“Struggle And Create: My Days With Com. Shankar Guha Niyogi” – Chapter 2: The Story of Shaheed Hospital

Shankar Guha Niyogi

Six prosperous doctors of different generations in my family inspired me to be a doctor. After I entered Medical College, the Medical College Democratic Students’ Association taught me to dream anew of being a very different kind of doctor…a doctor like Dr. Norman Bethune, like Dr. Dwarkanath Kotnis. But where would I go? There was no anti-Franco resistance in Spain or liberation struggle in China awaiting me. I wrote to a representative of the Sandinista government in Nicaragua expressing my wish to work with them, but there was no reply. In the end, three years after completing my medical education, I got the opportunity to work at Shaheed Hospital.

As a student, I had heard stories of the Dalli-Rajhara workers’ health movement. Dr. Pabitra Guha, a founder-member of our students’ organization, was one of the three doctors who had joined the workers’ health movement in 1981 before Shaheed Hospital was established. (The other two doctors were Dr. Binayak Sen and Dr. Ashish Kundu.) When the workers of Indo-Japan Steel inspired by Shaheed Hospital began the Belur Shramajibi Swasthya Prakalpa in 1983, the People’s Health Service Association provided support and I, a newly minted physician, was one of the physicians involved.

I was at Shaheed Hospital from 1986 to 1994, a period of eight years. In 1995 I came back to West Bengal and joined in the efforts to begin a health program of the Kanoria Jute Mill workers’ movement that was inspired by the struggle of the Bhilai workers. Everything I have done since then has been a journey along the same path that I began to travel on in 1986, and that the Dalli-Rajhara workers started on in 1979. The Shramik-Krishak Maitri Swasthya Kendra at Chengail, formation of the Shramajibi Swasthya Udyog in 1999, the Madan Mukherjee Smriti Janaswasthya Kendra at Beliatore also in 1999, the Bauria Shramik-Krishak Maitri Swasthya Kendra in 2000, the Bainan Shramik-Krishak Maitri Swasthya Kendra in 2007, support for the Singur-Nandigram movement in 2006-2007, the Sundarban Simanta Swasthya Pariseba in Jamespur in 2009, joining up with the Sundarban Sramajibi Hospital in 2014 (of course this hospital began its journey in 2002), the health workers training program of Shramajibi Swasthya Udyog, publication of the Asukh-Bisukh magazine with the Foundation for Health Action since 2000, the publication of Swasthyer Britte since 2011…all of these seemingly disparate activities are part of the same quest that I began decades ago.

The beginning of the beginning

shaheed hospital construction
Constructions of the Shaheed Hospital

It was not that Dalli-Rajhara with a population of one lakh twenty thousand did not have any hospitals. The Bhilai Steel Plant (BSP) hospital, a government primary health centre, a missionary hospital, private practitioners, quacks .. there was no shortage of those. But poor people did not get good care at those places. The people employed by contractors in the mines and their families could get free medical care at the BSP hospital with a note from the contractor. But there they were treated like second class citizens, the doctors and nurses were repelled by their red earth-scented bodies.

This medical negligence was the reason Kusum Bai, vice-president of the workers’ union,  Chhattishgarh Mines Shramik Sangh (CMSS), lost her life in childbirth in 1979. That day ten thousand workers gathered in front of the BSP hospital to protest against the lack of proper medical care. No, they did not destroy any hospital property. Not a single doctor or nurse was harmed. They pledged to build a birthing facility so that no other mother would ever lose her life in the same way.

The foundation stone of the Shaheed Prasuti Sadan (birth center) was laid on 8th September, 1980.

shaheed hospital constructions2

From spontaneity to consciousness

The seventeen departments of the Chhattisgarh Mines Shramik Sangh formed in 1979 also included a health department.

