How a young doctor transformed healthcare in rural Odisha: Interview
M3 India Newsdesk Mar 03, 2019
Dr. Kishore Chandra Das was posted in a small town eight years ago. With a lot of hard work and determination, he managed to turn around the small town's CHC into a well-functioning facility. In this interview, the young doctor shares his story of how he helped improve rural health care for so many people.
Villagers march behind Dr Kishore Chandra Das (in checked shirt) with drums beating during his farewell
He may not be in the big league of superstar doctors in India but in just a matter of eight years, 32-year-old Dr. Kishore Chandra Das has become no less than an icon for thousands of people living in a remote village of Odisha’s Nabarangpur district.
So huge is his fan following among patients in and around Tentulikhunti that they had no control over their emotions when Dr. Das decided to go on a sabbatical for higher studies. A video of his emotional farewell on the streets went viral.
In an in-depth exclusive interview with him, we talk to the doctor who is on a mission to transform rural health in India. Excerpts from the chat:
M3 India: How much time did you spend at the Tentulikhunti CHC during your post MBBS career?
Dr. Das: I was posted at Tentulikhunti CHC on September 30, 2010, on an ad-hoc basis. I spent my initial days after MBBS for around six months at Tentulikhunti from 2010-2011. Later I was posted at the District Headquarter Hospital (DHH) at Nabarangpur as the hospital was facing a shortage of doctors. I worked there for two years from 2011-2013.
In August 2013 I returned as the medical officer-in-charge of Tentulikhunti CHC. I started making myself available at the Nabarangpur DHH for almost 24 hours as the health centre was marred by the crunch of doctors. Only 3-4 doctors were managing the whole district hospital that time.
M3 India: What infrastructural problems confronted you when you joined the CHC in a rural area?
Dr. Das: When I joined the CHC it hardly had any facilities to function as a hospital. Basic amenities like first aid facility, operation theatre, delivery room, new-born care corner, etc. eluded this hospital. Irregular supply of oxygen cylinders was another problem. This really surprised me.
I wanted to bring some changes and so I consulted the Rogi Kalyan Samiti--comprising the CHC doctor, local MLA, BDO, and other officials--which look after the CHC affairs. After my consistent demands, gradually many facilities were started at the hospital.
M3 India: How many changes has the Tentulikhunti CHC undergone after your stint there?
Dr. Das: Now the hospital has all the basic facilities in good condition like a proper dressing room, labour room, new-born care room, regular supply and maintenance of oxygen cylinders. Besides that, to improve the function of the CHC, I have ensured the installation of CCTV cameras there, made the patient registration centre online. Small issues like lack of proper registration in the hospital also used to cause fights. Now the CHC also has a dedicated 24x7 drug dispensing counter.
M3 India: What were the major health issues that often used to take a toll on the lives of the rural population in Tentulikhunti?
Dr. Das: There were a number of cases relating to anaemia, particularly sickle cell anaemia. Cases of hypertension and diabetes used to come in good numbers. Maternal deaths were also very common in the area and so I focused my attention towards these diseases.
M3 India: Did you find that many of the diseases which affected the rural populace could be prevented? Did you also work on the prevention part?
Dr. Das: Yes, indeed. I had worked extensively for prevention and prophylactic activities too. I ensured routine vaccination in many rural areas where medical facilities had failed to reach people. I took boats to reach out to villages located on the banks of rivers. I also went to remote hilly areas. I tried to ensure 100 percent immunisation. I also advocated for changing the perception of village folks towards vaccination against preventable diseases. It was almost like a weekly affair.
Parallelly, we ran health awareness campaigns. We sat with priests and pandits on the issue of disease prevention and then asked them to persuade villagers.
M3 India: How did the people start building such a strong bond with you?
Dr. Das: As per rules, CHC should be opened from 8 am to 12 pm and then from 3 to 5 pm on working days. However, after I found that many people come from far away areas I decided to extend my services for 24 hours. My room was juxtaposed to the CHC and I used to keep my door always open even after the hospital closed. Any patient could consult me anytime.
