C-NES Newsletter (For the quarter April – June 2010)
Confront China on Brahmaputra River
With every day, news of fresh confrontations roils the Northeastern region. One day it is the Naga-Manipur face-off; another day it is a farmers’ agitation, a third is on demands to stop major dams. There are times when, because of media hype, these appear to be the only issues which are of concern to the area. But often unseen and not discussed are a few fundamental issues which lurk in the background and which the Indian media has failed to understand and hence to report and cover in any depth.Fundamental to the survival of the region and its people is the issue of water and particularly the future of the Brahmaputra. Since the 1990s, concern has grown in India and other countries over plans by the Chinese to dam or divert the Tsanpgo as the Brahmaputra is known in Tibet, where it is born and where it flows for more than half of its long journey to the Bay of Bengal. There are conflicting reports of where and how many dams the Chinese plan to build.
But what is clear is that the Government of India’s response has been weak and fuzzy. All that the Water Resources Secretary (as have his predecessors) has had to say is that “we are watching.” This is how it is, how it was (remember 1962 and the Chinese blitzkrieg across the borders in Arunachal Pradesh?) and how, unfortunately, it seems that it will be – we will “watch” without coming to any conclusion.It was as recently as in April this year that External Affairs Minister SM Krishna told Parliament that a “small project” was being built, with a capacity of 540 MW and a cost of 1,138 million yen. When I traveled across Tibet some years ago, I did not see any projects on the Tsangpo but did not two small hydel projects on streams that flowed into it.The question is what the Chinese intend to do with the Brahmaputra; after all they are never known for small projects but mega ones like the Three Gorges Dam on the Yangtze, which even the US Corps of
Engineers said was impossible to build. But the Chinese did build it, displacing two million people in the process. The displacement did not matter; what was important to Beijing was that the project, buttressing the image of a nation determined to complete its public commitments, no matter the cost.
Even among Chinese academics there is lack of clarity – and agreement — about the dams on the Tsangpo and what should be done about them. At a workshop in Dhaka earlier this year, three senior Chinese scholars of engineering and hydrology emphasized and re-emphasized that China was not building any dams on the river. One scholar said that there were only three data gathering stations in one section of the river; that material was then communicated to the Indian Government’s met department at least twice a day so that, especially at times of high rainfall in the summers, the Indians were fed information about scale and velocity of the waters and currents as they moved through the Himalayas into India. A few weeks after that assertion about no dams, came the External Affairs Minister’s worrying declaration that our neighbour was indeed building one, no matter how small. This will affect not just Assam and the North-east but also the final recipient of the waters
downstream – Bangladesh. India and Bangladesh need to make common cause on this issue – they have been so alienated from each other on Ganges water sharing. The Bramaputra is crucial to their common future and they cannot let China play games with it, just as it has done with the Mekong, the Irrawady and the Salween in South-east Asia, ignoring international norms and rights of downstream riparian states. Tens of millions of poor and marginalized farmers depend on such cooperation – and on the need to confront China on its effort to control the future of this part of the planet by controlling its water resources.
( From his regular column “North by North East” , in Sunday Guardian)
Annual Review Meeting at Shillong
The second annual review meeting of C-NES was held at picturesque Shillong, the capital of Meghalaya in April 2010 attended by thirty seven staff members from the organization led by the Managing Trustee (MT), Mr Sanjoy Hazarika. The first review meeting was held a year ago in May 2009 at Guwahati.
Members from the Programme Management Unit (PMU), nine doctors, ten District Programme Officers (DPOs) from an equal number of districts where the C-NES- NRHM “Boat Clinic” project to take health services to unreached communities on the Brahmaputra is being implemented, were present at the meeting. The District Education Coordinators from Dibrugarh and Lakhimpur working for the UNICEF supported education outreach programme and Family Planning Counselors from Dibrugarh, Tinsukia Dhemaji, Lakhimpur and Sonitpur districts, part of the C-NES- Population Foundation of India (PFI) family planning programmes were also present. Chaired for both days by the MT, participants present at the meeting shared their respective work plans, experiences, problems faced and how best to overcome them, engaging in dialogues with Mr Hazarika and with each other.
