By PURUSOTTAM SINGH THAKUR
" When the diarrhea did not stop and my health deteriorated, I decided to call a taxi from Sikarpai ( which is a road side village and only place where some taxis are available ) to go to hospital as there was no hope left behind. Prior to that, my family repeatedly called but neither doctor nor the health worker turned up. First my family took me to Shikarpai health center but when did not get well, so left for a private doctor in Raygada. The doctor took Rs.700. And I too had to spent on hiring taxi. In between my two sons were also affected by diarrhea, than they were too admitted in the hospital. " said Shirpati of Satpai village in Kashipur block in Raygada district.
" I had to spent around Rs.6000 for the treatment of the entire family. Now I am in debt. I have borrowed the money from the " kumti mahajan " ( kumti is a trader community who runs the business of money lending also ) local trader who gives money on high rate of intrest. The rate of interest is 50 paise in a rupee " he added. When asked, " How did you repay the amount ? " he said that, It will took him few years to repay.
But the good thing in this case is that, the lives were saved. Satpai is one of the remote village where the diarrhea has been affected. There is absolutely no communication. If you can you can hire a vehicle. But that requires money, which many people does not have in this part of India. Neither many of the people are so lucky to get the medical facilities what ever the way like Shirpati who is little aware than others.
" Some 2050 people were affected by diarrhea this year, out of them 41 people are died till the last week of the September " according to Dr. Benudhar Naik, CDMO, Raygada. But the unofficial record says it is more than hundred. The epidemic out break in mid July of this year.
" In 2007, some 7800 people were affected by diarrhea and 90 people were lost life " says Benudhar Naik, CDMO, Raygada. " Lack of safe drinking water, connectivity and peoples awareness are the factors responsible for the regular out break of epidemic where health department is helpless " he added.
When this reporter visited the district in the first week of August there were around 7 deaths have been recorded and at that point of time also the CDMO said that, " the situation is under control ".
Six blocks have been affected by the epidemic this year. That are Kashipur, K.Singapur,Bisam-Cuttack, Gudari and Raygada.
But by the last week of August and 1st week of September it goes out of control and when there was hue and cry in the media, government pressed in to action. The Chief Minister asked the Health Minister Prasanna Acharya and the health secretary to go the district to monitor and take stock of the situations.
Prasanna Acharaya was there for 3 days and found two reasons for the spread of epidemic which known to all since many many years. He blamed contaminated water and inaccessibility for the outbreak of epidemic in Raygada among others. Besides that, the report said, the remote areas are worst affected. As the villages are inaccessible, decontamination of water was not possible. Majority of deaths are during night and night patrolling parties were pressed into service to provide medical assistance to the affected, the report said. However, inter-departmental coordination is utmost necessary at this time and a special programmed be launched in Rayagada district to tackle the crisis situation, Acharya proposed in his report.
Perhaps he wanted to say neither of the problems belong to his department and shifted the responsibility but his report also reveals that, the lack of co ordination among departments is very well exist.
Some doctors along with para medical staffs were sent from other places including Bhubaneswar and Cuttack. Temporary health camps were in service in some place where the patients were brought and treated. Many people were treated and live were saved. But there were some instances witnessed by the volunteers which well explained the attitude of the government service and its service holders.
Dr. Biswajit Roy, National Convener, Rashtriya Yuva Sangathan who is now joined there as a bare foot doctor as part of the Sarvodaya relief camp to distribute medicines to the victims says, government servants posted here are not going to remote villages. When he asked one of them sent for this temporary camp, he blasted on Mr.Roy saying, " do you know I am from Cuttack, government has drop us here, where there is no electricity, no net work ! how can one work in this situations ! "
Ravi Das, the 70 years old leader of the Sarvodaya relief camp who is co ordinating the work to arrange medicines and looking after entire operation shared a similar story of Baliguda village of Gudibali panchayat. There are 40/45 house holds in Baliguda village and almost all are very poor. There is tube well but defunct and repaired later when one died recently." When the villagers informed the nearby temporary camp set up by the government about a patient who was serious and requested them to sent the vehicle to transport the patient, the camp in charge a doctor was found missing, the para medical staff who was present there did not respond. When we saw this we also requested them but they said that, why the villagers are not bringing the patient. We told them when the villagers are saying that there was non to bring the old patient as the entire family is affected by diarrhea ! at last when they sent the vehicle it was too late, The 70 years old Binidhar Goud was brought and died in the camp. " said Ravi Das with anguish.
Dr.Roy of Sarvodaya said, he spoke over phone to a senior state level officer of NRHM and complained about the apathy and their attitude, in reply the officer expressed his helplessness and said, the problem is that, our government people are not ready to step down from the pitch road ! They have attitude problem.
when asked why he is not taking action ? he replied, we already lacking staff so we can not just afford it. And you know the reality how it is difficult to suspend or dismiss even a 4th class employee in the government service.
" Now the season has changed. The continues rains has stopped and so the diarrhea cases. " said Ravi Das. He was here in 2007 when the epidemic was broke out and more than 200 people died, he was also done the same work in Kalahandi last year where around 40 people lost their life.
" Its not just the contaminated water and inaccessibility rather its endemic poverty which is prevailed here. They have no access to safe drinking water and the food as well. They are still forced to take contaminated food like mango kernel and seeds of tamarind, roots and poisonous mushrooms " he added.
Although the 25 kg PDS rice at two rupees are of great help to them but villagers says they are getting 5 kg less rice. When they asked the dealers its go unheard.
Reaching villages for outsiders is a very dfficult task so is for the people living inside. Outsiders can afford to go inside if they wish because they have the purchasing capacity but in case of villagers its beyond their affordable reach. You requires money in every step you go forward. So people even in distress and in badly need of health care prefer to die or forced to die a silent death but fear to go to hospital as he or she knows even its a government hospital you need money for the treatment.
And this reporter witnessd such an incident when he visited recently along with the Sarvoday team Huder village where a 7 years old boy Karan Majhi was found with a fractured and swelling hand, when asked he said he fell down from a guava tree a week back. The doctor with the team expressed his serious concern and said it may be lead to gangrene inside. When asked to his father Ghenu Majhi, he said he can not afford the treatment in a hospital so have treated with some paste of roots found in the forest. Than the Sarvoday team decided to take the boy and his father to Raygada district hospital. Next day he was treated in Raygada and returned to his village. So god knows if the boy would have brought by these people what would have happened to him.
In the same village we met 75 years old Rupali Majhi. When we were talking to some villagers, she came to us and try to listen to us. Than she told us that, " Please make a road to our village. You see the road is not good so you are too facing problem to reach here, you are not able to come with your vehicle. When we are felling ill who will carry us such a long distance to the hospital. So please do this, we will be grateful to you."
It shows even the older people of the area understood where the problems are lies.
In the meantime the paramedical staffs have been returned to their respective places outside the district from where they were deployed in temporary health centers as the centers are with drawn.
The epidemic has spread to about six more districts including Koraput, Nuapada, Malkangiri, Nabrangpur, Gajpati, Bolangir and parts of Sundergarh. The districts which are known for its poverty and backwardness but, in almost all the districts, 60 percent of the doctors’ posts have been lying vacant for years. There are 128 sanctioned posts of doctors in Raygada but out of it 58 are vacant. Recently after the spread of epidemic the government as appointed 408 doctors on ad hoc in Orissa, out of that 20 doctors have been posted in Raygada but only ................have joined by the end of August.
Its not only diarrhea, Malaria too is known as one of the dreaded killer in this part of Orissa. So far numbers of people have been killed by the malaria.
However, according to CDMO, Raygada, " The district becomes a " malaria endemic zone " during rainy season with about 97 per cent of the patients suffering from falciparum infection which causes brain malaria.
However, according to Nayak the district becomes a “malaria endemic zone” during rainy season with about 97 per cent of the patients suffering from falciparum infection which causes brain malaria.
The tribal couple Rajendra and Solomi Majhi of Panabandha village of Tikri block has lost their two children out of four in a week time. Rajendra, who is a landless narrates the agony he has gone through. " I had no money when my son Bina (13) suffered from malaria. I borrowed Rs.200 and trek down to the Tikri hospital with my son on my shoulder. He died there. 5 days later my another son fell ill but I lost him at home because I could not arrange money."
Villagers said, in last one and half month time 8 villagers have died in malaria.
There are 235 sanctioned health sub-stations for equal number of health workers. At least 166 sub-stations are almost non-existent, without own building that are supposed to be the residence-cum-offices of the health workers. “We cannot stay in our place of work even if we want to. Besides, when there is an outbreak, it becomes difficult to reach the inaccessible villages,” said a woman health worker, requesting anonymity.
Due to inaccessibility, the poor tribals have lost out on many government benefits. Last year, the administration distributed about 50,000 long lasting impregnated nets (LLIN) in the district to ward off mosquitoes. In the four villages that HT visited rarely anybody had one.
A trip to Kadapadar, a hill top village just about 10 km from Tikri, is arduous. Four children below the age of six have died in the village following high fever.
Health workers visited the village twice after almost all of 110 households – all tribals below poverty line – had been affected with high fever.
People are still down with fever, but health workers have not come since the last 15 days.
“It is not that easy to work here. We have distributed medicines in all villages. But the villagers dump them in their house,” said Prasanna Mohanty, a health worker.
CDMO Nayak also corroborated that the villagers rarely come to the hospital. “They rely more on the quacks and people indulging in witchcraft. They come to the hospital as a last resort. Actually, there is lack of awareness,” he said.
It is not that villagers do not come to the hospital. But they cannot afford to. “To be aware means to cough up more money,” said Luki Majhi (29) of Kadapadar, who lost his 2-year-old daughter because he could not hire a vehicle at a cost of Rs.800 to take her to the hospital. “As such, during rainy seasons, vehicles do not come to the village as rain cuts off the road.”
“Going to hospital without taking money is like banging one’s head against a wall,” said Reu Majhi (30), whose 6-year-old daughter died due to malaria.
Poverty is all pervasive across villages. The malnourished people have no work. They do not remember when they worked in a government project last.
