A recent trip to Rajasthan was an eye opener for me. All along throughout the medical school and later I have known Bihar, Jharkhand, Uttar Pradesh and Rajasthan to be backward states in terms of health care delivery, grim mortality and morbidity patterns but had never witnessed it firsthand.
This October, I had the opportunity to see the rural areas of southern Rajasthan (Salumbar & Gokunda) as a part of the Rural Sensitization Program (RSP) organized by Basic Health Services, an organization committed to working with the grass root and marginalized communities.
The RSP was not didactic but experiential which exposed us to the stark realities and helplessness of the rural and tribal populations of the Aravali hills. Our mornings were devoted to field visits and afternoons were for reflection. On one of the mornings, our small team had the opportunity to meet Ram Kishan ji (name changed) at Rawaach village where he lives with his wife and 3 children
Ram Kishan ji was leading a productive life and taking care of his family by farming near his home and doing construction work off and on in faraway towns. However, life took a downward spiral for him eight months back when he developed fever and became bed ridden following it. He could no longer farm and the family’s income received a devastating blow. Whatever small savings that remained with the family was utilized for their sustenance. After trial of treatments by neighborhood’s quacks, the family decided to take him toa private health facility for his treatment.
With further enquiry, I learnt and realized of the absolute lack of government health facility and the relatively understaffed work force of these facilities. The family had to sell their cattle and their wheat milling machine to pay the hospital bills. However, to their surprise after the evaluation and draining of already constrained resources of family, they were advised a referral to a higher center for proper diagnosis and treatment. Having lost their life savings, means for livelihood and mounting debt the family decided to reach out to the Basic healthcare services(BHS),the not for profit working in that region. At BHS, he was diagnosed to have extra-pulmonary Tuberculosis and treatment was
initiated at subsidized cost.The healthcare system at BHS made sure of the delivery of medical care at his home. This has prevented him from defaulting his treatment.
Today Ram Kishan ji walks with the help of a stick and is able to manage his day to day routine. However, he lives in a state of poverty with no earning member in the family. Despite their poverty and difficulties, the youngest girl of Ram Kishan ji’s family offered us a bagful of peanuts which were harvested from their farm. This small act of kindness by a small little girl touched the core of my heart.The idea of sharing wholeheartedly is deep rooted in the rural and tribal communities. While many of us city bred think and calculate before giving, most of our indigenous communities don’t blink an eye and share without thinking. Blessed be their heart.
As a physician, we might not be able to solve all the problems that come with the added burden of illnesses such as Tuberculosis but the least that we can do is provide an empathetic, responsive care to individuals like Ram Kishanji which helps them retain their dignity of life. The healthcare team of BHS (not just the doctors and nurses) are doing this day in and day out through their Amrit Clinics which deserves an applause.
When I head back to my home in Kodaikanal, where we run our rural clinics, some of my learning can definitely be put to use. As I learn from many of my conversations with the indigenous communities I realize that many of them harbor a feeling of being treated differently when they approach health facilities. We must ensure that this feeling does not emerge when people visit our centers. Dignity and compassion to our marginalized and indigenous communities is as important as to any other person in the society. Our clinics cater to diverse population from 15 different villages.
Our staffs come from a similar background as well. However, sensitizing the healthcare delivery team to treating everybody with empathy and dignity time and again shall help it to be ingrained in everyone on the team.
Dr. Vivek Karthikeyan
MBBS.,DNB. Family medicine specialist
Founder trustee
SITHARA trust, Kodaikanal
The initiatives of SITHARA are currently focused on providing high-quality responsive and dignified primary care to the rural mountain communities as well in creating sustainable livelihood opportunities for the tribal communities
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