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By the Brahmaputra ( Vol: 56)

C-NES Newsletter

(For the period April– June 2022)

International Nurses Day

Nurses Day is a special day to honour and celebrate the contributions of nurses all over the world. The day is celebrated on Florence Nightingale’s birth anniversary on May 12 every year. The special day was chosen by the International Council of Nurses and has been observed officially since 1974. Like nurses all over, the ones that serve the 15 Boat Clinic units do it  with a lot of dedication and sincerity.  The team members  express  gratitude to the dedicated nurses who work tirelessly, passionately and selflessly.

Glimpses of International Nurses Day Celebration in Boat Clinic Units(above).

C-NES Interns write:

Nandinee Sikdar and Safwan T, final year Masters (MASW Public Health) students of Tata Institute of Social Sciences, Guwahati interned with C-NES during May 2022  as part of fieldwork necessary for their academic requirements.

Follow their experience with the Boat Clinics at Kamrup and Majuli below:

Amidst every storm there is hope and this fieldwork experience with C-NES taught us the true essence of this possibility. From 9th of May, 2022 as an instrumental part of our curriculum we started our fieldwork with C-NES. We engaged for a 21-day period within which our primary task was to work with the Boat clinics of Kamrup and Jorhat (Majuli)in Assam and work around a central theme: ‘Health, livelihoods and poverty in the islands’. In Kamrup, we had the opportunity of attending the day-camps while with the Jorhat boat clinic team we had the opportunity to work on overnight medical camps. We were able to cover 8 saporis or island villages altogether namely Taparpathar, Kalardia, Burhakatapam, Noljuhi, Balagaon, Bhekali 1, Sikolichapori and Kartik across both the districts.

The medical camps  primarily designed to provide routine immunization services, maternal and child health care services, family planning services and general checkups are clearly serving a wide spectrum of patients especially pregnant women, lactating mothers, children between 0-5 years and children between 5-10 years in the isolated and medically inaccessible islands. Thus, in turn bridging the larger healthcare access issues of the population  residing in the islands resting in the Brahmaputra valley. In order to understand these nuances of accessibility from service provider and user-perspectives, we engaged in a wide range of activities such as conducting transect walks with kids and boat crew members, conducting interviews of the service providers as well as the users, documentation of existing medical systems in the islands through sub-center visits and  understanding the linkages between NHM Assam and the boat clinic intervention through Block PHC visit in Chhaygaon. However, within this stipulated time period, our expectations were quite minimal yet the outcomes and learnings went far beyond our perceived consciences. It was an eye opening experience for us to observe and learn a diverse range of ground realities and the everyday challenges of access of the service providers in dedicatedly providing services to the char populations since the last 10-12 years.

The interns with children from the community after conducting a transect walk in an island village of Majul

During the medical camps with both the Kamrup and Jorhat teams, we had a great on-field experience and their friendly behaviour made us feel comfortable and welcomed. Each one of the team members were wholeheartedly willing to guide us, clear our queries and make this field-work experience an enriching one. Not only the medical team, the rest of the crew members were also very helpful especially the two DPOs were very informative and we got the opportunity to learn and reflect from the on-ground insights they provided us about the socio-demographic features of the populations, the major disease trends in the islands and how far the boat clinics have been able to penetrate as a concrete medical healthcare institution for the islands. With the help of a wide range of stakeholders, we were able to experience realities and our learnings  from the field have been innumerable, however, as young public health professionals our whole perspective of looking at accessibility from the standpoint of merely the users has transformed and this fruitful fieldwork experience has been the fundamental driver of this perspective change. But though the experiences were quite ground breaking, the experience of travelling in a boat especially staying overnight during Jorhat boat clinic trips, heavy rains, strong river currents and high-risk storms during the Kamrup boat clinic visits were in itself massive challenges as interns yet the enriching experience and optimism we received from the teams helped us to overcome such challenges with ease making the entire experience remarkably fruitful.

Thus, for this eye opening experience we undoubtedly would like to present our gratitude to C-NES for providing us this immaculate opportunity to learn, unlearn and relearn from the ground realities of the populations residing in the chars and helping us to reflect on how issues of accessing basic healthcare still remains a luxury for many poverty stricken islanders of the Brahmaputra valley. And how interventions like the Boat Clinic initiative of C-NES remarkably is playing a fundamental role in eradicating many such issues of access and bringing hope closer to the people.

