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By the Brahmaputra (Vol: 51)

C-NES Newsletter
(For the quarter July- September 2020)

The Tinsukia Boat Clinic celebrates the Indian Independence Day onboard on 15th August 2020. On way to conduct health camps in flooded island villages

As floods ravage Assam once again and fear of the pandemic looms large, this is how the Boat Clinics work. Every year, every monsoon-facing an angry river, the flood fury, wading through knee-high water, walking for miles, and reaching out to the flood vulnerable and needy living in the far-flung Brahmaputra river islands.

C-NES’ 15 Boat Clinic teams from Tinsukia in upper Assam to Dhubri, bordering Bangladesh. The pandemic added a different and extremely challenging condition this year   In each campsite, social distancing was maintained as best possible. Medicines were distributed onboard.

  • Health and immunization camp in the remote Madhupur village at Amarpur island by the Tinsukia Boat Clinic
  • Health and immunization camp in the remote Madhupur village at Amarpur island by the Tinsukia Boat Clinic
  • Health camps by Tinsukia Boat Clinic during floods

Besides health and flood relief camps, awareness sessions on flood and post flood diseases and prevention was also conducted in most villages. A photo story during monsoon from July and September 2020.

Barpeta II Boat Clinic Team on way to set up health camps through a flood submerged village.
Barpeta I Boat Clinic Team on way to health camps in a small country boat through flood submerged villages
Flood relief camp at Domdoma NC by Barpeta Unit I Boat Clinic team
Bongaigaon Boat Clinic Team reaches people in Flood affected islands and set up health camps.
Bongaigaon Boat Clinic Team reaches people in Flood affected islands Homes are inundated. Tube wells are under water so there is no drinking water
Use of small country boat by the Nalbari Boat Clinic team to reach flooded river islands
Flood relief and health camp at Nalbari’s Chaprapara 1 village. Camps were mostly held in highlands locally known as “Sibir” or onboard.
The Dhemaji Boat Clinic team conducting camp at Boria island village
The Dhemaji team at Fransalian High School, Jonai for a health camp
The Dhemaji team on way to conduct camp in a country boat
Flood relief and health camp by the Morigaon Boat Clinic team at Paptamari island village
On way to flood camp at Buragaon LP School, Morigaon team
Morigaon team conducts immunization session at Suber char
Immunization session at flooded Chitolmari char village Morigaon
The Kamrup Boat Clinic on way to conduct camps during floods.
Pregnant women come in country boats for health service to the Kamrup boat clinic in flooded Balagaon island village
Kamrup team on way to a flooded Chhaygaon area island village to deliver health service
The Kamrup team conducting an awareness as part of family planning fortnight in a flooded village
A woman and her child being helped onboard for vaccination
Community water filters being distribution to ASHA workers and village headmen during floods in all districts
Flood relief camp by the Dibrugarh Boat Clinic team
Health camp by the Dibrugarh Boat Clinic team in flooded island villages
The Dibrugarh boat clinic “Akha”being sanitized by District authority
Flood ravaged Charkhulia sapori village as the Dibrugarh Boat Clinic team finds it while trying to conduct a camp
A constantly rising water level in the island villages of Dibrugarh with both Lahoal and Panitola BPHC under water
The Goalpara Boat Clinic team conducting a COVID-19/ general health camp at Killasara char in collaboration with Lakhipur BPHC Goalpara on 11th August 2020.
Awareness on safe drinking water by the Goalpara team
A flood relief cum health camp conducted by Dhubri Boat ClinicI at Dhubir island village
“SB Rustom” Dhubri Boat Clinic I being sanitized after Covid service in August
Post flood health camp conducted by the Dhubri Boat Clinic Unit-II
The Jorhat Boat Clinic on way to conduct camps in flooded villages of Bhimpara, Besamora, Salmora villages
Swab collection from health workers of island villages of Dhudang, Furfuria and Sikoli areas under Jorhat Boat Clinic .

With the water level of Brahmaputra increasing during July 2020, ferry services were closed. Majuli was flooded. In some of the Jorhat Boat Clinic campsites, cattle were given shelter in village platforms. Covid positive cases were found from the island areas. In each campsite, social distancing was maintained. the photographs shows precious livestock and cattle being given shelter at Jorhat’s Bilotia sapori island village
Screening of patients by Jorhat Boat Clinic
ANC check up at Gopal chuk
Women and children wait for their turn patiently. Social distancing norms being maintained at health camps being conducted by Lakhimpur Boat Clinic
Awareness Meeting on Population Control week by the Sonitpur Boat Clinic team at Tintikia char maintaining Social distancing even amidst flood
Awareness Meeting on World Breast Feeding Week at Pub-Lanke char maintaining Social distancing by Sonitpur Boat Clinic team in August 2020
Mousumi Dowerah, District Programme Officer, Sonitpur Boat Clinic attending the final review meeting on PM’s innovative idea Award. The district administration has tried to showcase the district Boat Clinic for exemplary health sector field work for the award from that district

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 Quint , Jul 30, 2020

Boat Clinics of Assam: Bringing Healthcare to Millions

For the 30-lakh people living on the 2500 river islands of Brahmaputra, the boat clinics are the only healthcare option. 15 boat clinics operate across 13 districts of Assam, providing free treatment, medicines, vaccines and diagnostic facility to the people living on the river islands.

