Inmates Living in Sub-human Conditions

A delegation of Indian Doctors for Peace and Development (IDPD visited relief camps in the valley and hills of Manipur from September 1-2, 2023, in both Meitei and Kuki areas to assess the health conditions in the relief camps. They have released a comprehensive report of the pathetic conditions in the camps.
The team consisted of IDPD president Dr.ArunMitra, general secretary Shakeel Ur Rahman, senior vice president Dr Ravindranath, and secretaries Dr Shanti and Dr Rajani. The team visited the relief camps in KhumanLampak Sports Hostel in Imphal district and IIT relief camps under Saparmeina PHC in Kangpokpi District in hill areas. There are 334 relief camps in Manipur as of now. The team of doctors met inmates and nodal officers of the relief camps, officials of the health department, workers of civil society organizations, and officers of district administration.
Vital Observations
n The referral systems for seriously ill patients in the relief camps in hilly areas are not satisfactory. The displaced people in the hills of Manipur informed that they had to travel to Nagaland covering up to 150 km to Kohima or Dimapur to get medical assistance in case of even moderately ill patients. Some of them even travel to Assam for their medical needs. Earlier, before the violence, they were referred to medical colleges in Imphal for better treatment. Now the movement of citizens from hills to valleys and vice versa is impossible due to ongoing turmoil in Manipur.
n Kangpokpi District Hospital presently has neither an operation theatre nor a blood storage facility. Manipur is facing an acute shortage of specialists’ other doctors and health workers. Most doctors with specialisations in various areas and all the medical college hospitals of the state are in Imphal district (3 medical colleges) and Churachandrpur district (1 medical college).
n No special immunisation drives especially against measles have been undertaken in the visited relief camps. Measles Vaccine Immunisation drive in children above 9 months along with Vitamin A oral suspension is imperative for relief camps according to United Nations Humanitarian Commissioner for Relief (UNHCR) SPHERE standards.
n The inmates and nodal officer of a relief camp in the valley said that no green leafy vegetables/ eggs/ meat/fish has ever been supplied in the ration of inmates by the government; although, local community, Civil Society Organisations, and a few individuals provide few vegetables sometimes. Another nodal officer in a relief camp in Hills said that they get one egg per inmate once every 13 days, but green vegetables are not supplied. Rice, dal, potatoes, and cooking oil constitute the bulk of the ration supply to the relief camps. The absence of green leafy vegetables and animal proteins in the diet of children for the last four months may lead to night blindness caused due to Vitamin A deficiency.
n The visited relief camps are overcrowded, availability of potable drinking water and water for bathing/washing/in toilets are not sufficient in quantity. Sanitation needs to be improved by many folds. Supply of Sanitary napkins to maintain good menstrual hygiene in relief camps is insufficient.
n There has not been fogging for mosquito control in and around relief camps.
n The inmates informed that they have been facing lots of mental stress by staying in relief camps for the last 4 months and they are not sure when they will go back to their homes or if ever will they be able to go back to their homes. Few children are having nightmares. Children are missing their schools and friends adding to their worries. These are signs of Post-Traumatic Stress Disorder (PTSD)
n Patients with Non-Communicable Diseases like – Diabetes, High Blood pressure, chronic kidney diseases, etc. are present in the relief camps. A couple of patients need hemodialysis.
n The IDPD delegation placed the following demands on both the Union and state governments in order to rectify the deplorable subhuman conditions of the camps.
n Robust referral systems after triage from primary health centres to higher relief centres both within the Manipur State and neighbouring states should be put in place at the earliest.
n Fabricated Operation Theatres should be made operational at district and sub-district levels with immediate effect. Blood storage units should be started around relief camps after cluster formation.
n ·Internet services should be restored in all health facilities around relief camps so that telemedicine services can be available to inmates of relief camps at the nearest health facility. These telemedicine facilities can also be used in training Basic doctors in performing Peritoneal Dialysis (for Renal failure patients), and other skills like the use of AMBU (artificial manual breathing unit) bags in case of Respiratory Distress Syndrome among children, counselling mothers for breastfeeding of newborn children etc.
n A strong medicine and vaccine supply system should be made functional and real-time monitoring of the stocks of medicine at ground zero level should be done.
n Both central and state governments should implement the UNHCR SPHERE standards for meeting the health needs of the displaced people sheltered in relief camps.
n Immunisation against Measles and providing Vitamin A supplements to children should be undertaken immediately. Supply of good nutritious food like green leafy vegetables, milk, eggs, meat, and fish should be ensured for all categories of the inmates in the camps.
n Fogging for mosquito control should be done in and around relief camps should immediately be undertaken.
n Psychological counselling of inmates with Post Trauma Stress Disorder should be a regular feature at relief camps.