Workers in the spice industry, brick kilns etc India, Nepal.
Children in poverty
Street Medicine India
Life and death in Kolkata
Like tight rope walkers’, life precariously hangs in the balance for the people who live on the streets and in the slums of Kolkata. The spidery thread between life and death is confronted with determination and grit everyday. Health care to these people is almost non-existent but there is one Doctor who has dedicated his life to helping them to survive and stay healthy.
Most doctors aspire to a successful medical career, and a nice income, not so, for this British physician. Dr Jack Preger began Calcutta rescue in 1979 and he has been nominated for a Nobel Peace prize for the incredible work he has achieved giving medical care to the downtrodden of Calcutta’s streets and slums. In 1972, when Preger had just qualified, he answered a call over the radio for doctors to help the people of then newly independent HYPERLINK "http://en.wikipedia.org/wiki/Bangladesh"Bangladesh. In 1975, he set up a 90-bed clinic in Dhaka and two farms on the outskirts of the city.
However, his work in Dhaka came to an immediate end when he discovered that a Swiss NGO was operating a child-smuggling racket and exposed it, and because of this he was deported to HYPERLINK "http://en.wikipedia.org/wiki/Singapore"Singapore in 1979. Not long after his deportation he went to HYPERLINK "http://en.wikipedia.org/wiki/India"India and worked in HYPERLINK "http://en.wikipedia.org/wiki/Kolkata"Kolkata for six months under HYPERLINK "http://en.wikipedia.org/wiki/Mother_Teresa"Mother Teresa's HYPERLINK "http://en.wikipedia.org/wiki/Missionaries_of_Charity"Missionaries of Charity. Mother Teresa testified that, “I have seen the work of Dr Jack Preger in Bangladesh and what I saw was very good for the people and the children. I do hope that he will be able to give that service to the people in Calcutta also”. However, Preger thought that he would be able to do more if he operated independently, he say’s" there was far too much prayer, far too little medical care". He remembers an occasion when a guard at a shelter run by Mother Teresa refused to admit two dying famine victims because it was past 6 p.m. An enraged Preger grabbed the crucifix hanging from the man’s neck and twisted it until the man started to choke. “In the name of Christ,” Preger roared, “let us in!” Terrified, the guard complied. He left Mother Teresa’s Mission and started a medical clinic for the poor below the flyover connecting the HYPERLINK "http://en.wikipedia.org/wiki/Howrah_Bridge"Howrah Bridge, where a lot of the towns poor live. However he still works with the sisters and quite often brings patients so ill that death is inevitable to the hospital Mother Teresa set up called, ‘Kalighat, the Home for the dying and of the Pure Heart. Those brought to the home receive medical attention from the sisters and are afforded the opportunity to die with dignity, according to the rituals of their faith; Muslims are read the Quran, Hindus receive water from the Ganges, and Catholics receive the Last Rites. "A beautiful death," Said Mother Teresa, "is for people who lived like animals to die like angels—loved and wanted."
Today, Calcutta Rescue is a registered charity but before being established as a registered charity Jack worked under cover as Calcutta Rescue, illegally’ operating his street clinic’s 6 days a week for, for fourteen years. The authorities eventually threw him into kolkata’s Alipore prison for operating these clinics. He shared a filthy cell with 40 other prisoners, scores of rats, and thousands of cockroaches. This did not discourage him one bit.
When asked “How can you bear all this indifference and hostility to your efforts to do good?” “What keeps you going, even in the face of failure?” Preger answers, “God doesn’t judge you by the results,” “Different circumstances lead to different results. What matters is the struggle, that you try. And if you try, God will never forget you.”
Today Calcutta rescue includes four undercover clinics, three schools and two vocational centers. Plus provides many other services to the poor in West Bengal, including free treatment in for multi-drug resistant TB and free treatment for resistant cases of HIV on second-line anti-retroviral drugs. It employs 150 locally hired staff.
Dr Perger’s story is extraordinary, like Mother Teresa, his dedication to the poor in Kolkata was the result of a ''command out of the blue''
In the most unlikely circumstances, he was told to ''become a doctor'' when sitting on his tractor, spreading manure on his farm in Wales.