As the area gets cut off during the rainy season, gnawing hunger force them to eat on whatever they lay their hands on – mainly dried mushroom and mango kernel, which tend to infected by fungus. “And that leads to several diseases and even death,” said social activist Pabitra Majhi.
In 2007, 99 persons lost their lives to cholera, half of them in Kashipur block. Every year, diarrhea claims several lives in the inaccessible villages. Children have been a major casualty. In the last three years, the infant mortality rate has increased from 78 per to 91 per 1000 children, against the state average of 69.
Orissa health minister Prasanna Acharya said that they were trying to check the spread of malaria. “Of late, malaria cases are being detected successfully because we have used several methods. More vigorous campaign needs to be done to eradicate it completely,” Acharya said.
According to Acharya, vacancy of doctors is a vital problem, not only in Rayagada or KBK area but in the whole of Orissa. “Recently we recruited 408 doctors. All of them have been posted in KBK districts,” he said.
Wednesday, 30 March 2011
HEALTH TAKES A BACK SEAT
August 15, 2010
Photo: Purusottam Singh Thakur
Almost all the families are beedi workers in this
dalit basti of Rengali village.
Health
takes a
backseat
When getting three meals a day is a problem, who will bother about
proper medication!
Purusottam Singh Thakur, Odisha
Eighteen-year-old Sulochana
Bag of Rengali Village in
Sambalpur district has spent
half (nine years) of her life in rolling
thousands of beedis, but earning a
decent livelihood or contributing
to overall income of her family
remain a distant dream even today.
If you ask Sulochana as to when
she relished her last luxurious meal
out of her income, the experienced
beedi roller would surely fail to
answer. But what she has earned out
of nine years of grinding in filthy
and disease-causing conditions is
evident. She often gets suffocated
and coughs up intermittently.
Like in case of most beedi workers,
her induction into the industry
happened when she turned five.
Being the cheapest ‘pleasure’
available to the low income group in
rural and urban areas, this product has
got a vast potential in the market. And
this labour-intensive industry does not
find any difficulties in getting young
recruits like Sulochana from poverty-
stricken western Orissa region.
In fact, beedi manufacturers of late
have distributed contracts of beedi
making to individual households
and are collecting finished products
from them. Rolling of 1000 beedis
fetches Sulochana a paltry Rs 45.
After toiling hard for whole week,
the entire family earns just Rs 360.
If the story of Sulochana Bag
sounds depressing, middle-aged
Rajkumari Mahanand’s miseries are
interweaved with the growth of beedi
industries in her area. Her father, a
beedi worker, had died about three
decades ago, she lost her husband
who was involved in the industry
and mother who brought up her by
rolling beedi is now bed-ridden.
"Although rolling beedis
increases health risk, I don’t have
the other options to get out of the
sector," says Rajkumari. In the
beedi rolling units, people of all
ages could be found. Most of them
look older than that of their age.
People engaged in the sector
are often deprived of actual wages.
"When the beedi making wage was
just 14 ana (0.87 paise) per 1000,
I learnt beedi making without any
wage. When they started paying me,
the rate was Rs 2 per 1000 beedi.
By the time I left the sector, it was
only Rs 10 per rolling out 1000
beedis,” says 60-year-old Bhimsen
Bag who worked 33 years with a
well-known beedi manufacturer.
General Secretary of Beedi
workers’ union affiliated to Centre
of Indian Trade Union, Orissa,
Satyananda Behera, said that although
the State Government had ordered
Rs 65 to be paid for 1000 beedis, it was
rarely implemented on the ground.
“Beedi workers are always living
on the edge of poverty. What they get
from the sector as wage just fulfils
their food needs. We need to think of a
drastic reform to make their lives look
better,” says Ranjan Panda, an activist
who works on the livelihood issues.
About 25000 beedi workers are
engaged in Rengali alone, which is
blessed with dense forest, the number
swells to one lakh in Sambalpur
district. Five companies are enjoying
the flourishing business in the region.
While beedi workers are forced
to toil at paltry sum and struggle to
make both ends meet, addressing
health concerns takes a back seat.
Beedi workers have common ailments
like respiratory and skin diseases.
"Workers are very poor. Most of
them live in single room houses and the
average family size is about six. They
are prone to tobacco related disease
such as tuberculoses and cancer,”
said Dr S N Mohanty, a government
doctor working in the dispensary run
by Bidi Shramik Kalyan Sanstha.
Poor health conditions and low
wages of Beedi workers never
improve due to fewer number of
inspections carried out by Labour
department. As many as 440
establishments are covered under the
Beedi and Cigar Workers (Condition
of Employment) Act, 1966 and 416
establishments have obtained licences.
Inspector declared under the
Act conducted 59 inspections
during the year 2008-09. Number
of inspections is on a declining
trend in the preceding three years.
While 94 inspections were
done in 2006-07, it came down
to 65 in the subsequent year –
2007-08. Lack of sticks from the
government agencies has made
workers more vulnerable to health
hazards in the beedi-making sector.
Photo: Purusottam Singh Thakur
Almost all the families are beedi workers in this
dalit basti of Rengali village.
Health
takes a
backseat
When getting three meals a day is a problem, who will bother about
proper medication!
Purusottam Singh Thakur, Odisha
Eighteen-year-old Sulochana
Bag of Rengali Village in
Sambalpur district has spent
half (nine years) of her life in rolling
thousands of beedis, but earning a
decent livelihood or contributing
to overall income of her family
remain a distant dream even today.
If you ask Sulochana as to when
she relished her last luxurious meal
out of her income, the experienced
beedi roller would surely fail to
answer. But what she has earned out
of nine years of grinding in filthy
and disease-causing conditions is
evident. She often gets suffocated
and coughs up intermittently.
Like in case of most beedi workers,
her induction into the industry
happened when she turned five.
Being the cheapest ‘pleasure’
available to the low income group in
rural and urban areas, this product has
got a vast potential in the market. And
this labour-intensive industry does not
find any difficulties in getting young
recruits like Sulochana from poverty-
stricken western Orissa region.
In fact, beedi manufacturers of late
have distributed contracts of beedi
making to individual households
and are collecting finished products
from them. Rolling of 1000 beedis
fetches Sulochana a paltry Rs 45.
After toiling hard for whole week,
the entire family earns just Rs 360.
If the story of Sulochana Bag
sounds depressing, middle-aged
Rajkumari Mahanand’s miseries are
interweaved with the growth of beedi
industries in her area. Her father, a
beedi worker, had died about three
decades ago, she lost her husband
who was involved in the industry
and mother who brought up her by
rolling beedi is now bed-ridden.
"Although rolling beedis
increases health risk, I don’t have
the other options to get out of the
sector," says Rajkumari. In the
beedi rolling units, people of all
ages could be found. Most of them
look older than that of their age.
People engaged in the sector
are often deprived of actual wages.
"When the beedi making wage was
just 14 ana (0.87 paise) per 1000,
I learnt beedi making without any
wage. When they started paying me,
the rate was Rs 2 per 1000 beedi.
By the time I left the sector, it was
only Rs 10 per rolling out 1000
beedis,” says 60-year-old Bhimsen
Bag who worked 33 years with a
well-known beedi manufacturer.
General Secretary of Beedi
workers’ union affiliated to Centre
of Indian Trade Union, Orissa,
Satyananda Behera, said that although
the State Government had ordered
Rs 65 to be paid for 1000 beedis, it was
rarely implemented on the ground.
“Beedi workers are always living
on the edge of poverty. What they get
from the sector as wage just fulfils
their food needs. We need to think of a
drastic reform to make their lives look
better,” says Ranjan Panda, an activist
who works on the livelihood issues.
About 25000 beedi workers are
engaged in Rengali alone, which is
blessed with dense forest, the number
swells to one lakh in Sambalpur
district. Five companies are enjoying
the flourishing business in the region.
While beedi workers are forced
to toil at paltry sum and struggle to
make both ends meet, addressing
health concerns takes a back seat.
Beedi workers have common ailments
like respiratory and skin diseases.
"Workers are very poor. Most of
them live in single room houses and the
average family size is about six. They
are prone to tobacco related disease
such as tuberculoses and cancer,”
said Dr S N Mohanty, a government
doctor working in the dispensary run
by Bidi Shramik Kalyan Sanstha.
Poor health conditions and low
wages of Beedi workers never
improve due to fewer number of
inspections carried out by Labour
department. As many as 440
establishments are covered under the
Beedi and Cigar Workers (Condition
of Employment) Act, 1966 and 416
establishments have obtained licences.
Inspector declared under the
Act conducted 59 inspections
during the year 2008-09. Number
of inspections is on a declining
trend in the preceding three years.
While 94 inspections were
done in 2006-07, it came down
to 65 in the subsequent year –
2007-08. Lack of sticks from the
government agencies has made
workers more vulnerable to health
hazards in the beedi-making sector.
Koraput tribals get addicted to tobacco young
http://dailypioneer.com/270610/Koraput-tribals-get-addicted-to-tobacco-young.html
SUNDAY PIONEER | Agenda Foray
BHUBANESWAR | Wednesday, July 21, 2010 | Email | Print | | Back
Koraput tribals get addicted to tobacco young
March 30, 2011 5:55:51 PM
Purushottam Singh Thakur | Bhubaneswar
When we were young we chewed tobacco with lime, now our teeth does not permit so we drink sap or sago palm, said 60-year-old Aaitu Durua of Malipadar village in Boipariguda block of Koraput district.
I have been taking tobacco with lime twice a day, said 48-year-old Chaiti Durua of Siribeda village of the same block, adding in their community people being chewing at a young age. “Some of my friends have stopped but I could not,” said Chaiti.
Kumhari Sisa of Narayanpatna village is proud of making a single leaf-rolled smoke leaf to consume for the whole day when she is at work adding it boosts her energy and sharing a smoke with friends is not a taboo.
Tobacco blended with lime and smoking is an age old habit which our forefathers did and so do we but we do not know its consequences, says Budu Bhumia of Mulasar village.
