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Sombari Hemrom gave birth to a premature baby boy in June last in Kalaimuri village that comes under Salboni block in Maoist-affected West Midnapore district of Bengal. "I thought I will die, my baby will die. Timely intervention from the doctor and nurse at the makeshift health centre in my village saved both of us," says the thankful 27-year-old. It is another matter that the said health centre’s "doctor" was a quack and the "nurse", an untrained attendant. "The people’s war started in this region around 2008. Government officials, including the health department staff, fled the area, fearing for their lives. There was no one left to run the government offices, schools and health centres," says Aarti Mahato, 55, of Kalaimuri village. "Even otherwise, health facilities existed in name only. Neither the doctors nor nurses made regular appearances at the primary health clinics or the health sub-centres. Only a compounder could be seen sometimes selling medicines, meant for free distribution, to the villagers," adds Pradyut Mahato, a member of the Maoist-backed People’s Committee Against Police Atrocities (PCAPA). West Midnapore is one of the most backward areas of West Bengal and lack of development and basic amenities is often cited as the primary reason for the people’s uprising in the district. For example, Salboni block, under which Kalaimuri village falls, has a population of about 1,65,000. For these rural residents, the state government has provided one hospital and just three primary health centres. There is one Central Government health undertaking and one privately-run nursing home. The total number of beds under the block is 79, while there are only 12 attending doctors. "It is wrong to say that the Maoist movement hampered health facilities in the district. They were negligible in any case," says Mahato, adding, "the PCAPA, in fact, started its own health centres to help the rural people and to distribute free medicines. We used the village women to run the centres." This is where the unqualified "doctors" and untrained "nurses" came into being. "The situation was terrible. Many of our men and women joined the movement voluntarily while others were forced to do so at gunpoint. In any case there was no work to be found. Our children could not go to school and there was hardly any food in the house. But worst of all, there was no one to care of pregnant women, deliver babies or even treat a snakebite. So I agreed to be a health attendant when the PCAPA asked me," says Aarti, who, along with two other women, took up nursing duties in her village. The PCAPA has set up about 25-30 medical centres in different villages under Salboni, Lalgarh, Midnapore and Jhargram. Local doctors and nursing attendants either served in these camps voluntarily or were forced to do so at gunpoint. Several untrained people were also asked to chip in. Each of these centres catered to about 100-150 patients daily. "Money was at a premium. People had no food to eat. Ration shops were closed and there was no agriculture produce. The Maoists extorted Rs 10-20 and a kilo of rice from every household that could afford it. The family was often left with nothing. Malnutrition became one of the primary health concerns," points out Jyotsna Tudu, 25, a trained nurse in Lalgarh, adding, "the PCAPA had arranged for glucose and electral powder, which we distributed free of cost. But there were too many suffering and very little relief." In the Jangalmahal area, skin diseases like scabies are common, as is malnutrition caused due to abject poverty. "Tuberculosis and diarrhoea-related diseases also abound due to poor drinking water, bad hygiene and scanty diet. Malaria is also commonplace," says Dr R. Dey, former block medical officer, Chandra block, West Medinipur. By extending service at the PCAPA-run medical camps, the poor villagers were only looking to help each other in times of adversity but even that effort had to be carried out under conditions that threatened life. "I am a trained nursing attendant. I worked at the government’s primary health clinic before the officials ran away. So, when the PCAPA ordered me to work in their health camp, I agreed so that the people could avail at least some medical care. If I had refused, the Maoists would have shot me,"says Kalpana Mahato, 45, of Bhulabera village. With the para-military forces gaining ground in the insurgency-affected district, such medical camps have all closed down. However, the government primary health clinics, despite claims to the contrary, are not fully functional. This has caused untold suffering to a population in dire need of medical attention. "We are also being constantly harassed by the force personnel. They claim that we are Maoists just because we had worked under duress at the PCAPA health centre. Was it a crime to help the people in need?" asks Krishna Mahato, 28, another trained nursing attendant. "The government is turning a blind eye to the needs of the people. If basic healthcare cannot be provided, how can one expect other infrastructural facilities? They are trying to curb this people’s movement by use of force but that’s not going to be a successful model. We realised the need of the people and tried to run the medical camps ourselves. But the government has closed them down and has not made other arrangements," points out Mahato. Under these circumstances, the hapless people living in this conflict-ridden region have no option but to live with insufficient food, poor sanitation and illnesses. Their health has become a casualty of conflict. This is unacceptable and help must urgently reach them. — WFS
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