‘The Mitanin Programme has Certainly not been Implemented in the Spirit in Which it Was Formulated’
Chhattisgarh and founder-member, Rupantar,
Dr Binayak Sen
In which areas and capacities have you been associated with the government of India’s programmes and policies? Are you still involved in some programmes?
I have at no stage been involved in the ‘government of India’s plans and policies’ except for my recent participation in the Planning Commission’s steering committee on health for the 12th five-year plan. This is a recommendatory body with 40 members, which has so far had one meeting, which I was privileged to attend.
You were one of the architects of Chhattisgarh government’s public health programme. What was the programme about, what was your contribution in it and has it been implemented in the spirit it was drawn up?
I was NOT ‘one of the architects of Chhattisgarh government’s public health programme.’ I stress this because any architect should take some responsibility for the final product, and I would certainly not like to be identified with whatever passes in the name of public health in Chhattisgarh today. However, I (along with other NGO-based colleagues in their independent capacities) was part of a high-power committee set up by the Ajit Jogi administration to conceptualise and give effect to the Mitanin (‘friend’ in Chhattisgarhi), who subsequently became the ‘Asha’ in the NRHM. In our conceptualisation, the Mitanin would be a woman from the community, chosen by the community. She would be expected to perform certain ‘first-contact care’ functions, for which she would be trained by the health-care system. Her main function however, would be, in the interface between the community and the health-care system, to articulate people’s agency, initiate and carry forward community-based monitoring, and ultimately, work towards the realisation of the right to health care.The Mitanin programme has certainly not been implemented in the spirit in which it was formulated.
Numerous concomitant changes would need to be realised before such a programme could be successfully implemented. Nevertheless, even the struggle to implement such a programme would take us further along towards the realisation of the goal of Universal Right to Health Care.
What is Rupantar’s nature and scope of work?
Rupantar, which means ‘transformation’, is a registered public charitable trust. Hitherto, most of its work has been in the state of Chhattisgarh, among communities of indigenous people displaced from their original habitations by ‘development’ activities, such as the building of dams on the headwaters of the Mahanadi. Our main areas of work have been rural community-based primary health care, primary education, community-based food security systems, and seed-biodiversity preservation.
Why are the tribal and the backward communities of India alienated? How can the State address their sense of dispossession?
The survival of these communities, who, even under ordinary conditions suffer from severe levels of deprivation, depends on their access to common property resources such as land, water and forest. The state is engaged in a protracted process of expropriation of these resources, under the doctrine of ‘eminent domain’, and handing them over to selected private interests under an utterly misconceived notion of ‘public purpose’. As a result, the very survival of these communities is called into question.
The directive principles of state policy in our Constitution enjoin that all state action should be directed to the promotion of equality and justice. Blindly following the present regime is likely to have disastrous consequences. No community can be expected to acquiesce in its own destruction.
It is evident that there is a huge deficit in State’s understanding of tribal issues and concerns. Do you think there is space in which the civil society (or those who understand tribal issues) can engage with the State to bridge this gap?
I do not agree that there is a ‘deficit’ in the State’s understanding. Responsible officers of the State, such as former commissioner for scheduled castes and scheduled tribes Dr B.D. Sharma, have laid these realities open before the State in minute detail. Nor is this process restricted to India. Similar processes of economic polarisation are recorded for the world economy as a whole as well as for specific national economies, including China and Russia. Given this situation, it is, of course, incumbent on all those who love peace and justice to do everything they can to ‘bridge this gap’ and bring about a dialogue. Ultimately, it is only through dialogue that a solution is possible. Confrontation, including military confrontation, is simply incapable of yielding any acceptable solution. If enough people come to share this understanding and take up this cause as their own, then surely this ‘space’ can be created.
What are your plans now?
I am already involved in working with the People’s Union for Civil Liberties, and the Right to Food and Right to Healthcare campaigns. I am also involved in working for peace. I plan to continue these engagements as far as I can.