C-NES staff at the Review Meet in Shillong
Journalist covers Boat Clinic
Hanna Ingber Win, multi-media journalist based in Mumbai, covering it for Global Post was assigned by the Pulitzer Centre to cover the Boat Clinics health services in April 2010. Hanna was the founding World Editor of the Huffington Post and has lived and worked in Burma, Thailand, South Africa and the United States.
The Boat Clinic health initiative provides basic health services to the remote island dwellers of the Brahmaputra with focus on maternal health. At 480 per 1, 00,000 live births, Assam has highest maternal mortality rate in the country. Having earlier covered maternal health in Ethiopia, the journalist selected the state for her study. She visited health camps in Nalbari, Morigaon and Dibrugarh. As the scheduled camps at Dibrugarh were cancelled due to high water, her focus shifted to the tea garden community. Relevant information was obtained through the MAPEDIR (Maternal and Prenatal Death Enquiry Response) study initiated last year by UNICEF at Dibrugarh on a pilot basis. Eleven maternal deaths were reported in the district during 2009-10 out of which seven were from the tea community. Out of these seven, three were selected randomly for the study. Successive visits were made to meet the family members of the deceased. Her writings on the Boat Clinic are available on the C-NES
Hanna interviewing young mothers at Morigaon’s Pithakhaiti char
Hanna with C-NES staff members at the Guwahati Office
UNICEF Officials at Boat Clinics
Unicef officials with the Dibrugarh Boat Clinic staff at Maijan Ghat, Dibrugarh
UNICEF Global and India Chiefs for Health, Mickey Chopra and Henri Ven Den respectively, visited the Boat Clinics in upper Assam accompanied by Dr Ajay Thakroo, Unicef, Assam in May 2010. The team arrived at Dibrugarh’s Maijan Ghat where the Dhemaji Boat Clinc SB Shahnaz was docked and were felicitated by the team. Also present on the occasion were Joint Director Health Services, Dr Tulika Goswami Mahanta of AMCH and Manisha Buragohain, Deputy Programme Manager, NRHM. The Dibrugarh and Dhemaji Boat team members were present. The boat sailed towards Nagaghuli for an hour with the visitors onboard.
Sanjay Sharma, Associate Programme Manager, C-NES gave a brief presentation on the boat clinics and its operational methodology, how and when the concept started, collaborations and the progress made so far. Photographs of the Boat Clinics and of health camps being conducted were shown to the visitors. “Your hard work and inspiration is bringing services to people who once thought they were forgotten” were the comments left behind by Mickey Chopra on the Visitors Book aptly summing up his impression on the Boat Clinics.
Training on RI
Training on Routine immunization at Dibrugarh
15 Medical Officers (MOs) from nine boat clinic districts attended a three day training on Routine Immunisation organized by the offices of the Joint Director Health Services & Assam Medical College (AMCH) in collaboration with C-NES and UNICEF in AMCH, Dibrugarh in May 2010. The training was intensive and technical wherein MOs were taught various issues related to immunization- drawing up of action plans, record maintenance, vaccine storage, cold chain and buffers stock maintenance. How and whenvaccines were to be given, possible side effects (following immunization) and how best to overcome them were discussed along with trainings on diagnosing various vaccine preventable diseases. An exposure visit was organized to a nearby PHC to show how cold chains, ILR and deep freezers were maintained and vaccines given. A documentary on various health related issues was shown along with a relevant guide book given to each participant.
