Thoughts & Ideas

Friday, August 23, 2013

A Rural Sojourn

I joined State Bank of India as a Probationary Office after doing my graduation with dreams of a plush life, with lots of money, prestige, cushy foreign postings, a relaxed life style, and all the other good things in life. I woke up to a little bit of reality in course of my 2 year probationary period, though the dreams were kept somewhat alive by the kind of deference one received from my colleagues, most of whom had come up through the ranks. But dreams are nothing but dreams, and I (along with rest of my batch-mates) was rudely awakened by the instructions given by the General Manager (Operations) to the effect that “all probationers are to be posted to rural branches on confirmation notwithstanding any constraints”.    

Rural India or Bharat looks very idyllic and beautiful through train windows and stories and poems of nationalistic writers, but a different image started emerging in course of conversations with colleagues over the 2 month period from the time we received our confirmation in service to allotment of branches for posting. The heat, lack of electricity or running water, no proper places to live, problem of getting clean edible food, absence of functional toilets, non availability of national daily newspapers, the petty rural politics, the violence, lack of motorable roads, mosquitoes, leeches etc. etc. was explained to us in gory detail by folks who had been there and lived to tell the tale. The books suggested for reading, which gave a much truer account of living in rural India, were Phanishwarnath Renu’s “Parthi Parikatha”, and Shrilal Shukla’s “Raag Darbari”, but these books did not prepare us for reality when we faced it in real life.

The process started off with a fight to get “good” rural postings. That is, places which qualified as rural branches as per definition of GOI but were easily accessible from the main towns. I remember the most sought after branches in Bihar were Deepatoli (which was virtually within Ranchi) and ADB Bihta (about half hour travelling time from Patna). Lesser mortals like me were allotted the Purnea Module which was popularly referred to as a “Kaala Pani” posting in Bihar. Landing in Purnea, with its lone restaurant and single hotel with its own generator with prospect of spending the next 2 – 3 years of life in its back-waters was my first major growing-up shock.

After completing my 2 years of rural service and another 2 years of semi urban service deep inside Bihar in the middle to late eighties, in retrospect, I can say with confidence that it was the best thing that happened to me. I resented it like mad when I was initially forced into it. All my colleagues with pairvi (clout) managed to avoid it and, subsequently got much better assignments but all of us who did the rural assignments turned into better bankers (and also hopefully better human beings) and the stint also gave us a lot of self confidence. The experience helped us build resilience, ability to innovate solutions and, most importantly cleaned up all the cobwebs that formal education had built up in our psyches. I understand that SBI has now more or less given up this policy of compulsory rural and semi-urban assignments. If it is so, it is a pity and a big loss to the Bank, to its managerial cadre, as well as to the nation.

My experience in living in rural India has been very interesting with various kinds of very educative encounters, of which the most memorable was my acquaintance which turned to friendship with Dr. Sitaram Shah and Dr. Bibhuti Narayan Jha.  Dr Sitaram Shah was posted by the Bihar govt and he actually lived for 6 days a week in that village in the back of beyond (Kursela) and was available on call on 24 X 7 basis. The innovations he brought about in rural health care were truly amazing (at least to my plebeian eyes). For example, one day he told me that, at the primitive Primary Health Centres (PHC), there was very high risk of post operative infection but most of his patients could not afford to go  even to the district hospital. He proudly then informed me that there had been zero post operative infection cases at his PHC. He explained that he used to get his surgery patients to bring along fresh straw mattresses, which he would arrange to get burnt after the patient was released, resulting in zero post-surgery infections!

In another interesting conversation, Dr. Shah mentioned that most of the illnesses faced by his patients had roots in malnutrition. At the same time his patients could not afford the solutions (eating milk, eggs, chicken, apples etc.) mentioned in the western text books doctors were brought up on, for either economic or religious reasons. In this profound dilemma he did some rudimentary research on nutritional value of locally available fruits and vegetables and found 2 excellent substitutes - tomatoes and bananas - and started prescribing one raw tomato and / or banana a day along with the medication and the results were excellent. He had one regret though; he did not have the wherewithal to write a proper research paper on his findings!

I really enjoyed my one and half year close association with him, and going around with him on his evening rounds to individual patients’ houses and witnessing at first hand how he handled those poor illiterate people with care and cheerfulness. I had similar experience with Dr Bibhuti Jha in Purnea (he now practices in Sitamarhi) and I still remember the intensity of his conviction on why Social and Preventive Medicine should be considered the most important MD specialisation, which unfortunately was not. Both Dr Shah and Dr Jha, incidentally, are still practicing what they preached and believed in.

Freshly minted doctors should take up the challenge and consider their rural stint as an opportunity not a chore!


  • At 5:09 AM , Blogger Unknown said...

    I absolutely agree with your doctor friend. As a doctor seeing many many patients among the urban & semi urban poor I feel that much of the morbidity & illnesses can be cured by preventive methods. Simply washing of hands before a meal is not practiced by many people - even doctors. I agree completely with Dr Shah that nutrition solutions can be found without resorting to expensive drugs or food. Some myths also need to be busted - things like bananas causing cough & cold. Ultimately it is education of the right kind which will be able to control much of the ills of society.

  • At 5:42 AM , Anonymous Diva Das, a friend of Sushil said...

    First the fundamental question of equity in access to quality medical care to each citizen of India,why a rural citizen should be subjected to care by novices in the profession while the experienced one should go to district HQ? We should have an inverse pyramid where most experienced doctor,beaurucrate and judge,police officers should end their career in rural postings.These guys in their vast experience in real measure contribute towards myriads of problem faced by an ordinary citizen.Just imagine being cared for by likes of CP Thakur who can make a diagnosis by just listening by a stethoscope.


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