Sevagram to Shodhgram

Hi!

I am guessing that many of you might have been perplexed by the title of the post.

The said title, however, is yet again not exactly my own.

If you guys remember (I hope I do, for otherwise my ‘wisdom’ has been falling on deaf ears after all), a couple weeks back I had written a post titled Man’s search for meaning, which was an essay written on a book of the same name by renowned Austrian psychiatrist and neurologist, Dr. Viktor Frankl.

In that post, I had also mentioned that my essay was actually a part of an assignment that I had to submit in order to get selected for a workshop.

And that’s how we arrive at the post I have written below.

Dr. Abhay and Dr. Rani Bang are prominent Indian social activists and researchers who in December 1985 established SEARCH which is an NGO that provides healthcare to the rural and tribal people in the district of Gadchiroli, Maharashtra, India of which NIRMAN has been a part since the past decade or so.

Every year, around 200 people between the ages of 18-28 are selected for a 3 stage workshop that takes place in Shodhgram, the home for the ngo. After submitting a written application, we are selected for an interview following which we are assigned certain material to read/view and opine on.

I have already shared one of my assignments with you. The other one, which I am publishing on this site today is about an autobiographical speech given by Dr. Abhay Bang in a conference in Canada in the year 2001, accompanied by a research that he and his team at SEARCH conducted in Gadchiroli. Not only was I inspired and moved to ‘create a difference’ by his speech, but I also sincerely believe that more people, especially my fellow Indians need to read and learn from it. Hence I am choosing this platform to share my views regarding the same.

Here’s to hoping that I have done it justice! 😅

(Note:- I am aware of the fact that some of the content that I have written below makes it sound as though I am racist/anti-american/ anti-‘whites’. But it’s my honest appeal to all of my readers to understand that I am not at all against any country, race or religion. It’s just my patriotism and my love for my country and my hatred for those who wish to ‘escape’ India despite being born here that is being reflected in the form of passionate wordings.

Thank you for your understanding!)

Sevagram to Shodhgram

Indian Social activists and researchers Dr. Abhay and Rani Bang SEARCH, Gadchiroli and NIRMAN founderDr. Abhay and Rani Bang

Well, first of all I would like to begin with a vote of thanks to the NIRMAN team for giving me these assignments to read and opine on. Because though I was vaguely aware of Dr. Abhay Bang’s inspirational personality, I hadn’t actually gone through any of his articles or his biography. This assignment hence gave me an opportunity to understand and appreciate the concept of dedicating your life to the service of the society as a medico. Both the biography and the field study helped me visualise a roadmap for my own vision of working for the rural and the tribal society.

Speaking of the booklet ‘Sevagram to Shodhgram‘*, I was hooked right from the preface wherein the translator, Usha Sheth mentioned that Dr. Abhay Bang described America as a country propagating ‘I’ ism. For even I have felt this very deeply. Today’s world has indeed become an epitome of self centred behaviour. Right from the cut throat competition in the under graduate as well as the post graduate examinations to the sheer downpour of posts on social media repeatedly emphasising to ‘love yourself’, people have forgotten the basic fundamental fact that by default human is a social animal. Meaning, we should derive happiness from making other people happy. And not oneself. That’s the only way to have a stable society where everyone is at peace. If everyone were to think solely of their own happiness, humanity would have gone extinct millennia ago.

Building up on my original point about Dr. Abhay Bang’s description of America, I was especially impressed by the fact that despite choosing to study Masters in Public Health in America and spending few years in it’s rich, luxurious lifestyle, he didn’t fall prey to it’s charm. He didn’t allow the prospect of comfort and ‘success’ (in the conventional sense) to deter his and Dr. Rani’s vision of changing the rural society in India. For that I truly admire him. For I have seen and heard many stories of once patriotic Indians who went to not just America but many other developed countries simply for the prospect of acquiring ‘higher education’, yet somehow found themselves trapped in it’s allure and settled there for the remainder of their lives. Above all, I despise and loath those people who actually desire to ‘run away’ from India because of it’s considerably lower standard of living than the conventionally defined ‘developed’ countries.

Do they think that we owe nothing to our country?

The mother who borne and raised us?!

I do hope that those NRIs in America who were fortunate enough to hear Dr. Abhay Bang in person did feel ashamed of themselves and did at least something for the betterment of their motherland. Be it in the form of monetary contribution to SEARCH or any other NGO or even better, were convinced to return to us.

Speaking of the influence a respectful person can have on one’s mind, I believe that Dr. Bang was very lucky to have a father who had the fortune of meeting the Mahatma himself. Moreover, he was luckier to have a father who actually listened to his advice, no matter how bitter it may have sounded.