But unlike Mother Teresa, he has little time for prayer, avoids churches except for weddings and funerals, calls most religious ceremonies ''theatre'' and instead of flirting with the authorities, he fights with them, a fiery quality which resulted in being thrown into prison.
In a bamboo pole and tarpaulin hut, at clinic set up for lepers by the Ganges river, slum area known as Chitpur, I met Sheik Maran who is 90 years old a sufferer of the terrible illness, he has had the leprosy for thirty years. All his family is dead and he lives alone on the street, his only hope for survival is to put out his hand and pray to god that someone gives him enough money to eat. He says, ‘the worst thing about suffering from leprosy is that it is getting more and more difficult to walk about’, and that now, not even his hands work properly. He says that the only help he gets from anyone in the world is the Calcutta Rescue, every two weeks he visits their Leprosy clinic to have his wounds dressed. The clinic is a makeshift affair, but the treatment is not. Only the most effective anti-leprosy drugs are dispensed while stumps and sores are expertly cleaned and bandaged. Leprosy is one of the oldest diseases, a disease often spoken about in the bible. It was not discovered in the modern world until 1869 by a missionary named Wellesley Bailey. When Bailey encountered leprosy for the very first time, he was stunned, he was quoted, “I almost shuddered … yet at the same time I was fascinated, and I felt, if ever there was a Christ-like work in the world it was to go amongst these poor sufferers and bring them the consolation, the hope”. In the midst of the people suffering from the disease at Chitpur, one simply cannot agree more. The disease still has such a stigma attached to it, and this stigma results in people leaving it far too late in seeking out a doctor. If the disease is found in the early stages it is one hundred percent curable. However Leprosy is endemic in West Bengal, particularly in the southern part of the State. The disease affects around 12% in a population of around 60 million. Of these patients,1.5% are blind due to the complications of leprosy whether from complicated cataract or uveal affection. One such lady at the Chitpur clinic Shanti Devi who is 75 and has suffered from leprosy for fifteen years, she had cataracts and was blinded by them for many years. When she came to the Chitpur clinic the CR doctors admitted her to hospital to have them removed. She informs us, “ When I arrived at the hospital I was an invalid my daughter took care of me as I could not see. I was in hospital for one month and Calcutta Rescue paid for everything. When the doctors took off my bandages after the operation I could see. The first thing I saw was my daughter and she was the most beautiful thing I have ever seen. I came to the hospital incapable of helping my self but when I left it, I had the ability of caring for myself.
"The need is infinite in Calcutta," said Dr Preger. "You get all kinds of migrants coming in - some are without any work, some have been evicted from the squatter's colonies, the slums." "There is no one organization that could possibly manage the health care of that population in Calcutta," he said. "There are estimated to be a million people on the streets in Kolkata, the actual medical needs of most of those people cannot be met, either by the government or a charity or NGO."
One such colony of people that Calcutta Rescue attempts to supply excellent health care to, is some 300 people, refugees from Bangladesh. These people were recently evicted from an inner city slum area, in the Canal area of Kolkatta. The people of the slum believe that the government started a fire in their slums to forcibly remove them. Of course these marginalized and forgotten people have no proof. The new area on the outskirts of Kolkatta, has one water pump, no toilets, there is nothing out there for these people, but even so, together they built little shacks from bamboo and old plastic bags. The medical team actually drives an ambulance directly into this poorest of the poor slums on the outskirts of Kolkata to provide medical services. The Doctors come out here with a well-recorded immunization program; they provide vitamins and education regarding hygiene. At one such makeshift clinic from out the back of an ambulance, I met two little girls the elder a sad quiet little 8 year old and her very frightened little 2-year-old sister. Together they climbed up into the ambulance to be immunized and given vitamins. The little two year old was crying, just like any baby does when being immunized. When the job was done and the brave eight year old picked up her little sister and gently placed her back up on her hip and drifted back to the slums, the doctor turned to me and told me, ‘ they are all alone, they have nobody to take care of them, so now they stay here in the slums.” Their parents - the victims of the fire that broke out in the inner city canal area slum. There were many people who lost their slum homes in this fire- and like these two tiny girls, they had nowhere else to go but to the outskirts of town, where some families have set up make shift shacks. They have no water, toilets and no idea of hygiene and sanitization, apart from the vital care that is provided by Calcutta Rescue.
