The weekend saw us at 19 degrees, 51 minutes North latitude and 83 degrees, 51 minutes East longitude – Bissamcuttak, Raygada District, Orissa/Odisha at the foothills of the Niyamgiri mountain. The place is synonymous with the illicit mining of bauxite by the Vedanta mining company; depending on which side your on, the infiltration by us in to the land of the adivasis; the Naxalite movement/Maoist uprising; and the Kandamal Riots of 2008. But we didn’t go there for that. We went to visit our friends who live and work in a small hospital that does big, much needed work for a lot of tribals and villagers. It was an unforgettable experience to witness first hand how much rural India needs and how much they’ve got in these little friends.
Bissamcuttack has a predominantly tribal or adivasi population. This is a beautiful part of India that many of us do not get to see – lush green imposing mountains, swollen rivers and unblemished countryside. Having previously seen only coastal Orissa we felt that people in these internal parts looked healthier. We didn’t see the abject miserable poverty that we’ve seen closer to the populated urban centres. There were lively markets, lots of people working in the fields and cattle was in abundance and looked healthy. Perhaps if we had gone at the peak of summer rather than at the peak of the monsoon we’d have a different impression. Rural India, especially these parts, looks idyllic in the monsoon that turns everything from dusty brown and grey (and red close to the Vedanta factory) to shimmering emerald green. Unfortunately like all small towns in India the basic town infrastructure particularly sewage and garbage collection/disposal is non-existent.
As for the roads, they are being laid and in parts are impressive while in others there is no road to speak of as work has halted due to the monsoon. It rained all the time we were there and on our return to Vizag we saw the hefty wheels of huge Sumos and Scorpios get sucked in to the wet mud while our little Nano just floated, glided and slid (or was it skidded?) over the chocolate coloured sludge that used to be a road before the pounding rains got to it. It was hairy for only about 20 minutes of the 6 hour drive but I was ready to roll up my salwar and push the little Nano out the sludge. Luckily that was not necessary but it was too tense for picture taking. We should probably have hitched a ride with some water buffalo.
What hides behind this natural paradise is intense mining, of which I’ve written about here before, and a hothouse of malaria – around 58% of children in 2010 tested positive for malaria. The Malaria parasite and the threat of malaria is just something they live with. There is no real government health care in these areas. For example, in 1994 there used to be 201 infant deaths for every 1000 born but thanks to the Christian Mission Hospital, this has come down to 79; that’s a 40% reduction.
The Christian Mission Hospital was started on the verandah of a church in 1954 by a Danish lady, Dr. Liz Madsen (1913 to 1991). The foundation they now call MITRA – Madsens Institute for Tribal and Rural Advancement (mitra in Hindi means friend) – carries on her work. In its current avatar, the hospital has around 200 beds and provides medical health for 12,500 tribals and villagers from 53 (mostly tribal) villages.
The work of the Christian Mission Hospital does not just rest with health. Theirs is a four fold dream: health for all, education for all, economic security for all and social empowerment for all. The thinking is that if you provide purely health care then you are only addressing one part of the problem. Community is not just about health – it’s about healthy people in all aspects of their lives, beyond the physical.
They have set up Self Help Groups (SHGs), credit schemes, health insurance, elderly support, youth programmes and training courses for local people. In 2006 the MITRA team consisted of 24 members of which 13 are from the tribal community. The key rationale in development work is not to make the community entirely dependent on you. Training and building skills in-house so that they can go on to help their own community and be a part of the change is vital to success and for the people you are helping to take ownership of the initiatives. For example, it was the tribals who built a pipeline connecting the river to the school so that their children would have continuous fresh water.
The old adage of why give a man food when you can teach him how to fish is what they are striving for. In this vein the hospital also runs a School of Nursing where they train their own nurses. This I thought was a remarkable achievement. It’s one thing to treat people, it’s another to impart medical education. There is no government assistance in any of their work. The school at a tribal village of Kachapaju, 20kms from Bissamcuttack, they affectionately call Mrs.K (MRSK – Mitra Residential School Kachapaju) is the main reason we came.
My friend Shikha, who is my first ever friend, whose hand I held all through the first day of nursery school, now
volunteers works at the school and the hospital at Bissamcuttack. While Shikha and I might not have kept in touch after high school we’ve recently reconnected and picked up exactly where we left off. Life us taken us on totally different journeys but we seem to have crossed paths again with different experiences to share. I was incredibly impressed by how fluent she is in Oriya, without which I think one would be pretty useless here, as I felt as I stumbled and bumbled in front of the children in my English.
