By the Brahmaputra (July-September 2016)

By the Brahmaputra (Vol: 35)
C-NES Newsletter
(For the Quarter July – September 2016)

C-NES – Manipal University Collaboration

A memorandum of understanding (MOU) for collaboration was signed on 8th July, 2016 between Manipal University, Karnataka and the Centre for North East Studies and Policy Research(C-NES). Manipal University is a leading university with extensive technical and professional expertise. Being a well-established renowned Center of Excellence in education, health, research and innovation, the University has shown its capacity to strengthen likeminded institution in similar fields. The proposed collaboration will provide opportunity to Manipal University the scope to take up research/study activities in a number of areas involving different communities, regions, ecology, health, culture, demography and environment. Research and analysis on  areas of mutual concern can help in advocacy and policy decisions for C-NES as also the state and central planners for  better planning implementation of developmental and health programs. The collaboration will provide emphasis to reciprocal relationship between science and society by working together to further grass root understanding and promote mutual benefit.

Over the past fifteen years, C-NES has grown from a small group to having a substantial presence in eastern India, partnering with a range of national, regional and international organizations. The long term goals of C-NES are to strengthen people’s participation in tackling problems, using the skills, resources and knowledge of local groups, representing a rights based approach. The Boat Clinics health initiative of the organization in partnership with the National Health Mission (NHM), Government of Assam, has been acclaimed nationally and internationally or its innovation and outreach. Through the Boat Clinics basic health services is provided to some of the most underprivileged and marginalized communities inhabiting the Brahmaputra river islands in Assam.

Sanjoy Hazarika, Managing Trustee, C-NES and Dr Narayana Sabhahit, Registrar, Manipal University were the signatories of the MOU.


On Call. At Midnight

31st July 2016. After a strenuous trip to remote Tinsukia districts Amarpur sapori, the boat clinic Tinsukia unit was returning back to Guijan. The unit reached Mohmara and decided to stop for the night. Mohmora incidentally is one of the most affected villages in the recent floods.

It was 11 o’clock at night, the staff members were tired and retiring for the night after a long, busy day in peak summer. Suddenly the team heard  voices near the river bank. river. I went outside and saw that the group of people were trying to tell us something. I could make out their sense of urgency

I went outside the boat and asked them the matter. An elderly lady came to me and informed that her daughter had delivered a baby at  home. But the patient was not in good condition as the placenta was not  out even after 3 hours of delivery. I quickly went to the Medical Officers room and informed Dr. Ankur about the patient.  Immediately preparing the essentials and medicines we  proceeded to her place. Along with me were Medical Officer Dr.Ankur, K.Tanti (GNM), Tara (ANM), Chandra (ANM), Murari yadav (Boat driver) and Durga prashad (boat helper).  Access was difficult, we had to  cross a river on a small boat and then walk for almost 30 minutes wading through knee high water and slush as the village was really hard hit by recent floods. It was past midnight

After reaching the house we got to know that she delivered the child at 8 PM and no experienced personal was present at the time of delivery. Moreover this was an unregistered case , she did not take any antenatal checkups and ASHA informed us that the family did not make the woman come for  antenatal checkups inspite of regular visits by her

The M.O and GNM were able to successfully handle the case  and the placenta was delivered. The team did the best in the most challenging conditions By the time we were ready to come back to the boat it was 3.15 am. But we were happy that the condition of the mother and child were stable The condition was pretty stable, the mother had started nursing the baby.The  M.O referred the baby and the mother for better treatment and advised the family members to take the mother and the infant to the nearest hospital as soon as possible.

Bhargav Baruah
DPO Tinsukia Boat Clinic Unit


From the Sonitpur Boat Clinic Unit

Sonitpur Boat Clinic team with rescued a deer

Sonitpur Boat Clinic team with rescued a deer

The Sonitpur Boat Clinic team rescued a deer from the sweeping flood waters in July 2016. It was subsequently handed over to the Department of Forest. The work of the Boat Clinics go beyond just delivering basic health care.