For when Mr. Thakurdas Bang went to Gandhiji at his residence in Bapu kuti and asked for his blessings to pursue studying advanced economics in America, Gandhiji replied:-

If you want to study real economics, then instead of America, go to the villages of India.

Mahatma Mohandas Karamachand Gandhi Father of the nation Black and White PotraitMahatma Gandhi

And with that Dr. Bang’s father did comply.

Effective immediately.

Shredding apart your dreams of a lifetime and completely turning around your life is no mean feat. No wonder Dr. Abhay Bang grew up to be the person he is today. For he had a role model to look up to right from the moment he was born.

Though Dr. Bang has such a great personality, I am sometimes surprised by the simplicity he seems to possess. One thing that caught my attention in particular was his conversation with yet another Indian freedom fighter, Vinoba Bhave, in which he innocently asked him whether the rats would eat the grains stored in the granaries, thus making their Bhoodan movement pointless. Granted, he was still an 8 year old back then, but it’s this innocence and simplicity which should persist in every human being. For it takes the innocent and pure heart of a child which believes that everything can be made a reality to bring about a change in this society which has already given up all hopes of a brighter future.

Vinoba Bhave Indian freedom fighter Gandhivadi Black and White PotraitVinoba Bhave

That being said, if only innocence and belief could have changed the world, then this world would have been remade by children ages ago. Then why haven’t they already?

Because though it takes the heart of a child to believe in the impossible, it requires the dedication, perseverance and tremendous willpower of an adult to actually make those dreams a reality. Which brings me to an important incident in Dr. Abhay Bang’s life that yet again highlighted many of his virtues as a human being and is the key reason he has become the person whom we know and respect today.

One of the greatest turnaround in Dr. Abhay Bang’s life occurred in Kanhapur, Wardha in the state of Maharashtra, India. The place where he first set out to materialize his vision of providing healthcare to the rural and tribal people. And also the place which denied him the same in a ruthless manner and taught him a very important life lesson.

After Dr. Abhay and Rani Bang completed their post-graduation in M.D. Internal Medicine and M.S. Obgyn respectively, they settled themselves in Kanhapur, a small village near Wardha city, in the state of Maharashtra, India and began providing basic medical care to the villagers therein.

For about 3 years they not only examined and treated almost every villager, but they also tried to transform them and attempted to bring about social development, something at which they were reasonably successful at until one fine day when they unintentionally crossed a line.

A labourer in the village had lost his arm while working on a thresher in his master’s farm. Not able to find another source of income, the poor guy had to resort to begging in order to make ends meet. Disturbed by his condition, Dr. Abhay and Rani Bang pleaded with his employer to compensate him with land. Almost all the villagers disliked the idea but agreed to a village meeting later that night.

But alas! For no meeting was actually intended to take place.

Instead, when Dr. Abhay Bang picked up the microphone to speak, he and Dr. Rani were pelted with stones.

Finding no choice, they retreated from their place and travelled all the way to their home despite it being a chilly December night.

The way the villagers maltreated Dr. Abhay and Rani Bang was indeed heart wrenching and surprising to read. It instantly reminded me of yet another problem we are facing today as a doctor, and which only seems to be increasing in magnitude with passing time. The rift in doctor patient communication which leads to verbal and often physical abuse of medical professionals. Maybe the villagers were right to think that Dr. Bang back then had not been either a social activist or a politician to expect to bring about a social change of any kind. Nor was he a village elder to advice such a measure. However, pelting rocks definitely couldn’t have been a way to show their anger and resentment.

Nevertheless, the more important point here is the way Dr Abhay and Rani Bang handled it. Despite receiving such a cruel vote of thanks for their services, they actually mustered the courage to go back and ask the villagers what went wrong with their behaviour! Who does that in today’s cruel, ruthless and self centred world?!

A saint? Maybe.

But a more mature answer would be a dedicated and determined person who has a heart of gold and the courage of a lion. A person who truly wants to serve a noble cause.

If there were only one thing that we, as a human being were to take away from Dr. Abhay Bang’s life as a lesson, I say it should be this incident. For not only is this a keystone for social development in this world, it also serves to remind us what we need as humans to rise above our adversities and to learn from it. Dr. Bang turned his suffering into an opportunity to understand the prime roadblock in his work.

The involvement of the society whom he wished to change.

And once he found out the secret ingredient for his vision, his success knew no bounds.