She helps with the teaching at the school, building the skills of the teachers and is interested in preserving and documenting the Kuvi culture of the tribals. The Kuvi language has no script and is purely an oral tradition. As the language gets slowly corrupted with people in the plains unable to understand the Kuvi of the hill people, there is a great need to preserve and document their stories and traditions. Some of this work has already begun on a small-scale. The Worli art of Maharashtra has manged to market itself in to the conscious of most Indians making it almost synonymous with all rural India. Sadly other tribal cultures are not so well known. Shikha’s blog is a thought provoking documentation of her ongoing experience at Mrs.K and in Bissamcuttack. (Please see her comments below for clarification on learning from ancient cultures rather than preserving them.)
The school is something incredible. Tucked away on a mountain slope in the clearing of a forest near a tribal village called Kachapaju, you get here on a 20km swift flight on a sumo from Bissamcuttack, on a steep track along the mountain and the occasional slushy lake like road that the Sumo skids across. When we arrive, a few older boys/grown ups are playing a volleyball match where each point seems to last forever – they’ve not heard of spiking I guess.
There are 16 tribal villages who have formed an informal association who send their children to this school. There are 5 grades and 150 children, 75 boys and 75 girls. Children get picked by lots or are nominated to attend the school as there is not space for all the children from all 16 villages. The school is residential to all but 35 children whose village is close enough for them to commute. The others live too far away. One child is the only one from a village called Nandi which is a hamlet at the top of the mountain, made up of just 11 families. There are 11 teachers, 8 are from the tribes. Mitra spends Rs.10,000 a child a year for everything from food to books to clothing to outdoor activities. That’s (US$180). The parents contribute Rs 350 per year for boarders which is paid in installments. Every year they start with empty coffers but every year they make it work through donations from family, friends and donors.
There is no electricity but they run a diesel generator for 3 hours in the evening. There are solar panels on all the buildings but are not as effective as they should be. They go down to the river to bathe and the bigger children help the little ones. They learn Kuvi (the tribal language) in Grade 1 and then Oriya, English, Maths, Science and Computers along with a whole lot of fun outdoor activities. They even have 10 Netbooks for the children. While I was there the girls proudly showed me not only their classrooms but also their dormitories. Neatly lined up along the walls were tiny little suitcases and steel trunks for each of the children containing all of their worldly possessions. They sleep together under a large mosquito net. Like any other school, they have teams or houses. Here they are named after Abraham Lincoln, Gandhi and Mother Teresa, real people who are also symbols of freeing the poor and enslaved. It feels like the school runs on dreams and ideals but it’s actually a real thing, doing incredible work with fascinating results.
What’s incredible is their success stories. 9 batches of students have graduated Class 5 since the school started in 1998; 130 of them are in high school; 30 have passed their 10th exams and a few are in college. 2 girls have gained admission to the School of Nursing at the Mission Hospital through a competitive exam and 2 boys are preparing for Medical College entrance exams. Their newsletter (click here) is a fascinating read and gives you more information on the school and how you can help.
But MITRA is not happy to rest on their laurels. They realise that for the 150 children attending Mrs.K there are another 150 children in these 16 villages that don’t get the chance to come to school. There are government schools but given the remote locations, some don’t have roofs, others don’t have teachers including one that hasn’t had a teacher for about 30 years. But on the government books there is a school. They realise that while creating opportunities for some they have created inequality for others. So Mitra started an experiment in one village who agreed to nominate their own teacher that was specially recruited and trained at Mrs.K. The village provides the teacher with a home to stay in, food and a monthly honorarium, provided by Mitra. The program called, AQTE (Adding Quality To Education) now has 21 trained AQTE teachers, serving 700 children in 17 villages. This is truly going above and beyond what they had originally set out to do. But to them the work is never complete till it’s done right.
The “they” that I keep mentioning is spearheaded by Dr.John Oomen. A graduate from CMC, the alma mater of my parents, in fact, where the DH and I grew up. We all studied in the same primary and secondary school, although Johnny is about 20 years my senior. Johnny came to Bissamcuttack in 1988 after completing his MBBS and then returned after his MD with his wife, a nurse, and since the early 1990s have been running the Mission Hospital.
Johnny is one of those unique souls. You don’t get to meet people like him very often in your life and I feel privileged to have spent the time with him. He’s creative, he’s thoughtful, insightful, incredible easy to get along with, he’s got an analytical brain, he’s a really funny guy with countless stories of his college days as a prankster. He’s a great physician and community health practitioner who could be working in much more fancy surroundings but he chooses this place. He’s been raised in an environment where working for the needy is like an instinct, it’s a given. He fits so well here in Bissamcuttack and over the years has learned a lot about how to read the tribals and their culture.
