Manipur Relief Camps: Physicians Request That Government Investigation Awkward Healthcare Infrastructure
While the nation’s capital gears up for a joyous G20 summit, unrest and war abound in the border state. Early in May, a protracted ethnic conflict between the Kuki and Meitei groups broke out in Manipur, and its devastating effects are still being felt by the local populace. Over 60,000 people have been displaced by the fighting, which claimed 130 lives. Even though the battle has been ongoing for more than 120 days, the administration only just decided to address the problem after receiving a harsh prod from the Supreme Court. There is still a long way to go, even though the government has subsequently intervened to improve the situation by establishing aid camps and supporting peace discussions between the groups. If not investigated, the government-established relief centers might rapidly develop into a breeding ground for untreated illnesses and community propaganda.
On September 1 and 2, a five-person team of medical professionals from Indian Doctors for Peace and Development (IDPD) visited relief camps in Manipur to evaluate the camp’s medical requirements in an effort to avoid a similar situation. The medical team visited with camp residents and nodal officers, health department representatives, members of civil society organizations, and district administration officials. The president, Dr. Arun Mitra, said, “We visited two camps, one was Meiti dominated situated in the district of Khumanlankpak, in Imphal, and the other was Kuki dominated along the hills, in Kangpokpi district.
Currently, there are 334 camps; some camps were combined since there used to be over 600 camps; each camp has about 200 residents. In most of these camps, two families share a room, while typically one family occupies one. added Dr. Arun.
While there are forces working for rehabilitation and relief, the medical team on the ground has noted and documented a number of problems that need to be addressed. They are as follows:-
Due to its geographic disadvantage, Kuki specifically suffers from a major lack of infrastructure and referral. The Kuki-dominated camps are situated in the hills and lack access to medical schools or adequate health care facilities; yet, Imphal is home to the great majority of experts and medical facilities. Additionally, the Kuki camp residents must travel great distances since Imphal (a region inhabited by Meitei) is off limits because to the conflict.
The absence of facilities and space was undoubtedly noticeable in both aid camps. Absence of proper infrastructure suggests a greater risk of infections due to a lack of space.
Due of their geographic disadvantage, Kukis in particular lack an appropriate referral and triage mechanism. Delay in screening might also result in a higher death rate in the camps. They claimed that the nearby district hospital did not have an operating room or a blood storage facility, which increased the danger to expectant women.
The mobility of services and drugs is further hampered by the mistrust between the groups, which also hinders drug supply and purchase.
Children, pregnant and nursing mothers, and older individuals have been shown to be the groups most often showing symptoms of post-traumatic stress disorder (PTSD). As a consequence of all the violence they are exposed to, children complain of nightmares, are unable to play with their friends or attend school, and develop dread psychosis. While expectant moms worry about their birth, nursing mothers struggle to breastfeed because of incorrect notions that have arisen as a result of the mental and physical stress; a lack of privacy also added to their predicament. Mothers often give their kids “powdered milk,” which is dangerous for a baby’s health. Senior citizens, particularly those from the Kuki tribe, often lament losing little things like their reading glasses, but because the majority of them are devout Christians who read their Bibles every day, even a misplaced set of spectacles may be stressful for them. And even if the government announced a program to provide people reading glasses with a fixed focal length, it is insufficient.
A populace in pain is further tormented by an internet outage since it deprives them of even access to telemedicine services. In the midst of a severe lack of experts, telemedicine services may have been beneficial for training physicians in addition to helping patients. Dr. Shakeel used the treatment of renal failure and pneumonia, respectively, to illustrate how peritoneal dialysis and Ambu bags are alternative and less common treatments.
Last but not least, it is important to consider the state’s recently jobless young when talking about mental health issues. The young, who are mostly from agricultural backgrounds, are also abruptly out of work and completely disoriented by the same since they have no knowledge outside of agriculture. Although some of them have begun doing odd jobs to supplement their income, it barely covers the cost of feeding a family, increasing their stress levels both mentally and financially.
Governmental Action
Dr. Arun Mitra and Dr. Shakeel Ur Rahman said that the panel has compiled a list of actions for the government to do in order to hasten and ease changes in these camps when questioned about the government’s involvement in the riot-hit state. The government’s work in these camps needs a lot of improvement, according to the physicians, even if pressure to recognise and assist people displaced by the ethnic riots has increased since the Supreme Court’s notice. The physicians emphasized the need of the relief camps according to the UNHCR’s formulated “sphere standards,” which fundamentally must be under the supervision of both the State and the Central Government. Food security and nutrition, housing and settlement, WASH (water, sanitization, and hygiene), and health are all included in the “Sphere Standard.” However, it has been recommended that a strong triage and referral system in established health infrastructures both within and outside the state be investigated first. Additionally, they emphasize the necessity for made-to-order operating rooms, particularly in light of the failing mother and child health system.
The administration has also been advised on how to avoid and start immunizing against a potential measles epidemic, which is frequent in relief camps. Government assistance with vitamin A supplements is required due to the lack of a nutrient-rich diet in these camps, where one egg is recommended for each person over the course of 13 days. Dr. Shakeel emphasized the critical need of vitamin A among youngsters, saying that if they stayed there for another six months, they would acquire night blindness. Additionally, it has been emphasized how crucial psychological counseling services are, particularly for the most vulnerable people, such as children, women, seniors, and young people.
Due to the fact that Manipur “survives on rumor,” especially after an internet outage, there is fierce animosity between the Kuki and Meitei groups that even affects healthcare. The physicians indicated that health authorities are positioned based on their ethnicity, with Meitei doctors limiting their services to their community and vice versa. Therefore, the physicians appeal to civil society to take the lead in fostering mutual trust between the two groups and ask the government to make this possible. They proceeded by saying that the government should be held accountable for ensuring and instilling a feeling of security among the groups rather than separating them since unrestricted mobility between the communities and their occupied territories is important for a sustained and enhanced flow of healthcare services and infrastructure. Dr. Shakeel Ur Rahman said that “Manipur has transformed into ghettos; we had last seen this in Gujarat in 2002.” He strongly emphasized that civic society and the government should undertake a significant campaign and a protracted project to integrate all nationalities.
