If the patient can’t go to hospital, the hospital goes to the patient.
That’s what’s been happening in India since 2005, when the first Akha (“hope” in the language of the north-eastern State of Assam) began navigating the waters of the Brahmaphutra.
Launched by the Centre for North East Studies and Policy Research (C-Nes), the boats of hope bring essential health services to villages that otherwise have no medical facilities and which are frequently isolated by flooding. But beyond this, they also promote vital capillary preventive medicine information campaigns among the local population.
Among the priorities in this respect are issues related to contraception and infant and maternal mortality.
According to the International Centre for Research on Women, roughly half of all Indian women marry before their 18th birthday, and one third of the world’s baby-brides live in India. Many of these become pregnant at less than 15 years of age, when the rate of pregnancy deaths is five times higher than for women in their early twenties (while between the ages of 15 and 19 the risks are still double). Of the women who die in childbirth around the world every year, one in four is Indian: a total of roughly 70,000.
In 2005 the Indian government launched a programme, connected with its Millennium Objectives, to reduce the rates of maternal mortality. At a national level this has since fallen from 677 deaths for every 100,000 births in 1980 to 254 in 2008. The State of Assam, however, still suffers from rates that are almost double: 480 for every 100,000.
Hence the need for the Ships of Hope, as recently described by the New York reporter Hanna Ingber Win in her recent work for the Pulitzer Centre.
Given the rural nature of the areas involved, these boats also provide veterinary care and information.
This is a typical example of a “local innovation” that has proved so effective that it has been awarded Unicef patronage and won a collection of humanitarian prizes around the world.
The first vessel, which is still in operation today, was 22 metres long and 4 metres wide. It contained a first aid centre with medicines and equipment, cabins for the medical staff and the crew, a kitchen, bathrooms, a store-room, a generator and a 200 litre water tank.
There are now ten boats operating, and it is estimated that between them they have so far reached roughly 200,000 inhabitants scattered over the 465 islands along the course of the Brahmaputra River.
But this is not the end of it, since potentially they could serve up to a million people in the zone: roughly one third of those affected by flooding in the Assam region.