Struggling with shortage of doctors, the remote hilly state of Nagaland has found an innovative way to meet its needs. It is training tribal healers dealing with traditional medicines to cure its ailing population.
With the support from National Rural Health Mission (NRHM), Nagaland is using the services of traditional doctors who use folk medicines prepared from herbs and plant extracts used commonly by the state’s rural tribal population. The state, that has strong population of tribals, has identified the many local healers and with the help of strong community system they have been brought forward, trained and incorporated in the mainstream to meet the shortage.
For instance, bone setters in villages are trained to help with orthopedic injuries while traditional birth attendants (popularly known as dai) help with the child birth as majority of women in the state prefer home-based deliveries compared to institutional deliveries.
Despite low institutional deliveries, the state has one of best rural Infant Mortality Rates (IMR) - 23 per 1,000 live birth - in the country and for this a lot of credit goes to these traditional birth attendants.
In fact, the traditional birth attendants are now doubling up as community health workers known as ASHA (Accredited Social Health Activist).
“The villagers themselves chose these traditional birth attendants as ASHAs. Since we cannot stop them we trained them to be more hygienic, scientific and safe by giving them knowledge of using sterile blades and identifying the signs of danger during deliveries,” said Bonnie Konyak, programme manager in Monn district, one of the most remote areas of Nagaland.
Since ASHA are more active in villages, the state health department is planning to use them in more technical way. Now they are also being trained to give injections as reaching health centres is almost impossible given the distances, difficult terrain and logistics.
“There are chances that one in 1,000 may go wrong but there is faith in them of people so we have sensitised and trained them to perform in more scientifically accepted manner,” said Yangerlemla, principal director, department of health and family welfare, Nagaland.
The total number of doctors in the state is 417 for a population of 20 lakh, while the need is for almost double.
Though the pay of doctors has been hiked substantially and some are paid as high as Rs60,000 to attract talent in the state yet geographically difficult terrain and lack of facilities are major deterrent for the doctors to serve in the state, which is why traditional doctors are nurtured and encouraged.
