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An age of innocence – my experience with govt health centers in 1980s

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Anuradha Deolalkar, a Doctor.

A simple tweet this morning, observing that one no longer sees swarms of insects around lights, evoked a strong feeling of nostalgia in me. I did my internship in 1983 and as part of our rural term, was posted to Mangaon, 150 kms from Bombay, along with 3 other interns. The usual practice was for interns to spend a couple of days there at the beginning of the term and then go and collect the Completion certificate on the last day. My friend and I, having been brought up by parents in an idealistic mould, decided to actually stay there for the whole month.

We traveled on a rickety ST (State Transport) bus as there was no rail connectivity, then. Mangaon was a small village, nestled on the banks of the Kaal river. It was September, the monsoon was ending and everything was lush green. The Health centre was a small one, with only out-patient services. Our quarters were across the road, basic but neat. The only hitch being that the loo was in the corner of the compound which was completely overgrown with thick, waist-high grass. This turned a simple visit to the loo after dark, into high adventure. Our meals were provided by Mai, a kindly lady with several offspring, who took turns to deliver the ‘Dabba’ of simple, home cooked food to our room.

Our initial experience in the OPD was extremely humbling. Dressed in our starched white coats and puffed up with the importance of newly minted doctors we set out to heal the population of Mangaon. In response to our question of ‘What’s your problem?’ to any patient, came a bewildering flood of complaints which would have filled an entire volume of the Medical encyclopedia. As for eliciting ‘family history’ as per our text book teaching…. we entered such a complicated maze of relations, all with the most deadly illnesses described to us in lurid detail that we had great difficulty in getting back on track! Finally, after coming to some kind of provisional diagnosis we managed to write out a prescription and sent the patient to the pharmacy to collect the medicines.

Little did we know that the pharmacy stocked only a few medicines and the compounder was a local, with no knowledge of Pharmacology. He identified the tablets by colour/size and complaints. Regardless of what we wrote, he simply asked them ‘do you have a headache – take this large white tablet,’ or is ‘your stomach hurting, then take this small pink one’!

We soon realised that with the doctor in charge of the centre moonlighting, the villagers only came to the OPD for some sort of group therapy. They grumbled a bit about various aches and pains, collected their quota of colourful tablets or evil smelling potions, gossiped amongst themselves and then went on their way, happy to have been seen by the new doctors from Bombay. For the really serious problems they all went to a two storeyed private hospital run by a doctor couple who were Surgeon and Gynaecologist and doubled or rather trebled up as Anaesthetist, Paediatrician and Physician. It was a sobering realisation and initially we were extremely disheartened.

But very soon we became experts at the game and would simply write ‘Ct all’ (Continue all) on their OP cards, stamp and sign it with a flourish and send them to the pharmacy where the compounder would dispense whatever he had in stock with his own advise on how to take it. The only emergencies we got called out for at night were scorpion stings and rarely, snake bites. Since coming to the Health centre at night meant walking through the tall grass in pitch darkness with only a torch to light the way, very often we were palpitating more than the victims who used to be extremely stoical despite the pain!

Afternoon OPD being conducted, we were free in the evenings to take a stroll by the riverside, returning as night fell. As there were only a few streetlights and a couple of shops with bulbs, the darkness was absolute – like being covered with a thick blanket. The lights attracted hordes of insects which swarmed around them in whirls. From the fairly big insects which looked like large ants with wings, to tiny green ones, all drawn irresistibly to the lamps. The silence, also, was eerie to our ears, accustomed as they were to the sounds & clatter of urban life. It would be suddenly broken by a shrill chorus of crickets which would reach a crescendo and then suddenly become silent again only to start up from another clump of bushes. The frogs would add their bit to this orchestra with their mating calls. Since it was the end of the rainy season all the ponds were full and the frogs in full throttle, croaking in romantic ardour through the night.

The dim light in our room also drew its share of insects. And the lizards on the walls which feasted on them.It was fascinating to watch the play of life and death – the beady eyed lizard, still and unblinking, the insects swirling around until one of them got too close and then out shot the sticky tongue, a single swallow and then it was still again. The morning showed us a litter of insects lying dead under the light. A short life, a brief moment of glory, snuffed out by dawn. What was the point of it all? Was there a point to it at all? Existential questions but we were too young to care or be bothered by them.

After two weeks we returned to Bombay for the weekend, again by a State Transport bus. While passing through one of the nearby towns our bus made an unscheduled stop. All the passengers watched interestingly while the driver got down, crossed the road, went into a tailor’s shop, stripped behind the counter (which shielded his lower half from our collective gaze) and tried on his new uniform. Then, satisfied and beaming, he ran back and putting the bus back into gear with a jaunty whistle, set off once again.

Another fortnight and we were at the end of our term. Considering that there was no TV or even a radio and the only recreation was a walk by the river followed by a drink of ‘kokum sarbat’, the days passed by only too quickly. Our parents drove down in my friend’s Ambassador and we spent a day at Srivardhan and Harihareshwar, two beautiful, pristine beaches, before heading back home.

Looking back, I’m appalled at the condition of the Govt health centre and its state of dysfunction. But there was no ‘Breaking News’ then nor was there any Twitter outrage. Just a sort of bemused acceptance. It was an age of innocence or blissful ignorance on our part or both – now long gone, just like the thousands of insects, seen no more.

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Anuradha Deolalkar, a Doctor.
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