Hazards of helping the poor

Meet Dr Binayak Sen. He is a medical doctor,a Paediatrician.He passed out from the prestigious Christian Medical College,Vellore.

He first worked in a rural health programme in Madhya Pradesh.
He moved to Chhattisgarh in 1981, and began working with the leading mine workers' trade union leader, Shankar Guha Niyogi. The two set up a hospital for mine workers after raising money from the community - the Shaheed Hospital in Dallirajhara is still cited as an example of a pioneering health initiative in India for the poor.
The doctor received a paltry salary of 600 rupees ($15) a month, and helped the facility grow from a small clinic to a 60-bed hospital in four years.
In the early 1990s, Dr Sen and his wife, Ilina, set up Rupantar, a non-governmental organisation training rural health workers, running mobile clinics and campaigns against alcohol abuse and violence against women. Dr Sen's efforts in public health programmes, say local doctors, helped bringing down the infant mortality rate in the state and deaths caused by diarrhoea and dehydration.


He was the recipient in 2004 of the Paul Harrison award for a lifetime of service to the rural poor. This award is given annually by the Christian Medical College, Vellore to its alumni.

He was awarded the R.R. Keithan Gold Medal by The Indian Academy of Social Sciences (ISSA) on 31 December 2007. The citation describes him as "one of the most eminent scientists" of India

He was selected for the Jonathan Mann Award for Global Health and Human Rights in 2008. The Global Health Council issued a public statement, "This 58-year-old pediatrician was selected by an international jury of public health professionals for this prestigious award because of his years of service to poor and tribal communities in India, his effective leadership in establishing self-sustaining health care services where none existed, and his unwavering commitment to civil liberties and human rights.

He is an advisor to Jan Swasthya Sahyog, a health care organization committed to developing a low-cost, effective, community health programme in the tribal and rural areas of Chhattisgarh.

He was also a member of the state Government's advisory committee set up to pilot the community based health worker programme across Chhattisgarh, later known as the Mitanin programme.
 
Finally he was awarded LIFE IMPRISONMENT by the Raipur Sessions Court on December 24,2010 and branded as Enemy of the State.
 
 
Here is an excerpt from the article in The Lancet,the prestigious medical journal  about Dr Sen  last year.
 
Indian doctors typically dodge rural postings. But Sen, a graduate from Vellore's prestigious Christian Medical College, opted to work in the neglected hinterland, where most Indians still live. Rupantar, a non-governmental organisation (NGO) founded by Sen and his wife, set up a weekly clinic in 1997 in a village in central India (now part of Chattisgarh state) plagued by malaria and malnutrition. Local tribal youths were trained to become community health workers. Ever since, the clinic has been providing low-cost medical care to those living within a 50 km radius and who cannot access health services easily. Today, however, the health clinic is denied the services of its creator—the doctor, who once advised the state government on health sector reforms, is now branded an enemy of the state.
 
 

Sen's troubles can be traced to his criticism of the Salwa Judum, an anti-Naxalite movement, allegedly initiated by the people of Chattisgarh in 2005, to oppose Maoist violence in the state. “He had highlighted unlawful killings of adivasis (indigenous people) by the police, and by Salwa Judum, a private militia widely held to be sponsored by the state authorities to fight the guerrillas of the CPI (Maoist)”, says Amnesty International. “Dr Binayak Sen questioned those policies of the Chattisgarh State, which has led to large scale displacements of tribal people, their growing impoverishment and starvation deaths”, notes Indian Doctor in Jail, The Story of Binayak Sen—a booklet brought out by Doctors in Defense of Dr Binayak Sen—a group of men and women who personally know Sen and his work. Sen was troubled by the effect of these displacements on the health of tribal people, the report notes.



My Take
When you are doctor you deal with diseases and premature deaths. You realise that diseases and premature deaths are caused by poverty, under nutrition and lack of health care facilities. You realise that you cannot cure diseases and prevent premature deaths by medicines alone.You realise that physical illness is part of  malady of the society. Injustice and exploitation of the marginalised communities have to be stopped if their health has to be improved.

At this stage most doctors will shrug their shoulders and will say 'we cannot help it' and turn away from the issue.They will escape to the cities and treat rich patients.

But Binayak Sen did not do that. He was brave enough to continue his struggle for betterment of health of the poor in Chathisgarh.

It was his attempt to highlight the injustice faced by the  tribals  that made him enemy of the State.

Dr. Sen being the Secretary of the People's Union for Civil Liberties,Chhattisgarh Unit had helped draw attention to the unlawful killing - on 31 March 2007 - of several tribals in Santoshpur, Chhattisgarh. Upon orders from the State Human Rights Commission, bodies of the victims were exhumed from a mass grave in the week immediately preceding Dr. Sen's arrest. The post-mortem examination proved that the killings were brutal murder of innocent villagers by the police in fake encounters. This was severe loss of face for the State Government. Dr Sen was arrested because he had helped focus attention on these and other unlawful killings by Police and Salwa Judum.


Now Dr Binayak Sen is sentenced to Life imprisonment for helping the poor. In this 'democratic' India it is really hazardous to help the poor.



Links
My old post on Binayak Sen
The Hindu
The Lancet