In his article “Health and Trade Union”, comrade Shankar Guha Niyogi said, “In India, trade unions have probably never included the question of workers’ health as an independent issue within their broader agenda. Even when the question of health is considered, it is confined to a capitalist ideological framework. Thus trade unions have limited their concerns to issues such as the availability of sufficient medical treatment, compensation for workplace injury or related disability, and providing alternate work for those disabled in this way for humanitarian reasons.

It is important to point out that the provision of suitable housing, schools, medical treatment, sanitation, water and other concomitants of a healthy life are the responsibility of the employer. The working class is the vanguard of social change and, therefore, it has the responsibility to analyze and experiment to support the development of more progressive alternative social practices. Alternative health practices are also a part of this. Along with this, the working class must also try to build alternative models using currently available materials and capabilities.”

Here we find intimations of Niyogi’s thinking that were later incorporated in the idea of “sangharsh aur nirman” or “struggle and creation”. The most remarkable implementation of the politics of struggle and creation was Shaheed Hospital. (This is the thinking we have continued to pursue in all our medical facilities.)

“Fight for health” “swasthya ke liye sangharsh karo”

The fight for health was formally begun on 15th August, 1981. The documents from that time reveal the following priorities:

  • Make arrangements for the treatment of tuberculosis
  • Create a roster of pregnant women and provide the care they need for safe delivery and the birth of a healthy baby
  • Provide children with timely vaccination and the care and nutrition they need for proper development
  • Run a dispensary, particularly for those who cannot get treatment at the BSP hospital
  • Run a hospital where farmers from the villages can get the treatment they need
  • Keep the environment healthy, in particular educate every household about the importance of clean drinking water, thus reducing the prevalence of cholera and other diseases
  • Collect and analyze health data for every family involved in the organization and the movement
  • Provide training to interested members of the organization to create “health protectors” and deliver primary health care and other health services through them

From the cleanliness movement..

The worker neighbourhoods in Dalli-Rajhara did not have sanitation services. One day, the men and women, the students, youth and businessmen from the worker neighbourhoods collected the refuse from each area in one place. Then they stopped thirteen trucks that were used to carry materials to the mines, loaded them with garbage, and took them straight to the mines manager’s quarters. The management was given a warning – if arrangements were not made for keeping the worker areas clean, the garbage would be brought every day to the mines manager’s house.

The doctors arrive

In 1981, Shankar Guha Niyogi was imprisoned under the National Security Act for activities connected to a mine workers’ agitation. The government imposed various repressive measures designed to destroy the movement. Dr. Binayak Sen came to Dalli-Rajhara as a member of an investigative team of the People’s Union of Civil Liberties. After teaching at the JNU Center for Social Medicine and Community Health from 1976 to 1978, he had set out in search of a meaningful life and was working with TB patients at the Friends’ Rural Center in Rasulia in Hoshangabad district of Madhya Pradesh. He did not find that job very satisfying. He was attracted by the Dalli-Rajhara workers’ movement. With him came his wife, the social scientist Ilina Sen.

Dr. Ashish Kundu arrived at almost the same time. One of the organizers of the democratic medical students’ movement in Bengal, Ashish da had completed his housestaffship and was looking for an opportunity to engage with an active workers’ movement and align his professional life with the struggle for workers’ rights.

Dr. Pabitra Guha joined them about six months later. He had to leave soon because of certain personal problems, but he returned to Shaheed Hospital in 1992 after Niyogi’s death. He is still in Dalli-Rajhara.

Before beginning their work, the doctors organized meetings in neighbourhoods in different mine areas to teach people about health.

Health committee

The job of the health department, one of the seventeen union departments mentioned before, was initially just to supervise the care of patients admitted to the BSP hospital. Later, the health department played the most significant role in the sharab-bandi movement (against alcohol consumption) from the late seventies to the early eighties, even though the entire union took part in it. The health committee was made up of the doctors and the hundred or so workers who had been inspired by the success of the 1981 cleanliness movement and had been trained at the doctors’ health meetings.

