Community health in Bhopal
Two days with Sambhavna clinic community health workers
Background
The Bhopal Gas Disaster
The 1984 Bhopal Gas disaster is widely considered the worst industrial disaster in history. On the night of December 2nd-3rd 1984, the Union Carbide pesticide plant in Bhopal released 30 metric tons of highly toxic Methyl Isocyanate gas, exposing over 500,000 people in the shanty towns around the plant. The official government death toll was 2,259, however municipal workers claim they loaded at least 15,000 bodies onto trucks in the first three days before the army took over. In 2006 the government of Madhya Pradesh stated the leak caused 558,125 injuries. Today, an estimated 120,000-150,000 survivors are chronically ill, with long term effects including vision problems, respiratory, neurological, gynaecological conditions and a high rate of birth defects.
Sambhavna Clinic
The Sambhavna Clinic opened on September 2, 1996, and offers free healthcare to survivors, through a blend of modern and traditional, Indian medicines. The staff include general and aurvedic physicians, panchkamra and yoga therapiusts, a paediatrician, and a gynaecologist, all supported by an on-site pathology lab. Over 150 species of medicinal plants are grown in its 1 acre garden which are manufactured, on site, into over 80 Ayurvedic medicines which are dispensed alongside the pharmaceuticals.
Community Health
Sambhavna also has a team of community health workers who serve over 40,000 people in 7 communities around the plant, providing on-site health clinics (at times on the side of the road), screening for TB, malaria and anemia, offering consultation and referrals, as well as health education.
This was my third visit to Bhopal, and I spent two days with the community health workers in Garib Nagar, Annu Nagar and Nawab Colonies.
I spent the day with Salman Hameed and Sangeeta Chaurasia in Garib Nagar, an impoverished neighbourhood close to the Union Carbide plant. We began the day at their community health office, gathering supplies for the street clinic.
Two small tables, a few plastic chairs, some basic equipment, and the clinic is on. There’s a strong educational component: four volunteers from the community work in conjunction with the Sambhavna staff, assisting with blood pressure readings, collecting blood smears for malaria testing and performing copper sulphate anemia screening tests.
Slideshow: Under Pressure
Malaria is a mosquito-borne infectious disease affecting humans and other animals caused by parasitic protozoans belonging to the genus Plasmodium. Malaria symptoms typically include fever, fatigue, vomiting, and headaches. In severe cases it can cause yellow skin, seizures, coma or death. The disease is transmitted by the biting of mosquitos, and the symptoms usually begin ten to fifteen days after being bitten.
The Indian government recorded only 561 malaria deaths last year, however, the real toll may be has high as 200,000.
In addition to malaria prevention education, the Sambhavna workers collect blood samples from people who present with malaria-like symptoms, for testing at the pathology lab back at the clinic.
Anemia is the most common nutritional deficiency disorder in the world. It is estimated that about 20%-40% of maternal deaths in India are due to anaemia and one in every two Indian women suffers from some form of anaemia.
Sambhavna health workers and volunteers carry out regular anemia testing at their street clinics.
The test used here is an old school but rapid method using copper sulphate. The blood is tested by dropping it into a solution of copper sulfate of known specific gravity – blood which contains sufficient hemoglobin sinks rapidly due to its density, whereas blood which does not sink or sinks slowly has insufficient amount of hemoglobin, thereby giving a positive result.
The clinic at Nawab colony
January 16, 2016
My second day volunteering had me with a new team, in a new neighbourhood: the Sambhavna community health clinic in Nawab Colony, with community health workers Rajeev Misra and Masarrat Jahan (plus volunteers from the community). This clinic operates inside, in a large structure with an attached herb garden.
The first patient was a young man who’d been running a fever for a week. Masarrat suspected malaria, and set about doing the fingerpick test.
Slideshow: Malaria Test
The next patient was an older woman with diabetes and suspected kidney problems.
Salman and Masarrat wanted to do a test, which was an opportunity to involve the community volunteers. The test, called ‘Benedict’s Test’, detects sugar in the urine, and is again, old-school, but rapid, needing minimal equipment: a urine sample, a test tube, some special solution and a bunsen burner (which rode over, LPG tank and all, on Masarrat’s scooter).
Slideshow: Benedict’s Test
We closed up the clinic, and walked over to nearby Annu Nagar, so Masarrat could deliver an educational talk on the signs and symptoms of anemia. This community is ‘illegal’, and has encroached on the train tracks. The government could decide to tear down their houses at any moment.
A foreigner with a camera is a magnet for Bhopali kids (more-so than elsewhere, in my experience) so I have dozens of street portraits of kids (and adults) from my Jan 15 & 16 community health volunteer work in Bhopal. Here’s a slideshow with a few...
Bhopal has a number of names...The City of Lakes, The City of Mosques, and The Heart of India. I prefer the latter, as the people of Bhopal are resilient, kind, generous and welcoming. The people who work and volunteer at the Sambhavna Clinic embody these qualities, and it was an honour to spend time with them as a volunteer.
Thank you to Sathyu Sarangi, Tabish Ali, Salman Hameed, Sangeeta Chaurasia, Tabassum Ara, Rajeev Misra, Masarrat Jahan, Devendra Panchal, Thorsten Gillmor and the people of Garib Nagar, Nawab Colony and Annu Nagar for their generosity of spirit.