Some people who give their lives to helping the poor, can be hard to get along with. They can have a ‘holier than thou’ attitude and their religious motivations or evangelical dogma can get overpowering. But that’s not at all the case here. One’s faith is one’s faith. They do not preach, they are not out to convert. What they do is in the name of the god they believe in, with his blessing and guided by the belief that god is love and everyone is created in his image. But they do not feel the need to shout it from the tree tops. That doesn’t achieve anything; in fact it creates more imbalance, at times a lack of trust and respect. Theirs is a much more refined sense of “mission” – irrespective of religion their work is driven by a deeper calling to uncover the needs of the needy and provide in the best way they know how. Not to lead but to walk alongside those they help. Not only by a sound analysis of their situation but with a love and respect for the people who need them.
There is also a delicate communal balance in this area that MITRA juggle. During the 2008 Kandhamal riots, 300 villages destroyed, and hundred or more christians (tribals and converted dalits) in the area were killed and property damaged by Hindu fundamentalists after a Hindu priest and his associates were killed by unknown persons. The school, MRS.K was under threat as they were being funded by Mitra and the Christian Mission Hospital. But the adivasis got together and 30 men with axes did watches in shifts outside the school. They met the groups that were causing much of the violence and said that they could do whatever they wanted to the town below but if they touched the school in the mountain, the tribals would come down and destroy their town. The Christian Mission Hopsital was left untouched during the riots because at the end of the day, everyone needs a hospital. The chaps who had the day before broken down the neighbouring church were bringing their wives to the Christian hopsital to have their babies delivered.
The other tightrope they walk is between the adivasi and the dalit community. The latter have always been at the bottom of the caste pile and have been marginalised and mistreated to a great extent. The former are not part of the caste system and probably have a lot more dignity and pride. But in villages with both tribals and dalits, they do live in separate areas. There is one dalit teacher in the school and his presence is very welcome by all others. Communicating with these different communities, knowing that the doctors come from a totally different culture as well, is something they give much thought to. Johnny has given a great interview on inter-cultural communication that you can watch here. The empowerment work that Mitra do may not be liked by everyone. The caste system is a great way of keeping people in their place and maintaining power in the hands of the few.
What I admire most about people like Johnny is that they do high thinking and simple living. They think big, they are able to see the larger picture but to get there they are able to implement small but effective solutions, ideas and changes with limited local resources, in incremental stages that in 10 or 15 years has an incredible impact. A good example of simple living and high thinking is the use of a combination of neem and coconut oil that people here apply on their skin as a natural mosquito repellent. A lot of local (tribal) solutions involve simple living and high thinking. Most of us would either get impatient with the slowness of progress and easily find fault at every stage, not to mention be totally demoralised by the “simple living”. By simple living I do not mean that Johnny and his doctors and volunteers live in mud houses and use the river as a crapper. Far from it. But there are no urban creature comforts like shopping, cinema, Amul butter, take out food, ice-cream, canned juices, and some of the services and products we take for granted. You can think of these as just first world trappings that we have only come to believe are essentials. They do have electricity, brilliant home cooked food, Tata Sky, Internet, mobile phones, air-conditioners. But as much as I love living in small town India or rather hate living in an urban setting, I’m not sure how long I’d last in Odisha’s outback without suffering from first world blues. It’s one thing to be an hour away from shopping like we are in Vizag, it’s another to be 6 hours way.
Initially the hospital and school was run mainly on donations by friends and family. Now the Tatas are contributing in a big way. They also have a number of connections with their German and Danish donors and provide training for doctors from those countries who visit India to learn about tropical medicine. With migrating populations, new diseases are emerging in the west that they didn’t have before so doctors come to India to learn how to recognise and treat tropical illnesses. The irony is that there might be more people in Germany and Denmark who know about the work being done in Bissamcuttak than (non-medical) Indians do about what’s happening in their own backyard.
