Tipaimukh: Frontier sans Medicines

By David Buhril *

Tipaimukh, the frontier without medicines and doctors, silently negotiates an epidemic that has already tolled more than 50 lives, mostly infants. Burdened with the threat of famine after the bamboo flowering, the hungry constituency walks death straits, while the Manipur Government is still sleeping.

"We are living with the predicted gloom of death and hunger after the bamboo flowers", Vawmkapthruom Pulamte voice broke through the smoke filled house that was vainly lit. "It is not just the famine and the fear of hunger that gnaw us, but also the mysterious disease that has already tolled many lives.

Many children have died in Lungthulien alone. I am afraid it might be my children’s turn next time when the slow church bell rings to announce about another departed soul." The fear of death has been an aching concern for parents in the sleepy villages in Tipaimukh sub-division in Manipur’s Churachandpur district. These villages remain as frontiers without medicines and doctors.

Vawmkapthruom said, "Our parents told us that when the bamboo flowers it is always followed by famine and death. The bamboo has flowered, there is hunger and death. We are doomed." Distressed villagers in Tipaimukh did not know about the "mysterious diseases" that have tolled more than 50 lives recently.

Majority of the victims were infants. They said it is caused by "mautam hri", an epidemic resulted by the gregarious bamboo flower. The current epidemic cannot be isolated from the natural phenomenon that has bled them hungry too. Tipaimukh villagers called it the return of horror or death flower.

The natural phenomenon of bamboo flowering has been recorded to have happened in 1862, 1881, 1911-12 and 1959 too. All of them resulted in severe famine. According to the Parliamentary Standing Committee on Science and Technology, Environment and Forests’ 159th Report, the 1959 famine claimed between 10,000 and 15,000 lives in Mizoram, Tripura, Manipur and Barak Valley of Assam.

The loss of lives was believed to have caused not only by hunger but also by epidemics. The cyclical flowering of the Muli bamboo species that occurs after every 48 years started flowering again in 2006. Tipaimukh, one of the epicentres of the gregarious bamboo flowering, has been the worst hit.

The rats, rodents, insects and wild animals that multiply after consuming the seed and flower of the muli bamboo destroy crops with no harvest for the jhum farmers who are totally dependent on their jhum fields. Today, the fringe constituency negotiates with hunger and the "mysterious disease" that put their lives at the brink.

In the heart of the doom flower the predicted nightmare is dark and gloomy. While the loss is mourned, there is widespread apprehension and confusion as there are no doctors and medicines to tame the unknown disease. The number is appalling. However, it could manage to sink into the public’s knowledge after the situation blew out of proportion.

While the deprived villagers remain as victims of entitlement failure, their unreported, if not under-reported issues and plights also remain to be journalistic orphans. Families recoil in helplessness. The outside world seems too far away. The dwarfed silence and absence of any proactive efforts herald victory for the strange disease that has been knocking at every door.

In Leisen village alone there are more than 70 children who are severely afflicted by the unknown diseases. In the absence of doctors Pastor Rolawm has been acting as the doctor for the entire village. "Many a time I did not even get time to sleep as the epidemic mercilessly multiply its victims and I get too many sick people to attend to. It is a desperate situation as there is nothing in the entire village to relieve their woes. I could not help much so I end up praying for them", Pastor Rolawm said.

Leisen village authorities told me that the village has been living with the "mysterious disease" since the middle of 2007. "The powerful disease acted so fast that in no time the village lost 16 lives in the middle of 2007 alone", Rotuoklien Joute, president, Hmar Youth Association said.

After the mysterious deaths, Leisen village authority (VA) then reported about the deaths and the "mysterious disease" to the Manipur Government. "To our relief they told us that they would be sending a medical team to our village. But when the medical team arrived on the evening of September 28, 2007, we found that the medical team comprised only one pharmacist and a nurse. The next day they collected blood from all the sick people. After collecting blood and without any other examination the medical team distributed one strip of chloroquine and primaquine to all the sick people and they left the other day. Irrespective of the diverse complaints different people have, all that the medical team did was to distribute the same medicine to all. Later we came to know that the free medicine distributed by the medical team was to treat malaria", Pastor Rolawm said.