Aaitu, Chaiti, Budu and Kumhari get their tobacco from the weekly market. They are not locally grown. The purchase is included in the weekly shopping list. It is planned what to buy from which market.
Smoking and chewing tobacco is a habit for almost every tribe in Koraput. This forms a part of their food habits and livelihood pursuits. However, some communities have specific restrictions.
Tribesmen of different communities chew tobacco for generations without knowing its impact on health. The life span of most of the tribal communities is short. Smoking is common in all tribal communities except a few primitive groups.
But this is not seen in Durua tribal community living in the forest villages bordering the neighbouring States of Odisha and Chhattisgarh.
The older members of the Durua tribe generally take drinks prepared from sago palm or beer brewed from rice, generally prepared at home. This is restricted to festive occasions only.
\However, men and women and children of the community between the age group of 13-14 years chew tobacco with lime, says Paresh Rath who has done intensive research on the community.
For members of the Durua community of both the States, the product is imported from the adjoining Chhattisgarh.
They live in about 30 villages of Boipariguda, Kundra and Kotapad block of Koraput district and depend on weekly market for buying tobacco. Traders bring it from Chhattisgarh to sell in the weekly market.
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SUNDAY PIONEER | Agenda Foray
BHUBANESWAR | Wednesday, July 21, 2010 | Email | Print | | Back
Koraput tribals get addicted to tobacco young
March 30, 2011 5:55:51 PM
Purushottam Singh Thakur | Bhubaneswar
When we were young we chewed tobacco with lime, now our teeth does not permit so we drink sap or sago palm, said 60-year-old Aaitu Durua of Malipadar village in Boipariguda block of Koraput district.
I have been taking tobacco with lime twice a day, said 48-year-old Chaiti Durua of Siribeda village of the same block, adding in their community people being chewing at a young age. “Some of my friends have stopped but I could not,” said Chaiti.
Kumhari Sisa of Narayanpatna village is proud of making a single leaf-rolled smoke leaf to consume for the whole day when she is at work adding it boosts her energy and sharing a smoke with friends is not a taboo.
Tobacco blended with lime and smoking is an age old habit which our forefathers did and so do we but we do not know its consequences, says Budu Bhumia of Mulasar village.
Aaitu, Chaiti, Budu and Kumhari get their tobacco from the weekly market. They are not locally grown. The purchase is included in the weekly shopping list. It is planned what to buy from which market.
Smoking and chewing tobacco is a habit for almost every tribe in Koraput. This forms a part of their food habits and livelihood pursuits. However, some communities have specific restrictions.
Tribesmen of different communities chew tobacco for generations without knowing its impact on health. The life span of most of the tribal communities is short. Smoking is common in all tribal communities except a few primitive groups.
But this is not seen in Durua tribal community living in the forest villages bordering the neighbouring States of Odisha and Chhattisgarh.
The older members of the Durua tribe generally take drinks prepared from sago palm or beer brewed from rice, generally prepared at home. This is restricted to festive occasions only.
\However, men and women and children of the community between the age group of 13-14 years chew tobacco with lime, says Paresh Rath who has done intensive research on the community.
For members of the Durua community of both the States, the product is imported from the adjoining Chhattisgarh.
They live in about 30 villages of Boipariguda, Kundra and Kotapad block of Koraput district and depend on weekly market for buying tobacco. Traders bring it from Chhattisgarh to sell in the weekly market.
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Tobacco eats into Koraput tribals’ health, hard-earned money
http://dailypioneer.com/268158/Tobacco-eats-into-Koraput-tribals%E2%80%99-health-hard-earned-money.html
SUNDAY PIONEER | Agenda Foray
BHUBANESWAR | Saturday, July 10, 2010 | Email | Print | | Back
March 30, 2011 5:50:22 PM
Purushottam Singh Thakur | Bhubaneswar
While smoking kills over nine lakh people every year in India, bidi-smoking women shorten their lives by about eight years on an average and smoking 1-7 bidis a day raises mortality risks by 25 per cent. Buduni Bhumia in remote Ramgiri village of Koraput district has never heard of these shocking details on tobacco consumptions.
In fact, the Budunis are hardly ever told in simple language that, what they chew or smoke in a carefree manner in the pristine village forests is all set to snatch them away from their near and dear ones much earlier than they imagine.
Rural Odisha, especially, the tribal-dominated regions have never been in the grip of tobacco as it has been today.
A weekly marketplace in Koraput depicts how the local-made tobaccos are sold like hotcakes and men and women queue up for stacking tobacco materials for their weekly consumptions.
Forty-year-old Bhagban Sagar of Ramgiri village has been a small trader of dhungia (colloquially bidi) over a decade.
Bhagban’s income has shot up in recent years as consumption of tobacco among the villagers has increased substantially.
He now hops from one market to another and enjoys his booming business.
He is now contented with his journey from mere daily labourer in the brick-kilns to becoming a trader.
However, he is not aware of the fact that he is dishing out slow deaths to his fellow tribes.
A small interaction with Bhagban makes it clear how tobacco consumption is higher among the least educated, poorest, and the scheduled castes and scheduled tribes.
“A big chunk of the buyers belong to the Kondh community and frequent the weekly market only for dhungia,” he said.
Bhagban himself pleads ignorance about the bad effects of tobacco.
At Dhandabadi weekly market, more than five traders of dhungia were seen raking mullahs over the locals’ lack of knowledge about the ill-impact of tobacco.
At Dhandabadi, people from Bhumia tribes are the main buyers.
Tobacco consumption is not all about health only, but it also eats into the hard-earned money of the tribals.
Two tribal women, who came to purchase dhungia leaves, said that they spent Rs 2 on tobacco daily.
This is a not a small amount considering the acute chronic hunger and poverty prevailing in the region.
Smoking bidi, suta and chewing dhungia has not been a habit developed in the adults. They catch it from young tribals.
Holding dry dhungia leaves, Sada Saunta said that he was into smoking since his childhood.
They give interesting reasons for developing tobacco consumption in Koraput.
Ram Saunta of Gadaguda village said that he has been using tobacco to get rid of dental problem.
“I am sure, it is not good for health, but I get relief from dental germs as tobacco kills them,” Ram said.
Besides, the tribal population faces bombardment of small tobacco packets which have been attracting the youngsters.
In Putiaguda village, most of the people have shifted to readymade tobacco from traditional dhungia.
“Since it is easily available in the local market, I am using gutkha (packed tobacco),” said Saba Saunta.
The prevalence of tobacco consumption in tribal region seems to be grossly underreported.
Tobacco is making further inroads into tribal regions in different shapes and cultures. Surprisingly, neither the Government nor any non-Government organisation has thought of creating awareness to persuade the tribals to give up the killer habit.
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SUNDAY PIONEER | Agenda Foray
BHUBANESWAR | Saturday, July 10, 2010 | Email | Print | | Back
March 30, 2011 5:50:22 PM
Purushottam Singh Thakur | Bhubaneswar
While smoking kills over nine lakh people every year in India, bidi-smoking women shorten their lives by about eight years on an average and smoking 1-7 bidis a day raises mortality risks by 25 per cent. Buduni Bhumia in remote Ramgiri village of Koraput district has never heard of these shocking details on tobacco consumptions.
In fact, the Budunis are hardly ever told in simple language that, what they chew or smoke in a carefree manner in the pristine village forests is all set to snatch them away from their near and dear ones much earlier than they imagine.
Rural Odisha, especially, the tribal-dominated regions have never been in the grip of tobacco as it has been today.
A weekly marketplace in Koraput depicts how the local-made tobaccos are sold like hotcakes and men and women queue up for stacking tobacco materials for their weekly consumptions.
Forty-year-old Bhagban Sagar of Ramgiri village has been a small trader of dhungia (colloquially bidi) over a decade.
Bhagban’s income has shot up in recent years as consumption of tobacco among the villagers has increased substantially.
He now hops from one market to another and enjoys his booming business.
He is now contented with his journey from mere daily labourer in the brick-kilns to becoming a trader.
However, he is not aware of the fact that he is dishing out slow deaths to his fellow tribes.
A small interaction with Bhagban makes it clear how tobacco consumption is higher among the least educated, poorest, and the scheduled castes and scheduled tribes.
“A big chunk of the buyers belong to the Kondh community and frequent the weekly market only for dhungia,” he said.
Bhagban himself pleads ignorance about the bad effects of tobacco.
At Dhandabadi weekly market, more than five traders of dhungia were seen raking mullahs over the locals’ lack of knowledge about the ill-impact of tobacco.
At Dhandabadi, people from Bhumia tribes are the main buyers.
Tobacco consumption is not all about health only, but it also eats into the hard-earned money of the tribals.
Two tribal women, who came to purchase dhungia leaves, said that they spent Rs 2 on tobacco daily.
This is a not a small amount considering the acute chronic hunger and poverty prevailing in the region.
Smoking bidi, suta and chewing dhungia has not been a habit developed in the adults. They catch it from young tribals.
Holding dry dhungia leaves, Sada Saunta said that he was into smoking since his childhood.
They give interesting reasons for developing tobacco consumption in Koraput.
Ram Saunta of Gadaguda village said that he has been using tobacco to get rid of dental problem.
“I am sure, it is not good for health, but I get relief from dental germs as tobacco kills them,” Ram said.
Besides, the tribal population faces bombardment of small tobacco packets which have been attracting the youngsters.
In Putiaguda village, most of the people have shifted to readymade tobacco from traditional dhungia.
“Since it is easily available in the local market, I am using gutkha (packed tobacco),” said Saba Saunta.
The prevalence of tobacco consumption in tribal region seems to be grossly underreported.
Tobacco is making further inroads into tribal regions in different shapes and cultures. Surprisingly, neither the Government nor any non-Government organisation has thought of creating awareness to persuade the tribals to give up the killer habit.
