These Healthcare Heroes of Assam Come on a Boat Clinic

These are like huge hospitals on the move, floating on the Brahmaputra, treating lakhs of patients.

The Boat Clinic in Morigaon district of Assam.

(Photo: Tridip K Mandal)

Cameraperson: Tridip K Mandal
Video Editor: Prashant Chauhan
Additional Reporting: Anjana Dutta

“To cross the Brahmaputra to provide healthcare services is a risky task. It’s a very dangerous thing to do. For people sitting in AC rooms in hospitals, it’s much easier than what we are doing.”

Dr Ashraful Islam, Medical Officer, Morigaon Boat Clinic

The monsoon is abating but the Brahmaputra is still at full fury, flooding and eroding its banks, when I join Dr Ashraful Islam and fifteen other crew members on the ‘Boat Clinic’ in Assam’s Morigaon district. The boat is called SB Pallavi.

The crew boarding SB Pallavi. (Photo: Tridip K Mandal)

We are onboard one of the fifteen boat clinics that ply on the Brahmaputra. And what these boat clinics manage to achieve is just staggering.

• They serve people in 13 districts of Assam.
• Most of these are inhabitants of the 2,500 river islands or ‘chars’.
• For more than 30 lakh (3 million) people living on these islands, the boat clinic is the only healthcare option.
• It’s absolutely free, people don’t have to pay anything for accessing healthcare services.

‘Boat Clinics’ are Critical for Brahmaputra's River Islands

Shamjit Passi, the district program officer tells me that the ‘char’ villages are dynamic with the river constantly eroding away and depositing soil on it. It’s just not possible to setup permanent hospitals on them. And then there’s the fear of Brahmaputra’s dreaded flooding. A single wave of floods can wash away the hospital. In this scenario, the ‘Boat Clinic’ is the only practical healthcare solution.

A patient being treated onboard a boat clinic. (Photo: Tridip K Mandal)

The Centre for Northeast Studies and Policy Research launched the first boat clinic in Dibrugarh district of Assam in 2006. The National Rural Health Mission or NHRM funds the Boat Clinic program. Most boats have 15 team members including the district program officer, two medical officers, two nurses, a lab technician and a pharmacist. The boat clinic I am travelling in provides healthcare to more than 18,000 people in 30 ‘char’ villages.

The island we are travelling to is called Panchuchar. It’s almost an hour-and-a-half away from Morigaon. When we reach the bank, there are already few young mothers and pregnant women anxiously waiting for the boat. It’s time for their monthly health checkup and vaccinations for their children. For almost five years, free vaccinations are provided to children who are monitored by the boat clinic.

A nurse on SB Pallavi. (Photo: Tridip K Mandal)

A Hospital on the Move

After the checkups on the boat are done, we walk inland. There are more than 200 villagers already waiting at the village centre.

“There are times especially during the floods when we are unable to reach people. We have to walk for 15-20 minutes in scorching heat like it is today. Then see the patients, prescribe them medicines. Come back and then have lunch on the boat.”

Dr Digjam Sharma, Medical Officer, Morigaon Boat Clinic

The crew members just don’t provide healthcare to the villagers. They also create awareness on nutrition, family planning and basic hygiene. Even diagnostic tests are done on the boat and in the camps set up in the villages.

The 15-member team of Morigaon boat clinic. (Photo: Tridip K Mandal)

The Discrimination Against Boat Clinic Doctors

Over the years, hundreds of doctors have treated millions on the boat clinics of Assam. They have worked on the river islands on Brahmaputra, which are one of the toughest and remotest areas to work in. Yet they are at a disadvantage compared to doctors working in other remote areas across India.

“We work on the river islands, it’s not easy to reach these places and treat people. Yet our work is not considered a ‘difficult area’ assignment. After MBBS, for post-graduation admissions we are not entitled to ‘difficult area’ reservation.”

Dr Ashraful Islam, Medical Officer, Morigaon Boat Clinic