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Hope floats in marooned villages of Assam

It was a painful five-day wait for three-year-old Nanhi of Chakia Sapori, a small island in the middle of Brahmaputra river near Dibrugarh in Assam.

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It was a painful five-day wait for three-year-old Nanhi of Chakia Sapori, a small island in the middle of Brahmaputra river near Dibrugarh in Assam. Nanhi was suffering from a severe ear infection, accompanied by high fever. Her village, which is marooned during monsoon, had no basic health facility, forget a doctor.

As Akha, the mobile boat clinic that visits the village once a week, anchored at the village, Nanhi and her mother rushed towards it hoping for some relief. Dr R Prasad gave Nanhi paediatric painkillers and anti-biotics, besides a lecture on basic hygiene. Slowly the queue grew with villagers seeking treatment.

Chakia Sapori is one the 3,000 villages that get marooned when Brahmaputra is in spate during monsoon. In summer months, too, they remain disconnected from the main land as water never recedes beyond a point. People in these villages have been marginalised due to geographical barrier and insurgency has brought its own set of problems. This essentially denies about 30 lakh people of basic healthcare.

However, Akha, which means hope in Assamese, is truly the ship of hope. It is one of the 10 mobile boat clinics that the state runs in partnership with NGOs Centre for North East Studies and Policy Research (C-NES) under public-private partnership (PPP).

Beating all odds, the boat clinics loaded with doctors, nurses, medicines and equipment provide sustained healthcare to about 2 lakh people. They camp in a village once a week, providing healthcare to roughly 16,860 persons per month. “There is problem of security due to insurgency. But our doctors are an inspired lot. Most of them are fresh medical graduates with a desire to serve the underprivileged,” said Ashok Rao, programme manager of C-NES.  Though it is difficult to reach these islands during monsoon, it is equally tough  during the summers when the water level recedes, forcing boats to anchor at a distance. The staff trudges two-three kilometre through wet clay carrying medicines and medical equipment.

The boat clinic was first started in 2005 by C-NES under PPP with the Assam government. When the idea clicked, support started pouring in from Unicef, Oil India Limited and India Oil Corporation. C-NES recently joined the project. The government under the National Rural Health Mission is funding the project to recruit full-time staff, provide medicines and equipment. Human resources on boat include a district community organiser, two doctors, one general-nurse-cum-midwife, one pharmacist, one laboratory technician, two auxiliary nurse midwives, three community worker and four crew workers. Each boat has space for an out-patient department, a doctor’s cabin, a medicine chest, laboratory, kitchen, toilet and a general store. A generator set and a 200-litre water tank have also been installed.

From one boat clinic, the state now has a fleet of 10 floating clinics in Dibrugarh, Dhubri, Dhemaji, Morigaon,  Tinsukia, Barpeta, Jorhat, Nalbari, Sibsagar and Sonitpur districts.

The success has started showing. The full immunisation rate of the boat clinics (in targeted population) in respective districts range from 79.5% in Dibrugarh to 39.85% in Dhubri. Akha won the World Bank’s India Development Marketplace 2004 competition for an unique innovation that can transform the lives of rural communities.
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