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ASHA: Delivering healthcare services to ethnic tribes in Arunachal Pradesh

An organisation saving large number of lives in Anpum forested area of Arunachal

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'ASHA' workers Source: Wikimedia Commons

Anpum (Arunachal Pradesh): Washed out bridges, absence of roads and uncertainty of reaching destinations deep in the forest, do not come in the way of ASHA workers in their effort to provide precious healthcare services to ethnic tribes in Arunachal Pradesh.

Till a decade ago, un-staffed Public Health Centers (PHCs) in this corner of India often led to the deaths of two-three tribesmen of the Adi clan every week.
Poor roads and remains of washed out bridges is what the ASHA workers have to face every time here in Arunachal Pradesh while delivering the medical services. Poor roads and remains of washed out bridges is what the ASHA workers have to face every time here in Arunachal Pradesh while delivering the medical services.

But the situation started improving after the state government handed over 11 of its PHCs to the Karuna Trust, an NGO, under the public-private partnership model to ensure better health services around six years ago.

Now, the entire task of providing healthcare at the PHCs has been entrusted to the efficient hands of trained ASHA (Accredited Social Health Activist) workers. And the results are visible.
Such has the dependence on ASHA workers grown over the years, that their absence could possibly push the tribes inhabiting the Anpum forested area of Arunachal Pradesh back to what existed earlier.

Everytime ASHA worker Kenjir Perme (name changed) is tasked with immunising children in a far off village, she prepares herself to tackle the tough hurdles she has to overcome to reach her destination.

Covering miles on foot through muddy roads that pass through deep forests full of wild animals, waiting for hours to cross a river on boat, and then uncertainty of being able to return home, is what she has to confront every time.

The presence of an ambulance at the PHC meant for taking ASHA workers to their destinations hardly matters, as often unexpected downpours play foul. Once stuck in the deep muddy roads, the ASHA workers have to wait for hours before being rescued by a tractor, a rarely available transport here.

“This is a regular phenomenon here and we are quite used to it. Just because there is virtually no mode of transportation we cannot afford to ignore the health of the vulnerable tribespersons living in this forest area, and providing them medical services on time,” Perme, who is among a few ASHA workers at the Anpum PHC operated by Karuna Trust, told the visiting IANS correspondent.
Though the PHC also has two other sub-health centers, at a distance of at least 15-20 km, the task of ASHA workers remains the same — delivering health services, including immunisation and drug delivery and reproductive and child health programmes, to all the villages in the area.
Locals say the healthcare has got a new lease of life after the PHC was handed over to the Karuna Trust.
“Earlier, our people would die of minor health problems, due to lack of medical care at the PHCs. But now, we are happy at the healthcare being provided,” Robin Tayeng, a local Adi tribesperson, told IANS.
With an area of 83,743 sq km and a population of 14 lakh, Arunachal Pradesh has one of the toughest geographical terrains in India. Even today about 70 percent of its area is inaccessible and it takes days to reach from state capital Itanagar.

In the initial years Karuna Trust also received funds from the Population Foundation of India to strengthen its medical care facilities in the PHCs.

“To reach some of our PHCs one has to trek, walk on foot for miles as no roads are available. But we have trained our ASHA workers to overcome all such hurdles,” Annop Sarmah, co-ordinator for Karuna Trust NE, said.

The state’s tribal population has benefited immensely from the handing over of the PHCs to the NGO, and they are now provided with services like family planning and immunisation. Today ASHA workers under Katuna Trust ensure that all the newborns are immunised against all major diseases.
Efforts of the ASHA workers has helped bring down the Total Fertility Rate to 2.1, from a previous high of over 3.

PN Thungon, Mission Director, National Health Mission, told IANS: “The ASHA workers are our lifeline. They have made the impossible, possible. Looking at the way Karuna Trust is training its ASHA workers to disseminate health services against all odds makes us feel that we can hand over some more government PHCs to it.” (IANS)

 

  • Pashchiema Bhatia

    This is a really good initiative. The Government should also take initiatives for the upliftment of tribal people. Social Activists like Soni Sori are fighting for a good cause.

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Pacific Northwest Tribes: Remove Three Major Hydroelectric Dams on Columbia River

The Yakama and Lummi nations made the demand of the U.S. government on Indigenous Peoples Day, a designation that's part of a trend

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Tribes, Hydroelectric, Dams
JoDe Goudy, chairman of the Yakama Nation, speaks with the Columbia River in the background near The Dalles, Oregon, Oct. 14, 2019. VOA

Two Pacific Northwest tribes on Monday demanded the removal of three major hydroelectric dams on the Columbia River to save migrating salmon and starving orcas and restore fishing sites that were guaranteed to the tribes in a treaty more than 150 years ago.

