In Assam, Solar Energy Helps Doctors & Medicines Reach Island Dwellers on Boats

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Dr Saddam Hussain from Silchar left his home around 7 am for his camp duty in Sadhu Sapori village of Majuli district – a large river island formed by the majestic Brahmaputra river and its tributaries.

After four hours of the boat ride, Dr Saddam reached the village along with his team of healthcare workers. It was not the regular OPD clinic of a city hospital. Here, the camp was set-up by the river bank. The community is always delighted to see the healthcare workers back.

“Since morning, I have seen at least 50 patients who complained of abdominal pain, urinary tract infections, hypertension, joint pains, skin related diseases; and those who required antenatal care,” Dr Saddam tells The Better India.

Talking about the healthcare gap in the region, he shares, “The flooding of the Brahmaputra river affects a large population residing in the islands. Whenever it rains heavily in Arunachal, the river water rises. There are no sub-centres in the islands. We are the only healthcare workers for them.”

With a focus on routine immunisation, primary healthcare services, child and antenatal care, the team rows from village to village across the district organising health camps.

Primary healthcare was a distant dream for the remote riverine community until 2009 when floating health clinics were introduced. Prior to this, hundreds of thousands of rural residents remained isolated in want of healthcare services.

Interestingly, these boat clinics harness solar energy to efficiently run the programme.

A journalist’s impact-driven project

The brains behind this project was Sanjoy Hazarika, a journalist and filmmaker who started the non-profit Centre for North East Studies and Policy Research (C-NES), driven by the tragedy he had witnessed on a ferry.

“As part of my work, I kept travelling to rural remote corners and observed that there was no sustained healthcare system in these islands. I also came across a case of a young woman who died during childbirth on the ferry. That’s when the whole thing hit me pretty hard,” he shares.

“Assam’s maternal mortality ratio was also the highest in the country back then in the late 1990s and continues to be so even today despite the slight improvement [195 per 100,000 live births],” he tells The Better India.

“In Assam, there are 2,500 islands and most of them are inhabited. I wanted to work on an idea that involved the support of local people and the state government to reach out to these people and improve the health conditions of the poor and the vulnerable communities, especially the women and children,” he adds.

“You can’t build roads everywhere and certainly can’t have helicopters give services throughout the year. So, we shifted to the traditional system of using boats and to look upon the river as an ally,” says Sanjoy.

In collaboration with the National Rural Health Mission, the non-profit launched the boat clinics in 2005 to bridge the healthcare divide. Since then, monthly health camps have been organised across 14 districts including Dibrugarh, Tinsukia, Jorhat/Majuli, Sonitpur, and Nalbari. 

For this purpose, 15 such floating health clinics are operating along the river to cater to the isolated communities.

Every month, a team comprising two medical officers, laboratory technician, pharmacist, and three nurses reach out to offer primary healthcare at the island itself. These boat clinics are equipped with vaccines for newborn babies to protect them from measles, Japanese encephalitis, polio, etc. 

The team conducts routine immunisations for pregnant women and also has a provision to test haemoglobin, blood glucose levels, sickle cell anaemia, and tuberculosis.

Solar energy to the rescue

Highlighting the challenges in running the programme, Riturekha Barua, the district programme officer of Majuli, tells The Better India, “Usually, we have to stay in the boats for 18 days in a month. The boat was our home. So, while patients go back to their homes, we could not. We slept in our respective beddings here, far away from the comforts of our homes.”

“We used kerosene-based generators for power but it would only help for 3 to 4 hours in a day. It would become challenging and uneasy for us to live on the boat, especially during the summer heat. Secondly, we did not have any cold storage facility for vaccines. Having a permanent energy supply was crucial for us,” she adds.

That’s when the non-profit decided to harness solar power.

In 2017, C-NES partnered with the Bengaluru-based SELCO Foundation that works to bring sustainable energy solutions to rural and urban communities in the country. As part of this, the large boats were equipped with solar panels of 3 KV capacity.

“It is to be noted that solar power can’t drive vessels on a river as powerful as the Brahmaputra. So, we use it to run lighting and basic services like fans. Apart from this, the cold chains for chilling units which store and carry vaccines and other life-saving equipment are also solar-powered,” informs Sanjoy.

Riturekha says that with solar energy, the crew has an uninterrupted power supply for a long time. 

Dr Saddam, who remains in the boat for at least nine days on a stretch says, “The solar-powered chilling units are very beneficial as without them, we could not keep the vaccines for more than three days. Besides, it is really helpful in running fans all day as it is extremely hot and humid in the area.”

However, he adds, “But I feel the capacity of the solar panels should be increased for better results. Last night, the solar-powered fans could only last till 9:30. We had to turn on the generator for the rest of the night. If the capacity is increased, we will be able to retire to bed and sleep peacefully after a hectic day providing quality service to the people.”

Although the healthcare provider believes the capacity must be increased, Riturekha says that with the additional support of solar energy, the floating health clinic is successfully catering to about 10,000 patients in the district every year.

“Due to soil erosion and regular flooding in the region, it has been a challenge to build a permanent structure in these places which leads to medical apathy for the residents. But with these boat clinics, we are able to bridge the healthcare divide in remote areas of the islands,” she adds.

Edited by Padmashree Pande; All photos: Riturekha Barua and Dr Saddam Hussain.