Assam's 'Akha': Boat Clinics That Give ‘Hope’ To Brahmaputra Islands During Floods And Always
The boat clinics, with a reach of approximately 2,50,000 to 3,00,000 people across 13 districts, have become a lifeline for many communities.
Did you know that over 10% of Assam's population, about 3 million, resides in some 2,500 villages on small river islands in the mighty Brahmaputra? Facing the haunting realities of the ongoing flood season, the situation remains grim for these inhabitants. But when all seems lost, a fleet of boats emerges as a glimmer of hope.
These floating medical facilities, known as ‘A Ship Of Hope In A Valley Of Flood’, were started to bring healthcare to vulnerable communities living on the islands. With dedicated medical personnel, medicines, and equipment, these clinics traverse the Brahmaputra, reaching those previously beyond the reach of healthcare services. They offer immunisation, curative care, reproductive health, and family planning facilities.
Leading from the front. Sanjoy Hazarika with the Lakhimpur boat clinic walking after a community interaction at Guwalmari village @nhm_assam @SanjoyHazarika3 @PomiBaruah @UNICEF @WHO pic.twitter.com/qx7MOmG2u4
— CNES (@CNESLive) May 4, 2022
C-NES, with support from UNICEF, the National Rural Health Mission, and private donors, has transformed the lives of villagers as they no longer have to travel long distances and incur great costs for basic medical treatment. Healthcare comes to their doorstep.
The second MoU today was signed by Dr. M S Lakshmi Priya, IAS, Mission Director, NHM Assam and Mr. Sanjoy Hazarika, Managing Trustee, C-NES. This MoU will operationalize and manage Boat Clinics in char/riverine areas of Assam. (1/2) pic.twitter.com/cPUrA8Xdie
— NHM_Assam (@nhm_assam) December 17, 2022
Each month, an average of 18,000 to 20,000 people are treated. Also in the pipeline is India's first Hospital Ship, which aims to expand specialised healthcare services to those in need in the region. A decade has passed since the project was announced, in 2013. According to officials, it will take at least another year to be completed.
Sanjoy Hazarika, an acclaimed author, researcher, filmmaker, and the visionary behind the first boat clinic of Assam, has been instrumental in bringing healthcare services to remote and flood-affected areas of the state. In a recent conversation with ABP Live, he shared insights into the journey of the boat clinics and their impact on the communities they serve.
"Essentially, we took part in World Bank’s what's called the first Indian marketplace (rural marketplace competition) where the competition was for ideas that would bridge rural gaps," Hazarika explained about his “Ship of hope in a valley of flood".
#NEWay | With dedicated medical personnel, medicines, and equipment, Assam's boat clinics traverse the Brahmaputra, reaching those previously beyond the reach of healthcare services.#WATCH to learn more about this innovation providing support to the flood-striken state
— ABP LIVE (@abplive) July 2, 2023
In… pic.twitter.com/QauqWdqw32
NHM On Board, Boat Clinics Reach 13 Districts
The initiative began with the design and construction of the first boat clinic, aptly named “Akha”, meaning ‘Hope’ in Assamese. Hazarika recalled: "We got an award, a small award of around $40,000. With that, we got the first boat designed and built locally in Dibrugarh, thanks to the network of people who supported us."
The collaboration with the district administration played a vital role in expanding the project to other districts. "We talked about getting it going in a couple of other districts, and that was in collaboration with the district administration. It was all ad hoc, and then NHM (National Health Mission) came into the picture," said Hazarika.
In 2008, N-CES entered into an agreement with the NHM, marking a significant milestone in their journey. "From that time onwards till about 2021, we worked under that agreement. In that time, we built our own boats and some places we had to hire because we didn't have our own boats. But now we have built 9 or 10 boats from our own resources," Hazarika said.
Hazarika expressed his gratitude towards private donors, especially Swaminathan Ayar, the noted economist who supported the project. "One of the main supporters has been Swaminathan Ayar. Six of the boats are named after his family, including his wife Shahnaz, his son Shekhar, and his companion Neeraj," he shared.
The boat clinics, tailored to meet different needs, have made a significant impact in the region. Hazarika elaborated: "Different boats have different dimensions and purposes. Some can function for 2-3 days at a stretch, like in insecure areas where they go out for three days and do several camps. Others are day-long trips or at least one-night trips."
Reflecting on the current status of the boat clinics, he noted: "Since 2021, the government has been basically running it. We run the boats and the clinics, but it's now directly with NHM." 
The boat clinics, with a reach of approximately 2,50,000 to 3,00,000 people across 13 districts, have become a lifeline for many communities. While primarily focusing on preventive care, the boat clinics have also performed emergency deliveries onboard and helped in bringing down Maternal Mortality Rates in a state where they were once the highest in the nation. Hazarika acknowledged the challenges faced during flood times, stating, "This is the most challenging time because it's flood time and people have to go long distances. It takes a long time to go even short distances."
Ashok Rao, the programme manager responsible for overall on-ground execution of the project, shared insights into their endeavors to deliver essential healthcare services, particularly in flood-affected areas. "Even during challenging times like floods, our focus remains on conducting general health checkups, providing antenatal and postnatal care, as well as raising awareness about health and hygiene practices," he said.
Rao added: "We have been conducting programmes on how to keep oneself safe during floods, including safe drinking water practices such as boiling and proper storage. We have also distributed sanitary napkins and other essential items." He mentioned the provision of Halazone tablets for water purification, facilitated by the public health department.
Mehebub Alom, the district programme manager, highlighted their reach. "We cover nearly 48 villages with our clinic units in the chore areas of Dhubri district. Our target population includes pregnant women, infants, and eligible couples. We provide them with basic healthcare services similar to those offered at primary health centres." Alom clarified that though they are employed by C-NES, they are directly managed by the NHM.
Sharing insights about the flood situation in Dhubri district, Alom said: "Compared to previous years, the flood situation this time was relatively normal. The primary flood season is during July and August, so there is still time. People living along the shore are accustomed to the flood situation and know how to cope with it. In certain areas, the government has constructed highland platforms where people can relocate until the floodwater recedes. Additionally, residents are familiar with preparing and creating floating structures using banana trees and pseudo stems."
Reviving The Once Dead Ship Hospital Project
Speaking about the Ship Hospital project, Ashok Rao said the project was shelved due to delay in funding. "The project was initially funded by NEC (North East Council). However, when projects experience delays beyond five years, the funding is usually discontinued," he said. As for its revival, he said: "This time, we received funding from a private organisation— an NGO. We resumed the project in November last year," Rao added, hesitant to disclose the name of the NGO behind the new funds.
The Ship Hospital will function as a secondary-level facility, addressing areas with limited healthcare institutions. The ship will primarily focus on serving pregnant women at high risk and will offer outpatient services, an operation theatre, and a dedicated ward for mother and child care, operating 24/7.
Underlining the significance of the Ship Hospital in underserved regions, Rao emphasised: "Due to the scarcity of healthcare institutions and the absence of towns or development activities in river areas, people tend to avoid staying there. Hence, the ship will specifically cater to pregnant women at high risk." The Ship Hospital will be stationed for three to four months at each location, with a particular emphasis on areas witnessing a higher number of home deliveries.
When asked about their collaboration with the NHM, Rao said the mission funds the entire boat clinic programme. Though the medical officers are appointed by C-NES, NHM provides complete support, including the salaries, and also offers quarterly funding for operational costs.
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