Thank you, C-NES Team

Nandinee Sikdar (MASW Public Health)
Safwan T. (MASW Public Health)

Interns from Vrije University, Amsterdam 

Interns from the Dutch University share their action plan and internship progress with  C-NES members at an online session

In March 2022, C-NES and the Amsterdam based Vrije University’s Athena Institute pre-master course- International Public Health starteda collaboration which commenced on 8 March 2022 and ended on 10 May 2022. The partnership  focussed on supporting a group of  four  pre-master students from Health Sciences premaster program at the university for an online internship. Bongaigaon in lower Assam and Majuli (Jorhat) in upper Assam, were  the two districts where the virtual internship took  take place and the students conducted an online  study on “Boat Clinics and Impact on maternal health.  Follow their experience:

Lard’s experience with the online internship at C-NES 

I am a biomedical analyst.  Doing this project with C-NES was a very interesting experience. Before this project I had little experience with mixed-methods research, and familiarizing myself with the literature regarding maternal health in India was a good way of learning how to investigate these types of health issues.  
The way of life on the islands of the Brahmaputra was completely foreign to me, and in the beginning, it was hard to comprehend the challenges that living on the Brahmaputra brings. The boat clinic project was inspiring to read about, as the river seems to be quite difficult to navigate. This fact makes the progression that the project has made a great achievement.  
It was enlightening to hear the stories of the crew on the boat-clinics; their information was key in understanding the health care situation on the islands and how physical and social factors influence it. The knowledge of the boat crews regarding the local community seems to me a very important factor in the success rate of the project.  
Investigating health care issues so different from my own situation has given me insight in the challenges many people across the world may face. This is something I will carry with me as I continue my studies, along with a great respect for the people working on these types of projects. 
I hope the project is able to reach its further goals, and create new opportunities for funding or others types of collaboration. I thank all the people from C-NES for the time and knowledge they made available to us! 

Luke’s experience

I am a lifestyle coach/research assistant.Before starting with the course ‘international health’ I was doubting between the course’s international health, and public health and prevention. I eventually decided to follow the course international health because I wanted to widen my scope on health in an international context. Together with my group members, we were given the opportunity to conduct a needs assessment for the C-NES organisation where we focussed on the boat clinics. Only after the first interview with workers with several backgrounds from the boat clinic in upper Assem, did I start seeing the complexity and severity of several problems which are present today. Of course, we did our back research and saw skyrocketing numbers when it comes to the prevalence of some diseases, mortality rates or crucial determinants of health such as poverty, lack of education and/or environmental threats. However, after conducting the interviews and footage which were shown to us by the friendly workers of the boat clinics, it made an impact on me. To see under what circumstances these people live, with what an environment they must cope each day, and yet how they maintain their daily routines, it is unbelievable how privileged we (Dutch students) are. 

It’s good to see what the boat clinics are doing for the people of the Brahmaputra River, what they already have done and what they are still striving for. With the workforce and materials, they have, they can do a lot to improve the overall health of these people, but there are still many barriers which cannot be solved by the boat clinics on their own.  Environment, poverty, infrastructure and education are severe contributors to the lower overall health of the people in the Brahmaputra River. I hope the problems which the boat clinics are trying to beat do get the (inter)national attention it deserves.  Collaboration with the government is a need. 

I want to thank the boat clinics for everything they do for the people in the Brahmaputra River and the effort they put into this project to collaborate with us.

Lindsay’s experience

Rosanne and  I are  community nurses.  Commissioned by the VU University in Amsterdam my group members and I had to conduct a community needs assessment. We spoke with stakeholders from the C-NES organisation who provided us with the essential information to start our research. We had the privilege to conduct our research in two districts of Assam: Bongaigaon and Jorhat (Majuli). We had group interviews with several key informants, such as the community workers and the medical teams from the boat clinics who know much about the (tribal) communities living in these two districts. Our meetings and interviews took place online via Zoom. Despite the few times we had a connection error, we could understand each other well and see the people we were talking with. Not being able to actually be there and see for myself how the situation in these districts are, is unfortunate. Nevertheless, I’m glad that the internet has made it possible for us to connect with the organisation and learn about the connection they have with the islanders and about their traditions concerning maternal health. All in all, it was an overall unique experience to be able to work with the C-NES organisation, even though they are a company on the other side of the world.   

VHAI-UNICEF Project Monitoring and Review meeting

A project, ”Empowering community-based institutions for supporting Risk Communication and Community Engagement (RCCE) for COVID-19 and Routine Immunization” is being  is carried out by C-NES in 4 blocks of two districts in Lower Assam for a period of six months,  starting from March 2022.

The projects aims to mobilize the eligible population for the uptake of COVID-19 vaccination with special focus on increasing the second dose coverage, mobilize the teenage population (15-18 years) and the 60 plus population for COVID-19 vaccination and precautionary (booster) dose, promote COVID appropriate behaviours and support the overall routine immunization uptake while delivering COVID-19 vaccine promotion. Goalpara Urban block and Lakhipur block in Goalpara district and South Salmara Urban block and Gazarikandi block in Barpeta are where the project is being implemented. Preliminary activities like mapping of intervention villages, identifying of Community based organization, and influencers have been completed.