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Tuesday, 29 March 2011
गुड़ाखू के गुलाम
http://raviwar.com/news/355_gudakhu-in-kalahandi-purushottam-thakur.shtml
पुरुषोत्तम सिंह ठाकुर कालाहांडी, ओडिशा से
इस तस्वीर में गुड़िया जैसी दिखनेवाली 3 साल की इस नन्ही परी का नाम टमी है. 3 साल की इस बच्ची की उंगली में गुड़ाखू लगा है और वह उस से दांत घिस रही है. कालाहांडी जिले के नियमगिरि पहाड़ में बसे गांव लाखपदर में जब मैंने उसे घर के बाहर खड़े होकर गुड़ाखू करते देखा तो पेशोपेश में पड़ गया. गुड़ाखू यानी एक तरह का तंबाकू मिश्रित दंतमंजन, जिसमें अच्छा-खासा नशा होता है. सोचा, जरुर यह बच्ची गलती से गुड़ाखू कर रही होगी. मैंने घर के अंदर बैठी उसकी मां को आवाज़ लगाई. मां का जवाब था- नहीं, वह गुड़ाखू ही कर रही है.
उसकी मां खुद भी गुड़ाखू करती हैं और उन्होंने कहा कि उनके गांव की ज्यादातर लड़कियां और महिलायें गुड़ाखू करती हैं. पुरुष तो गुड़ाखू करते ही हैं.
इतने घने जंगल में बसे इस डोंगरिया कंध आदिवासी गांव में यह गुड़ाखू किस हद तक अपने पैर पसार चुका है, इस बात को समझने के लिये टमी की हालत देखना पर्याप्त था. तंबाकू मिला यह कथित दंतमंजन उस नन्हीं सी जान के जिस्म में किस तरह के दुष्प्रभाव पैदा कर रहा होगा और आगे क्या करेगा, यह पता नहीं पर इसमें कोई शक नहीं कि टमी के लिये इसका इस्तेमाल जानलेवा भी साबित हो सकता है.
हालांकि टमी को तो इसका इल्म भी नहीं है लेकिन उसकी मां भी इस बात से बेखबर है कि उन्होंने जाने-अनजाने कितनी खतरनाक चीज़ को अपना लिया है.
आसपास के छोटे दुकानों के अलावा साप्ताहिक हाट में सब तरफ मिलने वाला यह गुड़ाखू जिन छोटी-छोटी डिबियों में बिकता है, उसमें किसी तरह की कोई चेतावनी भी नहीं लिखी होती है. यहां तक कि गुड़ाखू कैसे बनता है और उसमें क्या-क्या सामग्री मिलाई गयी है, उसकी भी कोई जानकारी नहीं दी जाती है. जनता के नाम अपील में दर्ज होता है कि गुड़ाखू वास्तव में तम्बाकू मिश्रित एक दंत मंजन है.
तंबाखू के सेवन से शरीर को जितना नुकसान होता है, उतना ही नुकसान गुड़ाखू के सेवन से भी होता है. इसके प्रयोग से मुंह और श्वांस नली के विभिन्न भागों में कैंसर हो सकता है. दांतों में इसे घिसने से हाजमा खराब होना, भूख न लगना, एलर्जी और अल्सर आदि रोग बड़ी तेज़ी से पनपते हैं.
आंकड़े बताते हैं कि भारत में हर साल तक़रीबन 10 लाख भारतीयों की मौत केवल धुम्रपान जनित बीमारी से होती है. लगभग 28 प्रतिशत भारतीय यानि आबादी का एक तिहाई तम्बाकू का सेवन करता हैं, जिनमें 15 से 49 वर्ष के लोग शामिल हैं. लेकिन इनके मुकाबले महिलाओं के आंकड़े भी कमजोर नहीं हैं. तक़रीबन 11 प्रतिशत यानि करीब 5 करोड़ 40 लाख महिलायें किसी ना किसी रूप में तम्बाकू का सेवन करती हैं. इनमें ज्यादातर महिलाएं धुआं रहित तम्बाकू का इस्तेमाल करते हैं, जैसे तम्बाकू वाला गुटखा, पान मसाला,मिश्री गुल आदि. 35 से 69 वर्ष की तक़रीबन 20 में से एक यानि 90,000 महिलाओं की मौत के लिए धुम्रपान को जिम्मेदार ठहराया जा सकता है.
लेकिन इन सारे आंकड़ों से बेखबर उड़ीसा के घने जंगलों में बसे इन गांवों में गुड़ाखू के अलावा खैनी और गुटका भी लोगों को नशे की एक ऐसी गिरफ्त में कस रहे हैं, जिससे निकलना मुश्किल है. पहाड़ी रास्तों में हर जगह गुटका और खैनी के खाली पाउच नज़र आते हैं. गांव की बुजुर्ग महिलायें और युवतियों में तो जैसे खैनी खाने की होड़ सी लगी हुई है. ये महिलाऐं खैनी को अपनी कमर में खोंस के रखती हैं. फिर चाहे वह घर पर हों, बाज़ार जा रही हों, काम पर या रिश्तेदारों के घर. कमर में हर वक्त खैनी की एक पोटली पड़ी रहती है.
गौरतलब है कि कालाहांडी जिले के लांजीगढ़ ब्लाक के नियमगिरि पहाड़ में बसे ये आदिवासी, बदनाम ब्रितानी कंपनी वेदांता के खिलाफ अपने अस्तित्व की लड़ाई लड़ रहे हैं, जो नियमगिरि पर्वत में बॉक्साइट की खुदाई करना चाहता है. नियमगिरि पर्वत को डोंगरिया कंध नियम राजा कहते हैं और उसकी पूजा अर्चना करते हैं क्योंकि यहाँ पीढियों से ना केवल उनका बसेरा है बल्कि यह नियमगिरि उन्हें वह सब कुछ देता है, जो उन्हें चाहिये. इस ‘सब कुछ’ में भोजन से लेकर जडी-बुटी और दूसरे जरुरी सामान शामिल हैं.
ऐसे में आश्चर्य नहीं कि तंबाकू, गुटका, खैनी और गुड़ाखू जैसी नशीली सामग्री को इलाके में जिस तरह से विस्तारित किया जा रहा है, उससे आदिवासी समाज के अंदर एक खास किस्म की अराजकता और कमजोरी पैदा हो रही है. जाहिर है, इससे ब्रितानी कंपनी वेदांता के खिलाफ चल रही लड़ाई भी कहीं न कहीं कमज़ोर पड़ेगी ही.
दूसरी ओर जिस राज्य सरकार को अपनी आदिवासी जनता की सुध लेनी थी, उसका कहीं अता-पता नहीं है. उदाहरण के लिये लाखपदर गांव को ही लें. गांव में ना तो स्कूल है, ना ही स्वास्थ्य केंद्र. गांव तक आने के लिये कोई सड़क भी नहीं है. गांव के छोटे बच्चे भी अपने मां-बाप के साथ जंगल जाते हैं और घर के लिए खाना जुगाड़ने में लगे रहते हैं.
मामला केवल लाखपदर और कालाहांडी तक सिमटा हुआ है, ऐसा नहीं है. कोरापूट जिले के पोटापोड़ू गांव में जब हम पहुंचे तो गांव के बाहर एक इमली के पेड़ के नीचे बड़ी संख्या में महिलायें बैठी थीं. अधिकांश महिलाओं के कान में तंबाकू के पीका लगे हुए थे. ये ऐसे पीका हैं, जिनसे महिलायें नशे का सेवन करती हैं. पता चला कि गांव की अधिकांश महिलाओं को इसकी लत है. दूसरी और महिलाओं के एक साथ मिल बैठने और खाली समय में बोरियत दूर करने के लिये भी पीका का सेवन किया जा रहा है. महिलायें पीका में डूबी हैं. कम उम्र की लड़कियां और गर्भवती औरतें भी. इस बात से बेखबर कि इसका उनके स्वास्थ्य पर क्या असर पड़ेगा. सरकार की लापरवाही और उदासीनता से एकदम दूर, जैसे हर फिक्र को धुयें में उड़ाते हुये और जीवन की हर समस्या को गुड़ाखू की तरह समय की धार पर घिसते हुये.
07.07.2010, 01.10 (GMT+05:30) पर प्रकाशित
इस समाचार / लेख पर पाठकों की प्रतिक्रियाएँ
devesh tiwari (deveshrisk@gmail.com) bilaspur c.g.
लेख बहुत अच्छा है. आपने उस जगह को अच्छी तरह निहारा है. आदिवासियों के लगभग सभी इलाके इसी तरह नशे की चपेट में है लेकिन समय के साथ साथ नशे के रूप में बदलाव आया है.
Beena (beenapandey927@gmail.com) Lucknow
"मैं जिंदगी का साथ निभाता चला गया, हर फिक्र को धुंए में उडाता चला गया."
कहना न होगा कि ये गाना गुड़ाखू का सेवन करने वालों पर कितना सटीक बैठता है. हम अपने माननीयों को क्यों कोसें जबकि हम भी तम्बाकू का सेवन करने वालों को रोक सकते हैं. पुरुषोत्तमजी अगर आपके और हमारी तरह सभी सिर्फ ऑनलाइन ही बैठे रहे तो इन भयावह रास्तों पर जाने वाले लोगों को रोकेगा कौन? जीतनी मेहनत हम रिसर्च करके लिखने में लगते हैं, अगर उसमें से थोडा समय उन अज्ञानियों को दे तो कुछ किया जा सकता है. है न.
Pallav Journo Delhi
If we read history books, then it is well evident how imperial powers have colonized china through 'opium', Illiteracy, negligence of our government and other factors are implicating such habits among these people.
May be in future course of time, the habit shall be processed by the Neo-Imperial powers (as mentioned in the article) to fulfill desired goals.
shailesh sharma (abshailesh@gmail.com) bilaspur
छत्तीसगढ़ के हेल्थ मिनिस्टर गुड़ाखू के बारे में बहुत अच्छा "व्याख्यान" दे सकते है. उनकी राय भी लाज़मी है. कोरबा के सांसद महोदय इसके उपयोग से होने वाले लाभ के बारे में भाषण 1-2 घंटा तो दे ही सकते है. कभी उनको मंच भी दिया जाये.
