Universal health goals battle myths, tradition in rural Naga areas

Even as the World Health Organization (WHO) pushes for Universal health coverage (UHC) by 2030 as defined under the Sustainable development goals (SDG), challenges remain in the far flung Naga areas where care givers are faced with not just the problems of distance, weak governance, absence of health infrastructure but the added roadblocks of myths and misconceptions among the uneducated masses.

An artist working on a message relaying the importance of family planning in a rural belt of Mon district, Nagaland along the Indo-Myanmar border.

“Suspicion against non-traditional medicines still persist”, says a health worker of the Government of Nagaland posted in Mon District, who has been trying to break such mindset among the rural population. Children are the most vulnerable because of such ignorance and myths in rural Naga areas.

“Most children with ailments are taken to clinics or health centers only after home treatments and those of traditional healers have failed, by which time a child may be critical”, the health worker explains.

Interestingly, when workers of the international medical aid organization, “Doctors Without Borders” first reached Mon district, the first question they asked was, “Why don’t the people want to come to the hospital? Why do they wait until they are bedridden or it is too late”?

According to a study done in the area there are many who are either ignorant or they have been misinformed about accepting modern treatments. To add to this, traditional health practices remain popular among the villagers. The goal of achieving Universal health coverage (UHC) is an ongoing challenge in the face of such barriers.

The health worker explains that even after decades of intervention; like vaccinating children against killer diseases, regular checkup of pregnant mothers, family planning etc. suspicion against non-traditional medicines still persist.

A few years back, in Wanching village of Mon district there was an incident as women were queued outside the dilapidated village hospital, waiting to vaccinate their children against polio. An old man carrying his grandchild on his back began running back and forth across the queue shouting, “It’s a trap. Don’t do it. It’s a trap to harm your child, don’t vaccinate!”

“Government health programmes and the way it is drafted as policy must factor in the cultural context in which it is going to be presented”, says a senior analyst of a local think-tank.

In some districts it has been observed that people were reluctant to participate in any modern health programmes, particularly programmes that were associated with the government.“This makes it even more necessary to encourage greater involvement of local people in planning and implementation of health programmes”, states the think-tank.

“We need to create a space for dialogue in order to understand attitudes and issues concerning their health”, the senior analyst says and adding that at the same time they must be politely told that while traditional health practices were helpful in many cases, but were often ineffective against new diseases.

It is also not uncommon the see people diagnosed with Tuberculosis (TB) or cancer opting to be treated by local traditional methods even when modern treatment is available or free.

Over the years, the medical department, especially the Information and Education Communication (IEC) wing has made several attempts to treat this problem. Pamphlets have been printed, in English and local dialects; advertisements in newspapers, talks have been given at local TV stations and on radio.

“In a district like Mon, these mass media methods are redundant. Newspapers do not reach our villages, local televisions channels are not available in our villages where even electricity is a luxury and radio does not work because transmission is impossible through the hills. Pamphlets are useless because most of our mothers do not know how to read”, says a frustrated young student from the area.

In recent years, the Department has resorted to two new methods; Focus Groups Discussions and churches to deliver key health messages to the people. Some measure of success has been noted but more needs to be done by all stakeholders.

Of interest to note is that during a recent official visit to several villages under Tobu Block, a dialogue was initiated with the men folk and village leaders and explained in detail, the benefits of vaccinating their children and the diseases that could be prevented by immunization. After the long discussion, in all the villages, the men admitted that it was they, who would scold their wives for getting their children sick (slight fever following immunization) by vaccinating them because they had not been explained the benefits of immunization.

“Considering the fact that 80 percent of the Public Health sector primarily concerned with Prevention of diseases, rather than the curative aspect of it, it is imperative that educating of masses be made a priority”, says the health worker from Mon.

And according to her, the department needs to have the vision to make a time bound plan and be willing to invest a generous chunk of its budget towards creating awareness, through specialized area/district specific plans and techniques in order to combat this problem of myths and misconceptions for good.

The service of educated youths from the region must also be tapped by the government so that they can help in advocating improved health practices and greater use of available health-care services and facilities.

Naga Republic Feature