If you’re not an Indian doctor or work in the field of development there’s no reason you would know about Bissamcuttack. But the Mission Hospital gets their fair share of foreign volunteers including young people from Germany who have just finished high school. They’ve had about 6 or so students in 5 years who stay for 3 to 6 month periods. Some come here thinking they can save the third world and when they get here they realise that they’re just at the foot of the mountain (literally and metaphorically). They see for the first time the ground reality and not perhaps an idealised version they may have had. They realise that they are worthless, that despite all their western education they may have no real skills to offer. In most cases it turns out that it’s not the hospital that needs them, it’s they who need this experience. When they get here they are in shock- shocked by the isolation, the slow pace of life and the poverty. School students have no medical skills to offer and some think they can come here and teach English. Frankly, our English is often better than theirs. There is an English medium school for the children of the hospital’s staff. So while they could work there, not all are good with children, not all want to teach or help with extra-curricular activities so their support in this area cannot always be relied upon.
Even medical students/graduates (who have stopped coming here since 2008 post the riots) who would appear to have the required skills cannot legally perform any medical procedures in India. It’s made clear to them at the outset that they will not be performing surgeries and saving lives with their incredible western medical qualifications. All they can do is observe. And while we may need more doctors, those are the rules. So they are circulated through the hospital to experience a variety of roles. For instance, they may spend two days in the pharmacy where they roll up suture material, pack gauze, stack medicine. Next they’ll be put in the kitchens to pack food, help prepare the food, visit the cook’s house, see how he/she lives. After 2 weeks they realise that living in the rural outback is not as glamourous as they thought it would be and they want to leave. They are emotionally battered. Johnny acts as counsellor, mother, mentor. He’s seen this all before and knows the twists and turns of the emotional roller coaster they’ve embarked on. He testifies that after 2 weeks they want to leave, after 2 months they’ve settled in and after 6 months they’ve cancelled their tickets back to Germany.
Some amazing people come here – like the Danish mathematician and musician who knew the only way he could help out was to first learn Oriya. He found the local ‘Learn Oriya in 30 days’ impossible to comprehend because these books are clearly written by people who know Oriya and not by someone who has had to learn it. So he sat down and wrote a book on learning Oriya with mathematically sound tables, comparisons, probabilities and word associations and combinations. He even presented this book to the Chief Minister of Orissa, Naveen Patnaik, who despite being in power for the past 12 years does not speak Oriya. Patnaik allegedly said that he already had a copy.
When you visit a place like Bissamcuttack you feel in the same heartbeat inspired and worthless. Inspired that there is good work being done here, that despite how pathetically useless our governments are, there is hope for people. And worthless because we live such a life of privilege. I am not teaching maths and science and computers to adivasi children. I’m not even reminding the children to put their neem oil to prevent the mosquitoes from biting. I asked my friend Shikha why she was here, living in the outback, working in this school. She said that she doesn’t see it as a clear cut Christian sacrifice with outright religious motivations. She is doing it for herself. She needs to do this for herself in this time of her life.
So I asked what the rest of us could do to feel less worthless. She was incredibly practical and incredibly insightful at the same time. She said that not everyone can live in the village, can teach in a school, can serve those in abject poverty but as long as you are living your life in an honest sustainable way, that’s all you can and should do.
From that I surmise that if you employ someone, be it a domestic maid or 10 factory employees, give them an honest wage, build up their skills, ensure their children are getting an education, or health care, pay for it if you can. If you can’t become a volunteer in the village then that’s fine, know your limitations and do your bit in your own way where ever you are. Value what you have and know who you share your place with on this planet. Sometimes in India we, the middle and upper classes, feel angry with the poor. “Why are we /they- like this?” we constantly ask in frustration. Our angst is not hatred but guilt. The poor and needy remind us of just how much we have, that no matter how much you feel you are suffering, it’s not a patch on what they go through and go without.
Whether it was serendipity or the universe reaffirming our experiences we returned home to find an emaciated, malnourished stray puppy on our door mat who had the bite marks of another dog on his haunches, crushing the nerves that would allow him to move his hind legs. He was paralysed, afraid and very hungry. Just as we were doubting our do-gooder credentials, we had given an opportunity to do good. We had to take him in – you would have too. The DH believes that when you’re standing at the pearly gates, should you be so lucky to get there, you’ll be asked what all you had and what all you did. “You had a house, you had food, you had every luxury but what about that stray paralyzed puppy you abandoned?” This particular puppy (who is slowly recovering his strength but still unable to use his hind legs) deserves a post all to himself which you’ll hear about soon.
People like Johnny and his wife and those who work and volunteer at Bissamcuttack are rare souls – like fiery stars lighting up a dark sky. They are doing only what they know how to do best– help others with the skills they have. They are such generous people and their invitations to come visit the school and hospital are incredibly genuine that I urge you (especially young people) to pay them a visit. Who said you need to go abroad to broaden your horizons – a visit to Bissumcuttuck can be your Polaris, the beacon on the horizon you were looking for.