Thursday, January 26, 2012

DOT Providers of the islands

Sugata M

(SHIS TB boat that sails around the islands)

Sundarban is the largest Delta of the world, comprised of 102 islands. Out of them 54 islands are habitable with a population of approximately 4.8 million. The unique feature of Sundarban is its dense forest denned by the world-famous Royal Bengal tigers. Tiger-bite is a common phenomenon among those villagers who infiltrate into the forests in search of wood and honey. Sometimes desperate bunch of tigers swim across the water to reach the villages to taste human flesh.
The public healthcare system of Sundarban is not sufficient to meet the need of the poor ailing people.  Transportation of emergency and complicated patients from the islands to the hospitals located at the main land always remains a challenge in the absence of speedy moving boats. Traditional man-drawing boats and slow-going motor launches are the only mode of communication between the islands. Electricity does not reach many of the villages till now.
Tuberculosis is not uncommon in Sundarban. An NGO named SHIS (Southern Health Improvement Samity) has been tirelessly working for the TB affected population in 30 islands since 1992. Currently, SHIS is helping the government to extend and expand the TB services in Sundarban.  SHIS operates mobile TB services through their motor launches within the islands. The launches are equipped with microscopes (for sputum examination), X-ray machines and other materials for diagnosing TB and carry the drugs to treat the TB cases.
SHIS developed a network of highly motivated cadres of community DOT (Directly Observed Treatment) providers across the islands over years. These providers have devoted their lives to cure the TB patients and give them new lives.
DOT providers are responsible to ensure that the TB patient is taking the medicines without missing a dose and completing the course in the due time.  The TB patients have to visit their respective DOT providers’ places and take their medicines in front of their eyes. So it is called directly observed treatment.
Sarbeswar Roy of Taranagar island had TB five years back. He was very ill and finally sought the TB services of the government. He got completely cured and the incidence brought sea change in his life. He decided to become a DOT provider.

(Sarbeswar and his wife with Patient wise Boxes at his hut)
‘I know what the hell a TB patient goes through. The sufferings sometime become unbearable. When I was cured, I decided to help the sufferers like me. So I become a DOT provider.’ said the 30 year-old Sarbeswar in front his small hut in Taranagar. ‘I cured 15 TB patients so far and am currently providing DOT to 3 patients.’
He has no fixed income. He has no lands to cultivate. His key earnings come through providing DOT, which is as small as Rs 250-00 ($5) per patient he cures. The disbursement of that remuneration is often delayed due to the bureaucratic complicacies of the government system, but Sarbeswar is undaunted.
‘I feel proud to be DOT provider. I will do this work till I die’ He said with a glow of satisfaction in his face.
When asked ‘what he does when a TB patient doesn’t turn up to take the medicines at his place’ he said, ‘I visit his or her residence to give the medicines. The patient can’t escape from me.’

Sundar Chandra Mondal of Amtoli island has been providing TB medicines to the patients since 1992 when the DOTS strategy was not even adopted in India’s TB program.
‘I am one of the oldest DOT providers created by SHIS during its initial years. I myself had TB many years back. Since then I vowed to get rid of this disease from the island.’
Sundar Chandra Mondal has crossed 70 few years back. He is still going strong to continue his fight against TB. ‘I treated more than 1000 TB patients in my life. I also give injectable drug for TB’. He is presently treating 1 TB case in his island.
Mohammad Shaheb Ali Gayin alias Gaiji of Kathalberia has been in DOT business since 2001. He has provided medicines to more than 70 patients of his village and currently in charge of 3 patients. Gaiji is a simple hearted man and dreams to make his place free from TB.
‘I look forward to the day when people will not suffer from TB any more’ he said with sheer determination in his voice.

I saluted them all.


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