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Civil society in a confrontational state

Economic Times, 17 Jan, 2008

Binayak Sen’s incarceration in Chhattisgarh underscores the paranoia of the developmental state towards NGOs that understand poverty in holistic terms. That has fuelled more violent forms of seeking redress, says Prabhu Ghate.

Shaheed Hospital in Dalli-Rajhara is a unique civil society institution. It started life 25 years ago as a dispensary, with donations of money and labour from the mine-worker members of the independent trade union started by Shankar Guha Neogi in this small iron ore mining town 70 km south of Bhilai. It attracted idealistic doctors and devoted nurses, and managed to pay for itself while adding to its facilities with no help from the state.

Among the group of founding doctors was Dr Binayak Sen, a gold medalist from Christian Medical College, Vellore. Today Shaheed Hospital has grown to a capacity of 100 beds, but the wards are still overflowing. It seems to run itself, under a highly collegial system of management, with doctors and staff taking very low salaries, and volunteer workers pitching in after their shifts in the mines.

This writer was here to attend a meeting on irrational drug use. There was a fabulous view from the terrace as the sun set on the ochre slopes of the open-cast mines rising in tiers across the valley, and adivasi families accompanying patients from miles around lit their evening fires at the back of the building. Any serenity one might have experienced, however, was disturbed by a depressing thought. Shankar Guha Neogi has been assassinated, and Binayak Sen is incarcerated in Raipur jail on vague charges of alleged links with the Naxalites. He has been denied bail since May last year. Clearly, something has gone badly wrong in Chhattisgarh in the relationship between civil society and the developmental state.

The charismatic Neogi was as much a thorn in the side of the state as he was of the various mafias that flourished in the steel belt, and his murderers were never brought to book. Binayak Sen, after leaving Shaheed Hospital, devoted himself to enhancing the effectiveness of the rural health delivery system, a contribution that was recognised in a prestigious award conferred on him during the recent annual conference of the Indian Social Science Congress, ironically just two days after a Raipur court started framing charges against him. The state at one time did work closely with Sen and other rural health NGOs in developing the ‘Mitanin’ programme, which is the Chhattisgarh version of the flagship ASHA (Accredited Social Health Activists) programme under the National Rural Health Mission. Mitanins are selected by the people through the panchayats and trained by the state or by accredited NGOs.

About 5% of the programme in the state is being implemented by NGOs. Many of them take the word “activist” in the acronym ASHA seriously, unlike the government which just pays it lip service. They encourage their mitanins to monitor the situation with respect to the attainment of other rights and entitlements too, such as whether the poor have been getting their rice and sugar from the local PDS shop, or have access to the muster roll under the NREGS. The logic is that unless the poor learn to demand the delivery of their entitlements generally, they are not likely to complain when the village health sub-centre is out of medicines, or has an absentee or incompetent doctor, either.

The lack of pressure from below allows poor governance to flourish unhindered, fuelling social unrest and leading ultimately to more violent forms of seeking redress. Instead of appreciating this dynamic, the state has allowed its lower level functionaries to harass NGO mitanins, especially in the parts of the state where they are most needed, such as Dantewada and Bijapur districts where health services have been withdrawn from a large number of villages because of conditions of virtual civil war between the Naxalites and Salwa Judum. Because mitanins are allowed by the Naxalites to continue visiting and providing services in these villages, they too have become suspect and are often detained for questioning by the police.

The stance towards NGOs, who take a more holistic and structural view of poverty and the incarceration of Binayak Sen, are both reflections of the extreme paranoia that has overtaken the state government and its exclusive reliance on a narrow law-and-order approach. It is significant (and ridiculous in the context of framing charges against Sen) that the government pleader spent much of his time in the recent court hearing dwelling on how the mitanin programme was being used to aid the Naxalites.

Sen has never condoned violence by the Naxalites. He learnt over the years, however, that improvements in the nutritional and health status of the poor required a secure foundation of food security, a stable eco-system, respect for human rights and above all social justice and equity. His work in defence of these causes on behalf of the PUCL raised the hackles of the state. This is the real reason for his incarceration under the states’ draconian “anti-terrorist” law.

Clearly, there are many complex socio-economic causes of extremist violence in the tribal areas, including the sense of insecurity engendered by the loss of control over resources, the demise of traditional livelihoods, and alienation of land for state and private sector projects without adequate rehabilitation and just compensation.

However, the neglect of basic social services such as food security, health and education is certainly a major cause, and one would have thought the state would do its utmost to forge useful partnerships with civil society to improve their provision.

It could also give the social sectors much higher priority by posting the best officers to them. State governments need to change the present value system that regards social sector jobs as inferior if not punishment postings. Being health secretary or education secretary should be as prestigious as finance or industries secretary.

Also, the IAS urgently needs to revert to its area of comparative advantage, which is to provide good clean routine administration and public services. IAS officers need to spend many more years in the districts and in the same job, learning it properly instead of moving on to greener pastures early in their careers, never to return. These are some of the failures in governance reform the country is paying a high price for, including left-wing extremism.