By-MK Singh
Two years ago, a video of villagers gathered to bid adieu to their nearby CHC doctor, who had served the community for eight years, went viral. Dr Kishore Das, a MBBS doctor just out of his medical college, went to the remote Tentulikhunti village in Nabarangpur district to serve the rural population of Odisha.
He reportedly transformed the state of the health centre there and endeared himself to his patients, some of whom came to visit him from miles away. He has been hailed as a hero and a role model for many doctors. In an in-depth exclusive interview with the theblink.in, the role model talks about his history and future plans. Excerpts from the interview:
Blink: How much time you spent at the Tentulikhunti CHC during your post-MBBS career?
Dr Das: I was posted to the Tentulikhunti Community Health Centre (CHC) on September 30, 2010 on an adhoc basis. I spend my initial days post-MBBS for around six months at Tentulikhunti from 2010-2011. Later I was posted at the District Headquarter Hospital (DHH) at Nabarangpur district of Odisha as the hospital was facing shortage of doctors.
I worked there for two years from 2011-2013. On August 2013, I returned as the Medical Officer In-charge of the Tentulikhunti CHC. I started making me available for the Nabarangpur DHH for almost 24 hours as the health centre was marred by crunch of doctors. Only 3-4 doctors were managing the whole district hospital that time.
Blink: What infrastructure problems confronted you when you joined the CHC in a rural area in Nabarangur district of Odisha?
Dr Das: When I joined the Tentulikhunti CHC it had hardly any facilities to act as an hospital. Basic amenities of a hospital like first-aid facility, operation theaters, delivery room, new born care corner eluded this hospital. Regular supply of oxygen cylinders also marked another problem.
This really surprised me. I wanted to bring some change to the existing facilities within my limits. I consulted the Rogi Kalyan Committee at the local level which looks after the CHC affairs which comprises the CHC doctor, local MLA, BDO and other officials. I asked for all the required facilities that is often an integral part of any hospital and pointed at them the apathy of the hospital. Slowly many facilities were started after my consistent demands.
Blink: How much changes the Tentulikhunti CHC has now undergone after your stint there and your consistent efforts?
Dr Das: Now the hospital has all the basic facilities in good condition like a proper dressing room, labour room, new born care room, regular supply and maintenance of oxygen cylinder. Besides that, to improve the function of the CHC, I have ensured installation of CCTV cameras there, made the patient registration centre online. Small issues like lack of proper registration in the hospital also used to cause fights in the hospital. Now the CHC has also a dedicated 24×7 drug dispensing counter.
Blink: What were the major health issues that often used to take a toll to the lives of the rural population in Tentulikhunti?
Dr Das: There were a number of cases relating to Anemia. I used to see a number of anemic patients coming to the CHC whom I treated. Sickle Cell Anemia was also rampant in the area. Cases of hypertension and diabetes used to come in good numbers. Maternal deaths were also a very common in the area which took my attention towards targeting this diseases.
Blink: Did you find that many of the diseases which affected the rural population could be prevented. Did you also work on the prevention part?
Dr Das: Yes Indeed. I had worked extensively for prevention and prophylactic activities too. I ensured routine vaccination for many rural areas where the medical facilities fail to reach. I have taken boats to reach out to villages on the banks of rivers where roads do not reach. I have taken the hilly terrain to reach out to people in remote hilly areas to provide them medical facilities.
I had tried to ensure 100 per immunization. I also advocated for changing the perceptions of the rural population towards vaccination to prevent many preventable diseases. It was almost like a weekly affair. Awareness activities were undertaken alongside. We sat with the priests and pandits to make them aware about prevention and make the villagers persuade for these things through them.
Blink: How the people of the areas started building a bond with your and posed their confidence on you?
Dr Das: As per the conventional rules, the CHC should have been opened from 8am-mid-day and then from 3pm-5pm on a working day. However as I saw many people used to come from far away areas, I decided to extend my services for 24 hours. My room was juxtaposed to the CHC and I used to keep my door open always even after hospital closes. So any patient who needed me anytime could consult me anytime.
I also started visiting villages and other areas nearby when demands for the same rose. As I treated many cases, people started building confidence and used to recommend my name in the area of any kind of medical assistance. So from mouth to mouth also people started sharing information about my services. I visited many villages in emergency cases like diarrohoea cases.
Blink: We have often heard about incidents of branding in rural Odisha where the villagers brand the kids with hot iron rods to ward off diseases. Did you see such superstitious activities in the rural areas?