Sunil Singh (sunilsingh.nirwan@gmail.com) Rajasthan, Jhunjhunu
It's very dangerous matter chewing of tobacco.
sunil sharma (sunillsharma@ymail.com) bilaspur
बहुत अच्छा. छत्तीसगढ़ में भी गुड़ाखू के लाखों गुलाम मिल जाएंगे. लोगों को इस ज़हर को परोसने वाले बड़े पदों पर काम कर रहे हैं.
पुरुषोत्तम सिंह ठाकुर कालाहांडी, ओडिशा से
उसकी मां खुद भी गुड़ाखू करती हैं और उन्होंने कहा कि उनके गांव की ज्यादातर लड़कियां और महिलायें गुड़ाखू करती हैं. पुरुष तो गुड़ाखू करते ही हैं.
इतने घने जंगल में बसे इस डोंगरिया कंध आदिवासी गांव में यह गुड़ाखू किस हद तक अपने पैर पसार चुका है, इस बात को समझने के लिये टमी की हालत देखना पर्याप्त था. तंबाकू मिला यह कथित दंतमंजन उस नन्हीं सी जान के जिस्म में किस तरह के दुष्प्रभाव पैदा कर रहा होगा और आगे क्या करेगा, यह पता नहीं पर इसमें कोई शक नहीं कि टमी के लिये इसका इस्तेमाल जानलेवा भी साबित हो सकता है.
हालांकि टमी को तो इसका इल्म भी नहीं है लेकिन उसकी मां भी इस बात से बेखबर है कि उन्होंने जाने-अनजाने कितनी खतरनाक चीज़ को अपना लिया है.
आसपास के छोटे दुकानों के अलावा साप्ताहिक हाट में सब तरफ मिलने वाला यह गुड़ाखू जिन छोटी-छोटी डिबियों में बिकता है, उसमें किसी तरह की कोई चेतावनी भी नहीं लिखी होती है. यहां तक कि गुड़ाखू कैसे बनता है और उसमें क्या-क्या सामग्री मिलाई गयी है, उसकी भी कोई जानकारी नहीं दी जाती है. जनता के नाम अपील में दर्ज होता है कि गुड़ाखू वास्तव में तम्बाकू मिश्रित एक दंत मंजन है.
तंबाखू के सेवन से शरीर को जितना नुकसान होता है, उतना ही नुकसान गुड़ाखू के सेवन से भी होता है. इसके प्रयोग से मुंह और श्वांस नली के विभिन्न भागों में कैंसर हो सकता है. दांतों में इसे घिसने से हाजमा खराब होना, भूख न लगना, एलर्जी और अल्सर आदि रोग बड़ी तेज़ी से पनपते हैं.
आंकड़े बताते हैं कि भारत में हर साल तक़रीबन 10 लाख भारतीयों की मौत केवल धुम्रपान जनित बीमारी से होती है. लगभग 28 प्रतिशत भारतीय यानि आबादी का एक तिहाई तम्बाकू का सेवन करता हैं, जिनमें 15 से 49 वर्ष के लोग शामिल हैं. लेकिन इनके मुकाबले महिलाओं के आंकड़े भी कमजोर नहीं हैं. तक़रीबन 11 प्रतिशत यानि करीब 5 करोड़ 40 लाख महिलायें किसी ना किसी रूप में तम्बाकू का सेवन करती हैं. इनमें ज्यादातर महिलाएं धुआं रहित तम्बाकू का इस्तेमाल करते हैं, जैसे तम्बाकू वाला गुटखा, पान मसाला,मिश्री गुल आदि. 35 से 69 वर्ष की तक़रीबन 20 में से एक यानि 90,000 महिलाओं की मौत के लिए धुम्रपान को जिम्मेदार ठहराया जा सकता है.
लेकिन इन सारे आंकड़ों से बेखबर उड़ीसा के घने जंगलों में बसे इन गांवों में गुड़ाखू के अलावा खैनी और गुटका भी लोगों को नशे की एक ऐसी गिरफ्त में कस रहे हैं, जिससे निकलना मुश्किल है. पहाड़ी रास्तों में हर जगह गुटका और खैनी के खाली पाउच नज़र आते हैं. गांव की बुजुर्ग महिलायें और युवतियों में तो जैसे खैनी खाने की होड़ सी लगी हुई है. ये महिलाऐं खैनी को अपनी कमर में खोंस के रखती हैं. फिर चाहे वह घर पर हों, बाज़ार जा रही हों, काम पर या रिश्तेदारों के घर. कमर में हर वक्त खैनी की एक पोटली पड़ी रहती है.
गौरतलब है कि कालाहांडी जिले के लांजीगढ़ ब्लाक के नियमगिरि पहाड़ में बसे ये आदिवासी, बदनाम ब्रितानी कंपनी वेदांता के खिलाफ अपने अस्तित्व की लड़ाई लड़ रहे हैं, जो नियमगिरि पर्वत में बॉक्साइट की खुदाई करना चाहता है. नियमगिरि पर्वत को डोंगरिया कंध नियम राजा कहते हैं और उसकी पूजा अर्चना करते हैं क्योंकि यहाँ पीढियों से ना केवल उनका बसेरा है बल्कि यह नियमगिरि उन्हें वह सब कुछ देता है, जो उन्हें चाहिये. इस ‘सब कुछ’ में भोजन से लेकर जडी-बुटी और दूसरे जरुरी सामान शामिल हैं.
ऐसे में आश्चर्य नहीं कि तंबाकू, गुटका, खैनी और गुड़ाखू जैसी नशीली सामग्री को इलाके में जिस तरह से विस्तारित किया जा रहा है, उससे आदिवासी समाज के अंदर एक खास किस्म की अराजकता और कमजोरी पैदा हो रही है. जाहिर है, इससे ब्रितानी कंपनी वेदांता के खिलाफ चल रही लड़ाई भी कहीं न कहीं कमज़ोर पड़ेगी ही.
दूसरी ओर जिस राज्य सरकार को अपनी आदिवासी जनता की सुध लेनी थी, उसका कहीं अता-पता नहीं है. उदाहरण के लिये लाखपदर गांव को ही लें. गांव में ना तो स्कूल है, ना ही स्वास्थ्य केंद्र. गांव तक आने के लिये कोई सड़क भी नहीं है. गांव के छोटे बच्चे भी अपने मां-बाप के साथ जंगल जाते हैं और घर के लिए खाना जुगाड़ने में लगे रहते हैं.
मामला केवल लाखपदर और कालाहांडी तक सिमटा हुआ है, ऐसा नहीं है. कोरापूट जिले के पोटापोड़ू गांव में जब हम पहुंचे तो गांव के बाहर एक इमली के पेड़ के नीचे बड़ी संख्या में महिलायें बैठी थीं. अधिकांश महिलाओं के कान में तंबाकू के पीका लगे हुए थे. ये ऐसे पीका हैं, जिनसे महिलायें नशे का सेवन करती हैं. पता चला कि गांव की अधिकांश महिलाओं को इसकी लत है. दूसरी और महिलाओं के एक साथ मिल बैठने और खाली समय में बोरियत दूर करने के लिये भी पीका का सेवन किया जा रहा है. महिलायें पीका में डूबी हैं. कम उम्र की लड़कियां और गर्भवती औरतें भी. इस बात से बेखबर कि इसका उनके स्वास्थ्य पर क्या असर पड़ेगा. सरकार की लापरवाही और उदासीनता से एकदम दूर, जैसे हर फिक्र को धुयें में उड़ाते हुये और जीवन की हर समस्या को गुड़ाखू की तरह समय की धार पर घिसते हुये.
07.07.2010, 01.10 (GMT+05:30) पर प्रकाशित
इस समाचार / लेख पर पाठकों की प्रतिक्रियाएँ
devesh tiwari (deveshrisk@gmail.com) bilaspur c.g.
लेख बहुत अच्छा है. आपने उस जगह को अच्छी तरह निहारा है. आदिवासियों के लगभग सभी इलाके इसी तरह नशे की चपेट में है लेकिन समय के साथ साथ नशे के रूप में बदलाव आया है.
Beena (beenapandey927@gmail.com) Lucknow
"मैं जिंदगी का साथ निभाता चला गया, हर फिक्र को धुंए में उडाता चला गया."
कहना न होगा कि ये गाना गुड़ाखू का सेवन करने वालों पर कितना सटीक बैठता है. हम अपने माननीयों को क्यों कोसें जबकि हम भी तम्बाकू का सेवन करने वालों को रोक सकते हैं. पुरुषोत्तमजी अगर आपके और हमारी तरह सभी सिर्फ ऑनलाइन ही बैठे रहे तो इन भयावह रास्तों पर जाने वाले लोगों को रोकेगा कौन? जीतनी मेहनत हम रिसर्च करके लिखने में लगते हैं, अगर उसमें से थोडा समय उन अज्ञानियों को दे तो कुछ किया जा सकता है. है न.
Pallav Journo Delhi
If we read history books, then it is well evident how imperial powers have colonized china through 'opium', Illiteracy, negligence of our government and other factors are implicating such habits among these people.
May be in future course of time, the habit shall be processed by the Neo-Imperial powers (as mentioned in the article) to fulfill desired goals.
shailesh sharma (abshailesh@gmail.com) bilaspur
छत्तीसगढ़ के हेल्थ मिनिस्टर गुड़ाखू के बारे में बहुत अच्छा "व्याख्यान" दे सकते है. उनकी राय भी लाज़मी है. कोरबा के सांसद महोदय इसके उपयोग से होने वाले लाभ के बारे में भाषण 1-2 घंटा तो दे ही सकते है. कभी उनको मंच भी दिया जाये.
Sunil Singh (sunilsingh.nirwan@gmail.com) Rajasthan, Jhunjhunu
It's very dangerous matter chewing of tobacco.
sunil sharma (sunillsharma@ymail.com) bilaspur
बहुत अच्छा. छत्तीसगढ़ में भी गुड़ाखू के लाखों गुलाम मिल जाएंगे. लोगों को इस ज़हर को परोसने वाले बड़े पदों पर काम कर रहे हैं.
