By Usha Alexander (Also cross-posted on 3 Quarks Daily.)
Two days in south Rajasthan with AMRIT Health Services, a not-for-profit initiative
A hamlet in Bedawal village
“The demand to sacrifice a goat was not something we had expected as a precondition for setting up the clinic,” Dr. Pavitra Mohan explained. A pediatrician and public health professional, he was telling me about the initial days of setting up the first AMRIT Clinic in Bedawal, a Meena village in south Rajasthan that otherwise had no healthcare facility. The problem was that the building he had identified as adequate for his purpose was directly across from the village temple to their god, Hemliya Bavji, but it required major renovations, including the construction of a toilet, apparently the first in the village. Though the panchayat welcomed the clinic, several villagers refused to allow a toilet so near the temple, on religious grounds. To make matters worse, they also refused to allow trimming the sacred tree overhanging the building in order to build rooms on the roof for the healthcare workers to sleep at night. But after further talks and negotiations, they finally granted permission to build the clinic and trim the tree as well.
And so, in early 2013, AMRIT Clinic opened in Bedawal with a small team of qualified nurses and healthcare workers, who constitute the core of AMRIT Health Services (AHS) in the villages. They are supported by a doctor who visits once a week and is also available for telephone consultations on other days. Hoping for a view into the work of this organization—its context, its challenges, its benefits to the local population—my partner and I went for a visit in early August; our plan was to produce an introductory video about their work.
AMRIT clinic in Bedawal
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At the Bedawal clinic: Himi, Manju Meghwal, Baiji, Moti, Dr. Mohan
Newborn with septicemia
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With Dr. Mohan, Niti Sharma, Manager of Operations, Himi, Fellow, public health, and Dr. Gargi Goel, a young pediatrician who had come out on a job interview, we drove ninety minutes from Udaipur city to Salumbar, the last little town where basic services—petrol, meals for purchase, rooms for the night—were to be found before we headed out into the fairly isolated villages of the remote countryside. From Salumbar, we continued for another forty-five minutes on narrow, broken or dirt roads to Bedawal, the first of two clinic sites we visited.
With little vehicular traffic, buffaloes and goats took up the slack. An occasional bus or jeep rattled back toward Salumbar, overloaded with people sitting on top or swinging off the sides, as this was their only available transportation. Maize stood tall in small plots receding into the hills and valleys on both sides of the roadway, and squatting among these fields were mud and stone dwellings with broad verandahs and rough tiled roofs supported by carved wooden beams and lintels. Droves of children in shabby school uniforms—mostly boys—milled along the roadside near the village center, laughing, playing. Electrical wires were stitched across the landscape, but we learned that much of the time they are dormant, sometimes for days. For me, arriving from the sticky heat of Delhi, the cooling breezes of this region’s modest elevations and its fresher monsoon air were invigorating.
Despite the goat sacrifice, Himi told us, one of AHS’s early challenges has been to gain the trust of the local people. There had never been qualified medical practitioners in these villages, but a particular brand of charlatan, known locally as Bengali Doctors, preys upon the people, charging hundreds of rupees to put patients on a saline drip and inject a drug cocktail that gives them a jolt, no matter their ailment. When villagers first came to the clinic, they expected the same treatment and were suspicious or dismissive if they did not receive it. And when the nurses asked only fifty rupees for a week’s treatments, the villagers scoffed. What kind of medicine can be so cheap? “Then they were afraid we might do some magic on them,” Himi said. Fortunately, as more and more people have been helped or cured by the efforts of AHS, the perceptions are changing.
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