Arogya Mitra - Selfless Saviours: The goal ‘health for all'

The goal of ‘health for all’ is still to be achieved even after seven decades of Independence. Thousands of people in remote areas of the country die every year in want of timely medicines. In such a tragic 
situation, the 14,000 Arogya Mitras have proved to be a boon for the people living in remote areas. They not only provide first aid, but also educate the people how to maintain a healthy lifestyle so that they do not fall sick
It was around 8.00 am on February 28, 2016, Sunday. Mamina Radus (25) was reading Dharitri newspaper sitting in her house. A news shook her completely. The news was about an eight-month pregnant Vanvasi woman, Rajni Munda, who was denied surgery at a district hospital. She was laying unattended there for four days. Doctors reportedly asked for Rs 20,000, which her family was unable to pay. Mamina immediately rushed to the hospital along with four other Arogya Mitra girls. They approached the Chief District Medical Officer (CDMO) and asked for the reason of denying treatment. The CDMO said the lady has tumor in her stomach and needs surgery, which requires medicines and several units of blood. Mamina said they would arrange medicines and blood also, you perform the surgery. They immediately arranged all required medicines and themselves donated four units of blood. During the surgery, a 1.5 kg tumour was removed, but the child of the lady could not be saved as he had died a day before. But somehow her life was saved. The lady belonged to Banspala Vanvasi region.

Arogya Mitra

Total Arogya Mitras all over the country:14,000
Trained so far 50,000
Working in North-Eastern states alone: 5,500
Who runs the Yojana: Sewa Bharati Purbanchal in North-East, Arogya Bharati, VHP, Vanvasi Kalyan Ashram and also the organisations like Jankalyan Samiti Maharashtra in different states. Rashtriya Sewa Bharati mobilises them at the national platform
What is an Arogya Mitra all about: A trained health awareness worker mostyly living in the remote village and provides first aid  and medicines under the monitoring of a trained doctor
What an Arogya Rakshak does? Apart from providing first aid and medicines, generates awareness among the people so that they do not fall sick. They also run Bal Sanskar Kendras, Matri Mandali, SHGs and several other activities for imparting training in self-reliance.
Who bears the expenses: All services are free. Even medicine is also provided free. They do not receive any honourarium. They do it along with doing earning their livelihood. The expenses are borne by the organisations to which they are attached.
Who imparts training: There is a foolproof mechanism for training. A central team keeps a close watch on the training. Initially, 10-day training, then one month training is imparted.
What is taught during training: How to identify the symptoms, how to provide first aid, which medicine to be given, how to consult the doctor, how to motivate people for maintaining a healthy lifestyle, etc.

The five girls who saved the life of an unknown Vanvasi woman were the Arogya Mitras of the Vishwa Hindu Parishad run Charak Health Services in the region. They are affectionately called ‘Charak Didi’. Before Mamina became an Arogya Mitra in 2012, the people of the village had to go about 30 km for taking even paracetamol tablet. But now the complete first aid is available in the village itself.

How the idea clicked?

Arogya Mitra Yojna is the brainchild of Dr Anant Narayan Kulkarni in Thane, who after completing his MBBS in 1980 joined a health centre run by some swayamsevaks in Jawahar and Mokhada tehsils of Thane, Maharashtra. Present RSS Sarkaryavah Shri Bhaiyaji Joshi, who was then Zilla Pracharak there, gave a shape to Dr Kulkarni’s idea. Dr Kulkarni gets disturb when he recalls an incident of 1981. “I was sitting in the health centre in the morning when a Vanvasi couple reached their with a seriously ailing child. When I put my stethoscope on his chest, I found the child was dead due to dehydration. When I inquired, they said they left the home at midnight and it took eight hours for them to reach the health centre. I suddenly thought if so serious was this child, what would be the condition of other people in that village. I immediately rushed to that village taking necessary medicines and a companion. After walking for hours we reached the village and found that almost every family had a sick person. We provided them medicines. We found the water in the well, which was prime source of drinking water there, had contaminated due to rains. We provided chlorine powder and tablets to a village youth to put in the well after a certain gap. And he did that work honestly thus saving the lives of his villagers. I thought if the experiment is conducted in other similar remote villages, we can save many lives. We started a pilot project in 1982 and then after getting inspiring results the then RSS Sarsanghachalak Shri Balasaheb Deoras formally granted medicine boxes to 25 Arogya Mitras in 1989. Then the scheme was launched in other areas like in north-east in 1995,” says Dr Kulkarni. Now in the areas where there are sufficient health facilities in Maharashtra, the Arogya Mitra scheme has been withdrawn.
Pabuni Lata belongs to Kobarkima Village of the same Kandhmal District. She is also an Arogya Mitra. Apart from providing first aid to the people she has started a campaign to ensure toilet in every house and also proper drainage system in the village. There is a government dispensary about 10 km away from her village, but it lacks both doctors and the medicines. Since there is no road, people have no other option but to walk. In such a situation, Pabuni ensures first aid in the village itself. Like Pabuni and Mamina, Odisha has more than 800 Arogya Mitras in the Vanvasi regions alone who work under the supervision of trained doctors. In Odisha East Prant, the scheme has been named after Charak, the principle contributor to the ancient Bharatiya Science of Ayurveda, while in Odisha West Prant, it is run in the name of Sushrut, the ancient Bharatiya Physician.

