Family members of Sharmila Kumari (15) and Samonti Devi (35) — two cerebral malaria patients at Paharia village, Bhoolpaharia, under Massanjore police station in Dumka — have no hope that the patients could survive.

The reason: poor healthcare facilities provided by the government at the hilltop village. "We hardly have anything to eat. How could we carry the patients to Dumka town for further treatment?" asked one of the family members.

The state — under special welfare projects for venerable Paharia tribes in six Santhal Pargana districts — has spent crores of rupees every year. It has even appointed special Paharia officer in each district to monitor government-sponsored schemes. Since the near-extinct ethnic community members prefer to stay at their hilltop villages, the state had arranged special medical services on their doorsteps. But all such efforts have failed to curb mortality rate, said a government official on condition of anonymity. "I was asked to visit the special Paharia health centre every fortnight on a monthly remuneration of Rs 200. Imagine my hardship to travel or climb the hilltop to take care of the patients," said Ramishwar Singh, an allopathic doctor in charge of Uparmurgathali, besides Chatupara and Ghoribad villages.

"Since the patients are in hand-to-mouth conditions, on many occasions I have to lend money from my pocket for the medicines," he added.

Lakshmi Devi Mirdha, an auxiliary nursing midwife posted at Ghoribad Paharia special hospital in Jama block, alleged that the monthly remuneration of Rs 1,200 came through the local gram sabha and she has to pay 10 per cent of the amount as "bribe" for releasing the amount. "Why such indiscrimination? Para-teachers posted at Paharia villages receive direct remuneration from the schools?" she said angrily.

Tulshi Das Hembrom, a compounder at Siddhapaharia Paharaia hospital in Gopikander, said that with the monthly honorarium of Rs 1,000 per month, it was very difficult for him to provide 24-hour duty.

"In June, I had attained more than 260 patients independently as the doctor on duty visited only two days," he said.

There are eight special Paharia health centres in Dumka district spread across 10 blocks run by the welfare department with three doctors (each having charges of two-three centres), with eight ANMs and eight compounders. The health centres are run by the gram sabhas under the supervision of special Paharia officer. The appointment of the heath workers was done by the gram sabhas. The government gives Rs 71,200 a year to each health centre out of which Rs 40,000 is meant for purchasing medicines.

Most of the staff in the health centres said that malnutrition, water-borne diseases, cerebral malaria and malaria along with other ailments were common in the areas. "We are working for the government but it is not recognising us as its staff," said Gita Hembrom, an ANM of Chatupara Paharia Hospital.

On July 8, 2008, Dumka deputy commissioner Prasant Kumar, in a confidential report to the welfare department additional secretary (letter no 1659/8-7-08), requested an increase in monthly remuneration of the workers in the special Paharia health centres in the district. He also requested the state to provide different allowances in accordance with the government sops offered to medical workers.

Even after over one year, the welfare department is yet to take notice of the letter. "The ball is now in the court of the state. What can we do with it?" Dumka special Paharia officer Dashrath Prasad Routh said helplessly. He admitted that because of hardship, proper attention to the endangered Paharia tribes could not be possible.

© The Telegraph / July 10, 2009