‘सिगरेट’ रात भर उनके खोखले सीने में लगातार जलती है
11 APRIL 2010
♦ पुरुषोत्तम सिंह ठाकुर
“मैं जब से 10 साल की थी तब से यह पीका पी रही हूं।” कान में पीका को खोंचकर रखनेवाली 70 साल की आदिवासी महिला चपाड़ी बुदेयी ने यह बात कही, जब हमने उनसे पूछा कि वह कब से धूम्रपान कर रही हैं। और अब यह वर्षों से उनकी आदत बन चुकी है। इसके बारे में उन्होंने आगे कहा, “पीका पीना अपने मां-बाप को पीते हुए देख कर ही सीखा और जब शादी के बाद ससुराल आयी तो देखा मेरे पति भी पीका पीते हैं। फिर हम दोनों मिलके पीने लगे।”
ओडिशा के कोरापुट जिले के पोटागीं ब्लाक के पोटापाडू गांव में चपाडी अकेली नहीं हैं जो पीका पीती हैं बल्कि उनकी उम्र की ज्यादातर महिलाएं और पुरुष पीका पीने के अभ्यस्त हैं।
60 साल की पामिया मंगाली को अब भी यह साफ तौर से याद है कि उन्होंने कैसे पीका पीने की शुरुआत की।
“मैं पीका पीने से पहले गुड़ाखू करती थी। (गुड़ाखू भी एक तरह का दंतमंजन है, जिसमें तंबाकू होता है, इसलिए इसे दांत साफ के लिए कम और एक तरह के नशा के लिए ज्यादा उपयोग किया जाता है।) लेकिन बाद में पीका पीना शुरू किया। जब मैं छोटी थी, तब जब मेरे मां-बाप मुझे पीका पीने नहीं देते थे। तब मैं तब तक जिद करके रोती थी, जब तक मुझे एक या आधा पीका नहीं मिल जाता था।”
जब उनसे पूछा कि वह पीका क्यों पीती हैं, तो उन्होंने जवाब कुछ इस तरह से दिया, “में अपना मुंह साफ रखने के लिए यह पीती हूं और साथ ही ठंड से बचाव के लिए भी”। पामिया दिन में पांच से ज्यादा बार पीका पीती हैं। जैसे गांव की ज्यादातर बुजुर्ग महिलाएं पीती हैं।
पीका या सुटा यानी तंबाकू के पत्ते को हाथ से मलकर बनाया गया 6 से 8 इंच का सिगरेट की तरह होता है जो सिगरेट से काफी ज्यादा मोटा और स्वाद में भी काफी कड़वा होता है। यह पीका, जिसे सुटा भी कहते हैं, ओडिशा के कोरापुट मलकानगिरी और आंध्रप्रदेश के ग्रामीण इलाकों में महिलाएं और पुरुष दोनों पीते नजर आते हैं।
महिलाएं अपने कान के ऊपर यह पीका रखती हैं। फिर चाहे वह घर में हों, खेत-खलिहानों में या बाजार में घूम रहीं हों, सुटा साथ में जरूर रखती हैं। और जब आपस में मित्र रिश्तेदारों से मिलतीं भी हैं, तो यह पीका पीकर बतियाते नजर आते हैं।
“मैं अगर यह पीका नहीं पीऊंगी तो मेरा खाना हजम नहीं होगा।” ऐसा 68 साल की पांगी कसाई कहतीं हैं।
“मैंने बहुत देर में पीका पीने की आदत अपनायी है। जब मेरे पति की मौत हो गयी, तब मैं बहुत अकेली हो गयी। तब मैं पीका पीकर समय गुजारने लगी और इससे मुझे काफी राहत मिली। इस तरह से इसकी मुझे लत हो गयी।”
गांव में आखिर क्यों ज्यादातर बुजुर्ग महिलाएं पीका पीती हैं? इसका जवाब देते हुए गांव के एक शिक्षित युवक बलराम पांगी ने समझाते हुए कहा कि “आजकल केवल बुजुर्ग महिलाएं पीका पीती हैं जबकि युवतियां गुड़ाखू घिसती हैं और इसके पीछे आर्थिक वजह है। गुड़ाखू महंगा है, जबकि पीका लोग खुद घर में बनाते हैं और बाजार में भी यह गुड़ाखू के मुकाबले सस्ता मिलता है। जब वह जवान होती हैं और काम करके पैसा कमा सकती हैं, तब तक गुड़ाखू घिसती हैं – पर जब वह बुजुर्ग हो जाती हैं और परिवार की जिम्मेदारियां कंधे पर आती है, तब वे गुड़ाखू छोड़कर पीका पीने लगती हैं। और बुजुर्ग होने के कारण उन्हें पीका पीने में शर्म भी महसूस नहीं होती।”
तो इस तरह से जो युवा हैं, वह गुड़ाखू करते हैं – वहीं बुजुर्ग पीका पीने के आदी हैं। यानि इन आदिवासी गांव में बच्चों को छोड़कर सभी किसी न किसी प्रकार से तंबाकू का सेवन करने के आदि हैं।
पर रुकिए!
क्या सचमुच बच्चे बिलकुल तंबाकू का सेवन नहीं करते हैं? नहीं, वह भी जाने-अनजाने तंबाकू का सेवन कर रहे हैं। वह प्रत्यक्ष नहीं बल्कि अप्रत्यक्ष रूप से तंबाकू का सेवन कर रहे हैं जो उतना ही खतरनाक है जितना प्रत्यक्ष रूप से तंबाकू सेवन से होता है। जितने छोटे बच्चे होते हैं, वह उतने अपने मां बाप और दादा दादी के पास होते हैं या गोद में होते हैं। और जब बड़े धूम्रपान कर रहे होते हैं, तो अनायास ही ये मासूम बच्चे धूम्रपान से छोड़े गये धुआं का सेवन करते हैं। उसके अलावा अपने छोटे छोटे कमरे में धूम्रपान करने से उसके अंदर रह रहे सभी लोग छोड़े गये धुंए को सांस में लेने को मजबूर होते हैं।
10 साल के देब का कहना है कि उसकी मां पीका पीती हैं, उसका धुआं उसे अच्छा नहीं लगता। देब यह बात कम से कम बता पा रहा है, पर छोटे बच्चे यह बता भी नहीं पाते।
अप्रत्यक्ष धूम्रपान के दुष्प्रभाव के बारे में पिछले चार दशकों में हुए सैंकड़ों गहन और विस्तृत अध्ययनों के बाद यह साबित होचुका है कि अप्रत्यक्ष धूम्रपान कई गंभीर बीमारियों की वजह है, जिनमें हृदयरोग, फेफड़े का कैंसर, अस्थमा आदि शामिल है। हाल ही में हुए अध्ययनों से इन बातों के संकेत मिले हैं कि अप्रत्यक्ष धूम्रपान कई तरह की खतरनाक बीमारियों की वजह बन सकते हैं। इस तरह के पुख्ता अध्ययनों के निष्कर्षों के बाद अब विश्व स्वाथ्य संगठन ने नीति निर्देशावली जारी की है, जिसमें यह बताया गया है कि अप्रत्यक्ष धूम्रपान के कुप्रभावों से लोगों को कैसे बचाया जा सके।
और अब यह भी जान लें कि बच्चों के आसपास धूम्रपान से उन पर क्या असर होता है?
♦ शिशुओं में अचानक मौत के लक्षण (Sudden Infant death syndrome (SIDs)
♦ फेफड़े के कैंसर, कान में संक्रमण, गहरा अस्थमा, बच्चे के सर्वांगीण विकास में रोक, ब्रोंकैटिस और निमोनिया जैसी बीमारी होने की संभावना है।
अब देखते हैं, धूम्रपान का कुप्रभाव बड़ों पर क्या हो सकता है?