On 26th January, 1982, Shaheed Dispensary started providing health services twice a day from a garage next to the union office. A few members of the health committee took turns helping the doctors run the dispensary, while the doctors started training them as health workers. The remaining members of the health committee took on the responsibility of building a hospital.

From 26th January 1982 to 3rd June 1983, the day when the hospital was inaugurated, almost 6000 people were treated at Shaheed Dispensary.

The eleven martyrs of 1977 and Shaheed Hospital

After the inception of the Chhattisgarh Mines Shramik Sangh, workers began a movement demanding an allowance for building materials. In order to break the movement, on June 2nd 1977 the police took comrade Niyogi into custody from the union office. The workers, demanding the release of their leader, encircled another group of policemen. The police fired the first shots on the night of June 2nd. The next day, a large contingent of police from the main city of the district fired shots a second time and freed the encircled policemen.

Eleven people lost their lives in the shootings of June 2nd and 3rd – Anasuya Bai, Jagdish, Sudama, Tivuram, Sonudas, Ramdayal, Hemnath, Samaru, Punuram, Deharlal and Jaylal.  The Shaheed Hospital was inaugurated on Shaheed Divas (Martyrs’ day) of 1983 in the memory of these martyrs. As a symbol of the friendship between workers and farmers, the hospital was opened by the oldest mine worker Lahar Singh and the oldest farmer from the surrounding villages Halal Khor. The Shramik Sangh pamphlets that day displayed the slogan “tumne mout di, humne zindagi” – you (the rulers) gave death, we will give life.

All hospitals are built by the efforts of workers, but Shaheed Hospital, built by the voluntary labour of the Chhattisgarh iron mine workers, was the first hospital in India in which workers were directly involved in administration. Shaheed Hospital was truly “mehanatkashon ke liye mehanatkashon ka apna  karyakram” – workers’ own agenda for the benefit of workers.

Dr. Saibal Jana joined during the Shaheed Dispensary phase, before the hospital was opened. Dr. Chanchala Samajdar arrived in 1984 after the hospital was inaugurated.

shaheed hospital1

A brief overview of Shaheed Hospital

Shaheed Hospital has grown to be the main resource for medical treatment for the poor in a vast adivasi majority area 84 Km from Durg the district headquarters, 62 Km from Rajnandgaon,

66 Km from Dhamtari in Raipur district and flanked on the other side by Dondi, close to the Bastar district. (This geographical location was before the creation of the small state of Chhattishgarh. Now Dalli-Rajhara is situated in the Balod district.)

Six days a week, except for Tuesday, the outdoor clinic was open from 9:30 am to 12:30 pm in the morning and from 4:30 pm to 7:30 pm in the evening. The hospital was open for emergencies every day for 24 hours. In 1983 the hospital started with 15 beds, after the second floor was built in 1989 the number of beds rose to 45. The hospital could accommodate up to 72 people with extra beds (charpoys brought from patient homes). People could buy medicines at low cost at the hospital. There were facilities for pathology, x-ray and ECG.  There were also operation theatres and ambulances.

Other than the doctors and one nurse, the health workers had no institutional education. Boys and girls from worker and farmer families were trained as health workers in this hospital. Another big resource was the team of volunteer workers who had been with the doctors since the early days of Shaheed Dispensary. They worked in the mines for their livelihood and, in the evenings and on holidays, they worked without pay at the hospital and with the health program.

Medical treatment was not the only goal of Shaheed Hospital. Raising people’s awareness about health and building a health movement was also part of the agenda.

Whose money was used to build Shaheed Hospital?

From a 15 bed one storey hospital in 1983 to a large hospital with modern facilities in 1994 – from where did all this money come?

Shaheed Hospital was built completely with contributions from workers. Even though well-wishers offered help many times, the workers politely refused because they wanted to get a measure of their own strength. After Shaheed Hospital became popular, many offers of funding came from agencies inside and outside the country. All those proposals were firmly rebuffed since the workers knew that outside funding also meant outside control.