Students from Tezpur University visits CNES

Students from Tezpur University visits CNES

A team comprising twenty eight students and four faculty members from  Tezpur University’s Department of Social Work visited the Sonitpur Boat Clinic Unit to see the work of the health team and how health care is delivered to remote islands which lack any infrastructure.

Mousumi Dowerah with Dr. R.C. Deka

Mousumi Dowerah with Dr. R.C. Deka

Mousumi Dowerah, District Programme Officer Sonitpur handing over the recently book on the Boat Clinic’ Hope Floats” coauthored by C-NES Managing Trustee and Communications Officer Bhaswati Goswami to Dr. R.C. Deka, Superintendent, Tezpur Medical College & Hospitals on 30th July 2016.


Media on the Boat Clinics

Held as a flagship innovative programme by the Government of Assam, the Central Government and UNICEF, the boat clinics along with other C-NES initiatives have been written about extensively in local, regional, national, and international media. The links recent coverages follow:

http://www.firstpost.com/living/in-flood-hit-assam-dedicated-boat-clinics-help-to-keep-hope-good-health-afloat-2963836.html

http://m.timesofindia.com/city/guwahati/Radio-station-plays-Good-Samaritan-in-upper-Assam/articleshow/53425937.cms (On C-NES’ Community Radio Station)

http://qz.com/758984/in-photos-life-on-assams-shifting-islands/ (A photo story by Devjyot Ghosal, a roving editor at Quartz on flooding in the river islands)

http://www.ourstories.org.in/special-series/3290/ ( An essay from ourstories.org.where CNES has been quoted)


Visitors from SELCO Foundation

Officials from SELCO Foundation, Bangalore, Adritha Subbiah Senior Analyst, Policy Team and Dipayan Sarkar, Projects Head visited Jorhat Boat Clinic on 9th July 2016 to make an assessment of the solar power requirement. The Boat Clinic team was on their regular five day trip and was travelling back to Nimati ghat on 9th morning. As the visitors waited on the banks of Nimati ghat they could see the boat traveling towards the ghat against the strong current of monsoon waters delighted to see the vastness of the mighty Brahmaputra and the sight of the Boat Clinic as it approached and team members on board waving in acknowledgement.

The Boat docked on the bank and the team came down to welcome the visitors and were introduced by DPO, Ms.Riturekha Baruah. Both Adritha and Dipayan inspected the Boat and then discussed with the team members about the equipment’s used and power required. Programme Manager Ashok Rao accompanied the visitors. SELCO will prepare a proposal on solar solution for Jorhat Boat Clinic and if possible look for CSR fund with Jorhat as a pilot project.


Importance of Health Education in Island villages: A Report

The environment has a close relation with human health. Studies show that   water borne diseases such as diarrhea, dysentery, cholera, gastroenteritis are common in rural areas, urban slums and tea gardens due to poor sanitation and contaminated drinking water. Vector borne diseases are comparatively higher in these areas. Both morbidity and mortality are also high due to  insufficient medical facilities. Lack of health education and awareness also contributes towards higher infant & child mortality rate in these areas. Most children here suffer from water borne diseases. Malnutrition is high.  The health scenario is similar for the river islands where the Boat Clinics operate. Water borne and vector diseases are the common causes of higher morbidity and mortality.

However while both rural and tea garden communities are covered by permanent health facilities- sub-centres, rural hospitals, tea garden hospitals the river islands have no such facility. Here the Boat Clinics are the only hope for the people, but being mobile units, moves from one island village to the next and returns to a particular island village only after a definite period. In this context imparting health education, awareness generation and promotion of best practices of preventive health is the best way to help people deal with basic health issues. The empowerment of people with health education and practice needs special attention and effort. As health issues, practices, knowledge level, socio-economic status are different from one island to the next specific issues to address needs to be addressed while planning  IEC/BCC sessions for classified audiences. The Boat Clinic unit, Dibrugarh district has been trying to incorporate health education  in its routine camp session, some of the critical issues the team has noted from their experience is that more audio-visuals need to be made in vermicular medium to be effective, time is a constraint as the teams have to move on to the next island so the audio-visuals need to be short. Again  logistics is a challenge too.  The need is to develop issue/ area specific IEC/BCC material and have regular  systematic sessions.

