After the Diwali vacations, when I came back to the school in Rajasthan, where I’m currently working, there was only one teacher who, at that moment, was sitting and reading the newspaper. I talked to him and entered in my class with full enthusiasm as I wanted to hear stories of the last two weeks, when school was closed for Diwali.
To my utter shock, only 6 of a total 46 kids were there, sitting and talking to each other. I greeted them and they responded followed by a small chat. I wanted to know if same is the case with other classrooms. So, I went out and met other kids in the school. In total, 23 out of 150 kids and 1 teacher were present in the entire school.
I wanted to know about those who didn’t come. To do that, I went around and asked a few students to accompany me. A boy named ‘Kana’ agreed and we went to the village. After walking for more than an hour, we reached in the middle of nowhere.
It was a hot day. We sat under a tree, thinking about where to go next. Soon, we decided to go to Kana’s house, 10 km away. As we were waiting for a Jeep to hitchhike, a couple of small kids from my school came and sat beside us. One of them lied down to relax while the other went to a nearby hand pump to drink water. Suddenly, the first one started crying. I asked him, “What happened?”, to which he replied, “I am not feeling well. Have a headache. Also, feeling dizzy.”
I immediately looked in my bag for something to eat but didn’t find anything. There were no shops in the vicinity. He got up in a bit, started walking towards his home but sat down after 10-15 steps and started crying again. I thought of taking him to the PHC (Primary Health Center) but it was at a distance of about 7 km. With no vehicle in sight, Kana and I decided to carry him on our back, one by one.
Kana has a strong built. He lifted the boy up on his back and within 15 minutes, this boy again started feeling uncomfortable. So, Kana took him off and just a few moments later, he vomited before going unconscious.
We tried doing it again. The kid’s home was now only 4 km away. We walked through fields and streams for a long time before finally reaching his home where we found his younger sister playing outside while their parents had gone to the fields. The boy’s friend ran to call them.
In no time, his father was there and we explained him the whole situation. He thanked us immensely for bringing his son, and as an act of Gratitude, offered me some “Gutkha” (Tobacco), Cigarettes and Alcohol. When I rejected them all, he asked if I’d be willing to have a cup of tea, to which I obliged. While I was sipping tea, it struck me.
What would have happened to the boy, if Kana and I were not there?
What are the chances of someone’s life getting saved in such a case of medical emergency?
In most Indian cities, whenever there is a road accident or any other such emergency, the passer-byes or neighbors gather to take the patient to the nearest hospital either on their own vehicle or by calling an Ambulance. Usually the casualties are rushed to the hospitals immediately except when the public feels that they may get into trouble.
But, the chances of a life getting saved in remote rural areas go down considerably, specially in cases when someone gets a snake bite or suffers from a heart attack. The time taken to reach any medical center is high and the facilities at their disposal aren’t enough. PHC’s and 108 or 104 ambulances are being operated by the government but are unable to reach far-off areas due to lack of proper roads. Tribal people trek and walk for several kilometers for medical assistance through dense forests. They carry the patient in a cloth cradle supported by two sticks on their shoulders. Valuable time is lost during the process, which, many a time, results in serious complications or even, death.
If this boy would have been in a critical condition, we would have to find a local transport and carry him to the nearest PHC but there was nothing at all coming our way, not even bikes. The second step would have been to call 108 or 104 but there was no network in the area. In network supported areas, people should have a phone, awareness to call an ambulance, ability to describe the location/give directions and then wait for at least half an hour before any help arrives. Aren’t these steps too unreliable to fall back on? Now, I don’t know if letting a family member die of an illness better than trying to take them to a hospital, when you know you can’t afford the treatment even if you reach there.
Related reading: Feeder ambulances to cater to emergencies in tribal areas
This is good field piece. Communities at micro levels find solutions to these by collective action. Some NGO in the vicinity might improve things a little. But vastly unaltered. System level improvement i am not sure to what extent is there …
Sometimes i also feel like too many people keep focussing conversations on primary healthcare in rural context. I am not sure how and when the balance will be restored.