Dhanwantari  Sewa Yatra

Dhanwantari Sewa Yatra, being conducted every year since 2005, has proved to be an effective tool in bringing the people of north-east and rest of the country together. Till now, 13 Yatras have been conducted and the latest one was conducted from February 21 to 28 this year. 75 doctors and 76 medical students from Gujarat, Maharashtra, Rajasthan, Banaras Hindu University, Uttar Pradesh, Bihar, West Bengal, Assam, Manipur and even from the US participated in the Yatra at their own expenses. They formed 25 teams and visited 25 places. They treated 20,965 patients free of cost in 282 villages under 37 districts of all the seven sisters by organising 118 health camps with the help of Arogya Mitras. In the earlier 12 yatras, a total of 390 doctors and 396 medical students participated in 865 health camps organised in 2,130 villages treating 1,54,958 patients.  According to Shri Naresh Kumar Vikal, Kshetra organising secretary of Sewa Bharati Purbanchal, the Yatra not only help the people of remote and inaccessible areas to avail world class health facilities, but also help the doctors to see and understand the north-east culture closely. The whole exercise is basically an endeavour to realise the people of north-east that the whole country is there to share their sufferings.
There is a place known as Bhootbangla in Kokrajhar District of Assam. Two Arogya Mitras go to this place from Guwahati to run an Arogyam, a kind of Bal Sanskar Kendra. One is Anita Deori while other is Vandana. Arogyam is part of the Arogya Mitra scheme, where children are taught about hygine, cleanliness in the surrounding, patriotic songs, sholkas, sports activities, etc. They also tell the child the benefit of Swadeshi. As a result, when the children go to the village shop even to purchase a chocolate they ask whether it is Swadeshi or Videshi. They reject it if it is Videshi, made by any multinational company. The shopkeeper was eager to know the name of the people who taught the children the difference between Swadeshi and Videshi. He was not angry at all but wanted to know after all who impart them such good sanskars in a remote village. One day, both the Arogya Mitra girls reached his shop to purchase something. As they were new in the village, he tried to know their whereabouts. They said they came from Guwahati to meet their friend. He understood the whole story and asked whether they are the same Didi, who teach children about Swadeshi. He was very happy to know positive response from the girls.