Arup Kumar Saikia
District Programme Officer, Dibrugarh


National Workshop on Brahmaputra Basin: A Report

C-NES’ Programme Manager, Ashok Rao, APM, Manik Ch. Boruah, State Advocacy & Family Planning Coordinator,  Chandana Bora and Technical Consultant, Dr. C. R. Hira attended a one day country level workshop on Trans boundary Policy Dialogue for Improved Governance of Brahmaputra River Basin on 12th August 2016 at the Hotel Radisson Blu, Guwahati. The workshop was organized by the South Asia Consortium for Interdisciplinary Water Resources Studies, SaciWATERS in association with the Department of Humanities, IITG and C-NES. SaciWARTERS is a policy research institute based in Hyderabad and the workshop is a part of the 3rd phase of a project undertaken a joint dialogue initiative involving four riparian countries i.e. India, Bangladesh, Bhutan and China towards effective and sustainable co- management of Brahmaputra river basin. The workshop was attended by members of civil society,officials and experts from Arunachal and Assam. Special Secretary to the Water Resources Ministry, GoI,  Amarjit Singh was  present in the workshop and made a presentation on the Brahmaputra. On behalf of C-NES, Ashok Rao and Manik Boruah shared  their experiences while working on Brahmaputra through the Boat Clinic services and spoke on relevant issues of concern including the proposed dams planned in Arunachal, India and in Tibet by China.  DPOs Arup Saikia from Dibrugarh Boat Clinic Unit, Mehebub Hazarika from Dhubri Unit II and Swapna Das from Barpeta Unit II  also attended the workshop.


Floods in Assam 2016: Photo stories from The Boat Clinic Units

Every year, millions of people are displaced and extensive property, crops and livestock are destroyed in annual floods in Assam and in downstream Bangladesh. Health problems are acute. Many are affected by water-borne diseases. A major problem is access to medicines and sustained health care.

As for Assam,the two valleys are prone to periodic devastating floods and consequent erosion which not only reduces or degrades the amount of available arable land, but also results in large scale destruction of infrastructure.This year’s floods not only destroyed lives,property and agricultural produce, but also brought about pest epidemics which have further lessened production.Follows a coverage of the flood and the damage done by the different Boat Clinic Units through out Assam.

Dhubri Unit I and II

The flood situation in the district  worsened with not only villages/char sapories  but also towns of the district getting submerged under water. As per report of the district disaster management authority, as many as 4,66,850 people in 371 villages have been affected fully and rest are partially affected.


Barpeta

16 flood relief camps were conducted by the Barpeta Boat clinic Unit-II . There was large scale damage to crops and agricultural fields, entire households were swept away. Bad road condition due to floods made it a challenge to reach the river banks where the boat is anchored.


Nalbari

The Nalbari boat clinic conducted  9 flood relief camps  from 27th July to 30th July where  674 patients  were treated. On July 30th the Governor of Assam visited  Tupkarchar where the Boat Clinic team conducted a health camp to see the flood condition in the district.


 Lakhimpur

The Lakhimpur Baot Clinic Unit  organized a Mega Flood Relief health camp on 6th August 2016 in association with the All Assam Medical Services Association (AAMSA) The health team included 12 Doctors.


Dhemaji

Dhemaji district was severely affected by the recent floods. The district boat clinic unit conducted two awareness camps at  Kobu Bazar and Kobu Nepali Ghat under Jonai BPHC on 9th July 2016 along with a flood relief camp. Medical Officers of the Boat Clinic Dr. Vivek Sahu and Dr. Yuwaraj Majumdar, spoke on diarrhea and sanitation respectively. Community Worker  Bhupen Taid spoke on prevention of water borne disease.