A group photograph at the review meeting at Guwahati Address hotel. Members of the project from various organisations attending the review meeting. C-NES members in the picture: First column from right – Anup Kalita, Accountant and  Abhinoy, Assistant Program Manager. Third column from left Mustafijur Rahman, District Coordinator.

On 11th and 12th May a two -day review meeting of the project was held in Guwahati. On the first day, Abhinoy Sinha, Assistant Program Manager, C-NES along with Dr Swapnil Jain, National Coordinator, VHAI visited Lakhipur block of Goalpara district for monitoring project activities. Mustafijur Rahman, District Coordinator conducted a training session on capacity building of local CBOs, volunteers and influencers from the target village on the need for COVID-19 vaccination and maintaining Covid appropriate behaviour at the Lakhipur BPHC Community Health Centre, Goalpara. On the second day, a review meeting was conducted at Hotel Guwahati Address’s meeting hall attended by Abhinoy Sinha,  Mustafiur Rahman, and Anup Kalita, Accountant from C-NES. The VHAI team evaluated  project activities and financial aspects of the project.

Training on Covid vaccination for adolescent drop outs

A day long training program was conducted by C-NES on 30th April’ 2022 at the regional office, Chandmari, Guwahati for the twelve newly appointed employees working on the project titled “Covid-19 Vaccination of Adolescents in Char Areas of Assam”  andsupported by Impact India Foundation (Dasra) and Purpose, India project’ The objective of the project is Vaccinating the adolescent population (12-18 years) in the riverine islands of three districts of Barpeta, Lakhimpur and Morigaon. The project  of 4 months starting from April. The speakers were Dr. Milan Barooah, Special Advisor, Ashok Rao, Programme Manager, Bhaswati Goswami, Communications Officer,  Nirmali Das, Research Analyst and Abhinoy Sinha, Associate Programme Manager  .

The training was undertaken to familiarize the participants with the project objectives and components and to enable them to learn about the different techniques and methods that can be employed to execute the project efficiently. The training programme also sought to give the participants a holistic understanding of the project; understanding of basic vaccination protocol for ANMs, communicating with the community regarding Covid-19 and Covid-19 vaccination and building trust and enable them to undertake interventions accordingly.

Book Launch at IIC, New Delhi

An attentive audience comprising of scholars and diplomats, writers and researchers as well as senior officials from the Centre and states attended a book launch at New Delhi’s  India International Centre on June 22, 2022. The programme was organized by Francis and Taylor, the international publishers of the book, and the Centre for North East Studies and Policy Research (C-NES).

Seated (Left to right): Takehiro Tsuchiya,  economic counselor at the Japanese embassy, Indian Ambassador to Myanmar, Afghanistan and Syria, Gautam Mukhopadhyaya, Minister Chandra Mohan Patowary, C-NES Managing Trustee Sanjoy Hazarika and former Prof Srabani Roy-Choudhury of the Centre for Japan studies at JNU .

In prepared remarks which were read on his behalf by Sri Chandra Mohan Patowary, Environment and Forest Minister, at a book launch on “North East India and Japan, Engagement through Connectivity”, Assam Chief Minister Dr. Himanta Biswa Sarma underscored the transformation in attitudes and approaches.

“Till a few years back, in our region violence and armed uprising were the order of the day”, he said in the speech.stressing that the North-east, building on peace and development, was currently “positioned at the cusp of great changes.”

The audience observed a minute’s silence to express solidarity with the suffering of people in Assam and other states, reeling from floods and rain-fed devastation.

 Sanjoy Hazarika, who also moderated the event, referring to the current flood devastation urged Japan to share its expertise on climate change with policy makers and specialists “to help our region and its people cope with the massive transition caused by climate change”.

The book, North East India and Japan: Engagement through Connectivity has been edited by Mayumi Murayama, Vice President of JETRO-IDE, Sanjoy Hazarika, the author and columnist and Preeti Gill, writer and cultural curator. It delves into the shared heritage between Japan and the Northeast through unique stories, collective memories, memorials about World War II and research. It highlights the importance of the region in the context of Indo- Japan relations and looks at shared economic, socio-political, and environmental concerns. With contributions from 16 Indian and Japanese academics, including 9 Japanese scholars, the authors believe the vlume will be key to understanding Asian politics and the new architecture that is growing across countries, the new highways, infrastructure and knowledge routes.

 Presentations were made by Dr Murayama, coeditor, and the trade economist Prof Prabir De who was a contributor. Others who spoke were former Indian Ambassador to Myanmar, Afghanistan and Syria, Gautam Mukhopadhyaya,, Prof Srabani Roy-Choudhury of the Centre for Japan studies at JNU and Mr Takehiro Tsuchiya,  economic counselor at the Japanese embassy. Ms. Gill, the third co-editor, was also present. 