Shodhgram, Gadchiroli, Maharashtra, India. Dr. Abhay and Rani Bang, SEARCH NGO, NIRMAN
Shodhgram, Gadchiroli

For when he began his efforts anew in Shodhgram, Gadchiroli, not only did he receive active support and coordination of the villagers and tribals around him, but he also learnt from them and tailored a hospital which perfectly blended with the surroundings and fulfilled all the oddities their society held dear. A set of huts complete with a waiting area for the patient’s relatives and a temple of the local Goddess was truly a beautiful concept in itself. The description of the hospital has only increased my desire to see it with my own eyes manifold. Faraway from technology and resources of any kind except perhaps human, the construction was simple, effective and definitely homely. I hope that one day the government follows Dr. Bang’s footsteps and makes a facility that caters to the need of the locals with their active involvement rather than simply pushing their own version of development down the people’s throats. For it definitely does not go well, even if you have honest intentions like Dr. Bang.

SEARCH hospital, Shodhgram, Gadchiroli, Waiting room
The waiting room for the patient’s relatives at SEARCH, Shodhgram, Gadchiroli

And that brings me to the last but the most important part of this essay. Dr. Abhay Bang and Dr. Rani Bang’s field trial of Home Based Neonatal Care.
The study and it’s detailed description cluttered my mind with a web of thoughts that I’ll try to simplify and represent here to the best of my ability.

{Note:- Because of the ultra-short format of blogging, I have refrained myself from going into more ‘scientific’ details than what I felt was necessary. For more comprehensive understanding kindly download and read the booklet Sewagram to Shodhgram (laymen)/Neonatal and Infant mortality in the ten years (1993 to 2093) of the Gadchiroli field trial: Effect of Home Based Neonatal Care (medical professionals)}

The very basic fact that India required a trial of ‘Home Based Neonatal Care’ told me many things about my country. It helped me understand that we had a long way to go before we called ourselves ‘developed’ in any manner, more so in the matters of public health. It’s the lack of medical resources and awareness of the delicate health of a neonate combined with poverty, in the sense of both money and education, which has made such an innovative step a necessity for our nation.

Okay, so maybe we needed such an innovation.

But why hadn’t anyone thought of it before? Especially seeing that the Infant mortality rate had always been a matter of concern for our nation? Let alone a study on IMR, it’s indeed shameful to read that hardly any field trial has ever been conducted in India. The studies on diagnosis and management of almost all of our infectious diseases have been conducted by foreign institutes. Institutes which are located in places which don’t even have most of the  diseases they have researched about!

As I have mentioned earlier, there are several members of the upper echelon of Indian society who desire to ‘escape’ the country and head into the more developed western countries. If they truly envied the west so much then why didn’t they take a leaf out of their books and at least try to sort out some of the issues of their own country?!

For how long are Indians going to depend on Western countries for new breakthroughs in almost any direction of their lives?!

Well, at least I found solace in the fact that Dr. Bang’s article was featured in the special copy of The Lancet featuring only the choicest few amongst all the articles it has ever published in the 180 years of it’s existence. Albeit, my feelings were rather mixed on knowing that it was the only Indian article there.

First volume of medical journal The Lancet in 1823, London, UK The Lancet

Coming to the study itself, the very reason I am saying that it was an innovation is because, as a rule it was believed that neonates (meaning infants less than 28 days of age) could not be treated at home and required hospitalised care in case of any complication. But, when it came to backward areas such as Gadchiroli, around 90% of the deliveries took place in a hospital. Also, seeing that neonates required a child specialist/neonatologist, it was practically impossible to expect that a mother hailing from a tribal community teeming with superstition would travel tens of kilometres with her newborn child.

Village house mud rooftop CowshedA house in the tribal areas of Gadchiroli

Hence, Dr. Abhay and Rani Bang had to come up with an innovative idea to decrease the alarmingly high infant mortality rates which were howering at 100-120/1000 live births.

The concept of Home Based Neonatal Care essentially thrives on the involvement of the local people. Women who were educated upto 7th standard (which was a rarity in itself), called Arogyadoots were specifically trained to coordinate with existing midwives and make routine visits and observations of all neonates in their village. They were also taught, yet again by innovations such as a breath counter, methods to detect infection in infants and determine the need as well as the dose and duration of antibiotics to be given.

With all this preparation, the study was finally begun in the year 1993, involving 39 villages as the intervention area and 47 villages as the control area. The study consisted of a 2 year observation period, a 3 year intervention followed by a 5 year period to draw inference from. The results were truly remarkable.

The Neonatal Mortality Rate in the intervention area declined from 60/1000 live births in the year 1993 to only 26/1000 live births by 2003!

Infant mortality rates in Gadchiroli, Maharashtra, India in 1989 to 2003 effect of Home Based Neonatal Care HBNC Lancet article by Dr. Abhay and Rani Bang SEARCH
Although, yet again, I was disappointed to see any significant change in the control area despite the standard government healthcare policies which I have heard have improved at least somewhat in recent years. A study of this magnitude in an area so backward wouldn’t have been possible if the locals had not been actively and enthusiastically involved in the process. Their dedication and affection for Dr. Abhay and Dr. Rani Bang was especially made more obvious when a midwife called Dr. Abhay and Dr. Rani Bang’s residence as their parental home when asked pointedly by an outside doctor.