Most of us don’t know the term “fall back wage”. If workers turn up for work but the employer is unable to give them anything to do, 80% of the minimum wage is their due as a fall back wage. The workers of Dalli-Rajhara were the first in India to negotiate a fall back wage. That money was used to buy bricks, stones, iron and cement to build the hospital. An organization of small truck owners, the Progressive Truck Owners’ Association, helped with the transportation of these materials. The hospital furniture was built by members of an associate group, friends from the Shaheed Engineering Workshop.

At the inception of the hospital, every member of the union gave one month’s mines allowance and house rent allowance as a contribution. A part of this money was used to buy the needed medicines and equipment. The rest of the money went towards buying an old truck which was transformed into a water tanker. The tanker supplied drinking water to the mines and the income earned in this way was used to pay the doctors.

This is how the hospital was funded initially. Any development, building or large equipment purchase undertaken after that was funded by contributions from workers.

Patients had to pay some money to cover the running costs of the hospital such as workers’ wages – an outdoor visit cost 50 paise (later raised to 1 rupee), an indoor bed cost 3 rupees a day (later raised to 5 rupees a day). However, for agitating workers who were out of a job and their families, for full-time employees of the organization, and for very poor patients, all types of treatment were provided free of charge.

This is how, depending solely on local resources, Shaheed Hospital advanced on the path to self-reliance.

The fight for rational and scientific medicine

The people of Dalli-Rajhara were caught between two extremes – on the one hand were the spells and rituals of traditional witch doctors, and on the other, the unnecessary and harmful use of modern medicines by trained and untrained doctors for whom medical care was a business. They had no awareness of such a thing as scientific medicine.

Some examples will make this clear. Work-weary mine labourers used to believe that weekly red injections of vitamin and calcium would help them regain their stamina. The forbidden Analgin injection, that reduces granular white blood cells and harms the liver and kidney, was routinely used to reduce fever. Pitocin (oxytocin) injection was used to hasten labour and increased the risk of strong contractions that could result in uterine rupture and death of the mother.

The movement for use of rational medicine in India happened at the same time as the Dalli-Rajhara workers’ health movement. The doctors who worked with the mine labourers were also part of the other movement – some were associated with the Drug Action Forum in West Bengal, some with the All India Drug Action Network. Shaheed Hospital was the first large testing ground for the theory of rational medicine use.

The use of medication was discouraged in situations where home remedies were effective. For instance, in order to replace salts and fluids in diarrhea, patients were asked to make a mixture of lime juice, sugar and salt at home instead of buying packaged ORS. To reduce fever one could give the patient a sponge bath with cold water instead of an Analgin injection. Instead of sucking on a throat lozenge for a lingering cough, a patient was asked to gurgle with warm salt water. A patient could avoid taking cough syrup by inhaling the vapor from boiling water.

When medicines had to be used, they were prescribed from the WHO list of essential medicines. Doctors wrote the generic names for medicines on prescriptions. With a few exceptions, mixtures of multiple medicines in fixed proportions (fixed dose combinations) were never used. Also avoided were harmful drugs such as analgin, phenylbutazone, and oxyphenbutazone. Unnecessary concoctions such as cough syrups, tonics,digestive enzymes, and hematinics were never prescribed. Injections were ruled out in cases where oral medicines were available.

Surgery at Shaheed Hospital

This unit deserves its own separate mention because it was a beautiful example of how much one can achieve with little equipment, and how much one can learn and progress when armed with the love of one’s fellow human beings. There is another reason – despite being trained as a general physician, I was in charge of this unit for eight years equipped with nothing more than my surgery training during housestaffship.

For the first ten years, the operation theater was just an ordinary 18 ft by 11 ft clean room. An 8.5 ft by 6 ft room next to it was used to store surgical equipment. Tools were sterilized using a single drum autoclave. The room was disinfected by burning sulphur in the room the night before the operation. The light source was a 200 Watt light bulb. When we needed to go in deep we used a 4-battery torch. Open ether anesthesia – though an ancient practice but quite safe –  was used to make the patient unconscious. When possible we used local anesthesia. This was nothing like the hospitals in which I had been trained. We were inspired by the stories of major operations performed with very little equipment on the Chinese battlefields by Dr. Norman Bethune and Dr. Kotnis. Compared to them, what we had was more than enough!