Media Coverage:

Book Launch news

The Deccan Herald covered the Bongaigaon Boat Clinic in May 2022.

From The Field:

Boat Clinics and Har Ghar Dastak campaign

  The two month long “Har Ghar Dastak campaign 2.0” to accelerate the pace and coverage of COVID19 vaccination across Indian States and UTs commenced  from the 1st of June 2022. The emphasis was to cover all eligible beneficiaries’ through door to door campaigns. Being implemented in a ‘Mission Mode’, States and UTs were advised to give an intensive push towards full COVID19 vaccination coverage by vaccinating all eligible beneficiaries. C-NES’  Boat Clinics were actively involved in this campaign where the heath teams visited homes in the remotest of island villages that they serve in a door to door campaign to vaccinate eligible beneficiaries with covid vaccinations.  A few photographs from the field teams:

Mission Shakti

The Boat Clinic Units were actively involved in the Mission Shakti campaign launched by NHM, Assam. The objective of the week long campaign from  31st  May to 5th May 2022 was to mobilize all pregnant women (new and already registered cases) for ANC checks up during the campaign as also to help woman  plan and prepare for birth (birth preparedness/micro birth plan) including  deciding on the place of delivery and the presence of an attendant the time of the delivery. The beneficiaries were given counselling on the advantages of institutional deliveries and risks involved in home deliveries along with emphasis on the importance of seeking ANC and PNC, importance of diet (nutrition), hygiene and adequate rest. History taking, general investigation of all pregnant women, physical examination, laboratory tests were conducted and IFA, Calcium supplements distributed   to all pregnant women as per guidelines as also administration of single dose of Albendazole 400 mg to pregnant women after 1st trimester. Photographs from Mission Shakti from the Boat Clinic Units follow:

Special ANC drive – Mission Shakti by Kamrup Boat Clinic at Koltuli and Batahadia island villages.

The Dibrugarh Boat Clinic team on way to conduct the special ANC drive as part of Mission Shakti at Charkholia and Pakhori sapori on 1st June 2022

Team members of the Barpeta Boat Clinic Unit Unit II on way to conduct a flood relief camp under physically challenging conditions
Medicines being distributed onboard at a flood relief camp at Chapori pothar island village by the Barpeta Boat Clinic Unit II in June 2022

The DPO Goalpara Boat Clinic Unit Rupalim Deka attending a Financial Review meeting  at the District Health office on  1st June, 2022

The Barpeta Boat Clinic Unit I led by DPO Sofiqul Haque planting at sapling at the the newly constructed Andabanga sub centre  on the occasion of World Environment Day on 5th June 2022
The Deputy Commissioner, Bongaigaon, Nabadeep Pathak visiting the district boat clinic unit to conduct a survey during flood at Bhutkura island village on 21 st June 2022
The Deputy Comminsioner being shown the solar panels of the Solar ILR installed at the Bongaigaon Boat Clinic supported by UNICEF and DIO on 7th June 2022. The solar ILR  will ensure efficient storage of ready vaccines

Successful FP intervention

A holistic development of the insular communities they serve is one important component of the health outreach programme of C-NES supported by NHM. After years of sustained, regular and decicated service the Boat Clinics have won the trust of the people they serve.

San Banu Bibi (25), mother of 2 children successfully underwent LS in May 2022 at Kanaklata Civil Hospital. She is a perfect example of beneficiary who was inspired by the health awareness talks including the need to plan a healthy family.

The Sonitpur Boat Clinic Unit DPO Mousumi Dowerah and  ASHA  Majeda Khatun were able to convince her. Amid bad weather,carrying her 7 month old baby, ASHA Majeda accompanied the beneficiary to the hospital. Working in areas where family planning is a daunting and challenging issue  the Boat Clinic and related health workers such as ASHA Majeda has been able to bring small but significant change in the community mind set.

Floods in Assam- Boat Clinics to the rescue

The floods this year seems to have surpassed the intensity of the previous years. The Brahmaputra river islands, where C-NES’ Boat Clinics work and serve, always badly hit by recurring floods, have been the worst hit.  The clinics save lives, provide healing during these difficult days in the Brahmaputra valley — from Dhemaji to Dhubri,  24X7 in collaboration with district authorities. Often they endanger their own lives while reaching out to the vulnerable and displaced people in despair. The teams- doctors, nurses, community workers and related staff   wade through  flooded island villages, every single day, without respite offering health service, medicines and relief supplies. Sharing some images from our field teams- the 15 Boat clinic units plying along the Brahmaputra and its tributaries. This spirit of dedicated service, such a rare quality today. The photographs- glimpses from all our Boat Clinic Units are self explanatory.

SB Shekhar,  servicing Bongaigaon on way to a flood relief camp in one of the districts flooded island villages- bringing hope and succour

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