The public health system of Kolkata and West Bengal are despicable. Public health is often context-bound and it is not meeting the needs of ground-level realities faced by the people of the streets and slums.
In an ideal world there would be no need for the help from an NGO that provides vital life saving and changing medical treatments such as those provided by Calcutta rescue. Recently a down on his luck rat catcher (one of the trades of the poor in Kolkatta’s metropolis), was struck by a heavy metal object, which fell on his ankle in the back yard of Dr Jack. Dr Jack heard the screams and cry’s for help and went out to see what had happened to the poor fellow. What he found when he came to the aid of the injured rat catcher, were minor cuts and a fractured leg. However rather than send the penniless man in an ambulance Jack took him to the hospital himself. In the fear that if he relied on the ambulance, the man would have had his leg amputated rather than plastered. Due to the lack of beds people’s limbs are regularly amputated when simple healing would have been the better out come for all concerned.
The government of Bengal admits it has been unable to deliver health service effectively along the entire chain of primary to tertiary. The Left Front government here is thinking of opening up its dilapidated primary healthcare sector to public-private partnerships. By doing so, it is admitting that despite 27 years of unbroken rule, it does not have the wherewithal to deliver services even at the lowest levels. Dr RD Dubey, joint secretary, the Indian Medical Association (IMA) said, “Many state primary health centers are not functioning because there are no doctors there. We believe things can be improved if local resources are used.” On the ground, doctors at medical colleges-cum-hospitals have to treat even simple cases instead of functioning as referral units. Doctors avoid rural postings, and those who do go to rural areas are often left there for years. The best doctors avoid teaching posts since it debars them from private practice. The battles are ongoing between construction and counter- construction and fundamentally finding out the truth about health care in the state of Bengal. What is needed is a better understanding of the organization of health care at a system level, which would go beyond the confines of the health department and delineate the appropriate role of the government with regard to the private sector.
There have been many disturbing incidents in the government hospitals in West Bengal. Recently a twenty-year-old girl was taken to one of the government hospital but the doctors on duty refused to admit her, in spite of her serious case. When they finally agreed to admit her after 24 hours of her waiting on the doorstep. It was too late the girl did not survive her injuries and instead was taken to the morgue. A few days before a six-month-old baby girl in a critical condition was being rushed by her parents to the medical college hospital. A severe traffic jam created by a massive rally on the way rendered the parents completely helpless. When they finally reached the hospital they were told that they had to deposit 1000 rupees around 14 Euros before treatment could be started. The unfortunate parents did not have that amount with them. By the time they returned with the money, it was too late, their baby had died. These are not isolated incidents there have been many similar cases of negligence and such horror stories as stray cats and dogs preying on the new borns in the government hospitals. A few doctors have been removed from their positions due to their negligence. And a series of government orders have been passed, one of which states, “no government hospital can refuse to admit any patient irrespective of the availability of beds. These steps the government believes would pacify the people at least for a time. In its long 27 years, this is not the first time that the Left Front run government in West Bengal is faced with such embarrassment on the health front.
Yet, amidst all this governmental chaos and disorganization, Dr Jack Preger and the team at Calcutta Rescue’s work goes on in orderly highly organized way. The clinics, the schools, the training centers, the oases of hope in Calcutta's soulless slums. It is a tribute not just to an amazing doctor who will not yield to a bullying government that throws its brute might behind its cruel system. It is also a tribute to a man's indomitable spirit that keeps fighting the Kafka-esque system in a foreign land that he has accepted as his own workplace. For those who live on the mean streets, in the darkest slums of Kolkata, for the poorest of the poor, as Mother Teresa so poignantly described them, Preger is the face of hope. Of love and charity. The one man who could save them from sickness and certain death without ever asking you whether you are a Hindu or a Muslim, a Brahmin or a Dalit. Nor would he try to figure out if you can afford the treatment.
Without Calcutta Rescue, the poor of Kolkata will continue to live their lives in a constant prayer, in lonely isolation, that only the truly humble and weak, will ever understand.