With the few instruments we had in the beginning, we could operate on boils, cuts, hydroceles, hernias, hemorrhoids and fistulas. Gradually we acquired more tools and the operations increased in number, type and gravity.

We began performing major operations in emergencies. I remember the first patient, a three year old boy who came from a village with an intestinal obstruction. It was too late to send him to the city. We had to open him up. In the absence of a small retractor, we had to use a tongue depressor. A portion of his small intestine was damaged. We had to remove it and sew up the two healthy parts. Intestinal clampswere needed to keep the stool from leaking out and also to prevent bleeding from the cut ends. Since we didn’t have one, we had another assistant join us. His job was to keep the ends of the intestine pressed and closed with two fingers of each hand. The operation was a success. The second patient was elderly, with a peptic perforation. In such cases, the diagnosis is usually confirmed with an x-ray to see whether the shadow of gas is visible on the liver below the diaphragm. At that time we did not have an x-ray machine at Shaheed Hospital. The only place where x-rays were available in Dalli-Rajhara was the missionary Pushpa Hospital, but not after evening hours. The abdomen had to be opened based on a clinical diagnosis.

Shaheed Hospital slowly became known as a center for surgery. The BSP hospital had qualified surgeons and gynecologists with Masters degrees, but even cases that were marginally more serious were sent to the main hospital in Bhilai and many patients could not survive the 91 Km journey. So the Shaheed Hospital MBBS doctors were then called on to take up their tools. The anesthetist was illiterate, but no one ever died from the administration of open ether anesthesia at his hands. He later became an expert at the use of air ether machine too.

A major problem was that the same room was used for operations as well as deliveries. After winning a large amount of money in1989 as the result of a workers’ agitation, the workers undertook the task of building a modern OT complex. This four-room complex with marble floors could rival any modern hospital. However, the simpler implements developed by the doctors and workers when money was limited also found room in the new OT. After the new OT was opened in1993, the old room was used as a minor OT and labour room.

Gradually we became so well known that even those who could have gotten free surgeries at the BSP hospital, paid money (albeit a small amount) to come to Shaheed Hospital.

Arrangements for testing

In the beginning, the laboratory was an 8.5 feet by 4.5 feet sliver of space beside the doctors’ examination room. Standard tests for blood, stool and urine, tests for phlegm and semen, were carried out by an adivasi youth named Madan. He used to be a helper on a truck. He had been admitted to Shaheed Hospital and had stayed for several months to treat the buildup of fluid around his lungs (pleural effusion) due to tuberculosis. It was then that he got his training from Dr. Saibal Jana and became an expert at his job.

By saving the income from the laboratory, we bought, one by one, an electrical centrifuge, a colorimeter and an incubator. A large laboratory room was built in the first half of 1993 and was staffed by three people who had been trained at Shaheed Hospital. The tests cost one-fourth or half of market prices.

In the beginning, ordinary x-rays were performed at the Pushpa hospital, and special x-rays at Durg or Bhilai. In September of 1993, we acquired a  20 mA x-ray machine. The hospital had some savings. Some of the remaining cost came from members of the Progressive Truck Owners’ Association and the rest was a long-term interest-free loan. A young man from a worker family who had completed his HS was chosen to be the x-ray technician. A radiologist friend in Kolkata took him under his wing and trained him in six months.

The ECG machine arrived in February, 1994.

shaheed hospital ambulance

The ambulance arrives

Before 1990, if a patient had to be taken from Dalli-Rajhara to Durg, Bhilai or Raipur, it was a major hardship for the family. The only ambulance belonged to the BSP hospital and the charge for the 91 Km trip to Bhilai was more than 3500 rupees.