"Till today they haven’t sent us report of the blood they collected", Rosanghlei, member of the Village Authority (VA) said. "Not only that, the condition of the sick people deteriorated after consuming the distributed medicines. The medicines were far from bringing any relief", Rosanghlei added. "There was no end to our misery. What do you think a pharmacist and a nurse would do to address our serious situation?", Laldawmsang of Leisen said.

"After we mourn the loss of 16 lives to the strange disease, our treasured cattle were severely plagued again. We were totally at loss. We don’t know what to do, so we wait and watch the losing game. We told each other that the year is not good for us", Laldawmsang said. Pastor Rolawm also said, "We were praying for a better year, but it dawned with no pleasant sight. We inherited the mysterious disease into the New Year and very soon three infants succumbed to it in the beginning of 2008. We are living a dreadful nightmare."

Keivom of Parvachawm said, "Our little boy developed slight fever with a clogged chest. His voice squeak and he was finding difficulty in breathing. He suddenly lost his consciousness. There was no doctor in the village or nearby. We have to walk a day and travel for another two days if we have to consult a doctor. That was never a viable option for us. There was no other way and we were so desperate that we kept pouring water on our little boy’s head. He passed away just like that."

Lallungawi of Parvachawm also said, "My boy developed breathing problem accompanied by fever. There was none to consult. Worse, there was no medicine. He suddenly passed out for some time and regained consciousness again. He was doing that for so many times and we were so helpless. Fortunately he did not die. But today he is not in his normal state of mind."

The symptoms of the "mysterious disease" were not all common. In many cases the nails of the victims turn blue and they complain of stomach ache, chest pain, nausea, loss of appetite, severe pain in the chest, fever, and sudden loss of consciousness. In many cases, the private parts are reported to turn black after the death. The temperature of the body also remains warm for more than two hours.

Moreover, there are many cases of jaundice too. The epidemic is not confined to human alone. Cattleheads are also falling prey to the sweeping disease. Tipaimukh villagers complained of unnatural deaths of their cattleheads. In Senvon and Sitam villages, VA’s reported the recent death of 19 buffaloes and more than ten cows.

The epidemic in Tipaimukh is yet to receive the treatment that it deserved today. Vawmkapthruom complains that even if the doctors come they visited three or four villages that are only accessible by vehicle. The rest of the worst hit villages, which are actually cut off, are left to fend for themselves.

"Authorities as well as doctors pay sporadic attention, turning on the spotlight only when there is mass dead and crisis situation. Doctors and any other government officials used to come like tourists on limited visa permit. If they come they prescribed long list of medicines which are never available anywhere near. We have to travel for two days to buy their prescribed medicines. Where on earth will poor farmers like us have the money to travel far and wide to buy medicines when we don’t even have the money to feed our hungry bowels."

Out team met with the tragic disease when, on April 14, the daughter of one, Lalchunghnung of Senvon who was assisting us, died of the dreaded epidemic. Chongi, Lalchunghnung’s wife said, "The disease acted so swift. We did not know what to do with it. Death took my little girl away from me."

The political paralysis and the terrible silence that surrounds the plagued Tipaimukh hills and mountain are making everyone desperate. Economic hardship and the absence of civil administration worsened the plights of the Tipaimukh villagers who remain bare and vulnerable to epidemic. These factors also acted to block possible intervention.

The lives of Tipaimukh villagers are a story about what happens when a disease leaps the confines of medicine to invade the body politic, infecting not just individuals but sweeping the entire community. For the impoverished and distressed villagers the "mysterious disease" mutated into a complex plague with confounding social, economic and political mechanics that locked together to worsened their plights.

