Swasthya Swaraj and the work of Dr Sr Aquinas

Moving Mountains
Toladehi Majhi is a young mother of 4 from the Kondh village of Pindhapadhar in Kalahandi district of Odisha. An elderly woman is soaking in the sun while a rooster struts around with curious yet vigilant eyes. As we wait in front of her home, we spot Toladehi walking towards us with a stack of bricks on her head. About half a kilometer away people are making bricks and baking them together as a community.
Toladehi's husband helps her unload the topmost layer of the brick stack from her head. As soon as the  bricks are within the reach of her extended arms, he steps away letting her unload the rest. She quietly unloads them. Her youngest son Deepak eagerly waiting for his mother. She wipes the sweat from her brow and picks up Deepak who immediately starts nursing.
Dr Aquinas of Swasthya Swaraj, who I had accompanied asks her about everyone's health in the village. Toladehi is the Swasthya Sathi – the healthworker of the village where there are no health facilites. It is 100km on forest road from the district headquarter Bhawanipatna. Over the last 10 months, Toladehi has learned to record births, deaths, pregnancies, provide ORS and alert the doctors, when they come for the weekly clinic about anyone needing attention. In another year or so she will be able to do a lot more.
A lean team to 2 doctors and a lab technician supported by a few other staff, Swasthya Swaraj has been training volunteer healthworkers in 75 villages. They conduct weekly clinics at two centers where many people come from as far as 25kms on foot. The team itself has at times walked 30kms to reach to many villages.

"But pregnant mothers cannot walk 25kms to come to the clinic...so we will take ante natal clinics to them," says Sr Dr. Aquinas.

Malaria, gastrointenstinal complications, tumors – to borrow a term from another brilliant peoples' doctor – small places do not have small problems. People here die as if there is a silent civil war going on. No one counts. Falciparum malaria takes a huge toll and the number of tuberculosis patients the team is seeing is mind boggling. Most of the people put on treatment stop taking drugs as soon as they feel a little better – a sure way to get drug resistant strains. Each one of them is capable of infecting 20 others, says the doctor. Following up with everyone in the distant mountainous villages is impossible even for this indefatigable team, so they have come up with the idea of getting the help of the postman who engages someone from the village to come to the postoffice once in a while. It is through this person Swasthya Swaraj team plans to send pictorial reminders which would encourage TB patients to take the medicine.
Toladehi informs that one of her neighbours is running high fever. Dr Aquinas checks and find that this mother with a 2 week infant has developed a big abcess in her breast – a known post natal complication.
"She must be in immense pain. I am always shocked at their capacity to endure," she says.

The puss needs to be drained to relieve her and reduce the chances of life-threatening sepsis. Not to say that the child's life would also be at risk. In the makeshift clinic in an abandoned building, the doctor drains almost a cup full of puss as Toladehi helps with Deepak in her sling.

This courageous team is innovating all the time. The young doctor Ashish is passionate about health communication and is learning to use theater to communicate. Otherwise, it is mainly through pictures. Most people are Kondhs and speak Kui, only a few speak Oriya.
As we were looking through Toladehi's record book, one column had "1" entered for each row – a confirmation of the fact that all the mothers had one new born die in the past. Dr Aquinas suspects the infant and under 5 mortality of the area to be 5 to 6 times higher than the national average. It was clear to me that it does not take too many people to move a mountain – Swasthya Swaraj was doing it.
Not too far from the area, is an army of humans and machines getting ready to move mountains – not of disease, poverty and exploitation, but of earth and rocks, streams and forests. Because lies beneath it are minerals that will further our appetite for more 'things'. Things that will make us forget that the whole planet is standing on the edge of a precipe. Last year when I visited, the roads were narrow and broken. This year they are being widened at a break neck speed to welcome the minerals into our world through the mountains and forests.

The corporation that has shouldered the responsibility of extracting the minerals has off late started conducting health camps and gifting school bags to children in the non-functional government schools. They have not forgotten the details of making sure that the bags are in the recognizable corporate colours. People and wildlife will be displaced – a gift to those who have lived in harmony with nature and sustained it for so long.

Mountains remain to be moved. Which ones we choose will shape our future as a society.

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