Quack Relief

The term loose cannon perhaps describes him best. And the sight of him would have been funny, had his way of earning a living not been so deadly for his victims or ‘patients’. He is the bulla (wandering) doctor. His name is Yudhishtra and we met him at Gangabada village which he crosses en route to his destination— the remote hamlets of Gangabada panchayat. One day, 10 years ago, he invested in a few syringes, bottles of glucose and chloroquine and set out from his home in Mandasa (Andhra Pradesh) to scour the hills of Raigada, Orissa, in search of "patients".

He has had no medical training but says that he diagnoses illnesses— ranging from cerebral malaria to tuberculosis— with the "aid of his thermometer". And charges Rs 5 to Rs 10 for each injection, depending on the paying capacity of his patients. The villagers think he is a godsend despite there being no evidence of his "injections" ever having worked. Yudhishtra is only a representative specimen of his ilk. Bulla doctors mushroom throughout these parts.

According to independent calculations, in a cluster of 62 villages of the Raigada block with a population of a little over 6,000, the IMR is 168, the below-five mortality rate close to 30 per cent and over 50 per cent of the people are severely or moderately malnourished. In fact, of the 231 deaths reported in the area between March 1994 and September 1995, only 12 have not been the result of a disease. These 12 deaths include those due to natural causes such as old age or due to accidents, murders and suicide.

"We are not too surprised that the villagers in the Raigada block are the poorest in India," says Dr A.V. Ramani, a young doctor with an NGO called Gram Vikas who has spent the past two years working in the area. "Places such as Kalahandi and Sarguja, where the situation was very bad in the ’80s, seem to have benefited in at least a small measure from the publicity the plight of the people there received. And even the drought conditions there, which have led to starvation deaths, have occurred once in a few years. Here, most children are killed by rampant infectious diseases even before they can grow up and severe malnutrition, or starvation, only increases the death-rate." And so, the cycle continues.