Health officials at Dhubri
The officials from MHA at Dhubri ghat
Officials from the Ministry of Health Affairs, New Delhi and NRHM were in Dhubri in May 2010 to oversee a health camp conducted by the Dhubri Boat Clinic at Solakura river block of the district. The team included Dr. S.K. Sikdhar, Assistant Commissioner, Family Planning, Ministry of Health and Family Welfare, P.Rajbongshi, Consultant Reproductive Child Health, Ministry of Health and Family Welfare, Dr.P.N.Bora, State Programme Manager, NRHM, DPM, Khrushid Alam and WHO consultants. The officials were accompanied from Dhubri ghat by the DPO Mehbub Ali Hazarika and Programme Manager Ashok Rao. The camp started in the afternoon to coincide with the teams visit. Dr.Sikdhar enquired about the action plan, targets and night halts facilities and was of the opinion that more boat clinics are needed to cover areas. The team also interacted with the local leaders, village headman, ASHA and Anganwadi Worker. “Commendable work by the Boat Clinic team in providing health care to the
marginalized” said Dr Sikdar.
A team from Guwahati Doordarshan accompanied by Associate Programme Manager, Sanjay Sharma visited Morigaon’s Panchur Char in May 2010 for filming the boat clinic health outreach programme even as a regular monthly camp was being conducted with community support and participation. Shots were taken of the boat and the health and awareness camp being conducted. The DPO and the Medical Officer spoke about the gradual positive change observed in the attitude of the community, more so the women in terms of utilizing the boat clinic services. Earlier during the month, the team visited the C-NES Guwahati office where members spoke on various aspects of the Boat Clinic initiative, a brainchild of the Mr. Sanjoy Hazarika and about the organization. The 25 minute documentary on Boat Clinics was later telecast by Guwahati DDK.
Deputy Commissioner at Morigaon Boat Clinic
Aruna Rajoria, the Deputy Commissioner of Morigaon visited the Morigaon Boat Clinic in April 2010 at Bhuragaon Ghat. She interacted with the team members, browsed through the record books of the health team and asked the team about the difficulties they faced. The DPO informed the Deputy Commissioner about the non availability of ASHA in more than 40% char villages and poor performance of Anganwadi Workers (AWW) hailing from the mainland. The DC was informed about the short supply of Iron & Folic Acid (IFA). Accordingly the DC instructed the DPO to submit the list of AWW & ASHA hailing from the mainland in the ensuing meeting of DHS. She instructed the DPO to submit the list of pregnant women (char wise) in order to send the required numbers of IFA for the Boat Clinic. She also enquired about the status of institutional delivery from char villages and added that if necessary, transport from the ghat to the nearest health institution could be provided to encourage
hospitaldelivery. Arup Jyoti Kalita, District Program Manager of NRHM, Morigaon accompanied the DC during her visit.
Appeasing the rain god
It was a hot April afternoon for the Nalbari boat clinic team at Chaprapara 2 char. As the team entered the village to conduct a health camp, a large gathering of women and children were seen. A small girl was sitting at the centre of the gathering, her face and body painted in different colours. Around her were planted four banana trees and elderly women were dancing and singing traditional songs. The team was informed by the local community that this ceremony called Hutum was performed to please the rain god. Most of the state has been witnessing severe drought conditions and people were apprehensive about a poor crop yield.Though this was a predominantly Muslim community the ceremony had an uncanny resemblance to a Hindu ceremony. These migrant communities from Bangladesh were mainly fishing communities in the 15th century AD, pre dominantly Hindus belonging to lower social economic group. When the Mughals invaded eastern India (included Bangladesh) most of them converted to
Islam. But to this day they continue to observe traditional ceremonies which their forefathers practiced creating a unique cultural synthesis.
Health Mela at Dodhia Kuligaon
A health mela was organized by the District Health Society, Dibrugarh in association with Panitola Public Health Centre and C-NES at Sarisuti LP School premises, Dibrugarh district in May 2010. Specialists from the Assam Medical College led by Dr. T.R. Borbora, Principal Assam Medical College and Hospital, Deputy Commissioner Dibrugarh, GD Tripathy along with senior health officials traveled with the Dibrugarh Boat Clinic team from Balijan ghat to the island. The Deputy Commissioner inaugurated the event in presence of a large number of villagers from the island and nearby villages. There were six units- Medicine, Pediatrics, ENT, Gynecology, Eye and Orthopedics. Out of the 698 patients registered, 118 were examined by boat clinic doctors.
