothers and young girls were asked to take food rich in to prevent anaemia which is common here along with the need for regular deworming. Personal hygiene was discussed by the counselor.  Chandana Borah spoke about proper eating habits and cooking procedure at home and how food value can be improved with locally available ingredients. Participants shared their opinions.

The Morigaon health team coming from camp at  Dimbur Char 

The Morigaon health team coming from camp at  Dimbur Char

 


Building Trust: Sonitpur

Amena Khatoon from Sonitpur’s Alitengoni char, has been attending health camps regularly ever since her first pregnancy. On way to the camp early morning on 11th January 2015 the team found her  eagerly waiting for the vehicle which drops the health team to the river bank. She waved out to the vehicle to stop and requested the Medical Officer to look at her sick child suffering from cold and fever the past three days. Dr Sahidul examined the child and prescribed some medicines to the child. She expressed her gratitude. It needs mention the child was referred to district civil hospital by the Boat Clinic Medical Officer over a month ago with birth trauma as he did not cry till 24 days after delivery.

Before leaving the DPO Moushumi Dowerah asked her about she knew about teams arrival that way,that day. She smiled and said that “some villagers saw your boat at the ghat yesterday evening. That means you have come for a trip and today surely you would go by this way”.   Over time the teams have managed to strike the right chord with the villagers.


From Barpeta Boat Clinic unit II     

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A woman unaware that she was two months pregnant attended a camp conducted by the Barpeta Unit II at Jaourimari Char for a pregnancy test.  Even while she was at the camp she fainted. Extremely anemic with a hemoglobin count of only 6 gm% she has five children. The health team  found that along with domestic duties she also works in the paddy field  assisting her husband.

Repeated child birth, not adequate spacing between each delivery, unhygienic living conditions and lack of personal hygiene combined with physical labour are some of the factors responsible for poor health status of women in the river island villages. Despite regular awareness sessions on family planning women cannot adopt family planning measures even if they want to as their husbands do not support them in this decision. Where they take contraceptive pills to prevent pregnancy they often forget to take it regularly, finding  themselves pregnant repeatedly which takes a heavy toll on the health. Illiteracy is a big disadvantage.

But the health team has been noticing a positive change in the community, more so amongst the newly married couples who are open to adopting family planning measures and spacing children. The contribution of the boat clinic in bringing about awareness is significant as they build a rapport with the community and give them health tips. Women who were hesitant about approaching the health team are letting go off this inhibition and talk about family planning and their reproductive health. Regular counselling sessions with them have started showing results.


Awareness at Aunibari Sapori, Lakhimpur

An awareness camp was organized by Boat Clinic, Lakhimpur, in collaboration with District Health Society, on 3rd November, 2014 at the Aunibari L.P School, under Bihpuria Block PHC. The objective of the meeting was to spread awareness and knowledge about health and hygiene. Madhab Phukan District Extension & Media Officer (DEMO) Deptt of Family Welfare, Phanindra Das, Block Extension Educator (BEE) of Bihpuria Block PHC and health workers from Bihpuria Block PHC attended the camp, attended by about 200 people from the community including ASHA and AWW of Aunibari Sapori and teachers of Aunibari L.P School.

Madhab Phukon spoke about various health related issues such as ante and post natal care and immunization. Phanindra Das talked about prevention of diseases and the importance of family planning. Apart from this, a general health checkup and regular routine immunization camp  was  also conducted .Dr Firoz Kr Pegu and Dr Bishnu Kaman,MOs of Boat Clinic,Lakhimpur checked up 85 patients. A personal counseling was also facilitated by Madab Phukon. Leaflets were distributed among the audience and the banners about green and clean environment and the importance of hand washing were hung in the school premises. Manisha Baishya,DPO boat clinic thanked the  participants and the  district health society, Lakhimpur  for their consistent cooperation.

From Barpeta Unit I: Photo stories

 

 

 

The Barpeta Unit I Boat Clinic anchored at Nirola Char during a health camp, in the foreground is wheat cultivation. Photo Credit: Mohd Abdul Halim,DPO, Barpeta Boat Clinic Unit I

The Barpeta Unit I Boat Clinic anchored at Nirola Char during a health camp, in the foreground is wheat cultivation.
Photo Credit: Mohd Abdul Halim,DPO, Barpeta Boat Clinic Unit I

 

Sun set at Barpeta’s Bahari Ghat Photo Credit: Mohd Abdul Halim

Sun set at Barpeta’s Bahari Ghat
Photo Credit: Mohd Abdul Halim

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