The cut-off Tipaimukh villages, which are the heart of the epidemic, represent the breeding ground of the hidden invasion that revealed with the shocking scale of the devastation as many lives were lost. "Our existence as human being with our fundamental citizenship rights seems to have no meaning at all. The voices of the living hardly matters. The alarming deaths, which should shame any government, did not matter too. There is no respite for us", Ralkapthruom said.

Tipaimukh villagers were dissatisfied with the practice of the visiting doctors who tends to negate if not mitigate their plights even when they are at great loss. Vawmkapthruom said, "They always try to downplay our serious plights. How then do they explain the sudden loss of many lives? They come and merely felt our pulse without conducting any examinations to diagnose our problems. When the tourists like visiting doctors did not even spend five hours in the affected villages, how could they understand the severity of the diseases we are living with?"

Despite the mitigating attempt, the "mysterious disease that follows the gregarious bamboo flowering since 2007 has already taken more than 50 lives. For the cut off Tipaimukh villages, the absence of communication barred them from waking up to the severity of the epidemic that has invaded them.

Moreover, the absence of any medical aid and health facilities worsened their numb existence where, initially, the villagers merely interpreted and related the "mysterious disease" to the recurring cycle of the gregarious bamboo flowering. Their understanding of the natural phenomenon and their belief system have been hardened with the orally transferred knowledge that everything bad and evil happens when the bamboo flowers. Modern science and medicines are yet to deconstruct the age-old belief attributed to the natural phenomenon, which Tipaimukh villagers are made to realise once again.

Villages in Tipaimukh are supposed to be equipped with health centres and doctors if the government records are to be trusted. According to official records, there is a community health centre at Parbung and primary health centres at Pherzawl, Patpuihmun, Senvon and Sibapurikhal villages respectively. However, none of them exists and there is no doctor stationed in any of these villages.

The deplorable situation speaks for itself when the village authorities at Parbung and Lungthulien did not even know who their community doctor is. Doctors and nurses for these health centres have been officially recruited and posted. However, they are not to be found in any of their posted stations.

The absence of any health care facilities in Tipaimukh has caused too many distressing situations. In Lungthulien village, parents have resorted to extreme by giving their children button in the guise of medicine to relieve their children of their pain and suffering. In another case, children suffering from diarrohea were pushed on cart along the rough national highway 150 that remains unmaintained for more than 20 years so as to relieve them from the turbulent ride.

These frontiers without medicines and doctors have been disgracing the nation’s celebration of its boom in science and technology. The emergence of such epidemic was due in large part to the absence in government spending on health care. There is no surveillance and monitoring efforts, leading to insufficient knowledge about the impending threat that people are exposed to. Worse, the health delivery facilities did not exist at all.

As such, there are no doctors or nurses to seek their services in times of need. There are also no transportation facilities to health centres. Many of the villages were not interlinked. The villages are without proper roads and there are no standing bridges over their many swift rivers.

The Government of Manipur should immediately improve intervention strategies for the prevention and control of epidemics in places like Tipaimukh. The current epidemic has put severe burden on the public health system and socio- economic development of the affected areas.

Priority should be accorded for prevention of its occurrence and re-occurrence. Doctors should be stationed in their respective health centres so as to press them into service as and when required. The authorities should intervene and play an essential role by providing necessary resources and undertaking efforts to monitor the situation and develop an integrated disease control strategy.

There is also an urgent need to set up communication and infrastructure facilities. Above all, what is required is a committed political will. Otherwise, frontiers like Tipaimukh could be easily wipe out by the problems of famine and epidemic they are living with.

Related Articles:

• Man made disaster :: TSE Editorial
• When the Rats Came Calling :: Part 1 | Part 2 :: Dilip Chakma
• Tipaimukh Woes :: Elf Hmar
• Of famine, starvation and apathy :: Ringo Pebam

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* David Buhril, a research scholar in JNU & Ramnath Goenka Journalism Awardee contributes regularly to e-pao.net. The writer can be contacted at davidbuhril(AT)yahoo(dot)com. This article was webcasted on May 08th, 2008

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