Rains hamper health camps
Camps have been cancelled twice in Dibrugarh during April 2010 with a continuous pre monsoon showers leading to unprecedented strong currents in the river. The Boat Clinic could not cross the channel at Rohmoria. Subsequent erosions at Nagaghuli and Rohmoria are threatening the very existence of Dibrugarh town.
While there was joy and festivity in April with the approaching Assamese New Year, the Rongali Bihu, residents of Dodhia Kuligaon sapori in Dibrugarh spent sleepless nights. With continuous rains for nearly a month, large areas have been hit by erosions and engulfed by water from the brimming river. People have lost their homes and fields. Local ASHA Deepika Pao was also a victim, her home swept away. When the health team reached the island most people were busy shifting or relocating their homes. The team met the villagers and the ASHA to offer solace.
At Tinsukia, the Brahmaputra was flowing above the danger level. Laika, Erashuti Sapori and most river line villages of the district, including the police station and forest office at Guijan were submerged. The district administration requested the Tinsukia Boat Clinic team to serve the affected villages. Accordingly with the subsiding of the water level, the team traveled to Laika sapori crossing a rivulet flowing through Dibru – Saikhowa reserve forest on a small country boat. The camp was held in the Laika Pamua L.P. School premises and continued for 4 hours where 125 patients were treated, 9 children were immunized and 5 ante natal check ups were conducted. The team conducted a health camp at Erashuti, another flood affected village.
Water Testing Kits to sapori
At Lakhimpur’s Kankur Sapori, erosion and water logging are perennial problems. The impure water resulting from floods and water logging is used for domestic consumption and is one of the main reasons for frequent outbreak of water borne diseases. The Lakhimpur health team supplied water testing kits in the sapori for testing drinking water. Awareness campaigns on the need for safe drinking water are regularly held. In April 2010 an awareness meeting was held on diarrhea, its prevention and cure.
Positive Response to awareness campaigns
Awareness Campaigns through Information Education Communication (IEC) and Behavior Change Communication (BCC) by the boat clinic health teams have brought in a gradual mind set change in an insulated community. Emphasis is laid on Inter Personal Communication method of awareness building and the results are gradually beginning to show. Continuous visits and interactions with residents have created this transformation. Small children have started wearing slippers; walking around with naked feet being one of the main causes for worm infestation. People pay attention to personal hygiene and on maintaining a clean environment to thwart the onset of diseases. The health teams in all districts have noticed a distinct change in attitude, with increasing numbers of young mothers with babies clinging to their backs coming to the immunization centers Gone are the days when the very idea of an immunization team coming to their homes was met with hostility. There are frequent instances of
women coming to the doctors and saying that they want family planning because they do not want any more children and are aware of the dangers this poses to their health.
The doctors feel it a part of duty to educate people on the basics of health. . The teams lay more emphasis on the preventive aspect of health care. It has been a constant challenge as people do not let go off age old beliefs and superstitions easily.
Awareness Camp at Hamur Char:
An awareness camp was held at Morigaon’s Hamur char in May 2010 at the LP School premises of the char village. About 400 people were present . They were informed earlier about the camp through the community workers. People from nearby Lahari, Namabasti and Bhangkhaura chars villages also attended the camp. Along with imparting general awareness on health issues like importance of immunization, ante-natal, post-natal care, exclusive breast feeding, family planning, sanitation and personal hygiene some entertainment and sports were also organized for community entertainment. A documentary promoting Family Planning, Immunization, Malaria, and Polio was shown.The meeting was addressed by the DPO Morigaon Boat Clinic, A K Azad, Dr. PS Bordoloi, Joint Director of Health Services, Morigaon and Arupjyoti Kalita, DPM, NRHM Morigaon. The JD Health Services shared the district health society’s plan of setting up a sub-centre in char villages in the near future. Arupjyoti
Kalita, District Programme Manager of NRHM, Morigaon emphasized the need to have institutional delivery
An open quiz for women on Mother and Child health and family planning was held and prizes given to enthusiastic participants. 30 year old Kulsum Bibi was chosen the ‘best mother’ from Hamur Char. Married at the age of 19 Kulsum is now the mother of three children who are fully immunized. She had undergone the mandatory 3 ante-natal checkups and delivered all three children in a hospital. She has been taking oral pill for the last one and half years and plans to undergo permanent sterilization soon.