The Yakama and Lummi nations made the demand of the U.S. government on Indigenous Peoples Day, a designation that’s part of a trend to move away from a holiday honoring Christopher Columbus.

For decades, people have debated whether to remove four big dams on the Lower Snake River, a tributary of the Columbia, but breaching the Columbia dams, which are a much more significant source of power, has never been seriously discussed.

Proposals to merely curtail operations, let alone remove the structures, are controversial, and the prospects of the Columbia dams being demolished any time soon appear nonexistent.

Tribes, Hydroelectric, Dams
FILE – Water flows through the Dalles Dam, along the Columbia River, in The Dalles, Oregon, June 3, 2011. VOA

Tribal leaders said at a news conference along the Columbia River that the Treaty of 1855, in which 14 tribes and bands ceded 11.5 million acres to the United States, was based on the inaccurate belief that the U.S. had a right to take the land.

Under the treaty, the Yakama Tribe retained the right to fish at all their traditional sites. But construction of the massive concrete dams decades later along the lower Columbia River to generate power for the booming region destroyed critical fishing spots and made it impossible for salmon to complete their migration.

After a song of prayer, Yakama Nation Chairman JoDe Goudy spoke Monday at the site of now-vanished Celilo Falls near The Dalles, Oregon, and said the placid Columbia River behind him looked “like a lake where we once saw a free-flowing river.”

“We have a choice and it’s one or the other: dams or salmon,” he said. “Our ancestors tell us to look as far into the future as we can. Will we be the generation that forgot those who are coming behind us, those yet unborn?”

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Celilo Falls was a traditional salmon-fishing site for the Yakama for centuries, but it was swallowed by the river in 1957 after the construction of The Dalles Dam.

Support for dams

The three dams operated by the U.S. Army Corps of Engineers are a critical part of a complex hydroelectric network strung along the Columbia and Snake rivers in Oregon, Washington and Idaho that powers the entire region.

Government officials were unavailable for further comment Monday due to the holiday.

Tribes, Hydroelectric, Dams
FILE – Water flows through the Bonneville Dam near Cascade, Oregon, June 27, 2012. VOA

Supporters of dams along the Columbia and Snake rivers note the vast amount of clean energy they produce and their usefulness for irrigation and transportation. For example, they allow farmers to ship about half of U.S. wheat exports by barge instead of by truck or rail. According to the Pacific Northwest Waterways Association, about 40,000 local jobs are dependent on shipping on the Columbia and Snake rivers.

Salmon, orcas 

The Lummi Nation is in northwestern Washington state, far from the Columbia River, but it has also been touched by construction of the dams, said Jeremiah Julius, Lummi Nation chairman.

Chinook salmon are the preferred prey of endangered orcas but just 73 resident orcas remain in the Pacific Northwest — the lowest number in three decades — because of a lack of chinook, as well as toxic contamination and vessel noise. The orcas were hunted for food for generations by the Lummi Nation in the Salish Sea, he said.

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“We are in a constant battle … to leave future generations a lifeway promised our ancestors 164 years ago,” he said. “Our people understand that the salmon, like the orca, are the miner’s canary for the health of the Salish Sea and for all its children.

“I choose salmon,” he added. “I will always choose salmon.”

Fish ladders built into the dams allow for the passage of migrating salmon, and migrating fish are hand-counted as they pass through. But the number of salmon making the arduous journey to the Pacific Ocean and back to their natal streams has declined steeply in recent decades.

The Columbia River Basin once produced between 10 million and 16 million salmon a year. Now there are about 1 million a year.

The Bonneville Dam was constructed in the mid-1930s and generates enough electricity to power about 900,000 homes — roughly the size of Portland, Oregon. The Dalles Dam followed in the 1950s and John Day Dam was completed in 1972.

Environmental groups applauded the tribes’ demand and said efforts to save salmon without removing the dams aren’t working because without the free flow of the Columbia, the entire river ecosystem is out of balance.

“The stagnant reservoirs behind the dams create dangerously hot water, and climate change is pushing the river over the edge. Year after year, the river gets hotter,” said Brett VandenHeuvel, executive director for the nonprofit group Columbia Riverkeeper. “The system is broken, but we can fix it.” (VOA)