♦ फेफड़े का कैंसर, हृदय रोग, हृदघात का खतरा, स्थायी सांस की बीमारी, अस्थमा, छाती में दर्द हो तो उसका और बढ़ना, फेफड़े के काम में गिरावट, आंख और नाक में जलन, सर दर्द, गले में दर्द, चक्कर आना, अरुचि, कफ और श्वास प्रश्वास संबंधी बीमारी शामिल है।
और इसका गर्भ पर होनेवाले असर इस प्रकार के हैं :
♦ कम वजन के शिशु का पैदा होना और समय से पहले प्रसव, शिशु के कम समय में मौत होने का खतरा, मृत बच्चे का पैदा होना, गर्भ नष्ट का खतरा, जन्मजात असामान्यता, अचानक शिशु की मौत का लक्षण (SIDS), स्थायी कफ, जोर जोर से सांस लेना या हांफना, अस्थमा, कान की बीमारी, फेफड़े का काम प्रभावित होना आदि शामिल है।
जाहिर है इन सबका असर उन मासूम आदिवासियों पर और खासकर आदिवासी बच्चों पर पड़ता ही होगा, जिसके बुरे असर से न केवल वह बल्कि उनके मां बाप भी अनजान हैं। इसलिए इसका क्या असर हो रहा है, इसके गहन अध्ययन की जरूरत है। साथ ही लोगों में इसके दुष्प्रभाव के बारे में जागरूकता फैलाने की जरूरत है।
(एनडीटीवी इंडिया से लंबे समय तक जुड़े रहने के बाद पुरुषोत्तम सिंह ठाकुर इन दिनों स्वतंत्र पत्रकारिता कर रहे हैं। साथ ही एनएफआई के फेलो भी हैं।)
♦ पुरुषोत्तम सिंह ठाकुर
“मैं जब से 10 साल की थी तब से यह पीका पी रही हूं।” कान में पीका को खोंचकर रखनेवाली 70 साल की आदिवासी महिला चपाड़ी बुदेयी ने यह बात कही, जब हमने उनसे पूछा कि वह कब से धूम्रपान कर रही हैं। और अब यह वर्षों से उनकी आदत बन चुकी है। इसके बारे में उन्होंने आगे कहा, “पीका पीना अपने मां-बाप को पीते हुए देख कर ही सीखा और जब शादी के बाद ससुराल आयी तो देखा मेरे पति भी पीका पीते हैं। फिर हम दोनों मिलके पीने लगे।”
ओडिशा के कोरापुट जिले के पोटागीं ब्लाक के पोटापाडू गांव में चपाडी अकेली नहीं हैं जो पीका पीती हैं बल्कि उनकी उम्र की ज्यादातर महिलाएं और पुरुष पीका पीने के अभ्यस्त हैं।
60 साल की पामिया मंगाली को अब भी यह साफ तौर से याद है कि उन्होंने कैसे पीका पीने की शुरुआत की।
“मैं पीका पीने से पहले गुड़ाखू करती थी। (गुड़ाखू भी एक तरह का दंतमंजन है, जिसमें तंबाकू होता है, इसलिए इसे दांत साफ के लिए कम और एक तरह के नशा के लिए ज्यादा उपयोग किया जाता है।) लेकिन बाद में पीका पीना शुरू किया। जब मैं छोटी थी, तब जब मेरे मां-बाप मुझे पीका पीने नहीं देते थे। तब मैं तब तक जिद करके रोती थी, जब तक मुझे एक या आधा पीका नहीं मिल जाता था।”
जब उनसे पूछा कि वह पीका क्यों पीती हैं, तो उन्होंने जवाब कुछ इस तरह से दिया, “में अपना मुंह साफ रखने के लिए यह पीती हूं और साथ ही ठंड से बचाव के लिए भी”। पामिया दिन में पांच से ज्यादा बार पीका पीती हैं। जैसे गांव की ज्यादातर बुजुर्ग महिलाएं पीती हैं।
पीका या सुटा यानी तंबाकू के पत्ते को हाथ से मलकर बनाया गया 6 से 8 इंच का सिगरेट की तरह होता है जो सिगरेट से काफी ज्यादा मोटा और स्वाद में भी काफी कड़वा होता है। यह पीका, जिसे सुटा भी कहते हैं, ओडिशा के कोरापुट मलकानगिरी और आंध्रप्रदेश के ग्रामीण इलाकों में महिलाएं और पुरुष दोनों पीते नजर आते हैं।
महिलाएं अपने कान के ऊपर यह पीका रखती हैं। फिर चाहे वह घर में हों, खेत-खलिहानों में या बाजार में घूम रहीं हों, सुटा साथ में जरूर रखती हैं। और जब आपस में मित्र रिश्तेदारों से मिलतीं भी हैं, तो यह पीका पीकर बतियाते नजर आते हैं।
“मैं अगर यह पीका नहीं पीऊंगी तो मेरा खाना हजम नहीं होगा।” ऐसा 68 साल की पांगी कसाई कहतीं हैं।
“मैंने बहुत देर में पीका पीने की आदत अपनायी है। जब मेरे पति की मौत हो गयी, तब मैं बहुत अकेली हो गयी। तब मैं पीका पीकर समय गुजारने लगी और इससे मुझे काफी राहत मिली। इस तरह से इसकी मुझे लत हो गयी।”
गांव में आखिर क्यों ज्यादातर बुजुर्ग महिलाएं पीका पीती हैं? इसका जवाब देते हुए गांव के एक शिक्षित युवक बलराम पांगी ने समझाते हुए कहा कि “आजकल केवल बुजुर्ग महिलाएं पीका पीती हैं जबकि युवतियां गुड़ाखू घिसती हैं और इसके पीछे आर्थिक वजह है। गुड़ाखू महंगा है, जबकि पीका लोग खुद घर में बनाते हैं और बाजार में भी यह गुड़ाखू के मुकाबले सस्ता मिलता है। जब वह जवान होती हैं और काम करके पैसा कमा सकती हैं, तब तक गुड़ाखू घिसती हैं – पर जब वह बुजुर्ग हो जाती हैं और परिवार की जिम्मेदारियां कंधे पर आती है, तब वे गुड़ाखू छोड़कर पीका पीने लगती हैं। और बुजुर्ग होने के कारण उन्हें पीका पीने में शर्म भी महसूस नहीं होती।”
तो इस तरह से जो युवा हैं, वह गुड़ाखू करते हैं – वहीं बुजुर्ग पीका पीने के आदी हैं। यानि इन आदिवासी गांव में बच्चों को छोड़कर सभी किसी न किसी प्रकार से तंबाकू का सेवन करने के आदि हैं।
पर रुकिए!
क्या सचमुच बच्चे बिलकुल तंबाकू का सेवन नहीं करते हैं? नहीं, वह भी जाने-अनजाने तंबाकू का सेवन कर रहे हैं। वह प्रत्यक्ष नहीं बल्कि अप्रत्यक्ष रूप से तंबाकू का सेवन कर रहे हैं जो उतना ही खतरनाक है जितना प्रत्यक्ष रूप से तंबाकू सेवन से होता है। जितने छोटे बच्चे होते हैं, वह उतने अपने मां बाप और दादा दादी के पास होते हैं या गोद में होते हैं। और जब बड़े धूम्रपान कर रहे होते हैं, तो अनायास ही ये मासूम बच्चे धूम्रपान से छोड़े गये धुआं का सेवन करते हैं। उसके अलावा अपने छोटे छोटे कमरे में धूम्रपान करने से उसके अंदर रह रहे सभी लोग छोड़े गये धुंए को सांस में लेने को मजबूर होते हैं।
10 साल के देब का कहना है कि उसकी मां पीका पीती हैं, उसका धुआं उसे अच्छा नहीं लगता। देब यह बात कम से कम बता पा रहा है, पर छोटे बच्चे यह बता भी नहीं पाते।
अप्रत्यक्ष धूम्रपान के दुष्प्रभाव के बारे में पिछले चार दशकों में हुए सैंकड़ों गहन और विस्तृत अध्ययनों के बाद यह साबित होचुका है कि अप्रत्यक्ष धूम्रपान कई गंभीर बीमारियों की वजह है, जिनमें हृदयरोग, फेफड़े का कैंसर, अस्थमा आदि शामिल है। हाल ही में हुए अध्ययनों से इन बातों के संकेत मिले हैं कि अप्रत्यक्ष धूम्रपान कई तरह की खतरनाक बीमारियों की वजह बन सकते हैं। इस तरह के पुख्ता अध्ययनों के निष्कर्षों के बाद अब विश्व स्वाथ्य संगठन ने नीति निर्देशावली जारी की है, जिसमें यह बताया गया है कि अप्रत्यक्ष धूम्रपान के कुप्रभावों से लोगों को कैसे बचाया जा सके।
और अब यह भी जान लें कि बच्चों के आसपास धूम्रपान से उन पर क्या असर होता है?
♦ शिशुओं में अचानक मौत के लक्षण (Sudden Infant death syndrome (SIDs)
♦ फेफड़े के कैंसर, कान में संक्रमण, गहरा अस्थमा, बच्चे के सर्वांगीण विकास में रोक, ब्रोंकैटिस और निमोनिया जैसी बीमारी होने की संभावना है।
अब देखते हैं, धूम्रपान का कुप्रभाव बड़ों पर क्या हो सकता है?
♦ फेफड़े का कैंसर, हृदय रोग, हृदघात का खतरा, स्थायी सांस की बीमारी, अस्थमा, छाती में दर्द हो तो उसका और बढ़ना, फेफड़े के काम में गिरावट, आंख और नाक में जलन, सर दर्द, गले में दर्द, चक्कर आना, अरुचि, कफ और श्वास प्रश्वास संबंधी बीमारी शामिल है।
और इसका गर्भ पर होनेवाले असर इस प्रकार के हैं :
♦ कम वजन के शिशु का पैदा होना और समय से पहले प्रसव, शिशु के कम समय में मौत होने का खतरा, मृत बच्चे का पैदा होना, गर्भ नष्ट का खतरा, जन्मजात असामान्यता, अचानक शिशु की मौत का लक्षण (SIDS), स्थायी कफ, जोर जोर से सांस लेना या हांफना, अस्थमा, कान की बीमारी, फेफड़े का काम प्रभावित होना आदि शामिल है।
जाहिर है इन सबका असर उन मासूम आदिवासियों पर और खासकर आदिवासी बच्चों पर पड़ता ही होगा, जिसके बुरे असर से न केवल वह बल्कि उनके मां बाप भी अनजान हैं। इसलिए इसका क्या असर हो रहा है, इसके गहन अध्ययन की जरूरत है। साथ ही लोगों में इसके दुष्प्रभाव के बारे में जागरूकता फैलाने की जरूरत है।
(एनडीटीवी इंडिया से लंबे समय तक जुड़े रहने के बाद पुरुषोत्तम सिंह ठाकुर इन दिनों स्वतंत्र पत्रकारिता कर रहे हैं। साथ ही एनएफआई के फेलो भी हैं।)
Orissa : Diarrhoea, still a major killer
By Purusottam Singh Thakur,
On October 2, Gandhi Jayanti, when members of Gandhi Foundation, Khariar, visited the local Primary Health Centre to distribute fruits and bread to patients, they found a family from Bichhnapali Village admitted in the hospital for diarrhoea. The epidemic, which had started three months earlier, had not yet stopped in Nuapada District. Out of 52 deaths in the district, three were in Khariar.
Children have been the major victims. So much so that in the last three years, the infant mortality rate has increased from 78 per 1000 to 91 per 1000 children, against the state average of 69.
Pratima Majhi, a 9-year-old girl of Khadupani Village in Nuapada District died of diarrhoea in Boden PHC on June 21. Her mother, Khira Dei, was affected simultaneously and was admitted in the headquarters hospital at Nuapada. Her diarrhoea stopped but the child in the womb died and her situation became complicated. She was sent to Mission Hospital in Khariar. A Caesarean was done and the baby was delivered. “I had to spend over Rs 10,000,” says Khira.
Over 50 persons developed diarrhoea in Khadupani due to contaminated water. Villagers were using water from a small well, temporarily dug alongside a pond. There was no other source.
