Health Care in the Sunderbans: A Precarious Situation

by Ranjita Biswas

Access to and availability of health care is extremely poor in the islands of West Bengal's Sunderbans, but a group of 70 women from five villages are now in the process of bringing in positive change. With the help from a Kolkata-based NGO, these women are cultivating, looking after, and distributing medicinal plants used in curing common ailments.

To the outside world, the Sunderbans – situated in the great delta of the Ganges where it meets the Bay of Bengal – is a wonderland in biodiversity. It is also a world heritage site, a national park, and the site of a tiger project albeit with a fragile ecosystem.

According to the 2001 Census, 4.2 million people live on the 158 islands in the Sunderbans. For the people inhabiting these islands, life is anything but easy. Cut off from the mainland, they can commute between the islands only by country boats, that are often overcrowded and dangerously close to being capsized. Moreover, they have to wait for the tide to be able to sail across. Although concerted efforts are now being made to harness solar and wind power, so far, electricity reaches only a few villages. And while access to primary health care is generally poor, the lack is more pronounced in the remote areas of the beautiful Sunderbans.

The health care initiative
Given this background, the initiative taken by the ENDEV (Society for Environment Development) has been a significant one. According to A K Ghosh, ENDEV President, it all began in September 2002, when an experimental project was under way to provide electricity through a biomass plant in the area. When the feasibility of the eco-friendly biomass energy option (based on plantation produce) was communicated to the local people, they responded enthusiastically.

ENDEV also began to discuss the idea of a health care project with the people of five villages, with a population of 30 000, on the island of Choto Mullakhali. With the help of anganwadi (child day care centres) workers and other women from the villages, a survey was conducted in December 2002 and January 2003 to understand the health-related needs and problems of the people and livestock in the area.

Predictably, it was found that the local primary health centre, with only one doctor and inadequate equipment and infrastructure, did not meet the needs of the people; most went to quacks for their health needs. The list of common medical problems included enteric diseases, skin problems, throat infections, fever, and reproductive tract infections. Based on its earlier work, ENDEV felt that most of these diseases could be cured by using locally grown medicinal plants: the knowledge of which had declined with time. The more serious problems, of course, had to be referred to doctors.

The herb garden
The idea of a herb garden was therefore introduced, and once again the people – particularly women – responded with enthusiasm. The two local panchayats (village councils) covering five villages provided about 10 000 square feet of land on lease for the project. From the beginning, the idea was to involve women in planting and maintaining the medicinal plants. It was thought that women would have a natural affinity for the task and that they could contribute to the health needs of the community. Most importantly, women could also be empowered in the process by learning as well as earning some money.

Initially, 14 women were trained for their new role, and this group formed the Gobindapur Mahila Samiti (women's committee). All these women had partially or fully completed primary level education.

Medicinal plants known for their curative power and vetted by botanists were chosen. Kolkata's Agri Horticultural Society and the Ramkrishna Mission at Narendrapur contributed with seeds and saplings. Plants that were not available locally were brought in from the Forest Research Institute, Dehradun. A total of 50 medicine-yielding plants were cultivated under the supervision of ENDEV. The plant, nishinda, for instance, is used for relief from and for curing boils, swollen gums, tonsillitis, ear infections, and bed-wetting.

Today, the herb garden is flourishing, and the project has created an interest in other islands as well. In addition, a one-room resource centre – named after the great botanist, Sir Jagdish Chandra Bose – has also been set up on the herb garden site. The centre stores samples of medicinal plants, their common names, and explains their use in curing ailments. There is also a library of books on the subject; the books are in Bengali and members use the library free of charge.

Saplings at the centre are sold at one rupee each to local families so that they can plant these on their own land too. Recently, the centre published Sohoj Oshudh (simple medicines), a book written primarily by a local woman, Madhumita Ata. At 10 rupees a copy, the book is selling extremely well.
Meanwhile, the number of women tending to the herb garden has grown to an impressive 70. Both satisfied and happy with their work, the women are now keen to register a cooperative society, says Ghosh, so that they can expand their work. A few of the women are already growing some plants on their own land, with the idea of selling these commercially.

Sharmila Mondal, Lalita Mistri, Shyamali Mistri are a few of the women of Choto Mullakhali whose lives have a new meaning. ‘When we first started working, people were not very supportive, just curious. But now they are happy to accept us,’ they say.

Source: Women's Feature Service, Terra Green: News to Save the Earth