The Clarion Indi , August 18, 2020:
Assam’s Boat Clinics are the only Hope for Million to Fight Coronavirus Pandemic

South Asia Monitor, Sep 10, 2020

BOATS OF HOPE: ASSAM’S UNIQUE HEALTH LIFELINE

Vivekanada International Foundation, November 11 , 2020
The Boat Clinics of the Brahmaputra: Life, Hope, Healing

C-NES Intern

Boat Clinics have provided opportunities to students doing research on delivery of primary healthcare and education to the islands on the Brahmaputra. Research studies have been conducted by students from across the globe for the last eight years. While the interns have benefited from the unique work the organization does in the Brahmaputra valley be it in the spheres of health, education, conflicts and communications (through the Brahmaputra Community Radio Station) among others, the organization has also gained from their internship[1]. Their work with the organization and the reports shared with C-NES has given the organization constructive feedback focusing as they do on both the positive impacts of the Boat Clinics and the organizations work as also the gaps which need filling up, valuable suggestions for improving service delivery with a fresh perspective

Abhinav Sankar Goswami, from TISS Guwahati’s, Centre for Undergraduate Studies Interned with C-NES in December 2019. His internship was to understand the socio-economic scenario and complexity on the ground as a participant though the Boat Clinic as the programme is “highly successful and extremely attractive to engage young people to work in the sector of both public health and community service which would help him in expanding his horizon to further continue my professional community service in future.

The report below was covered also by the Vivekanada International Foundation – https://www.vifindia.org/article/2020/november/11/the-boat-clinics-of-the-brahmaputra-life-hope-healing

Intern Report

I woke up to a beautiful breeze right through the windows of the S.B. Nahor (boat clinic for Jorhat district) on the morning of the first weekend of December last year. What could I ask more? The previous night, I slept with the excitement of waking up at “Luitor Bukut” meaning, at the heart of Luit. One can imagine my extent of excitement and enthusiasm if enquired to the closest of my friends. Anyway, long story short, I was on S.B. Nahor with the dedicated team of medical practitioners, healthcare professionals, and community workers led by the District Project Officer (DPO) of the Boat Clinic Initiative of Jorhat as an intern at the Centre for Northeast Studies and Policy Research (C-NES). I went there to understand the grassroots reality of healthcare and the family welfare of the people in the ‘saporis’ or riverine islands of Majuli and to carry out independent research on assessing livelihood opportunities.

The existence of the “Boat Clinic Initiative” dates back to June 2004-05 when C-NES launched the initiative to make better healthcare efficiency for the diverse communities in the riverine islands of Brahmaputra valley with a focus on routine immunization of children, pregnant mothers, and new mothers. The concept has been widely applauded and won a World Bank award for innovation for bridging rural gaps. Over the years, the initiative has expanded its operation to thirteen districts from Dibrugarh being the first district. The initiative got a new dimension when it came into collaboration with the National Rural Health Mission (NRHM) ushering one of a kind model of Public-Private Partnership (PPP) in the health sector. Apart from NRHM, financial aid and other support have also come from ONGC Limited, OIL, Indian Oil Corporation (Assam Division), Numaligarh Refinery Limited (NRL), State Bank of India, Jalan Industries, and district administrations of various districts. 

My experience with the initiative was for twenty days with ten days in the camp, which means; moving in the boat from saporis to saporis of Majuli. The purpose of the boat clinic is intensely specific to the healthcare needs of the ‘char-saporis’ situated across the long course of Brahmaputra in Assam. In the sense, ‘saporis’ of Majuli are dynamic in the geographical sense, they are not permanent. These ‘saporis’ or riverine islands get eroded by flood annually and change their positions. The government cannot construct permanent hospitals and therefore, the requirement of boat clinics is imperative in every district. It was a crucial exposure for me as a resident of the state and as a student of social sciences to acquire a ground-zero understanding of the public healthcare system in Assam. The principal focus areas of the program are along the lines of curative care, reproductive and child care, family planning services, and basic laboratory services. One of the most concerning phenomenon which I noticed was the absence of family planning and the prevalence of malnutrition among mothers and children. Personally, observed a significant portion of young mothers bearing three children below the age of five in many villages. These challenges are among the top priorities of the Boat Clinic Program to improve the health conditions of the people. Apart from the medical and administrative staff, ASHA workers and community workers are fundamental to the success of the initiative. It is noteworthy to appreciate the rapport building between the ASHA workers, community workers, and the target population which is substantial for the sustenance and success of healthcare awareness. In recent months, the boat clinics have also contributed essentially to the challenges inflicted by COVID 19 in the riverine islands across the valley. 

Being a twenty-year-old living in Guwahati for all my life, my comprehension of rural Assam or Assam, in general, has been myopic. I happen to only visit the villages adjoining to the national highways in the Brahmaputra valley until then. I do not doubt saying that I learned about my land beyond urban discussions and academic readings. Hence, such an experience is deeply personal to me apart from expanding my horizon of knowledge professionally on the sectors of health and family welfare. Also, my romanticist expression of “Luitor Buku” comes from the privilege of staying for ten days as an escapist adventure from regular life. However, it takes tons of effort for the teams of the boat clinics to deliver service to the most vulnerable in the remotest of riverine islands.

Abhinav S. Goswami
Centre for Undergraduate Studies
Tata Institute of Social Sciences, Guwahati Campus
Tetelia Road, Jalukbari, Guwahati-13

This beautiful shot from the Jorhat Boat Clinic conveys a message of hope amidst the despair of flood and fear of pandemic

Send your questions, comments to: co.pmu@c-nes.org

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