We had been thinking for a long time about buying an ambulance but where was the 2 lakh rupees going to come from? In 1989, after the victory in the anti-mechanization movement, a few junior officers of BSP impressed by the activities of the union wanted to donate some materials to Shaheed Hospital. Niyogi told them that the hospital did not take contributions from outside. But they could arrange for the union to buy a discarded ambulance from BSP. An old ambulance was purchased for 12,000 rupees. It cost 28,000 rupees to repair it. We got an ambulance that was almost like new for Rs. 40,000.

A citizens’ meeting was convened to decide what the rent for the ambulance would be. It was decided that the fee would be 1.5 rupees per Km, Rs. 270 to go to Bhilai, 0.077% of what was charged for the BSP ambulance. Poor patients would not have to pay anything.

Despite the cheap fare, the income from the ambulance covered the cost of diesel, repairs and the driver’s salary.

An unusual blood bank

There was no blood bank at Dalli-Rajhara and yet the number of deaths due to lack of blood were reduced to zero.

As in other places, people here were scared and confused about donating blood. To educate the people about blood donation, wall magazines were created along with poster exhibitions and publication of a booklet in the health education series: “raktadan ke bare me sahi jankari” or “Accurate information about donating blood”. To show people that their fear was misplaced, hospital workers, doctors and union leaders continued to donate blood. When the others saw that donating blood did not hurt, on the contrary it helped save the lives of the dying, they too became eager to donate. They had their blood groups tested and were registered as volunteer donors until we had more than five hundred of them.

When a patient needed blood, the family was asked to donate at first. If there was no appropriate donor among them or if the blood group did not match, the volunteers were summoned. A circular went out from the hospital or the union office and a volunteer appeared within the hour or at most an hour and a half. The hospital employees, doctors and union leaders were maintained as emergency stock.

This is how we developed a blood bank which, in reality, did not exist but which stocked enough blood of all groups. (Nowadays it is not possible to run a blood bank this way given current rules and regulations. But I am confident that the workers of Dalli-Rajhara would have been able to run a blood donation service even if they were required to follow the rules and regulations of today.)

Shaheed Hospital as a part of national health programs

Shaheed Hospital was the leading institution in Durg district for the national tuberculosis control program and the vaccination program. In the early nineties, the supply of tuberculosis medicines and vaccines became irregular because of new economic policies and the consequent restructuring.

In 1989, the local health centre conducted a survey of polio patients in the worker quarters of Dalli-Rajhara. The survey revealed that no child had been struck with polio since 1984. This was not just a victory for the Shaheed Hospital vaccination program. The rise in living standards and dissemination of education among the workers, due to the socio-economic-cultural movement begun in 1977, was the true reason for this achievement.

However, Shaheed Hospital did not participate in the national family planning program that was designed to curb population growth. This was because we did not support the governmental policy that placed population, and not inequity in distribution, at the root of all problems.

The health movement must be part of a larger social movement

The Dalli-Rajhara health movement I am talking about was part of a larger struggle for the rights of working people. The workers learned from their own experience that most health problems were rooted in economic, social and cultural causes. So in order to root out health problems, it was necessary to change existing economic, social and cultural conditions or, in other words, existing social arrangements.

Let me try to explain with an example. Diarrhea is a leading deadly infectious disease in poor countries. People, especially children, suffering from malnutrition are vulnerable to this disease. It is spread through indiscriminate defecation and contaminated drinking water. For people who are forced to live in small unsanitary houses, this disease can become an epidemic. Loss of water and minerals from the body can cause this disease to become life-threatening. But if people know how to compensate for this loss by making a drink with salt, sugar and lemon juice, the number of deaths due to diarrhea can be much reduced. Countries that have been able to control diarrhea have only been successful by assuring clean drinking water, toilets, proper housing, enough food and education for all people.

