Photo above: Dhanga Baiga, attended to by Dr Yogesh Jain of the Jan Swasthya Sahyog at a weekly clinic held in Bamhni village. Bilaspur District, Chhattisgarh. India ©Tom Pietrasik 2010
My good friend and fellow-journalist Dilip D’Souza wrote to me a few days ago with the sad news that a man called Dhanga Baiga, whom we both met a year ago, died last Monday.
I was introduced to Dhanga while photographing the work of a group of doctors called the JSS who run a hospital in the small, dusty town of Ganiyari in Chhattisgarh, central India. The JSS stands for Jan Swasthya Sahyog which means People’s Health Support Group.
It was while photographing Dr Yogesh Jain as he ran an outreach clinic in the village of Bamhni that the wizened figure of Dhanga Baiga entered the consultation room.
Moving with a caution that was in keeping with his fragile state, Dhanga, a member of India’s indigenous Baiga community, eased himself onto a plastic stool in front of Yogesh. It was clear that Dhanga knew and trusted Yogesh. Indeed, he owed his life to the intervention of the JSS medical team who had temporarily slowed the advancing tuberculosis that was gripping his hunger-ravaged body.
Dhanga Baiga photographed twelve months ago while being treated for the hunger-related tuberculosis that led to his death on March 21st 2011. Bilaspur District, Chhattisgarh. India ©Tom Pietrasik 2010
As Dhanga recounted his most recent ailments, Yogesh examined him, gently prodding and squeezing in a manner intended to reassure his patient as much as facilitate a diagnosis. Weighing just 29 kilos, Dhanga was certainly not doing very well and Yogesh concluded by asking him stay overnight for observation before venturing home on foot the next day.
The tuberculoses that had all but destroyed one of Dhanga’s lungs had undoubtedly reduced his chances of survival. But when I enquired, Yogesh had been reasonably optimistic about the sick man’s prognosis so long as he could raise his calorie intake and avoid the kind of opportunistic infection that so frequently claims the lives of those weakened by hunger.
By the time he died, Dhanga had been able to increase his weight by only two kilos. And, as Yogesh had feared, a fever did eventually strike, confining Dhanga to his bed and leaving him unable to eat. Dhanga died last Monday evening, too late for the intervention of JSS field staff who were informed the following day. Though no one knew his exact age, Dhanga was probably in his early 50s.
Dhanga’s is not an isolated case. Thirty-three percent of Indians are underweight with a BMI (Body Mass Index) below 18.5 which, Dr Binayak Sen says amounts to a “genocide without bullets”. Sen, a public-health activist and advisor to the JSS, currently resides in prison, serving a life sentence on false charges of sedition. Sen’s real crime has been to expose the Chhattisgarh state government’s appalling failure to represent the interests of those to whom it was elected to serve: ordinary people like Dhanga Baiga.
Continually exposed to illnesses associated with malnutrition and poverty including tuberculosis and rheumatic heart disease, Yogesh Jain, Binayak Sen and others at the JSS argue that any serious challenge to hunger necessitates that we also confront India’s vast and growing inequities.
I was privileged to spend some more time with Yogesh and his colleagues last month while on assignment for Oxfam and will return to them again here in my blog. In the meantime, a gallery of my photographs of the JSS working with the people of rural Chhattisgarh, including the unfortunate Dhanga Baiga, can be seen here. And, for a revealing insight into the experiences of working as a doctor in rural north India, I’d certainly recommend the Fieldnotes blog written by the JSS’s, Dr Ramani Atkuri.