Doctorhood, Mosquitos and the Adivasis: How DAMaN obfuscates the politics of public health in Odisha

DAMaN

When there seems to be a growing recognition of regional cine industries in recent years, the fanfare around Odia film DAMaN probably marks Ollywood’s resurgence with a strong populist overtone. Besides its off-centred storyline around public health, the film garnered a staggering response at the box office and beyond for its virtue signalling on ideal doctorhood and developmental statecraft in contemporary Odisha. The state government has declared the film tax-free and even directed all district collectors to arrange its special screenings at district and sub-district levels. DAMaN is now getting ready for pan-Indian release in Hindi. However, amidst glorifications from all corners, the film’s discursive half-truths have gone unnoticed, notwithstanding its explicit endorsement of a government scheme.

The acronym DAMaN stands for Durgama Anchalare Malaria Nirakarana (translated as Malaria Eradication in Cut-off Regions), a health scheme by the Odisha government to eliminate malaria in selected Adivasi pockets. The film is marketed as “based-on-true-event” showing the journey of a young doctor, who not only fights against the deadly mosquitos in far-off villages of Malkangiri but also has to deal with the Adivasi people who resort to indigenous healing over the barely available government healthcare facilities. The film presents the doctor, a sharp-featured, fair-skinned, Savarna, urbanite male as a role model for its audience while the Adivasi people are consistently presented as ignorant, superstitious, dim-witted victims as well as unruly villains.

The film opens with the story of Siddharth Mohanty, an MBBS graduate who is deputed for two years of compulsory community service at a primary health centre (PHC) in Malkangiri’s cut-off region, notwithstanding his desire to build a private hospital near Bhubaneswar airport. Upon arriving at the dilapidated PHC and experiencing a sleepless night with mosquitos there, his reluctant spirit resolves to leave next morning. Yet, the doctor had to stay back when a villager comes begging to save his daughter from an unknown fever and it is when Dr Siddharth discovers the dire situation of malaria in the region and the people adopting local remedies of Dishari. Disharis are the local medicine men who practice ethnomedicine as well as magico-religious means to treat the ill. Representation of Adivasi people as obnoxious liabilities of the state is repetitively foregrounded in the film to project the doctor as their messiah. The film’s demonical portrayal of Disharis reaffirms the epistemic hubris of modern biomedicine against the ethnomedical healing systems of Adivasi communities. It tries to draw a reductionist picture of public healthcare as a modern technocratic enterprise that has to replace traditional forms of treatment with biomedicine.

As the film progresses, Siddharth decides to tour the hamlets on mule back to do rapid malaria testing and discipline the Adivasis to visit the health centre and get allopathic treatment. Finally, he succeeds in convincing the state to launch a blitzkrieg-styled awareness and surveillance campaign for malaria prevention by enforcing the use of insecticidal mosquito nets among Adivasis. To the end, the Savarna white man’s goal is accomplished, and so is the majoritarian state’s!

Anthropologist James Ferguson’s work on the third-world development realities is an apt lens here to look at DAMaN’s anti-political agenda. Ferguson’s idea of “Anti-politics” talks about how depoliticised understanding of development always tends to treat its antecedents and the corollaries as technical problems of human condition, not political ones. As a result, discounting the temporal politics undergirding developmental interventions, as in the case of malaria eradication in Malkangiri, would be a gross misreading of the What, How and Why of development. Why Adivasis inhabit the so-called cut-off region with a high risk of malaria and the historical dynamics behind their current state of health impoverishment have been eluded in the film.

To recognize the discursive window-dressing of Adivasi people’s health problems, one needs to take a historical detour of the overall logic and practice of development in Malkangiri (erstwhile undivided Koraput district). For the state, Malkangiri has long been an annoyance for persistent epidemiological crises ranging from malnutrition and tuberculosis to encephalitis and malaria, let alone the district being caught up at the crossroads of Maoists-military crossfire. The socio-historical moorings of the grim health scenario in Malkangiri must be probed vis-à-vis the spatial and social politics of the state and the dominant Odia caste society, which the film’s messiah politics belie.

