Jaising Baiga of Tilaidabra

I met Jaising Baiga of Tilaidabra village in Chhattisgarh on a hot, humid afternoon earlier this week. I had gone to his house to see his daughter Jyothi, who the health worker in the village described as "kamzor", or weak.

Jaising Baiga and his family in their hut

Jaising works in Pratapgarh in a brick factory and had just returned after seven months of work there. He was asleep under a thick blanket when we reached his hut, but his wife insisted on waking him up. I asked him about his job. He works in a brick factory there for 12 hours each day, he said, cleaning out the ash from the kilns after the bricks are baked. The bricks themselves are made by labourers from Bihar. For his labours he earns Rs.9000 per month, and he supplements this with headloading for trucks, which earns him an additional Rs. 3000. He spends Rs. 2200 on food for himself, he said. So does he send the rest home, I asked him. He said he was paying off the advance given by the contractor to the family when taking him to Pratapgarh, as well as the interest. So he has now returned only with a small amount of money. No, he did not have to return during the lockdown in 2020 as it is a very large brick factory and work continued even during the lockdown.

Two other Baiga men from his village also work there. 

Their mud and tile hut is falling to pieces, some of the tiles on the roof missing in one corner. In another corner the broken tiles had let in the rain resulting in the corner being washed away and leaving two walls in danger of collapsing any moment. He will be here for four months now during the agricultural season before returning to Pratapgarh later in the year, he said.

Jaising is extremely thin, as is his wife Meena who works as an agricultural labourer in Tilaidabra and nearby villages. And their daughter Jyothi is severely underweight for her age.

The Anganwadi building in the village is dilapidated and a hazard to enter, and the anganwadi worker lives far away and comes to the village once a month to distribute the month's allocation of dry rations to the children enrolled at the centre. 

I had gone to enquire about the young child, to visit the family, to ask about her diet and health, and to advise the mother if necessary, on what she needed to do to improve the child's nutritional status. 

After meeting the family and talking to Jaising, I left without offering any solutions. I found I lacked the courage to do so. 

 

View of Tilaidabra with Anganwadi centre in the foreground

Tilaidabra Anganwadi centre.

Ambikapur, 1987

 

It was the transistor radio that kept me sane that year.

It was 1987. I was fresh out of internship, and had opted to work in a hospital in a remote area for a year, before thinking of specialization. I had a room in an empty ward of the Holy Cross Hospital, Ambikapur in Madhya Pradesh. During the day, the crowded outpatients kept me busy, and before that the morning rounds that had to be conducted in the wards to check on patients. On duty nights too I would remain busy in the evenings as well as sometimes through the night. The Sisters were welcoming and gracious, and glad of an extra hand to help. I ate in a small room off the kitchen – delicious home-made food, mostly rice, daal, and vegetables.

It was in the evenings that I got lonely, missing my colleagues at Vellore, and my family. The sisters would retreat to their convent, and the other doctors to their families and homes in Ambikapur, and I would be left to my own devices. Except on the days I was on call, I would speak to no one from 6 in the evening till about 9 the next morning, and at 23, it drove me crazy. Those were the days before email and internet and cellphones and the STD booth for long distance calls was nearly 2 km away from the hospital on the edge of town. I did not have access to a library for reading material.

I paid the handsome sum of Rs. 700.00 for a Philips transistor radio from my first salary, and it brought the room alive. From being a large bare hospital room, it became a place where there was music, news and conversation. I listened to the All India Radio (English and Hindi and even the Sanskrit news bulletin to try and remember my elementary school Sanskrit), to the BBC, to the Voice of America, as well as broadcasts in a few languages I did not understand. Vividh Bharti and the Srilanka Broadcasting Corporation were my favourite stations for songs, and Vividh Bharti had some lovely instrumental and vocal classical music as well.

My interest in surgery was encouraged by the Medical Superintendent who was a plastic surgeon herself, but like most surgeons in rural India, conducted surgeries of all kinds. Under her guidance and I soon learnt to do minor procedures by myself and to assist in the more major ones like intestinal and gastric perforations, or in Caesarean sections. What a thrill it gave me to see a patient who had been admitted in pain recover fully; or a mother and baby recovering well after the C-Section. The well-planned and sychronised, orderly world inside the operation theatre also appealed to me.

But outside the operation theatre I was plunged into the chaotic, untidy, real world. The emergency cases (and almost all who came outside regular hours were emergencies) were all critically ill – an unconscious child with tuberculous meningitis (the coverings of the brain), a pregnant woman with malaria and jaundice, a comatose man with severe malaria, a pregnant woman with eclampsia (seizures due to high blood pressure in pregnancy) – the list went on. These were terribly poor patients, who had been brought several kilometers on a cot to the nearest main road before being brought here in a bus or more often in a jeep that had charged them exorbitant rates. It was obvious in their thin and wasted bodies- both of the patients and their relatives; the tattered clothes they wore; the patient, almost fatalistic attitude with which they waited for care. Many of these patients died within hours of admission in spite of our best efforts, while others would have a long and slow recovery. Malaria and tuberculosis were the most serious and frightening problems I saw, in all their various forms and degrees of severity. I felt helpless and often lost – how could so many patients just come to the hospital and then die? Could it not be stopped? Why did someone not diagnose it earlier, or why did they wait till their illness became so severe?  

All these questions led me, at the end of my year there, to apply for my post-graduate studies in Community Medicine at my alma mater in Vellore.