A Bridge between Doctor and Patients

Akhil Bharatiya Sahsewa Pramukh of RSS and Palak Adhikari of Rashtriya Sewa Bharati Shri Ajit Mohpatra has closely been monitoring and guiding the Arogya Mitra scheme for several years. Talking to Organiser he explains about the whole scheme and how the Arogya Mitras have become a change agent. Excerpts:
  • What the Arogya Mitra Yojana is all about?
People living in remote areas do not have access to medical facilities. Patients die even before reaching the medical centre or the doctor. If they are ensured timely first aid and are also advised when to approach a qualified doctor, their lives can be saved. Arogya Mitra is a trained health awareness volunteer sitting in a remote area armed with necessary medicines and knowhow to provide both first aid and also the required guidance. This work is purely done as sewa without charging anything.
  • Is Arogya Mitra just a health awareness volunteer or do something else too?
Health awareness is just one aspect of his multifarious activities. He or she is the person who looks after the health of the entire family and the village. He takes all steps, which ensure that people do not fall sick. Here I would like to share an incident. I was on the tour of North-East. I visited a family along with the local Arogya Mitra. Family members were away for work. Only the children and a sick old lady were at home. She was not even in a position to get up for taking medicine. The Arogya Mitra gave her medicine and boiled water. My point is that if he didn’t had contact in the family, how could he enter into their kitchen? Then he asked the children why they didn’t go to school? They said it was holiday. He then said even if it is holiday, they should study for one or two hours. Those who did not go to school, he persuaded them to join the school. He also taught them the benefits of medicinal plants growing in their house premises. Similarly, a family had to sell all the goats following some trouble in the family. He helped the family to get loan for purchasing goats again. There are many such works that an Arogya Mitra does.
  • Is the service totally free or any nominal amount is charged?
Medicine is provided totally free of cost. At some places if people donate one or two rupees that amount also is used for purchasing further medicines for the villagers itself.
  • Then who bears the expenses?
Sewa Bharati or the organisations to which the Arogya Mitras are attached. The organisations too take help of the society.
  •  What is the mechanism of their training?
There is a foolproof mechanism for it in all the states. There is a central team also which keeps a close watch on the training. Dr Arun Bannerjee in north-east is fully dedicated to this cause since inception. Which medicine to be give, how to be given, when to be given, are all taught. Additionally, there is a team of doctors at the district level, which helps the Arogya Mitras round the clock. Apart from it, the Arogya Mitras also learn from their experience. All the Arogya Mitras remain in contact with any of the qualified doctor and they give medicine under their close watch only. In this way, an Arogya Mitra is a bridge between the doctor and the patients.
  • Can the Arogya Mitras practice like this under the government rules?
They have training for what they normally do. The day government ensures health facilities in all villages and towns we will close down the scheme. The prime objective of the Arogya Mitras is not to give medicine, but to create the healthy atmosphere where people do not fall sick. They teach people to follow a healthy lifestyle. Our objective is to create a healthy society and ensure that the last person living even in a remote village is fit and healthy.
  • How many Arogya Mitras are active all over the country today?
About 14,000, however we have imparted training to more than 50,000. They are not active due to some reasons. But they at least try to keep their own family healthy and fit.
  • Is there any plan to depute at least one Arogya Mitra in every village of the country?
We are working on it. The issue was also discussed at our national level meeting. We have to reach every 
village, but it may take some time. First, we have to 
reach every district. 
The poor condition of health facilities in rural areas can be understood from the fact that 60% of population don’t have access to health services. If there is dispensary in any area, there is no doctor and medicines and everyone cannot bear the high cost of treatment charged by private nursing homes. Therefore, the dream of ensuring ‘health for all’ is still unachieved in seven decades of Independence. In such a situation, the Arogya Mitra Scheme has emerged as a boon for the people living in remote and inaccessible areas. The idea of the scheme basically clicked to Dr Anant Narayan Kulkarni in Thane in 1982 when he was serving the villagers in Jawahar and Mokhada tehsils after getting MBBS degree. But the scheme was formally launched in 1989 by the then RSS Sarsanghachalak Shri Balasaheb Deoras by providing heath boxes to 25 Arogya Rakshaks. In the highly diverse region of North-East, this scheme has helped in saving the lives of lakhs of people who had no option even to get first aid in their remote villages. In North-East region alone, 5,500 Arogya Mitras treat about six lakh people in a year. However, the list of trained Arogya Mitras includes more than 16,000 names but they are not active due to various reasons. They just look after the health needs of their 
