"Attappadi". Dr Shijin John Aloor replied instantly when the National Rural Health Mission (NRHM) interview board asked where he wanted to be posted.
His answer left the panel baffled. Some ridiculed his choice of a remote tribal zone as being silly. But sneers did not deter Shijin as he knew that he was making an important choice up on which he would be speaking with pride and satisfaction in the days to come.
“Attappadi was my first preference when I got an opportunity to work under contract with the NRHM. Sensing my excitement, the then Palakkad district medical officer (DMO), who was a member of the interview panel, told me about Parambikkulam. It was one of the most backward areas in the district with a considerable tribal population. People were reluctant to see doctors as they were more inclined to the indigenous healing practices and traditional beliefs. My first job was at the primary health centre (PHC) situated on the fringe of forests in Parambikkulam,” Shijin, who belongs to Marathamcode in Thrissur district, explained.
Tribals have their unique ways. As they don't approach a doctor seeking medical aid, Shijin had to go out in search of them. Hence, medical camps were conducted in order to identify patients. There was high prevalence of oral cancer among tribals due to rampant use of tobacco. Screening and detection camps were conducted in coordination with the Regional Cancer Centre and as many as 12 persons diagnosed with early-stage oral cancer were provided treatment. Several tribals also benefited from cataract surgical camps organised under the supervision of Dr Shijin. He also made significant efforts to study the common health issues prevalent among tribal communities in the area. It was found that a majority of the indigenous people had high blood pressure. Based on the findings, he submitted a detailed report to the State Health Department.
As per tribal culture, menstruating women are forced to move out of their home as they are considered ‘impure’. They would live in an unhygienic and unsafe temporary hut during the entire period and stay in the same cramped hut after delivery too. Shijin’s effort to end this inhuman custom did not yield much results. So, instead of forcing them to change the traditional practice, he took the initiative to build 'menstrual huts' in a safe and hygienic environment. The DMO extended full support to the project. Tribal women in Parambikkulam now spend their menstrual period in the well-kept outdoor shed without any fear of wild animals.
Childbirth in the wild
Dr Shijin has interesting incidents to narrate. “One day, a group of people from a nearby tribal colony came to my residence around midnight requesting me to attend to a woman who complained about ‘stomach ache’. Accompanied by a nursing assistant and a driver, I reached the colony located on the other side of a dam reservoir on a bamboo raft. The patient was a pregnant woman and the stomach ache was indeed labour pain! By the time we rushed to Pollachi in the jeep, the baby's head had started popping out. We folded down the rear seats of the vehicle and set it up into a ‘delivery room’. I was a bit tensed, but concealing it I helped her deliver and immediately took her to Pollachi. Luckily, both mother and the child were safe," he reminisced.
Shijin bid goodbye to Parambikkulam when he got admission to master's degree programme at the Kozhikode Medical College Hospital. After completing the studies, he joined the government service, once again opting for a tribal hamlet, Narkilakkad, near Nileshwaram in Kasaragod district. The PHC in Narkilakkad caters to 41 tribal colonies and several migrant farming families.
“At present, there is no in-patient facility at the PHC. I’m happy that a 20-bed unit has been sanctioned,” Shijin, whose wife Julie is also a doctor at the Narkilakkad PHC, said.
In recognition of his dedication and commitment to public service, the Kerala Government Medical Officers Association (KGMOA) chose him for this year’s best doctor award in the general category. Also, the Narkilakkad PHC was selected for the central government’s Kayakalp Award for the best PHC in the state. This centre has also won the Kerala State Pollution Control Board’s award.
At a time when doctors and paramedics are reluctant to accept postings in rural areas, Dr Shijin is looking forward to return to Parambikkulam.
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