A woman gets her child checked at a rural health centre

Biplab Das, a schoolteacher from Agartala, was bewildered beyond expression: the senior specialist at Vellore Christian Medical College of Tamil Nadu had specifically advised him in his prescription ?never to consume any medicine without medical advice and not to rush to doctors at the first opportunity?.

A popular teacher of life science, Das had consumed umpteen number of tablets and capsules to get rid of his chronic gastro-enteric ailment. The medicines, instead of curing him, pushed him to the brink of death. Finally, he was cured by a few inexpensive tablets prescribed by the senior specialist at the Christian Medical College in Vellore.

Cases of wrong treatment and excessive intake of medicine abound in Tripura even as a move is on to launch a 125-seat and 500-bed private medical college and hospital in the state.

The healthcare situation of the state is best illustrated by the diary annually printed and circulated by the state government.

Named ?Important Hospitals in Calcutta, Chennai and Guwahati?, pages 113 and 114 are reserved for names and telephone numbers of 24 leading hospitals and diagnostic centres in West Bengal, Tamil Nadu and Assam.

Saikat Debbarman, manager of the Tripura Government Press, entrusted with the responsibility of printing the government diaries, justified the detailed references to private and government-run hospitals and diagnostic centres outside the state saying that the thousands of patients rushing there for treatment needed the information.

Faced with a near collapse of the government-run health service, the Tripura government has been encouraging people to seek medical advice outside the state, though officially the health department is loath to admit it. On paper, the state health department still runs 19 hospitals, 82 primary health centres and rural.

Hospitals and 652 dispensaries and sub-centres (including homoeopathic and ayurvedic ones), manned by 860 doctors and 947 nurses and a host of junior and paramedical staff, serve a population of 32 lakh.

It is also officially claimed by the health department that more than 23.86 lakh people in the state had undergone treatment in government-run hospitals and dispensaries in 2003-2004, while figures for the current year are yet to be computed.

But the records only contain names of people who had sought treatment in the government-run facilities.

Insurgency has contributed to the collapse of the health sector, where even doctors and nurses are not immune to militant attacks.

In 1986, Tripura National Volunteers militants had abducted a doctor Sanjib Debbarma and a nurse, Prajapati Debbarma.

In November 1998, another doctor, Parthasarathi Mazumder, was kidnapped from Mandai area in Sadar subdivision and taken to the All Tripura Tiger Force hideout in Bangladesh.

In the autumn session of the state Assembly last year, the government admitted that more than 30 dispensaries and sub-centres had to be closed down because of insurgency.

According to the Opposition, however, doctors and nurses, including those belonging to the tribal community, refuse to work in the interior areas for fear of extortion, abduction and killing.

The outcome is reflected in the annual death toll of tribals in interior areas from perfectly curable diseases like malaria, cholera and other enteric diseases.

Last year, more than 127 tribals, including women and children, fell to enteric diseases in rebel-infested areas like Chhawmany in Dhalai district, Kanchanpur subdivision of North Tripura and the areas bordering Chittagong Hill Tracts of Bangladesh.

History is likely to repeat itself this year as well, though the government is trying to provide a modicum of health service to the people in the interior areas by organising health camps under heavy security.

The government had set up a super-speciality block at the G.B. Hospital, in collaboration with Hyderabad-based Care Foundation, in 2002, but the centre has turned out to be a huge flop as the specialists from Hyderabad left the state long back.

The facility provided in Udaipur, headquarters of South Tripura district, to enable heart patients to access medical counselling and tests through the Internet from the Narayan Hridayalay, run by Dr Debi Shetty in Bangalore, is also non-functional now.

The state government is trying to wash its hands off the health service collapse by helping Kerala-based Global Educational Net (GEN) set up a 125-seat medical college and a 500-bed hospital.

For this, the state government has signed an agreement with the GEN and this was followed by a registered deed, handing over 25 acres of land, with all the buildings, furniture and medical equipment of the government-run B.R. Ambedkar Hospital, on a 99-year lease.

The GEN Trust, which runs medical colleges in Nepal and Saint Lucia and Saint Kitts in the West Indies, is preparing to set up a medical college and upgrade the 300-bed hospital to a 500-bed one with an initial investment of Rs 152 crore.

The medical college and the ?world class? hospital will start functioning from September this year with courses on anatomy, bio-chemistry and physiology.

GEN chairman K. Balachandran Nair recently visited the state and assured the government that work on extension of the hospital, staff quarters and students hostels would begin soon.

Even though details of the state government?s agreement, signed on October 7 last year, have not been disclosed by the government, the GEN authorities have made it clear that 25 seats of the medical college would be filled by nominees of the state government. About 82 of the 500 beds in the hospital would be reserved for patients belonging to the Below Poverty Line (BPL) category for free treatment.

Even though GEN has promised liberal benefits for the people of the state, the government?s decision has triggered a furore, because privatisation of the government-run B.R. Ambedkar Hospital would mean an increased cost in treatment.

While leader of the Opposition Ratanlal Nath has described the privatisation of the hospital as ?scandalous?, senior officials of the health department justify the move on the ground that Tripura needs a hospital and the occupancy rate in B.R. Ambedkar Hospital was only 3 per cent.

The validity of the argument will be proved in the days to come when the GEN actually sets up the extended hospital and medical college and details about the state government?s agreement with the trust are disclosed.