#Chattisgarh – Maoists do not “obstruct” government health programmes- Jairam Ramesh

Health services in Maoist areas a challenge and an opportunity: Ramesh


His letter to Azad acknowledges Maoists do not “obstruct” government health programmes

Union Rural Development Minister Jairam Ramesh, in a letter to Health Minister Ghulam Nabi Azad, has acknowledged that Maoists do not “obstruct” government health programmes.

Mr. Ramesh has defined delivery of health services to Maoist-controlled areas as an “opportunity” to reach millions of tribal people in the remotest areas of the country. However, government health workers and administrators cite Maoist intervention as a reason for non-delivery of health services.

In underdeveloped areas of Chhattisgarh, especially in Maoist-controlled districts, government healthcare is virtually non-existent. In most cases, primary health centres (PHC) are miles away from villages and people could hardly make it to the PHCs due to non-availability of transport, hostile terrain and extreme climatic conditions.

In addition, health workers rarely visit the PHCs due to what is perceived as “Maoist threat.” Even in a place like Chintagufa in Sukma district, next to a Central Reserve Police Force camp on the main arterial road, the health centre is only occasionally visited by health workers, the villagers toldThe Hindu .

Moreover, according to data released by the Chhattisgarh Health Department, a huge percentage of health workers’ posts are vacant across the State. For example, in Dantewada, 60 per cent posts are vacant. The situation is more or less the same in all tribal districts.

Interestingly, the National Rural Health Mission (NRHM) has also failed to fill the vacant positions announced by them. The demand-supply gap of health workers has been met by quacks and barefoot Maoist doctors, who provide basic health care to villagers.

Mr. Ramesh has said in his letter, a copy of which is with The Hindu , delivery of health services in Maoist areas is “both a challenge and an opportunity.” “It is an opportunity since the health programmes are not obstructed by the Maoists, and if delivered effectively, [it] has the potential to soften the local tribals’ attitude towards the government,” wrote Mr. Ramesh.

Mr. Ramesh has suggested to Mr. Azad to introduce some “flexibility” in the NRHM to deal with “health challenges” in Maoist areas. He has strongly recommended government support for four non-profit health organisations, which have done substantial work in central India. These are Ramakrishna Mission (RKM) in Narayanpur and Jan Swasthya Sahyog (JSS) in Bilaspur district of Chhattisgarh and the organisations led by Dr. Abhay Bang and Dr. Prakash Amte in southern Maharashtra.

He feels the NRHM should not only be used “to support existing institutions,” but also to create “new [health] networks,” and, therefore, “such organisations” should be supported under the NRHM.


  • In underdeveloped areas of Chhattisgarh, government healthcare is non-existent
  • Health workers rarely visit PHCs in remote areas due to perceived ‘Maoist threat’


Dr Prakash Amte carried out vasectomies on Maoists in Gadchiroli

Ashutosh Bhardwaj Posted online: Mon Dec 03 2012
Gadchiroli : Magsasay award winner Dr Prakash Amte, son of legendary social activist Baba Amte, has conducted vasectomy surgery on Maoists at his community centre in Maharashtra’s Gadchiroli district. But he has said that he only did his duty as a doctor and never helped or intended to help the extremists through the procedure that has become controversial.Surrendered Maoists have often said that they were forced to undergo sterilisation by their leaders but top Maoists have denied this and termed it as police propaganda. Chhattisgarh police have termed this operation as the “greatest violation of human rights”.

The Indian Express reported in October that three ex-Maoists underwent reverse vasectomy surgeries as they wanted to become fathers and live a normal family life. According to them, nearly 40 Maoists have undergone vasectomy at Amte’s

Lok Biradari Prakalp in Hemalkasa village so far and they include some top leaders and even a member of the Central Committee of CPI (Maoist).

The Indian Express has details of some of these Maoists but is withholding their names to protect their identity.

Amte admits to have conducted the operations but says he only performed his duty as a doctor and medically, it was less risky compared to abortion. Also, sometimes he was not aware of the identity of those who came for the surgery, he added.

“Several tribals in the area approach me for vasectomy or tubectomy. It becomes difficult to ascertain their identity. I opt for vasectomy as it was safer. Also, Maoists came to me for abortion of their wives, and vasectomy of their cadres. Abortion was risky for women, it endangered their life,” he told The Indian Express. “There was also a possibility that if we conduct abortion once, they may come again for another abortion of the same woman. It involved great health risk for her, so I opted for the lesser evil — vasectomy. Also, I knew vasectomy was reversible.”

Amte, however, makes it clear that he never helped or intended to help Maoists. “By conducting vasectomy, at no point of time I helped Maoists or their movement. I only performed my duty as a doctor on purely humanitarian grounds. I have provided medicare to thousands of tribals in the area,” he said.

Hemalkasa, just a few kilometres outside the Abujhmaad forest, is a remote tribal village bordering Chhattisgarh and Andhra Pradesh, 175 km from the Gadchiroli district headquarters. Baba Amte set up a community project, Lok Biradari Prakalp, in the village in 1973. A year later, Prakash quit his masters in surgery course, opened a medical centre in a hut and settled down there with his doctor wife Mandakini.

Starting in the 1980s, the region became a stronghold of the Maoists. The extremists would visit the Prakalp for medicare and sometimes they also sought vasectomy surgeries for their cadres. A few Maoists said the operation was conducted by Amte himself. The Maoists who underwent the surgery at Hemalkasa included teenagers. “I was only 18 when I was sterilised,” one of them told The Indian Express.

Amte’s clinic is the first and only choice for tribals living in an area spread over hundreds of square kilometres and until a few decades ago, there was no government health centre in the vicinity. Besides his wife, Amte’s two sons and daughters-in-law also live in the Prakalp, a small commune the family has formed and one which is highly respected by the locals.

While Baba Amte won the Magsaysay in 1985, Prakash and his wife won it in 2008 for “enhancing the capacity of the Madia Gonds through healing and teaching and other compassionate interventions”. It is the only instance in India where two relatives of a family have won the ‘Nobel of Asia’.

When Amte came to Hemalkasa, it did not have roads, electricity and schools. Today, the Prakalp treats nearly 50,000 patients every year, a third of them from neighbouring Chhattisgarh and 5,000 from Andhra Pradesh and almost all of them tribals. Besides, it also has a residential school with 650 children and an animal rescue centre.



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