Feature story

Healthy haven

Christian Hospital Bissamcuttack is much more than a hospital — it is a vehicle for community healthcare and social development in Odisha’s tribal heartland

Inever thought I’d make it,” says Govind Nayak as he recalls his traumatic experience of being stricken by Covid-19 in August last year. Seriously ill, he was brought from his village to Christian Hospital Bissamcuttack (CHB) in Odisha’s Rayagada district and put on respiratory support. Mr Nayak struggled for a month with the virus attack before recovering. When he was finally discharged, the hospital gave him a small farewell and wrote off a part of his bill. “I felt like I was reborn,” says Mr Nayak.

CHB operates in one of India’s most remote and backward regions and it serves as the main centre of healthcare for the predominantly tribal communities living there. The wider area, known as the Kalahandi-Balangir-Koraput (KBK) belt, is ravaged by disease and destitution and mostly bereft of development, with the vast majority living below the poverty line. Education is scanty and village electrification is a relatively new phenomenon.

CHB stands out as a beacon of hope in this underserved geography, offering locals access to a range of medical services. That’s how it has been ever since Elizabeth Madsen, a Danish doctor set up the hospital in 1954. The good doctor began by treating patients on the verandah of the local church, a far cry from the full-fledged tertiary hospital that CHB has grown to become.

“We have to be the best we can for everyone,” says 58-year-old John Oommen, CHB’s medical superintendent. “Despite being in one of India’s most deprived regions, we have been providing the best of healthcare services to some of India’s most marginalised people at a fraction of what comparable hospitals in the country charge.”

Dr John Oommen (wearing spectacles) conducts a session in Togapodhar village to promote science among tribal youth

CHB is now a 350-member institution, with its own nursing college and a community development arm called MITRA (Madsen’s Institute for Tribal and Rural Advancement). The Tata Trusts have been long-standing supporters of the hospital, not least for its commitment to caring and community health, and the high standards it brings to the task.

The Trusts first joined hands with CHB in 2010 to combat malaria, which accounted for more than one-third of all deaths in the region. Conditions were perfect for the disease to thrive: dense forests that are breeding grounds for mosquitoes, low levels of health awareness, poor living standards, and minimal health resources and infrastructure.

Combating malaria

MITRA and the Trusts collaborated on a community health intervention in the 2010-13 period to deal with the malaria menace. They were armed with a five-point plan to combat the disease: building awareness, providing mosquito protection aids, training communities in vector control and prevention of breeding, setting up infrastructure for early diagnosis and primary treatment at the village level, and monitoring and tracking of results.

The programme covered more than 150,000 people living in 630 villages, spanning four districts of the KBK belt.Workshops were conducted across the region to educate village communities about malaria. Volunteers from 10 NGOs — selected by the Trusts and trained by MITRA — helped roll out awareness programmes. Mobile clinics and primary care points were set up in remote villages to facilitate early testing and diagnosis, especially in children.

Medicated mosquito nets and neem-based repellents were provided to villagers. ‘Mosquito proofing’, which involves netting of village houses to prevent mosquito entry was also undertaken. So well did this idea take shape that MITRA is now advocating for it to be adopted for nationwide implementation.

Over time, the programme’s efficacy fostered a people’s movement against malaria. The impact has been clear. In CHB's catchment area of Rayagada district, the malaria parasitemia rate in children below age five came down from 58.6% in 2010 to 15.9% in 2014.

Sister Jyotsna, a community health nurse with Christian Hospital Bissamcuttack, during a screening drive of tribal villagers
Sister Jyotsna, a community health nurse with Christian Hospital Bissamcuttack, during a screening drive of tribal villagers

Consequently, the mortality rate for children aged five years or under, for the same period, came down from 138.7 per 1,000 births to 92.7. Deaths after the onset of fever reduced from 3.8 per 1,000 people to 1.8.

Expanding to good effect

The next big partnership between the Trusts and CHB got going in 2014 and this was to ramp up the hospital’s facilities. The need for it was acute. As the only hospital offering specialised care in a 200-km radius, CHB was getting overwhelmed. Over a five-year period, CHB built new infrastructure and renovated the existing facilities on its 16-acre campus to emerge better equipped to cope with its care burden.

CHB now has a new OPD area, three new operation centres and an emergency care department. Alongside a raft of other refurbishments, the institution also improved its campus roads, sewage systems, residential quarters and waste disposal mechanisms.

“Perhaps the revamp project was preordained,” says Dr Oommen. That remark refers to the fact that less than a year after the new facilities were in place, Covid-19 hit India. CHB was able to create isolation centres and Covid care zones, and the Trusts pitched in with protection kits and guidance for a testing centre.

Celebrations to mark the completion of 20 years of the MITRA Residential School in Kachapaju
Celebrations to mark the completion of 20 years of the MITRA Residential School in Kachapaju

A friend for life

MITRA, the acronym for Madsen’s Institute for Tribal and Rural Advancement, means friend in Hindi. For the Kalahandi-Balangir-Koraput belt’s tribal communities, the institute has been that and lots more.

Named after Elizabeth Madsen, the Danish doctor who established Christian Hospital Bissamcuttack (CHB), MITRA’s community-focused efforts cover healthcare, education and livelihoods, and they have benefited more than 13,000 tribals living in 53 nearby villages.

MITRA, which was set up in 1990, has been involved in a variety of initiatives: village clinics, adult literacy and other education projects, tree plantation activities, training local youth in community healthcare, and malaria-control campaigns.

In 2000, MITRA set up M-TRU (MITRA Training and Resource Unit) to amplify its knowledge and experience in community development. M-TRU conducts training workshops in community health for NGOs, government bodies, etc. Roshni, another successful intervention, targets adolescent girls and is all about personal health and hygiene. Over the years, these training programmes have helped doctors, healthcare workers, community leaders and others in multiple ways.

CHB’s nursing school, operational since 1978, offers the auxillary nurse midwife and general nursing and midwifery programmes for women. In 2018, the hospital set up a college of nursing that has a four-year graduate programme.

On a different tack is the MITRA Residential School in Kachapaju, which is operated and managed in partnership with 16 villages. The school has a curriculum rooted in tribal culture and the medium of instruction is the local language, Kuvi.

One of the school’s standout pupils is Mitra Gogeranga. Born in a village that got electricity just five years back, she is now studying for her medical entrance exams. “I want to become a doctor and inspire other children in my community to dream big,” she says.

The enhanced setup that CHB can bank on has made Dr Oommen confident about the future. He believes the extended region will soon be able to shed its backward tag and he is quick to acknowledge the role of the Trusts in helping with the change.

“More than a benefactor, the Tata Trusts have been our friend,” adds Dr Oommen. “We are two like-minded organisations that have come together to generate ideas, to implement them and, thereby, to improve the lives of the tribal community here. It has worked brilliantly.”