#01: Bhartiya Swasthya Yatra | Harijan Tola | Araria

For two years, I practiced as a doctor in Delhi, immersed in the structured world of urban healthcare. But something felt missing. Seeking a deeper understanding of grassroots health issues, I left my job and embarked on a journey to rural India, landing in Rampur, a village in Bihar’s Araria district.

Rampur, part of the Seemanchal region, is home to marginalized communities, particularly the Harijan Tola. Here, access to healthcare remains a distant dream for many. Accompanied by Mandvi Didi, a dedicated community worker engaged in raising awareness about anemia and ensuring maternal healthcare access, I found myself in a world where the presence of a doctor was a rarity. For many villagers, it was the first time a medical professional had come to them.

The 70-Year-Old Man’s Struggle

One of my first encounters was with a 70-year-old man suffering from drastic weight loss, a persistent productive cough, and recurring high-grade fever for over a year. Multiple visits to doctors had yielded no definitive diagnosis. Reviewing his records, I noticed abnormal liver function tests and signs of pancreatitis on an ultrasound.

When I probed further, I suspected alcohol-induced pancreatitis. However, the deep-rooted stigma surrounding alcohol consumption — especially with Bihar’s liquor ban — kept the patient from admitting to it. The fear of societal backlash overrode his willingness to disclose critical information, making accurate diagnosis and treatment difficult. This fear-driven silence is a major barrier to effective healthcare.

The Forgotten TB Patient

Next, I met an elderly man who had been diagnosed with tuberculosis (TB) years ago. He had started anti-tuberculosis treatment (ATT) but discontinued it midway, unaware of the necessity of completing the full course. His symptoms resurfaced without proper follow-up: fever, weight loss, and a productive cough.

His story is not unique. Many impoverished families prioritize daily wages over consistent treatment. They seek immediate relief, and when they don’t see instant results, they abandon medication, unknowingly increasing their risk of multidrug-resistant TB (MDR-TB) or even extensively drug-resistant TB (XDR-TB). Despite government efforts to eliminate TB, local workers like Mandvi Didi play a vital role in educating and guiding patients toward completing their treatment.

The Widespread Anemia Crisis

As I moved through the village, I saw an alarming pattern — anemia was rampant among men, women, and children. Many had never been diagnosed. A simple examination revealed telltale signs: pale conjunctivae and extreme fatigue. Some had learned of their condition through unrelated blood tests, but most remained unaware.

The root cause was poor nutrition. Harijan Tola’s residents, primarily landless laborers, struggled to afford balanced meals. Despite the government’s Anemia Mukt Bharat initiative, which distributes iron supplements, adherence was low. Many women discontinued the pills due to side effects like nausea and vomiting, unaware of how to manage them. Education about the benefits of iron therapy and dietary improvements is crucial to tackling this hidden epidemic.

A Hepatitis B Survivor’s Tale

One villager, diagnosed with Hepatitis B, shared his story. He had contracted the virus through an unsafe blood transfusion from a local quack during his childhood. Fortunately, he and his family received treatment from a gastroenterologist. However, his experience underscored the long-lasting impact of unsafe medical practices and the urgent need for awareness about Hepatitis B transmission and prevention.

The Overlooked Epidemic of Vitamin D Deficiency

Elderly villagers, particularly women, frequently complained of back pain, knee pain, and weakness — classic symptoms of vitamin D deficiency. Limited sunlight exposure and poor nutrition contributed to this widespread issue. Many women spent most of their time indoors, and their diets lacked vitamin D-rich foods. Simple supplementation and lifestyle changes could drastically improve their quality of life, yet awareness remained low.

Bridging the Gap: The Way Forward

My time in Harijan Tola reinforced a sobering reality: healthcare alone isn’t enough — education, support, and sustained interventions are essential. Addressing issues like TB, anemia, Hepatitis B, and vitamin D deficiency requires a collaborative approach between healthcare professionals, government programs, and community workers like Mandvi Didi.

Key Steps to Transform Rural Healthcare:

• Strengthening Awareness Campaigns: Educating communities on the importance of completing TB treatment, managing anemia, and preventing infectious diseases.

• Enhancing Follow-Up Care: Ensuring that those receiving treatment adhere to medication regimens and seek regular check-ups.

• Expanding Mobile Health Clinics: Bringing medical services directly to villages to reduce dependency on distant healthcare facilities.

• Empowering Community Health Workers: Training local health workers to not only provide basic care but also to advocate for better health practices.

  
  

The resilience of Harijan Tola’s people is inspiring, but their struggles highlight a stark truth — healthcare must be accessible to all, not just a privilege for some. With concerted effort, we can create lasting change, ensuring that every individual, regardless of background, receives the care and dignity they deserve.