A tribal cheat

Having just graduated from a prestigious medical college in South India , I was raring to go . Had all my plans in place – finish internship , complete the mandatory 2yr post-MBBS service obligation and immediately after that get into postgraduation . But this remote tribal village I was posted to in Odisha ( then Orissa ) along the beautiful eastern coast of  India, as a junior doctor , hit me like a bolt from the blue . When I got there , after a 14 hr train journey followed by a  3hr drive into the interior of the hills in the hospital’s Mahindra jeep which had been sent to the train station to pick me up – I learnt this village had no reliable telephone services , forget internet or cell phones . As the driver drove , I realized why he had come driving a four-wheel drive – an essentiality in this kinda terrain . Only 1 bus service a day, with weekend being a holiday . The nearest town was about 1.5 hrs away by road . Frequent power cuts were the norm . And this wasn’t early 1900 but the first decade of the 21st century , the new millenium . Unbelievable! Where have I landed , how do people still manage to live in such areas without even the basic services and required amenities ,  I thought to myself .

The hospital wasn’t very big , just like a primary care centre , but I soon learnt I was gonna be the only resident doctor, on duty 24×7 – not a very pleasant thought for someone who’s just passed out of college . Great , so there’s no senior to guide or teach me , and there’s nothing to learn here . I hope I somehow last the next 24 months and get out of here . As word spread that there’s a doctor available round the clock , more and more patients would come over the next few months .  Sometimes all the 40 beds would be occupied and there would be patients lying down on the floor . Being the only doctor , at times physically very tiring and challenging but professionally extremely satisfying it was .

After an unusually busy night , I had just gone to bed around  2am when the watchman rang the doorbell – a sick 12yr old child had just been brought . I knew if the patient had arrived at this hour in the night , the family, seeking medical attention, would have actually left their tribal village sometime during the daytime , several hours ago , coz most villages around had no motorable roads and the only way to get to the hospital was on foot . Yes , on foot through the hills and terrains , carrying stone-age fire-lit torches . The sick were usually carried to the hospital on a 4-legged cot turned upside down , with ropes tied to the front and the back pairs of legs , and a long bamboo stick passed between the front and the back ropes , with the tribals taking turns in carrying the bamboo on their shoulders . The codeword in the hospital for an emergency was “ Rocket “ which means the patient was unable to walk by himself and hence had to be carried in the make-shift ‘bamboo rocket cot’ .

Realising this could be serious , without wasting much time , went down to see the patient whose relatives even at this unearthly hour said ‘Namaste’ to me with folded hands . The family didn’t look well-to-do at all . One glance at the ‘ rocket ‘ cot and I was wondering how it managed not to break while carrying the sick boy for the past several hours . Poverty , such abject poverty one probably cannot imagine . Definite BPL ( Below Poverty Line ) candidates I told myself .

The patient had severe Cerebral malaria , something that was rampant in this part of the country , and it took us a few days to get him back . But thankfully inspite of having suffered repeated episodes of seizures on the way to the hospital , he had suffered no brain damage . We were all glad when about a week later he was able to walk a few steps and was later fit to be discharged in a healthy condition , except for some loss of weight . His survival was nothing short of a miracle to me and I honestly never gave him even a 10% chance of surviving , but I guess , he was a fighter  .