own families.
Mamina Radus, 25
Village-Pandpada, Dist. Kandhmal, Odisha, Arogya Mitra since 2008
Borne the surgery expenses of an eight month pregnant Vanvasi woman who also carrying 1.5 kg tumour in her stomach, and was denied surgery by government hospital. Four Arogya Mitra girls donated 4 units of blood.
Pabuni Lata, 23
Village-Kobarkima, Dist. Kandhmal, Odisha, Arogya Mitra since 2014
Apart from providing first aid, motivates villagers to built toilet in every house and also proper drainage system. Also runs Satsangh and Bal Sankskar Kendra.
Laxmanan, 31
Village-Attapadi, Dist. Palghat, Kerala, Arogya Mitra since 2009
Focus on de addiction in 25 surrounding villages. Admit seriously addicted people in Swami Vivekananda Medical Mission hospital. De addicted about 200 people so far.
Deepankar Biswas, 30
Village-Raikata, Dist. Hojai, Assam, Arogya Mitra since 2004
Successfully cured a six year old village child who was critically suffering from tetanus and was denied treatment by the government hospital saying he will not survive. The child now studies in ninth standard.
Bobita Baishoy, 26
Village Khetri, Dist Guwahati, Assam, Arogya Mitra since 2005
Foiled repeated attempts of conversion in surrounding villages. Apart from providing first aid, imparts training of self-reliance to women. Many women now financially support their families.
Umawati Kanwar, 25
Village-Navjang, Dist Golaghat, Assam, Arogya Mitra since 2004
Provided medical aid and relief material to the people of 14 villages, which were set on fire by the miscreants at Nagaland-Assam border last year. Also played a key role in restoring normalcy in the village.
The young boys and girls mostly belonging to the same village are imparted special training by the Sewa Bharati Purbanchal in Homeopathy and they are provided with medicine boxes containing 76 medicines after completion of their training. Then they provide primary medical aid to the people in their respective villages. Those who are found critically sick are either sent to the big hospitals or are provided medicines after consulting the senior doctors. All the Arogya Mitras work under the supervision of any of the trained doctor. Therefore, there are very little chances of mistake. The service is totally free. Neither the patients pay anything nor the Arogya Mitra is paid any honourarium. They do it as service. They mostly have their separate means of livelihood. Apart from providing regular first aid, they also organise health camps involving senior doctors to treat the people on large scale. Dhanwantari Sewa Yatra conducted every year involving qualified doctors has proved very helpful in this regard.
According to Dr Arun Bannerjee, who has been associated with the scheme in north-eastern states since its inception in 1995, the prime task of the Arogya Mitras is not just to provide first aid, but to generate health awareness to the extent that people do not fall sick. Therefore, there is concentration on cleanliness, hygiene, healthy lifestyle and healthy diet. 
RSS Sarkaryavah Shri Bhaiyaji Joshi who has materialised this scheme, repeatedly stresses on training Arogya Mitras in all the remote villages and slums of the cities so that people get first aid without delay. Arogya Bharati deputy organising secretary Shri Ashok Varshneya points out that the Arogya Mitras are working in all states of the country. Apart from Arogya Bharati, Sewa Bharati, VHP, Vanvasi Kalyan Ashram and many other RSS associated organisations also train Arogya Mitras and depute them in different areas. The Rashtriya Sewa Bharati has now started efforts to mobilise all these efforts at a single platform. It organised a national workshop for Arogya Mitras in Agra from March 19 and 20.
Since the objective of the scheme is to ensure affordable health to all, many experiments are being conducted on different aspect of the scheme. Arogya Bharati in Hyderabad imparts training to school students from 6th to 9th standard as Bal Mitras who then impart training of first aid and health awareness to the students in their classrooms. Then they educate their family members and then the people in the village about staying fit. Through this experiment, thousands of families have been made addiction free, which is not a minor achievement. 
The health problems in the remote areas have different aspects. Sometimes people too are not ready to receive aid. The solution to it was found by a Sewa Bharati run hospital in Nellor region of Andhra Pradesh. Since the Vanvasis in seven blocks there were not coming for treatment, the hospital trained some people from those villages as Arogya Mitras. Some of them were even illiterate. The main problem was that even the pregnant women were not ready for delivery in the hospital and the mortality rate of child and mother during delivery was very high. After persuasion by those Arogya Rakshaks, when some of the women started coming to the hospital it was found that the hemoglobin level of some of them was between 3 to 4. They even required blood transfusion before delivery. Another problem was detected. The women who were provided iron and folic acid tablets, they did not take them. Then the Arogya Mitras started educating them about healthy diet, which helped in improving the hemoglobin level. As a result, the mortality rate of mother and child was arrested substantially. 
