No Doctors? Their Assistants Can Treat Villagers, Says Bengal Government

Birbhum (West Bengal): What if you live in a remote village, far from a hospital, don't have a car and suddenly fall ill? In Bengal, many go to a local quack, defined by the dictionary as "ignorant pretenders of medical skills" but in many cases, assistants of registered MBBS doctors in cities who, after some years of experience, return to their own villages and set up a shop.

Bengal has roughly 2 lakh such practitioners and Chief Minister Mamata Banerjee is considering training and deploying them as rural health care providers where trained government doctors won't go.

The issue has, however, kicked up a debate, with protests in from many doctors and the Indian Medical Association (IMA) which is historically opposed to quackery.

But out in Dighul village in Birbhum district, Santosh Ghosh is 'daktarbabu'. Just class 10 pass.  He has been giving injections, medicines and even stitching small wounds for the last 25 years.  

For the villagers, he is god. The local government health centre is 2 km away but a doctor visits for only a few hours a day.  For the villagers, Mr Ghosh is always there at his home cum chamber.

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Ashok Kundu has a BSc degree and a lab technician's diploma. But, like Mr Ghosh, no MBBS. At Ghurisha village, however, call him a quack at your own risk.
 
"Quack means magic in Bengali. But we don't do magic. We treat people, help them get to a hospital in a crisis. We are not quacks or magicians," said an angry Mr Kundu when asked what he should be called.  

"The people call us 'doctor', " he said. "You can call us rural health care providers. If government gives us some recognition, some training, we can help in giving health care in rural areas," Mr Ghosh added.

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32-year-old Haroon Rashid, a farm labour, waited in queue at Mr Ghosh's "chamber" on a Sunday. He had a bad cut on his leg. "The health centre is closed today, the hospital is 20 km away, so where do I go? I have come to Santosh 'daktar'. For us he is mother," Rashid said.  

Both Mr Ghosh and Mr Kundu took a nine month course for such practitioners offered from 2007 by Liver Foundation, a health NGO, with government support in Birbhum. The project leaders have now proposed that the government train these practioners and integrate them in the peripheries of the health care delivery system.

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"We are expecting the government of West Bengal to take a decision any day," says Dr Abhijit Chowdhury, a government doctor and the head of Liver Foundation. "Once that happens, the rest of the country will also think about it. We are already talking to Uttar Pradesh, Rajasthan and MP where vast areas are taken care by this group of people."

Those in favour of the idea argue that 70 per cent of Indians live in villages where health care is wanting. Government doctors avoid rural postings. So why not use an existing resource? "People want to pretend that these practitioners don't exist. But they do. So train them and use them," Dr Chowdhury argued.   

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Dr SR Satpathy, Bengal's director of health services, has confirmed the proposal is under consideration. But IMA is against it. Dr Santanu Sen, secretary of IMA Bengal chapter, said: "IMA is promoting the anti-quackery movement nationwide.  How do you regulate or enlist quacks? Yes, they should be enlisted by the local administration so they can't harm any person."

Dr Sen is also a Trinamool councilor but denies his politics have put him in spot as his leader. Chief Minister Mamata Banerjee is thinking of giving "quacks" recognition, he said.

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"Ms Banerjee is also the health minister and is doing a very good job. She is encouraging government doctors to go to the villages so that quacks become redundant," he added.

An estimated 2 lakh such practitioners in Bengal are holding their breath for the government's decision. Their patients are not. For them, daktarbabu is in.