I finished reading Staying Alive: Dispatches from the Margins today and found myself reminiscing about a train journey I undertook about a year ago. The journey followed a riveting reunion at my alma mater, Christian Medical College, Vellore. About 70 of the 140-odd people who had completed their postgraduate training in the Department of Community Health at CMC Vellore gathered for a day of memories, conversations, and reconnecting.
On the return journey, I had the opportunity to spend a good amount of time with the author of this book, Dr. Ramani Atkuri. A humble and unassuming professional, I learnt that she had spent over three decades working in the ‘hard-to-reach’ rural and tribal areas of Central and Eastern India. I had the fortune of being inspired by her in person on that journey. And while reading her book, I could almost hear her voice in my head, stating, matter-of-factly, the abysmal condition of healthcare for the disadvantaged in our country.
That perhaps made the book even more powerful for me.
What is the book about?
The book paints a deeply disturbing, raw, and real canvas of the state of affairs in what is generally referred to as ‘the periphery’ or ‘the margin’ in India. Anyone who has lived and worked in rural and tribal areas of our country will relate to the graphic stories Dr. Atkuri narrates. But what makes these stories come full circle is the way they reveal the interplay of social, political, and economic factors that shape people’s health and their ability to seek healthcare.
Take, for example, the author’s description of ‘Sewage Basti’, a temporary settlement of labour migrants in Ahmedabad, Gujarat. The babool-tree houses covered with plastic sheets, the daily lives of the migrants, their precarious existence and the challenges they face because no one considers caring for them their responsibility—all of this is described with an immediacy that statistics alone can never convey.
Similarly, under Project Tiger, forests marked for ‘no human habitation’ resulted in the displacement of tribal forest people in the Achanakmar Wildlife Sanctuary. Dr. Atkuri traces how a decision that may have appeared, on paper, to be about conservation affected the lives, livelihoods and health of people over the years. These are not simply stories about healthcare. They are stories about land, displacement, poverty, work, governance, environment, and power, and how all of these eventually find their way into a person’s body.
The author uses riveting narratives, recent data, statistics from published research, and infographics to make the colours on this canvas even more vivid. The stories are often difficult to read. My eyes actually teared up when Sombari Sabar’s story ended. And yet, the book never feels as though it is trying to manipulate the reader emotionally. The facts are allowed to speak for themselves.