Some health programs treat diarrhea only with medicine. Some programs talk about boiling water to reduce stomach problems and about making salt-sugar-lemon drinks for treatment. They forget that a person who has no money to buy food will not be able to afford fuel to boil drinking water. These programs ignore the importance of sufficient food and proper housing, and the right to safe drinking water is overlooked.

Right at the beginning of the Dalli-Rajhara health program, diarrhea was chosen as one of the central subjects for dissemination of information. In all communications, emphasis was placed on the socio-economic roots of diarrhea, the need for clean drinking water and the fact that medicines were unnecessary. The Chhattishgarh Mines Shramik Sangh and the Chhattishgarh Mukti Morcha then began their movement with people who were informed and aware. The government and the BSP management were forced to install 179 tube wells in Dalli-Rajhara and surrounding villages.

A medium for public health education – Shaheed Hospital

Shaheed Hospital used all proven methods for health education. Doctors and other health workers had extensive discussions with both outdoor and indoor patients and their families about the causes of illness and treatment. On Tuesdays, when the hospital was closed, groups of health workers and doctors went to the villages and worker neighbourhoods with poster presentations, slide shows and magic shows. The hospital also published a wall magazine known as “Swasthya Sangwari” (health companion). From 1989 to 1991, a health booklet with information about common health issues was published every two months. This series was known as “Lokswasthya Shikshamala”.

The themes that were stressed were the following:

  • Debunking blind beliefs and superstitions related to health
  • Exposing the true nature of the unscientific treatment meted out by health businessmen
  • Empowering people with the knowledge of simple prevention and treatment techniques
  • Raising awareness of exploitation of the public by domestic and foreign pharmaceutical companies

A tool for struggle as well

In many instances, health education was used to prepare the ground for struggle by enlightening the public about social problems.The use of diarrhea awareness in highlighting the demand for clean drinking water is one example.

When any organization within the Chhattishgarh Mukti Morcha family went on strike, Shaheed Hospital took complete responsibility for the medical treatment of workers or farmers that were out of work and their families.

Shaheed Hospital played a prominent role in the movement for the health rights of Bhopal gas victims as well as in the Narmada Bachao Andolan.

In the past Dalli-Rajhara did not have a government hospital and the capacity of the BSP hospital was limited. Alarmed by the increasing popularity of Shaheed Hospital, the administration set up seven health centers in the Dondi-Lohara legislative assembly constituency. The BSP hospital increased the number of beds.

The management was unique too

In a class-based society, class divisions are reflected in the management of any organization. That is why the management of any hospital is headed by an administrator or director and, in levels below that, senior doctors, junior doctors, nurses, class 3 staff and class 4 staff.

As a realization of the idea of “struggle and creation”, Shaheed Hospital was envisioned as a model of an embryonic classless society within a hierarchical society based on exploitation. So there was no position for an administrator or director. There was no difference between mental and physical labour. A committee made up of doctors, nurses, medical workers, volunteer health workers and cleaners met every week to make policy and operational decisions. Every person had an equal right to express his or her opinion and decisions were made based on the opinions of the majority. Union representatives were included in the discussion when any important decision had to be made that would affect the union or the political organization.

About limitations

Shaheed hospital was unable to study occupational diseases primarily due to the shortage of people even though there was a need to study work-related respiratory problems suffered by mine workers and the back and neck pain that plagued transportation workers.

Another weakness was the dependence on West Bengal for doctors. Binayak-da, Ashish-da, Pabitra-da, Saibal-da, and Chanchala-di came before me. After me there were Dr. Pradip Das and Dr. Bhaskar Saha. All of us were products of the West Bengal medical students’ movement that aimed to transform society. Even after Comrade Niyogi’s death, when Saibal-da and I were the only regular doctors, and at least one of us was needed in the work of organization, the only doctors who responded to our appeals and came to volunteer for 10-15 days were the doctors from West Bengal. The first non-Bengali doctor, Rajeev Lochan Sharma, was not from Chhattishgarh either. He was from Indore and he came to us from the Narmada Bachao Andolan in 1992.