Jorhat 

he Jorhat  Boat clinic participated in a flood relief camp at Majuli’s Subidha sapori  as directed  by Joint Director of Health Services, Dr. Amrit Saikia on 16th August 2016. Furfuria Sub Centre and Sikoli Sub Centre also participated. Food and clothes were distributed with medical help. The boat clinic was assigned with a disaster management team and a veterinary team consisting of two members each. The teams  stayed and provided their services along with boat clinic crew in the affected areas. Assistant Commissioner Megh Dahal,  Prankrisna Gogoi from Disaster Management, Dr Ranji Gogoi and one field assistant from Veterinary department were with the health team for second round flood relief camp.

The Assam Chief Minister Sarbananda Sonowal visited the Jorhat Boat Clinic Team at Nimati Ghat on 7th August 2016. The health team felicitated him with a hand woven Gamusa. The Chief Minister was accompanied by ADC Health Utpal Doley, Joint Director Health Services Dr. Amrit Saikia, SP  Jorhat Smt. Amanjit Kour, SDO Inland Water Transport Sri. Bimal Tamuli and other dignitaries. The team presented C-NES  Annual Report with  a current flood report and overall activity report of  15 Boat Clinic units of  2016-17 in his hand. The Jorhat district administration has been supportive of the Boat Clinic and the visit was arranged by the district administration and Joint Director Health Service Dr Amrit Sakia

Earlier in May 2016, the Jorhat Boat Clinic conducted an awareness drive on ‘’Menstruation Cleanliness” in  10 island villages for women and adolescent girls. It was a welcoming change to observe men attending the meetings. Cleanliness, personal hygiene and the need for a healthy diet to reduce Hemoglobin deficiency was stressed. The health team informed that sanitary napkins ‘’Freedays Napkin ‘’ are available with ASHAs at a nominal amount of Rs 6. It is seen that most girls leave school after puberty due to social norms which isolate them. A documentary on

“Menstruation cleanliness” was screened with the help of projector in the villages. In June 2016 the Jorhat Boat Clinic also conducted an awareness programme on ‘’Maternal Mortality ‘’ where the DPO with help of ANMs interacted closely with pregnant women about the need to take good care of their health.


Awareness camp at Bongaigaon

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DPO Bongaigaon, Monjur Hussain Mondal participating at the Population Control fortnight.

Boat Clinic Bongaigaon with the help of Boitamari BPHC  organized a  demonstration and awareness camp in the various flood affected areas along with group discussions on flood preparedness, related  water and vector borne and other communicable disease like diarrea, skin infection, malaria, typhoid etc.  Water purifying tablets were distributed  to ensure safe drinking

The Boat Clinic team also got in touch with  experts and public health officials and requesting to provides some local needs in flood prone area like phenile, blecine power. The BC community worker closely monitored the situation and held regular discussions with ASHAs and AWWs for any health related issues.

After being trained by DHS Bongaigaon, the team similarly organized  many awareness and demonstration camps on diarrhea and population control from 11th to 24th july 2016 in the boat clinic operational area and supplied ORS and ZINC tablets to children from age group 6 month to 5 year.And as population control fortnight the team was able to successfully conduct 11 laparosecopy and 9 IUCD female sterilization.


Goalpara

On 12 th July, 2016 the District Family Planning Co-coordinator from Agia PHC visited  Boat Clinic Goalpara unit. With the help of District health Society the  Boat clinic unit organized an orientation programme on  consumption of ORS and Zinc tablets under IDCF with emphasis on  diarrheal disease. The  World Population day was also observed and the team gave awareness to the villagers about Family Planning.


Awareness session for school children

The Tinsukia Boat Clinic unit conducted a health camp at Majgaon village in July 2016 in the local school building where 28 children were attended to.  An awareness session for students and their guardians was also held with the help of the L.P school teacher and ASHAs of Majgaon and Sonitpur village where personal hygiene and cleanliness was highlighted along with precautions against  diarrhea and other water borne diseases. Importance of handwashing was emphasized and demonstrated by the community workers. The heath team distributed ORS packets to children.

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