The Boat Clinic initiative has provided opportunities to students doing research on delivery of primary healthcare and education to the islands on the Brahmaputra. Five interns from the US are conducting studies on the Boat Clinics from May 2010. Dwijo Goswami, Alon Slutzy, Julia Evans and Tarika Shridhar are undergraduaute students at the Institute of Global Leadership at Tufts University, Boston and Brian Orland is doing his post graduation from John Hopkins University, Washington DC. Binita Kakati, a second year student of Sociology at Lady Shri Ram College, New Delhi, also interned for a month with C-NES in Guwahati and at the boat clinic in Dibrugarh..Dwijo researched the barriers that both institutions and communities are facing in providing service deliveries to mothers at Barpeta Dhubri, Morigaon, Jorhat, Dhemaji, Dibrugarh and Tinsukia attending health camps at the boat Clinics. Julia and Tarika have attended Boat Clinics health camps at Dibrugarh , Tinsukia,Jorhat,
Morigaon, and Sonitpur and are also conducting a study on the indigenous Assamese Muslim community. Alon studied the Boat Clinics giving health services to marginalized communities in a rural setting visiting Barpeta, Nalbari, Morigaon, Jorhat, Dibrugarh, Tinsukia and Dhemaji. Brian has been conducting a research on the Brahmaputra, flood prone communities and related issues in Dibrugarh, Tinsukia, Dhemaji, Lakhimpur, Jorhat and Dhubri.
Earlier in 2008 four Interns from “Knowledge Community on Children in India” (KCCI) summer internship program sponsored by UNICEF conducted a two-month case study on the boat clinics. Research on the Boat Clinics was also conducted by two students from the Tufts University, US in 2008. This is developing into a major partnership with a leading US university which sends senior students for on hand field experience in complex social and environmental conditions.
Sanjoy Hazarika at literary festival
Sanjoy Hazarika in conversation with Ravi Singh, publisher of Penguin India,at the literary festival
Sanjoy Hazarika, Managing Trustee of C-NES and renowned author, was invited to the first literary festival held in Bhutan from May 17-21, 2010 at the Himalayan kingdom’s capital of Thimpu. Mr. Hazarika, was invited to read from his books on the North-east and share his experiences at the Mountain Echoes festival, which was supported by the Indo-Bhutan Foundation and other sponsors. The festival, which was curated by Siyahi, the literary organizers and agents, based in Jaipur, drew celebrities such as the great poet and Oscar winner Gulzar, best-selling author Chetan Bhagat, Penguin India’s publisher Ravi Singh and TV personality Sunil Sethi of NDTV as well as Ms. Namita Gokhale and Patrick French. The festival was inaugurated by Her Majesty the Queen Mother, Ashi Dorji Wangmo Wangchuck, who is herself an author, and Prime Minister Jigme Y.
Thinley while Shr Pawan Varma, India’s Ambassador to Bhutan and a prominent writer himself, also spoke. At a reception at India House, Mr. Varma’s official residence, HM the Queen Mother greeted Mr. Hazarika warmly and said that they had long read and admired his writings.
Mr. Hazarika had separate meetings with the Prime Minister of Bhutan, Mr. Thinley, whom he has know for several years, as well Commerce Minister Lympo Khandu and the Home Minister. They expressed their deep appreciation about the historic and friendly ties between Assam and Bhutan and the need to further strengthen these relations.