WHERE THERE CAN GO NO DOCTOR……. Public Health Situation in Dantewada, Chattisgarh  A Preliminary Assessment.

A seminar was organised by Centre of Social Medicine and Community Health, School of Social Sciences, Jawaharlal Nehru University, alongwith Jan Swasthya Abhiyan (JSA) and Medico Friend Circle (MFC), on 14 September at JNU, for the release of the report of a preliminary visit to Dantewada by some members of JSA & MFC to assess the public health situation there in the wake of the ’Salwa Judum’.

A preliminary visit was undertaken between 26-28 June 2007, by some members of JSA and MFC following reports from JSA Chattisgarh and local activists about the serious public health situation prevailing in Dantewada. It was felt that there was need for an external team to make an assessment of the public health situation. The broad objectives were: to identify the public health issues arising the wake of the salwa judum; to make a preliminary assessment of the status of health care services as well as key health issues in the camps and salwa judum affected villages; and to analyse the overall situation arising out of the conflict, from a public health perspective.

In the opening remarks, Dr. Imrana Qadeer, CSMCH, said that the findings fo this visit had to be viewed in the context of the kind of development that was taking place in the country, and the facilitation of these by the state by enacting certain laws, such as the Promotion of Industrialisation Act by the Chattisgarh state government. Doctors and public health activists needed to think about whether they could continue to remain aloof in such situations. A joint presentation was made by the team members, in which the situation in Dantewada, the context and objectives of this visit, the main findings on the public health situation, and the major concerns were presented.

Some of the significant findings regarding the overall situation were:

- There was significant restriction of movement.

- Massive dislocation and disruption of village communities, and large numbers of people unaccounted for.

- There was a general sense of uncertainty about the future, fear and insecurity, heightened by the destruction of livelihood as well a lack of food security in the camps.

Regarding the health status in the camps it was found that:

- Although the administration has posted health personnel at camps, their presence was irregular.

- There were significant numbers of untreated morbidities, some of them quite serious in nature, and reports of a outbreaks of epidemic diseases, as well as number of deaths.

- Circumstances, individual observations and anecdotal evidence indicate malnutrition, mental health problems in camps. Such issues need to be substantiated through detailed studies.

- There were no emergency services.

- Similar situation in the villages. There were no regular services only ’team’ visits.

- There seemed to be an increase in unnatural deaths, as indicated by one doctor that he was performing a large number of postmortems, and had become a ’murdon ka doctor’ (doctor of the dead).

Regarding the Public Health System, it was found that it was working under great strain.

- Regular schedules had been done away with, and there was a ’team’ approach to provision of services.

- Threat / obstruction of movement of public health personnel by Salwa Judum, concerning villages on ’other side’. Reports of attacks on Public health staff by Salwa Judum members.

- Serious sense of insecurity in public health staff resulting in non-provision of health services in over 300 villages.

- Pressure on certain voluntary agencies not to visit villages on ’other side’ of the Indravati river.

- Violation of Code of Medical Neutrality in Armed Conflict.

The team concluded that the health situation in Dantewada must be looked at in the wider context of violence and displacement, both in the name of state policies of development and of tackling ’naxalism’, which were actually leading to livelihood insecurity and all-pervasive fear. It seemed logical that adverse health impacts would result from the given conditions of restriction and deprivation.

Given the limitations of this brief visit, this team stressed the need for a large, comprehensive study documenting various aspects of public health conditions in both, camps and villages in the area. However, there arose the difficulty of carrying out an ’objective’ and ’comprehensive’ study in such a situation, due to the threat of violence and obstruction by the Salwa Judum. Several of these issues were discussed in detail after the presentation. Given the repressive situation prevailing in Chattisgarh, where most local organisations were finding it difficult to openly take a stand on these issues, it was considered significant that a public health team could go there for a fact finding. It was also pointed out that the purpose of this report was to draw attention to the denial of public health services as well as other services, and the use of this denial as a political weapon against the tribals. It was felt that there was need to highlight the larger context, the underlying structural violence, role of the corporate sector in the area, and the attempts to displace people. Given the limitations of this visit and the report, it was felt that such a comprehensive study was needed not just in Chhattisgarh, but also in other states where there was a similar situation.

(Chairperson, Centre of Social Medicine and Community Health, SSS)

“Philosophy and Society : Contemporary Issues by  Prof. Étinne Balibar 

Étienne Balibar, formerly Professor of Philosophy at University of Paris, Nanterre, France, and currently Visiting Professor at University of California, Irvine, U.S., was the guest speaker under the Distinguished Lecture Series of J.N.U., on 17 September, 2007. He is the co-author of two well-known works, among others: Reading Capital with his renowned teacher, Louis Althusser, and Race, Nation, Class  Ambiguous Identities with Immanuel Wallerstein. Professor Balibar, on a brief to Delhi had agreed to participate in a ’Conversation’ with the university community on the topic, “Philosophy and Society: Contemporary Issues.”

In his opening words, Balibar outlined the project of understanding the possibility of transnational citizenship. This idea was examined in the context of philosophical perspectives on cosmopolitanism. He noted that serious philosophical proposals have been made in recent times in favour of the cosmopolitan idea which, though historically evolving, has very ancient roots. The modern idea of cosmopolitanism begins from late 18^th and early 19^th centuries with the institution of international law.

The classical notion of national citizenship has focused on its extensive or quantitative aspects as well as its intensive or qualitative aspects. The question of the unattained equal liberty of all has been addressed not only by the European liberal philosophers, but more recently by Amartya Sen. In addition to this limitation of classical citizenship, contemporary critical philosophers of the Frankfurt School and post-structuralists like Michel Foucault, have brought up the question of social and political exclusions of large sections of people. These excluded sections  such as the women, the workers, the mentally ill, the children, the aged, and the racially discriminated  in fact always amounts to a majority in most national contexts. Therefore, the very idea of a ’human nature’ has become questionable. At the same time, philosophers have been sensitive to the dark side of a utopian cosmopolitanism. However, Balibar was of the view that a revival of cosmopolitan networks has become more necessary and more urgent than ever before. Globalization has tended to remove some, if not all, of the barriers that isolated human beings on  cultural and communitarian bases, and this has created a material basis for what was for philosophers like Kant, only a regulative idea.  Marx too, had anticipated such a moment, where in a post-capitalist state, there could be internationally-based social movements, involving the ’wretched of the earth.’ Post-colonial studies have in recent times activated internationalist communications on such a plane. Blaibar stressed on the need for the invention of a form of universalist discourse for post-national citizenship and for a higher form of democracy. 

The meeting was chaired by Satya P. Gautam, Professor of Philosophy, who initiated the discussion that followed in which students and faculty actively participated. The questions and comments pertained, among other things, to the problem of economic inequality, the difficulty of acceding to a political consensus in a multiply divided world, to technological-cultural quandaries, and to the relevance of historical analyses. Anil Bhatti, Professor of German Studies, presented Etienne Balibar, a memento on behalf of the university.  

(Franson D. Manjali, Centre for Linguistic, SLLCS)