Since 1994, doctors from Chhattishgarh have come and are continuing to come, but that is usually for a short interval before they get a government job or a chance to pursue post-graduate studies.

There was another problem. All medical employees of the hospital were from worker and farmer families. When they were hired, their interest in the Mukti Morcha movement was also assessed. Despite that, some of them viewed their work in Shaheed hospital as just another job. We tried to change their thinking through discussions about general politics and the politics of health, analysis of significant national events, and by involving them in the work of the organization and in movements.

There was a larger problem. The health workers used to take on the work of management in the running of Shaheed Hospital. Some of them, in their roles as managers, treated other workers in the same arrogant way as the BSP or contractor managers in the mines. So there was an ongoing need for an ideological struggle.

Journeying backwards

After Niyogi’s martyrdom in 1991, a large influential section of the leadership tried to first move the organization away from the path of class struggle and then, when faced by opposition from a large part of the membership, to dispense with the democratic practices within the organization.

The doctors at Shaheed Hospital were not there just to practice medicine, we were also full-time workers of the Chhattishgarh Mukti Morcha. So several of us got involved in this ideological conflict between class struggle and class compromise, between democracy in the organization and dictatorship. In 1994, after protesting against some compromise made by the leadership in favour of mechanization, I was first suspended, then expelled. I was not given any opportunity to defend myself. This was the first time a decision was taken at Shaheed Hospital that did not involve all the doctors and workers in a democratic way.  Two doctors resigned in protest against this incident, two others remained. This was the beginning of the journey backwards.

Of the two who remained, the older doctor was away from Shaheed Hospital for two years. This was when the other doctor, claiming that there was a need to increase income, instituted special cabins in the hospital. And yet, our motto had always been equal service for everybody.

Workers and doctors had always received equal pay, now some people were given higher pay in the name of proficiency. The hospital workers went on strike.

Some new doctors brought in corruption. There were many patients and few people to keep track of them. They started operating at night and releasing patients in the morning with no record kept at the hospital. The doctors and the workers in league with them divided up the money.

My leave-taking from Shaheed Hospital was filled with bitterness, so I did not go there for a long time. Thirteen years later, when Dr. Binayak Sen was jailed for the first time, I went to participate in a meeting at Shaheed Hospital. I wished I hadn’t come. The hospital has grown several times in size and yet is moving backwards –

  • They do not stick torational use of medicine
  • Only one health booklet, about sickle cell anemia, has been published since 1994
  • The worker employees behave like managers in their management roles
  • A group of employees has become corrupt
  • A senior doctor is now in the position of director
  • There are allegations of corruption involving the national health insurance scheme (RSBY—Rashtriya Swasthya Bima Yojna)

This is only to be expected when we don’t have politics in command.

Yet Shaheed hospital lives

It lives in the Chengail-Bauria-Bainan Shramik-Krishak Maitri Swasthya Kendras, in the Beliatore Madan Mukherjee Smriti Janaswasthya Kendra, in the Sundarban Simanta Swasthya Pariseba camps, in the Sundarban Shramajibi Hospital at Sarberia…we are developing the lessons from Shaheed Hospital further in these places. A new generation of physicians is attracted to this work, doctors and health workers with new values are being born.

All hope is not lost for Shaheed Hospital

It still has our colleague Dr. Saibal Jana, head nurse Alpana De Sarkar.  I will assume that they have been too busy to pay attention to ideological matters. Dr. Dipankar Sengupta, a leader in the students’ movement and junior doctors’ movement joined the hospital about few years ago. Gynecologist Dr. Sheela Kundu is also on staff now. That many idealists joining together will again bring Shaheed Hospital back to the path of idealism is not too much to hope for.

This is chapter 2 of a 10 part series. To be continued….

Read Chapter 1 – “Struggle And Create: My Days With Com. Shankar Guha Niyogi” : Chapter 1- Niyogi And His Mission

Translation from Bengali to English by Sreela Dutta

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