“Water quality of three tube wells in our Gauntia Pada is not good. A yellow layer of an oily substance accumulates at the top if a bucket of water is left for some time,” says Harmani Majhi, daughter-in-law of Chandni Dei, who died of diarrhoea on July 10. Khadupani is the home town of Duryodhan Madhi, who was Orissa Health Minister in the BJD government.
Nuapada is not the only district which was hit by diarrhoea. The story is the same for the whole of undivided Kalahandi-Bolangir and Koraput, known as KBK. Raygada in particular was badly affected.
"When diarrhoea did not stop and my health deteriorated, my family repeatedly called up the staff of Shikarpai Health Centre. Neither the doctor nor the health worker turned up. First, my family took me there in a taxi but when I did not get well, I was taken to a private doctor in Raygada. The doctor took Rs 700. My sons then fell ill and they were hospitalised,” says Shirpati of Satpai village in the district.
"I had to spend around Rs 6000 for the treatment of the entire family. Now I am in debt. I have borrowed the money from a local money lender who gives money on 50 paise rate of interest to a rupee," he adds. Asked how he will repay the amount, he replies that it will take him years.
Satpai is one of the remote villages where diarrhoea spread. There are many such, which have absolutely no communication. One has to hire a vehicle in case of health complications. But that requires money, which many people do not have in this part of India.
The epidemic broke out in mid-July last year. "Some 2050 people were affected by diarrhoea this year. Of them, 41 died till the last week of September," says Dr Benudhar Naik, CDMO, Raygada. The unofficial record says it is more than a hundred.
"In 2007, some 7800 people were affected by diarrhoea and 90 lost their lives," says Dr Naik. "Lack of safe drinking water, connectivity and lack of awareness are the factors responsible for the regular outbreak of epidemics. The health department is helpless," he admits.
When this reporter visited the district in the first week of August, seven deaths had already been recorded and at that point of time the CDMO said, "the situation is under control."
Six blocks were affected by the epidemic in 2010. They were and lack of access, endemic poverty was a reason.
Dr Roy of Sarvodaya says he spoke over the phone to a senior state-level officer of NRHM and complained about the apathy, and the officer expressed helplessness. When asked why he was not taking action, he pleaded staff shortage and no funds. “And you know the reality, how difficult it is to suspend or dismiss even a 4th class employee in government service.”
"It is not just the contaminated water and inaccessibility, rather it’s endemic poverty which prevailed here. They have no access to safe drinking water and the food as well. They are still forced to take contaminated food like mango kernel and seeds of tamarind, roots and poisonous mushrooms."
Poverty prevents people from seeking treatment for other ailments too. This reporter witnessed this in person when he accompanied the Sarvodaya team to Huder Village. Another problem is shortage of doctors. After the spread of the epidemic, the government appointed 408 doctors on an ad hoc basis in Orissa, but reports said the joining rate was very poor. The heavy workload was cited as one reason. Malaria is endemic in the area. Kashipur, Singapur, Bisam, Cuttack, Gudari and Raygada. After the situation seemed to be going out of control, there was a furore in the media and the Chief Minister asked Health Minister Prasanna Acharya and the Health Secretary to go to the district and monitor the situation.
Prasanna Acharaya blamed contaminated water and inaccessibility, among other factors, in his report submitted to the government.
Another distress factor was that most of the deaths occurred at night. Night patrols were pressed into service to provide medical assistance, the report said. Inter-departmental coordination was the need of the hour and Acharya proposed this in his report.
Some doctors, along with paramedical staff were sent from other places including Bhubaneswar and Cuttack. Temporary health camps were organised in some places and lives were saved. Some private doctors remarked, “When there is no power, no connectivity, nothing, how does the government expect the government doctors to perform.”
Ravi Das, a 70-year-old social activist shared his experience in Baliguda Village of Gudibali Panchayat. “There are 40/45 households in Baliguda Village and almost all are very poor. There is a tube well but defunct, which was repaired after one person died."
He adds, “When the villagers informed the staff at the nearby temporary camp set up by the government about a patient who was seriously ill and requested them to send a vehicle to transport the patient, they did not immediately respond. By the time the vehicle came, it was too late and the victim had died.” Ravi Das said apart from bad water
A Woman in Khadupani Village in Nuapada District collecting water from a chuan.
Patients affected by diarrhoea recovering at a health centre.
An affected villager carries the medication (drips) bottle along.
Apart from bad water and lack of access, endemic poverty is a cause for the disease. There is also a severe shortage of doctors in this village in OrissaDiarrhoea, still a major killer
On October 2, Gandhi Jayanti, when members of Gandhi Foundation, Khariar, visited the local Primary Health Centre to distribute fruits and bread to patients, they found a family from Bichhnapali Village admitted in the hospital for diarrhoea. The epidemic, which had started three months earlier, had not yet stopped in Nuapada District. Out of 52 deaths in the district, three were in Khariar.
Children have been the major victims. So much so that in the last three years, the infant mortality rate has increased from 78 per 1000 to 91 per 1000 children, against the state average of 69.
Pratima Majhi, a 9-year-old girl of Khadupani Village in Nuapada District died of diarrhoea in Boden PHC on June 21. Her mother, Khira Dei, was affected simultaneously and was admitted in the headquarters hospital at Nuapada. Her diarrhoea stopped but the child in the womb died and her situation became complicated. She was sent to Mission Hospital in Khariar. A Caesarean was done and the baby was delivered. “I had to spend over Rs 10,000,” says Khira.
Over 50 persons developed diarrhoea in Khadupani due to contaminated water. Villagers were using water from a small well, temporarily dug alongside a pond. There was no other source.
“Water quality of three tube wells in our Gauntia Pada is not good. A yellow layer of an oily substance accumulates at the top if a bucket of water is left for some time,” says Harmani Majhi, daughter-in-law of Chandni Dei, who died of diarrhoea on July 10. Khadupani is the home town of Duryodhan Madhi, who was Orissa Health Minister in the BJD government.
Nuapada is not the only district which was hit by diarrhoea. The story is the same for the whole of undivided Kalahandi-Bolangir and Koraput, known as KBK. Raygada in particular was badly affected.
"When diarrhoea did not stop and my health deteriorated, my family repeatedly called up the staff of Shikarpai Health Centre. Neither the doctor nor the health worker turned up. First, my family took me there in a taxi but when I did not get well, I was taken to a private doctor in Raygada. The doctor took Rs 700. My sons then fell ill and they were hospitalised,” says Shirpati of Satpai village in the district.
"I had to spend around Rs 6000 for the treatment of the entire family. Now I am in debt. I have borrowed the money from a local money lender who gives money on 50 paise rate of interest to a rupee," he adds. Asked how he will repay the amount, he replies that it will take him years.
Satpai is one of the remote villages where diarrhoea spread. There are many such, which have absolutely no communication. One has to hire a vehicle in case of health complications. But that requires money, which many people do not have in this part of India.
The epidemic broke out in mid-July last year. "Some 2050 people were affected by diarrhoea this year. Of them, 41 died till the last week of September," says Dr Benudhar Naik, CDMO, Raygada. The unofficial record says it is more than a hundred.
"In 2007, some 7800 people were affected by diarrhoea and 90 lost their lives," says Dr Naik. "Lack of safe drinking water, connectivity and lack of awareness are the factors responsible for the regular outbreak of epidemics. The health department is helpless," he admits.
When this reporter visited the district in the first week of August, seven deaths had already been recorded and at that point of time the CDMO said, "the situation is under control."
Six blocks were affected by the epidemic in 2010. They were and lack of access, endemic poverty was a reason.
Dr Roy of Sarvodaya says he spoke over the phone to a senior state-level officer of NRHM and complained about the apathy, and the officer expressed helplessness. When asked why he was not taking action, he pleaded staff shortage and no funds. “And you know the reality, how difficult it is to suspend or dismiss even a 4th class employee in government service.”
"It is not just the contaminated water and inaccessibility, rather it’s endemic poverty which prevailed here. They have no access to safe drinking water and the food as well. They are still forced to take contaminated food like mango kernel and seeds of tamarind, roots and poisonous mushrooms."
Poverty prevents people from seeking treatment for other ailments too. This reporter witnessed this in person when he accompanied the Sarvodaya team to Huder Village. Another problem is shortage of doctors. After the spread of the epidemic, the government appointed 408 doctors on an ad hoc basis in Orissa, but reports said the joining rate was very poor. The heavy workload was cited as one reason. Malaria is endemic in the area. Kashipur, Singapur, Bisam, Cuttack, Gudari and Raygada. After the situation seemed to be going out of control, there was a furore in the media and the Chief Minister asked Health Minister Prasanna Acharya and the Health Secretary to go to the district and monitor the situation.
Prasanna Acharaya blamed contaminated water and inaccessibility, among other factors, in his report submitted to the government.
Another distress factor was that most of the deaths occurred at night. Night patrols were pressed into service to provide medical assistance, the report said. Inter-departmental coordination was the need of the hour and Acharya proposed this in his report.
Some doctors, along with paramedical staff were sent from other places including Bhubaneswar and Cuttack. Temporary health camps were organised in some places and lives were saved. Some private doctors remarked, “When there is no power, no connectivity, nothing, how does the government expect the government doctors to perform.”
Ravi Das, a 70-year-old social activist shared his experience in Baliguda Village of Gudibali Panchayat. “There are 40/45 households in Baliguda Village and almost all are very poor. There is a tube well but defunct, which was repaired after one person died."
He adds, “When the villagers informed the staff at the nearby temporary camp set up by the government about a patient who was seriously ill and requested them to send a vehicle to transport the patient, they did not immediately respond. By the time the vehicle came, it was too late and the victim had died.” Ravi Das said apart from bad water
A Woman in Khadupani Village in Nuapada District collecting water from a chuan.
Patients affected by diarrhoea recovering at a health centre.
An affected villager carries the medication (drips) bottle along.
Apart from bad water and lack of access, endemic poverty is a cause for the disease. There is also a severe shortage of doctors in this village in OrissaDiarrhoea, still a major killer
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