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Naxal threat overshadows health services in orissa

Akshaya Kumar Sahoo

The growing influence of Naxalites over the last few years has not only seen a rise in casualties, but also taken a toll on the health services in the affected districts of Orissa. Health services, both in public and private sectors in south Orissa and other affected pockets, have borne the brunt of Naxalite attacks, increasingly so since 2000, defying the CPI (Maoist) own ideology that seeks to target the state for not sharing the fruits of development with the "have-nots".

Although the Maoists have not attacked any health establishment so far, frequent roads blockades, ambushes on the police parties and threats to government officials in the affected districts have left delivery of health services in a lurch. Of the 965 posts for doctors lying vacant, nearly 75 per cent belong to the undivided KBK districts (Koraput-Bolangir-Kalahandi). Besides, 102 pharmacist and more than 1,000 para-medical posts are lying vacant in those areas.

The undivided districts of Kalahandi, Bolangir and Koraput are universally known as the most backward regions in India. After the reorganisations of districts in Orissa in the early ’90s, these three districts were divided into eight districts — Kalahandi, Nuapada, Bolangir, Sonepur, Malkangiri, Koraput, Gajapati and Nabarangpur. Statistically speaking, the total area of these districts are 47.646,000 square kilometre, the total population is of 72,490,691, and among all the 80 revenue blocks, there is only one block which is developed, three blocks are developing, 28 blocks are backward and 49 blocks are declared as most backward.

According to the legislators, both of the treasury and opposition benches, most of the doctors and para-medics produced by the state-run medical colleges, despite attractive pay packages and incentives announced by the state government, are shying away from serving in the tribal-dominated KBK region because of security concern.

In the remote Malkangiri district, which is nearly 650 km from the state capital Bhubaneswar, some Primary Health Centres (PHCs) and Community Health Centres (CHCs), as the local MLAs said in the recently concluded budget session of the Assembly, are run by staff nurses with the help of peons and sweepers.

Kashipur, Narayanpatna, Bandhugaon and Laxmipur blocks in Rayagada district; Kalimela, Balimela and Chitrakonda areas in Malkangiri district present a sorry picture: nearly 80 PHCs in the two districts have no doctors. The situation in Kalahandi and Bolangir districts is no better. Due to the lack of good communication network and absence of doctors in nearby hospitals, people walk miles, carrying their sick relatives in bamboo baskets to get them treated at district headquarters. A few people, who can afford taxi fare, go to the far-off VSS Medical College at Burla in Sambalpur district.

The Union Government’s flagship health programme, National Rural Health Mission (NRHM), which has greatly contributed to the improvement of health services in coastal pockets, has not yet been successfully implemented in Naxal-affected pockets due to frequent unrest.

The state health minister, Prasanna Acharya, while making a candid admission in the House that delivery of health services still remained unorganised, said that the his department was trying to provide minimum healthcare facilities to the people in KBK areas at their doorstep through NRHM programme and mobile health units.

The Naxalite strikes on security targets in KBK districts have progressively grown in recent years. Among these, communication towers were the most targeted this year, having seen six attacks between January 1 and July 30. Railways came second with four extremist strikes so far this year on its infrastructure and properties in Sundergarh and Keonjhar.

Mines, which are abound in the Naxal-infested areas of Keonjhar, Sundergarh, Dhenkanal and Jajpur, have also been attacked over the years, though no attack has been reported yet in 2009. The last two years saw several incidents of Naxal violence targeted at crusher units and mineral traders in Jajpur and Keonjhar districts. The Railways are a favoured target, given its vast network and infrastructure and the practical difficulties involved in protecting the same. The Railways’ property has seen nearly a dozen attacks since 2000. 2008 and 2009 have logged a number of strikes, mostly in Koraput, Malkangiri an Rayagada districts, on communication infrastructure.

Sources in the state home department said that this is mainly on account of the vulnerability of the towers due to their location in remote areas, making their protection difficult. Insiders, however, blame the failure of telecom companies to pay extortion money to the Naxalites for the frequent attacks on their towers.

Essar Groups properties in Malkangiri have been consistently targeted over the last three years. Essar Pipelines have been hit by the Maoists twice in Chhattisgarh and four times in Orissa in the first half of 2009, as against three and one attacks in Chhattisgarh in 2008 and 2007, respectively.