Dr Das: Yes there were many against which we fought extensively. In many tribal areas some kids complain of stomachache due to the dilation of the veins in their abdomen area. However, in some tribal areas people used to touch hot iron rods on the abdomen of the affected kids with the view of making them well. We fought against this practice.
The Health Department and the officials from the Integrated Child Development Scheme (ICDS) in my area used to work together to fight this. We counselled many and told them the real reason and what to seek medical aid under such circumstances. We even in extreme cases also took the assistance of the local police to weed out the evil practice.
Quackery was also common in some areas and many thought taking medical aid could be a costly affair. The results were overwhelming. The Nabarangpur district then also received an award for the steps taken to fight against the menace and yielding a grand success. The cases have dwindled to a great extent and many arrests were also done in such areas.
Blink: Do you think that doctors need to build a bond with the patients to boost the health care sector?
Dr Das: Yes this is very much needed. Many patients have many pre-conceptions about doctors and hospitals like medical treatment is costly, doctors would not be available at hospitals. They also fear from referrals from local hospitals. The whole thing makes them fall in the trap of local quacks and risking their own lives.
Blink: Now you have recently joined PG in Orthopedics in a medical college in Bhubaneswar. Do you want to go back to Tentulikhunti after your PG?
Dr Das: I would love to go back there but the CHC now does not have any orthopedic department where I can serve. There is no such post there as of now. Such specialization department now only exist on the DHH hospitals. It is not feasible now as it would not be possible now to join there but I will continue serving the rural population.
Blink: Do you think rural posting for doctors during studies should be mandatory?
Dr Das: Yes. I think it should be mandatory for the medical students to serve in rural areas but transfers should also be done accordingly. Doctors still have apprehensions that if after posting they would be able to come back or not. New medical students have reservations on this due to this reason. I was posted in Tentulikhunti and Nabarangpur for eight years and was not transferred. A transparent transfer policy is needed for doctors who are keen to give their services in rural areas.
Blink: Do you think a change in policy is needed to encourage medical students or doctors to serve in un-served or rural areas.
Dr Das: Yes that is much needed. Because if a person is joining a CHC in Nabarangpur in 2018, by 2022 he would be in a position to know that he would be transferred or have an option. Doctors have their own liabilities too which should be taken into account. There are many doctors who have kids who need quality education while many have their old parents in other areas which they do not want to ignore. Fixed tenure for such postings should be made mandatory.
If such a transparent policy is made I don’t think doctors would hesitate in serving in rural areas. Odisha has an exit policy now but other states also need to have such a system. Government can keep the doctors in rural areas who are very much interested to serve there but for many who don’t like a long term stay there, options should be made for them. Tribal and rural population also have their legal right to be served by doctors which should not be hampered due to policy deficit.
Blink: How you see the Ayushman Bharat or the Biju Kalyan Insurance Scheme in Odisha for majority of the population specially for the poor and the marginalised?
Dr Das: This is a very good step to cover the poor with health insurance at lower premium rates. However I am not satisfied with the coverage. I believe benefits under the insurance schemes should also covered OPD services so that the poor community are insured for all their health related expenditures.
Blink: You had a very good track record and reputation in your area. But do did you ever face threats while in service?
Dr Das: Yes I too had faced some incidents of threats and intimidation. One was a case in 2012 when a person suffering from Cirrhosis of liver came to me in a complicated condition. I advised him to shift to a bigger hospital the same day, but he did not agree. The next day he died. His family brought him dead to the hospital. When I attended him I saw he was dead.
But they family claimed that he was not dead as his muscles were showing some movements. I rechecked and told them he was dead and the movements are normal movements post deaths body reactions. Although they did not attack me but they attacked the hospital and broke many equipment and infrastructure of the hospital as they were not convinced with my response.
Blink: Do you think a stringent policy is needed to tackle the cases of threats and attacks against doctors?
Dr Das: Professional hazards are part of lives. However, I believe by going through my past experience and other heard stories that a police outpost should be there starting from the CHC level. Presence of at least one police personnel can act as a deterrence in cases of threat to a doctor.
Blink: Now you are an inspiration to many medicos and working doctors due to the support your garnered and the services you garnered. How you see the sudden fame at the national level after national media reported about you?
Dr Das: There is not much difference. It is just that now people ask about my experience there more. I have to still do a lot of thing for the people. I want to ask the almighty to give me blessings so that I can serve many people. I really felt bad when I left Tentulikhunti where I was bestowed with so much of love.
Arrogance should never come to me. I have to pursue my PG and serve more people and do better things for the society at large. I have a dream to open an NGO later and reach out to more people by getting on board more like minded people together.