Arogyadoot trained by Dr. Abhay and Rani Bang for field trial effect of Home Based Neonatal Care HBNC Lancet article SEARCH Shodhgram GadchiroliThe ‘Arogyadoot’ team

But it wasn’t just their involvement and dedication. I was simply amazed by the innovative ideas Dr. Bang had come up with to tackle the lack of even the most basic of medical technologies. The breath counter was indeed a beautiful improvisation. Also borrowing the concept of ‘having a medical health post at a distance up to which a mother can carry a child’ from the Chinese health system and educating midwives and recruiting children educated at or above 5th standard for the study were some additional beautiful human touches that I liked.

Breath counter for neonates and infants for pneumonia case detection Dr. Abhay and Rani Bang SEARCH Shodhgram Gadchiroli innovationBreath counter for detection of Pneumonia

The trial also reflected upon the curse of superstitions that has wreaked havoc in our nation since centuries. To think that even in 21st century parents took their children to witch doctors and quacks for life saving treatments is indeed a very depressing reality that this study highlighted. More work needs to be done on this part and like Dr. Bang, we should all connect with the locals and convince them the importance of healthcare and gently but firmly take them away from such practices.

However, speaking about the brighter side of the rural community, I was pleasantly surprised to hear that a paediatrician from none other than AIIMS, the apex medical institute of India, when asked about the performance and knowledge of the midwives in managing neonates actually complimented them by saying that they knew more about neonatal health care than AIIMS undergrads!

Tribal and Village women of Shodhgram, Gadchiroli, Maharashtra SEARCH trained by Dr Abhay and Rani BangTribal village women of Gadchiroli, Maharashtra, India

Although that spoke rather poorly about us as medical students, it also helped me reflect that it’s not just formal education that defines the knowledge and intelligence of an individual. These are concepts that go far deeper than our shallow beliefs of them. This is an excellent example of how proper education and willpower can truly bring out the best in a person.

Lastly, I am glad to know, that somewhere, somehow, there’s still hope for this world. Because even after Dr. Abhay and Rani Bang’s period of intervention was completed, the Infant Mortality Rate was more or less stable indicating that the tribals were still sincerely following the guidelines. Also, it greatly boosted my morale to see that Dr. Bang’s field trial finally made the government see sense and 5 states of our country are now practising Home Based Neonatal Care on a trial basis.

(Since this article has been published in 2006, I am not really aware of the scenario afterwards. Pray excuse me for the same.)

Dr. Bang’s method of diagnosing and treating Pneumonia is now being practiced in not just 1, but 77 developing and under developed countries! Not just that, after Dr. Bang’s study highlighted the stark lack of field trials conducted in developing and under developed countries, studies are now being initiated or at least discussed in these nations. And now it’s up to us youngsters to carry this wave of social reform and and not lose the momentum that many social reformists have generated in the past decades. And I hope that we all do our part in whichever way possible and not let them or our country or society down.

On that note, I would like to end my essay here, yet again with a vote of thanks for your patient reading.

Thank you!

27 Comments »

    • Oh! You do?!

      Wow! That’s great! I haven’t visited Shodhgram and Gadchiroli district yet as the workshop has been delayed this year due to covid.

      It’s indeed a pleasure meeting you.

      Thank you so much for your kind words! Actually, a lot of the credit behind this post goes to Dr. Bang himself for his inspirational work and the Nirman team for assigning me this post….

      Stay safe and stay tuned! 😊✌️

      Liked by 1 person

      • Wow… that’s great.✨And yeah My hometown is Gadchiroli exactly..Come Sir whenever u get the time to visit Nirman.

        Your always welcome.i am also feeling great while meeting you Sir 😇

        And one last thing Sir ..I am also The medical student ,still studying ☺️.

        Liked by 1 person

        • Oh! That’s great to know! I will certainly be coming to Shodhgram when the workshop takes place, which could be anywhere between March and May…

          If I may ask, which college are you studying in and in which course?

          Just genuinely curious. No need to respond to the question if you feel uncomfortable answering it.

          Liked by 1 person

          • Oh. I see! All the best for your further education and career! 😊

            And it’s cool! 😅 I have also just completed my MBBS from KEM Hospital, Mumbai. So I am a brand new doctor with loads to learn!

            BTW, I went through your blog. Felt really nice to see that you write in Marathi. I hope you like few of my posts that I have written in Marathi as well.

            Liked by 1 person

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s