This incident occurred on 26th August, 2019 at Narmada Jeevan Shala run by Narmada Navnirman Andolan. This tribal school is situated in Thuvani in Dhadgaon block, Dist Nandurbar, Maharashtra. The school is constructed out of local materials like bamboo plastered with mud and cow dung. The bamboo woven walls have gaps that exposes the dwellings to all kinds of creepy crawlies. To make matters worse, there has been an increase in snake sightings in the area due to backwater of the Sardar Sarovar Dam project.

Around 2:00 AM  Rohit Padvi and Pravin Vasawe, both boarders of the Narmada Jeevan Shala, studying in class IV, started complaining of pain in their abdomen. Due to lack of cellular network and bad roads, the teachers Mangu Pawara and Sukalal Pawara were not able to call an ambulance. Since the children were crying incessantly, Mangu rushed Pravin Vasawe to a Primary Health Centre in Roshmal on his motorcycle.

This PHC is situated in a hilly terrain with bad roads. On the fateful night, it was raining which made the drive difficult to negotiate on the slippery mud road in complete darkness. After much difficulty Mangu Pawara reached Roshmal PHC with Pravin Vasave. He found that the PHC had no doctors. Mangu Pawara then rushed Pravin to Dhadgaon Rural hospital, about 30 km away, where the child was declared brought dead.

In the meantime, the second boy, Rohit Padvi’s condition was also getting serious. To add to the predicament, there was no mode of transportation left. After waiting for help, the teachers mounted him in a makeshift stretcher; a cloth tied to two bamboo sticks and carried him up to the main road, which was 15 minutes away. He was then taken to the hospital in an ambulance, but he too died on the way.

The two children’s post-mortem revealed that both boys had died due to snakebite envenoming. Pravin was found to have been bitten behind his ear and Rohit on his hand. The teachers said that both boys were crying through the night, but no one suspected snakebite.

The author visited the Roshmal PHC on 8th Jan 2020. The state of the building was thoroughly dilapidated. All the windows of the PHC had shattered panes. Rooms were filthy with rat droppings and stains from months of neglect. There were no toilets even for staff. In case of an emergency, the staff has to answer to nature’s call in the nearby hillock.

This PHC also has no electricity and therefore cannot store vaccines required for the Out Patient Dispensary (OPD). The facility did have a stock of 70 Anti Snake Venom vials in the cupboard in the doctor’s room. There were two brand new and unused Ambu bags. On inquiry, none of the staff present knew how to intubate a patient in an emergency situation.

As per the staff there, they close the hospital between 4-5pm as driving back in the dark is dangerous.

On the fateful night when the Thuvani children were bitten, the second doctor, who should have been manning the PHC in the night shift was not available.

The author has witnessed similar situations in other states as well. Even in places where a doctor is available, snakebite patients are referred to district hospitals. In many cases, patients die on the road while being transported to a higher hospital. Unless our PHCs are fully functional and able to stabilize patients of medical emergencies, cases of deaths especially due to snakebite envenoming will not go down.

This is a serious situation. The status of Roshmal PHC is merely the tip of the iceberg. There are tragedies happening or waiting to happen at innumerable places and the victims are usually the tribal or rural poor whose passing does not affect anyone. Life goes on as if they never existed. The saddest part is that these deaths could have been prevented.

Written by Priyanka Kadam, Jan 2020.