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Magazine
A healthy change
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In the absence of civic or infrastructure development, people in Sittilingi, Tamil Nadu, fell prey to numerous preventable diseases. But the vision of one doctor couple changed everything. SOMA BASU recounts Sittilingi's journey to good health.
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SOMA BASU
Care, coupled with wisdom, is enough.
THE empty promises of different governments since Independence have left several pockets in modern India grossly underdeveloped. Take the case of Sittlingi in Dharmapuri district, Tamil Nadu. This verdant valley at the meeting point of the Eastern and Western Ghats is bereft of any civic or infrastructure development.
The nearest towns to Sittlingi are Dharmapuri at a distance of 100 km and Salem another 120 km away. The nearest taluk hospital is 50 km away in Harur, which has no surgical facility. There are no pucca roads, power or telephone cables. Till the early 1990s, proper medicare was unheard of. Fifteen out of every 100 children died before they reached the age of one; 75 per cent of babies born were low Birth Weight (LBW) babies and the Infant Mortality Rate (IMR) was as high as 154/1,000.
But it did not take a "gora sahib's missionary zeal" to change the lives and health profile of the tribals here. Instead a young husband-wife team, who shared a common dream of "educating and medically equipping the unreached", has in the last decade transformed Sittlingi and its people.
Dr. Regi George and the petite gynaecologist Dr. Lalitha George, fondly called Gi and Tha, consciously gave up comfort, higher academic and professional opportunities to chase their own dream — to convince people that "only very basic things and not high tech medicare helps to lead a healthy life".
Vivacious Regi drew inspiration from the example of Dr. Albert who spent 50 years in Gabon, Africa, running a hospital solely for the poor. The reticent Tha, who as a child was stirred by Swami Vivekananda's teachings and believes that the greatest act is doing good for others, echoes softly, "We are trying to build a model that endorses medicine as a social subject that depends on people's felt needs and which can be practised with trained local people who are intelligent but illiterate due to a lack of opportunitiy."
Had it not been for the vision of these two young medical graduates from Allepy Medical College in Kerala; had it not been for the unflinching passion of Regi and his friend, S. Ravichandran from Gandhinagar, Madurai, who trekked through countlessvillages in Tamil Nadu, Maharastra, Rajasthan and Gujarat to find an appropriate working place; had it not been for an old tribal in Sittlingi willing to give away an acre of wasteland land when he learnt that the buyers wanted to set up a hospital for the welfare of his community; had it not been for the initial corpus fund of Rs.10,000 donated by Action Aid, Bangalore, had it not been for the guts of a few individuals like Rajamma, Dhanalakshmi and Madheswari who dared to become "barefoot doctors" Sittlingi would not be what it is today.
Paralysed by poverty and ignorance, development seemed almost impossible till Gi and Tha registered their dream project as the "Tribal Health Initiative (THI) and started off from a mud-thatched hut in the summer of 1993. The duo ran the Out Patients' Department (OPD) in the mornings. With a floor mat and lantern as accessories, the room was transformed into a labour room when emergency came calling.
Traditionally, in tribal communities, women were forced to give birth out of doors — mostly in the dirty backyards of their huts — where they were obliged to stay for a week, as they were considered unclean. As a result, newborns died of cold and infection. It was hard work to convince tribal women to come to the hospital.
However, the unassuming and low profile couple did not lose hope. Confident of ushering in change, they visited homes, counselled, selected and trained a band of village girls as nurses and slightly older women as health auxiliaries.
If the shocking statistics from the National Commission for the Scheduled Castes and Scheduled Tribes in Delhi brought Gi and Tha to Sittilingi, the statistics of the last decade now egg them on. The proportion of pregnant women coming for check ups has increased from 11 to 85 per cent. Newborn deaths are down by 50 per cent. The proportion of under weight babies under five years has dropped by 20 per cent. Death and illness of mothers in childbirth has also reduced drastically.
From a mud-thatched OPD-cum-labour room, the THI now boasts of a 10-bed hospital with a separate operation theatre, labour room, neo-natal room, emergency room and a laboratory. The OPD attendance stands at an impressive 12,000 a year while surgeries, deliveries and in-patient admissions have multiplied over the years.
Gi and Tha give all the credit to their core group of 25 staffers and an equal number of health auxiliaries. "It is due to their persistent counselling and persuasion that there is an increasing willingness among local tribals to bring patients for treatment in the early stages of illness. They have mapped every village, filed every family's profile, and recorded every individual's health status. Mothers are being made aware of feeding and basic health and hygiene advice imparted has also improved the survival prospects for pre-term and low birth weight babies and also anaemic and malnourished mothers," says Gi with pride.
Tha adds, "These girls are the real barefoot doctors. They document and maintain health records of the villages, teach villagers about three major problems (nutrition, respiratory infection and diarrhoea) and also run a pharmacy out of a steel trunk for ordinary ailments. In case of emergencies they are the ones who ensure that the patient is rushed to the hospital."
In the journey so far, organisations like Child Relief and You, Action Aid, JRD Tata Trust, the Tamil Nadu Voluntary Health Association have helped them take small steps forward with financial help. However, their efforts to get another trained doctor to share the workload has failed so far.
Tha and Gi have come a long way since the days when local quacks tried to drive them out by spreading rumours about them. "Our aim is impart and integrate basic healthcare knowledge into tribal wisdom so that they can prevent common diseases and easily curable infections and lead a healthy life," they say.
Things don't happen overnight. With a rare sense of devotion, Gi and Tha are silently arming the unreached sections of people with basic medical knowledge.
For more details, contact Tribal Health Initiative, Sittilingi, Theerthanamalai P.O., Dharmapuri district, Tamil Nadu 636906 or e-mail sittilingi@tribalhealth.org
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