On delivering care - MV Akha in Assam

There’s not much focus on Asia in our research - therefore, I’d like to present you some inspiring initiatives from India and Nepal, which present a very different approach to delivering care: actually delivering it.

First, of them is MV Akha, a floating clinic that travels along Brahmaputra Netri to the inhabitants of the saporis/the islands. One look at the map of the region is enough to understand how difficult for them it would be to access hospitals and doctors otherwise. 2500 islands sit on the Indian part of the river, which starts from the Tibetan mountains and flows through the Assam region, being a home to 3 million people, 10% of the region’s population.

There are numerous reasons why providing these places with health care is particularly difficult: due to huge shortages of doctors in India to start with (0.7 per 1000 people), shifting territories of these islands, unstable population and difficult living conditions: they’re connected to the land by boats and suffer from frequent energy and drinking water deficit. Not to mention strikingly high numbers in maternal and infant mortality.

Sanjoy Hazarika pitched the idea of floating clinics to the World Bank in 2000 and received their support - 20,000 dollars to start with. One year later the first boat sailed to bring care to the Assamese, and until today, 14 more followed. The project was eventually joined by the state, which established a public-private partnership with the trust and started funding the offered service. Each month around 20.000 people in total are reached by these facilities.

Some of the doctors who joined the ships helped to improve their service. One of the keys to success is frequency - by ensuring that each island is visited at least once a month it is possible to take good care of immunization and condition of pregnant women. They also bring the basic medicine, which is cheap in India - but if one needs to hire a boat to get it, the costs soar.

And the service provided by the boat is free - the funds provided by the state amount for 72 400 000 million rupees per year - which, after covering the costs of the boat and the staff, means that there are 480 rupees per person left. Around 5 dollars per year.

More about the project here: The Boat Clinics of the Brahmaputra - Centre for North East Studies and Policy Research (C-NES)

Photo comes from http://www.tehelka.com/2014/07/boat-clinics-provide-healthcare-to-3-million-people-in-assams-river-islands/

Boat clinics for the win

Hey, I now think this post may have slipped attention because it doesn’t have “boat clinics” in its title!

Thanks for getting the story, Natalia. I find it meaningful that while it was one small idea in the beginning, it has evolved into a public program due to involvement of district administration, WB and UNICEF - all of which helped it scale and work out a run-of-the-mill approach.

I found this telling quote by a gov employee: “The government has the resources and the mandate to create a thousand Ships of Hope that will bring health to people who are at the receiving end of a highly volatile and moody river. We need the  humility and the willingness to learn from those who know better