Then came the accountant Mr PC , a very senior bespectacled man in his late 50’s ,more than double my age , who I did respect a lot for his thorough knowledge of the entire tribal area , one of the few staff who was fluent in English , carrying the patient’s treatment chart to my OPD cubicle . ‘Doc , this family cannot pay the hospital bill right now , but they’ve agreed to clear up the entire bill as soon as they can . We can let them go , if you can sign saying “ Can leave without settling the bill “ . You’re the only resident doctor here , and only you are allowed to let them go .’  I laughed at him . “Mr PC , I’m fresh from my internship at Vellore . I have seen umpteen number of patients who can actually pay but get away without paying their hospital bills . Just to quickly give you an example , a couple of patients I very clearly remember – a lady with a thick gold chain who refused to pay up , and another patient who was treated for severe TB , paid only 20% of her bill , but at discharge I saw her being picked up by her family in a brand new red sedan . People will be people Mr PC , they will always cheat if they can . I’ve seen this family for the past few days , and I know they genuinely cannot pay up this bill even after 2 years . You wake up at a God-forsaken hour , you and the staff do everything you can , and this man doesn’t even realise how fortunate his son is to have survived . The least he could do is pay up for the services rendered . Im not happy “ Reluctantly , I signed to let them go , knowing fully well that they’d never return . Mr PC just took off his glasses , held them in his hand , and as he was leaving my cubicle said “ Doctor, the father has said he’d pay , so he will  “ . Extremely annoyed by now , almost instinctively I shot back ‘Have you heard of oxymorons Mr PC , this is a perfect example – an ‘Impoverished Rich’ father , poverty-stricken but rich in false promises’ . Was expecting him to angrily retort , but he kept his cool and just smiled .

Every month I’d sarcastically ask him if the father had come back and cleared the dues . And he would just nod and say no . For the next 6 months , Mr PC would always say no not cleared yet , but he would always smile , as if he knew the family personally and that they were somewhere around the hospital , just waiting to clear up the dues . Eventually both  I and him forgot about this episode .

That evening as I was wrapping up work and about to bolt the door behind me , Mr PC walks towards me . ‘Doc You’ve been proved wrong’ . A little angry at his choice of words , What are you talking about Mr PC I asked . Showing me the chart I had signed 11 and a half months ago , he said “The bill has been cleared today doc . Every single paisa they’ve returned . No more outstanding dues to the hospital ” with his eyes beaming .

I pushed the door open , went back into my cubicle , sat down , and gestured to Mr PC too to take a seat  . I was shocked . ‘Really , are you serious ? A year down the line ? Wow ! Let me guess , this year I know the monsoon was very good , so the family would have had a bumper crop and that’s how they paid up . Am I right Mr PC .’

Smiling , he says ‘ No doc , not entirely . You’re forgetting that they are uneducated, illiterate tribals . Monsoon or no monsoon , they would never go back on a promise . If not for the father , the son would have paid up after growing up . These tribals wont have any finances or property to give , but they pass on their rich values to their children and their children’s children . In the last 22 years of my service here , I have never seen a tribal not pay up his dues , be it 1 month or 1 year down the line . You know , the only ones who very occasionally do not clear the dues are the educated ones who have worked in towns or have lived in cities . And these do not like to be called tribals coz they claim , you know , that they’ve been to the real world  .’

 I was at a loss for words . In my mind I probably gave his son a better chance of survival than him clearing up his son’s bill almost a year down the line .  Sheepishly , I followed Mr PC , met the father of the sick child who had come to clear up the bill . Learnt that his son was fully fit and well , and he had now walked 7 hrs to the hospital just to pay up . Since it was already late evening , he would sleep over in the hospital’s corridor for the night , if I , as the only resident doctor gave him the permission to , and would leave early at dawn for the 7 hr trek again . He had come prepared with some food and a ragged old bedsheet to cover himself for the night as he slept on the floor . He was genuinely grateful to me and the hospital for having let them go without clearing the bill , but deep inside I was so embarrassed I was desperately searching for a place to hide .

No telephone , no internet , no basic services and amenities but these tribals were alive in the true sense , they had no education but the concept of going back on a promise was alien to them  . Though uneducated and illiterate , the boy’s father will always be one of the greatest teachers I’ve ever met – teaching me a lesson I’ve hardly come across in many of the textbooks I’ve read over the years .

Unfortunately Mr PC succumbed to a heart attack a few years ago , but his words as we were leaving my OPD cubicle that evening , holding his round glasses in his hands , still ring fresh in my ears “ Doc , in this tribal belt , you know what a perfect oxymoron is – a tribal cheat “

If only the world had more ‘tribals’ , maybe it would be a much better place . I honestly hope I could be a ‘ tribal cheat ‘ all my life .