I also started visiting villages and other areas nearby whenever needed. As I treated many cases, people started building confidence in me and began recommending me to other patients. I visited many villages in emergency cases like diarrhoea outbreak.
M3 India: We have often heard about incidents of villagers in rural Odisha branding kids with hot iron rods to ward off diseases. Did you see such superstitious activities?
Dr. Das: Yes, there were many cases against which we fought extensively. In many tribal areas, some kids complain of stomach ache due to the dilation of veins in their abdomen area. However, in a few tribal areas, people used to touch hot iron rods on the abdomen of the affected kids hoping to cure them.
The health department and officials from the Integrated Child Development Scheme (ICDS) in my area used to work together to fight this practice. We counselled many such folks, explained to them the cause of the disease and the need for medical aid under such circumstances. In extreme cases, we even took the assistance of local police to weed out the evil practice.
Quackery was also common in some areas and many thought taking medical aid could be a costly affair. The results were overwhelming. Nabarangpur district also received an award for its success against the menace. The cases have dwindled to a great extent and many arrests were also made.
M3 India: Do you think that doctors need to build a bond with patients to boost the healthcare sector?
Dr. Das: Yes, this is very much needed. Many patients have pre-conceptions like medical treatment is costly, doctors would not be available at hospitals. They also fear from referrals from local hospitals and end up falling in the trap of quacks and risking their own lives.
M3 India: Now you have recently joined PG in orthopaedics in a medical college in Bhubaneswar. Do you want to go back to Tentulikhunti after your PG?
Dr. Das: I would love to go back but the CHC now does not have any orthopaedic department where I can serve. I will, however, continue serving the rural population.
M3 India: Do you think rural posting for doctors during studies should be mandatory?
Dr. Das: Yes. I think it should be mandatory for medical students to serve in rural areas, but transfers should also be done accordingly. Doctors still have apprehensions that if after such postings they would be able to come back or not. New medical students, therefore, have reservations on this issue. I was posted in Tentulikhunti and Nabarangpur for eight years and was not transferred. A transparent transfer policy is needed for doctors who are keen to give their services in rural areas.
M3 India: Do you think a change in policy is needed to encourage medical students or doctors to serve in unserved or rural areas?
Dr. Das: Yes, that is much needed. Because if a person is joining a CHC in Nabarangpur in 2018, by 2022 he should have an option of seeking a transfer. Doctors also have their personal liabilities. Some of them may have kids in need of quality education while others may have old parents back home.
Fixed tenure for such postings should be made mandatory. If such a transparent policy is made I don’t think doctors would hesitate in serving in rural areas. Odisha has an exit policy now, but other states also need to have such a system. The right of access to health care should not be denied to tribals and rural people due to policy deficit.
M3 India: You had a very good track record and reputation in your area. But did you ever face threats while in service?
Dr. Das: Yes, I too faced some incidents of threats and intimidation. One was a case in 2012 when a person suffering from cirrhosis of liver came to me in a complicated condition. I advised him to shift to a big hospital on the same day, but he did not agree. The next day his family brought his dead body to the hospital under the impression that he was still alive as his muscles were showing some movements. I checked and rechecked and told them he was dead, and the movements were normal due to muscle twitching and other factors. Refusing to buy my argument, they ransacked the hospital and broke many equipments. But I wasn’t attacked personally.
M3 India: You are now an inspiration to many medicos and doctors. How do you see the sudden fame after the national media reported about you?
Dr. Das: It doesn’t make much difference. It is just that now people ask me more about my experience there. I still have to do a lot for the people. I want to ask the almighty to bless me so that I can serve many more. I really felt bad when I left Tentulikhunti where I was bestowed with so much of love.
I have a dream to open an NGO later and reach out to more people by getting onboard more like-minded people together.
This story was contributed by Manish Kumar, a New Delhi-based freelance writer and a member of 101Reporters.com, a pan-India network of grassroots reporters.
This article was originally published on 13.10.19
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