Health services in KBK bear the brunt of Naxalite attack

Economic Times, Aug 17, 2009

The growing influence of Naxalites in the tribal dominated districts in Orissa over the last few years has taken a severe toll on health services.

Health services – both in public and private sectors in South Orissa and other affected pockets - have borne the brunt of Naxalite attacks, and increasingly so since 2000, defying the CPI (Maoist)’s 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 establishments so far, frequent roads blockades, ambushes on police parties and threats to government officials in the affected districts have left delivery of health services in a lurch.

Of the 965 doctor posts lying vacant, nearly 75% belong to the undivided KBK districts (Koraput-Bolangir-Kalahandi). Besides, 102 pharmacist and more than one thousand para-medical posts are lying vacant in those areas.

The eight undivided districts of Kalahandi, Bolangir and Koraput are universally known as the most backward regions in India. After the reorganizations of districts in Orissa in the early 1990s, these three districts were divided into eight districts, - Kalahandi, Nuapada, Bolangir, Sonepur, Malkangiri, Koraput, Gajapati, and Nabarangpur. Of the 80 revenue blocks, there is only one block which is developed, three blocks developing, 28 backward and 49 blocks are most backward.

Legislators cutting across party lines and officials admit that most of the doctors and para-medics produced by the state-run medical colleges are shying away from serving in the tribal dominated KBK region because of security concern even as the state government has offered them attractive pay packages and incentives.

In the remote Malkangiri district, which is nearly 650 km from here, some Primary Health Centres (PHCs) and Community Health Centres (CHCs) – as 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. People walk miles carrying their sick relatives in bamboo baskets to get them treated at district headquarters due bad road network and absence of doctors at nearby hospitals.

The Union Government’s flagship health programme – National Rural Health Mission (NRHM), which has greatly contributed to improvement of health services in coastal pockets, remain a virtual non-starter in Naxal-affected pockets due to frequent unrests.

State health minister Prasanna Acharya, while making a candid admission in the House that delivery of health services still remained unorganized, said that the his department was making efforts 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. Till now there have been 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.

Railways are a favoured target, given its vast network and infrastructure and the practical difficulties involved in protecting the same. Railway properties have seen nearly a dozen attacks since 2000.

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.

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.