The Arogya Mitras in border areas of Gujarat have done a wonderful job by educating the people not to allow any anti-national activity in their area. Now, if there is any such activity it reaches the people and authorities concerned within a few hours. Dr Vineet Kayath in Alirajpur of Madhya Pradesh has motivated people how to prevent diseases by maintaining hygiene. This has reduced the rate of people falling sick. Amit Pandey lives in Along town of Arunachal Pradesh, but visits the surrounding villages to serve people as Arogya Mitra. He too has focused on cleanliness. MK Sivan at Angamali in Kerala has imparted yoga training to thousands of people. Now he is working on curbing diabetes through yoga. He also imparts training to school students. Similarly, Laxmanan at Attapady Village in Palghat District of Kerala focused on deaddiction. Those who are seriously addicted are admitted in Swami Vivekananda Medical Mission hospital. He has so far successfully addicted 200 people from 25 villages. 
Deepankar Biswas who belongs to Raikata Village under Hojai District of Assam, became an Arogya Mitra in 2004. He is now Vibhag convener of the scheme and looks after the work in Naugaon, Morigaon and Karbianglong districts near Nagaland border. When he became an Arogya Mitra there was no health facility in this village. He feels satisfied when he recalls an incident of 2008. “A child in my village had tetanus and the doctors in government hospital had declared that he would not survive as the infection is beyond control. I gave him homeopathy medicine after consulting my senior doctor. He found relief within 24 hours and finally he got completely cured. Now that child study in 9th standard,” says Biswas.
Bobita Baishoy is an Arogya Mitra since 2005. She belongs to Khetri Village of Assam, about 35 km from Guwahati. She played a key role in curbing conversion in the surrounding villages. Apart from providing medicines to the villagers, she also runs Arogyam and some projects for making women self-reliant. Some of the women in the village now earn good money every month.
Even though most of the Arogya Mitras belong to the same village where they work, it took years for them to win the confidence of their fellow villagers. Umawati Kanwar is Arogya Mitra since 2006, but not even a single patent visited her for months. She belongs to Navjang Village under Golaghat. But now she attends about 200 patients in a week. Last year, when some miscreants burnt 14 villages at Nagaland border she went there to treat the victims and also to provide them relief material. She also played a key role in resting peace in the villages. The clashes among different communities in this region are not new, but since the institution of Arogya Mitras is getting stronger, the repeat of such clashes has come down.
Jyotsna Sinha lives in Silchar Town, but visit New Bhagatpur Village for serving the people. Since malaria is a major problem there, she concentrates on building drainage system. She also imparts training of handicrafts to women. The Arogya Mitras in highly remote and bordering Sadia region under Tinsukia District have played a key role in bringing the Maoist influenced people back to mainstream. The expense of an Arogya Mitra training camp there was borne by a local Congress leader whose entire family now propagates this work in the region. 
Dr Arun Bannerjee who is backbone of the Arogya Mitra scheme in north-eastern, is now popular as ‘mobile doctor’, as he attends hundreds of patients every day through Arogya Mitras on his mobile phone. He is fully dedicated to the scheme since 1998. Talking to Organiser he points out that about Rs 4,000 are spent on an Arogya Mitra in a year and that expenses are borne by the Sewa Bharati Purbanchal with the help of the society. “The main task of an Arogya Mitra is to educate people about healthy lifestyle and imparting good sanskars to their children,” he says. Another major project run under Arogya Mitra scheme is Kishori Vikas project, which mainly focuses on resolving the problems of adolescent girls. A good team of nationalist and committed youth has been created in north-eastern region through the Arogya Mitra scheme. They have played a key role in generating the feeling of harmony in the entire region. However, many Arogya Mitras had to sacrifice their lives for it. Sometime back an Arogya Mitra in Kokrajhar region was killed by the villagers, because she had opposed the villagers’ decision to brand a woman as a witch,” recalls Dr Bannerjee.
The systemically and dedicatedly the Arogya Mitras are working all over the country and develops a hope that ensuring health for all is not impossible. The major problem why the country could not achieve this objective so far is that the health comes under the jurisdiction of State governments and they have their own agenda and compulsions, while implementing the schemes. The Central government also has its limitations. The success of Arogya Mitra scheme shows that the society too can play a big role at several fronts. The scheme can show better results if the governments extend help to such voluntary efforts.  Pramod Kumar


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