First, the spatial politics in development in Malkangiri began with a specific vanity project of the post-colonial state. Odisha and Andhra Pradesh built Balimela hydroelectric dam across the Sileru River in the 1960s for catering electricity to urban and industrial centres. The dam reservoir drowned vast stretches of habitable and agricultural land, displacing Adivasi settlements along the riverbank. With no land pattas for claiming compensatory land, hundreds of Adivasi hamlets were cast away by the reservoir to what the government and the film conveniently and convincingly label cut-off regions. While Balimela dam was emblematic of state-led modernity and development in Odisha, the Adivasis found nothing except forced displacement and spatial segregation. From being part of the mainland, the Adivasi hamlets became inaccessible islands with no access to state welfare provisions, including the right to healthcare, let alone the rights to vote, education and livelihood security. For most of post-dam history, the state chose to withdraw its responsibility of providing its citizens with their rightful access to healthcare.

Second, the miserable health infra-system in the region has not only been the outcome of the geographical distance between citizens and state brought about by dam, but also of the pervasive social distance between doctors and patients. This non-medical aspect of public health reveals why patients do not trust government healthcare providers and their prescribed medications, or why they trust traditional medicine men. Adivasi people in Malkangiri or elsewhere regularly experience condescending behaviour and casteist abuses from healthcare professionals, predominantly of Savarna Odia background. Being frequently gazed upon and treated as ignorant, superstitious, stupid patients makes Adivasis averse to hospital walls. Medical Historian Kiran Kumbhar in his work dismantles the doctors-as-gods discourse touted by the upper-caste urban elites. Kumbhar argues that caste supremacy gives birth to a bizarre sense of exceptionalism among healthcare professionals and this perpetuates various forms of symbolic violence against their patients, mostly belonging to Dalit-Adivasi communities in rural India. He shows how the nationalistic discourse of doctors as noble messiahs of the masses is a social construct produced by Savarna media, mainly through populist movies.

The Balimela dam reservoir bears a direct connection to the syndemic nature of malaria among Adivasis. Syndemic refers to the complex scenario in epidemic outbreaks where diseases and socio-historical-political conditions of the people mutually reinforce each other and can generate other comorbidities. Malaria interacts syndemically with the Adivasis of cut-off villages of Malkangiri where associated conditions like upper respiratory tract infection, anaemia, spleen infection, vitamin deficiency and diarrhoea are common. Also, recent studies in public and community health have flagged the role of dam backwaters in tropical countries in transmitting malaria with extremely high chances of community outbreaks.

The film weaves together its tactics of invisibilisation of these historical facts and the depoliticisation of the structural poverty of health in Malkangiri with the saviour complex of dominant Odia caste society. On the subtle connections between films and popular memory, French philosopher Michael Foucault once noted, “If one controls people’s memories, one controls their dynamism. And one also controls their experience, their knowledge of previous struggle.” DAMaN’s deceptive “based-on-true-event” narrative of rescuing Adivasis from deadly mosquitos is an attempt to manipulate the collective memory of the Adivasis of their systemic dispossession from the basic human right to health. It excuses the dark power play in Adivasi healthcare in Odisha and obfuscates the history that has had produced the preconditions of structural poverty- of health and dignified life- among the Adivasis.

Its half-truths are a reaction of dominant Odia society and the state to divert attention away from historical injustices against Adivasis and create a crisis where the perpetrators view themselves as virtuous saviours. Adivasis have the right to remember their past and decide what form of good life they want for their future. Lest we not forget that, the precarious health status of Adivasis in Malkangiri is the collateral damage of the majoritarian model of development and is a mirror to the casteist face of the medical community.

Pradyumna Behera is a PhD student at the Department of Humanities and Social Sciences, IIT Bombay.

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