India’s eastern front in April of 2019 encountered one of its biggest, strongest tropical cyclone to have stuck the state of Odisha since the catastrophic 1999 Super cyclone. Forming near the equator around April 26, by the time Cyclone Fani reached India, it had gathered enough momentum to affect 1.6 crore people, cause over INR 24,000 crore worth of property damage, as well as about 89 fatalities.

While the entire nation came together to aid Odisha and the east in tackling such a calamity, CARE India, a disaster relief organization, uncovers the stories of those who worked tirelessly day and night behind the scenes on this operation, in spite of their own distress and torment to provide medical support to the survivors- the medical caregivers.

In times of such disasters, we call these people in, the functionaries in the line of duty, without considering how they, themselves are affected by the turn of events. We fail to acknowledge their spirit, when without exception they stand next to the people to provide emergency services and aid. We overlook their huge efforts in the line of duty, when such disastrous events demand increased health facilities, which in turn call for such health care facilitators to provide round the clock service and for major and minor injuries. Despite the increased pressure, damaged facilities and ever decreasing supplies, they perform to their potential.

Even though understanding the sentiments of disaster-stricken people is unimaginable without experiencing it, we attempted to get as close as possible by interacting with some healthcare facilitators from the Community Health Centre and health staff at block and panchayat level.

Aasha (name changed) shared, “Our supervisors didn’t recognize our plight. Day in day out, we were forced to appear at the facility in the name of duty, without the knowledge of where my family’s next meal would come from. Every hour of everyday was spent in a spirit of uncertainty, would I find my children safe, fed when I head back home today?”

Let me now paint you a picture. A health functionary, stuck at the healthcare centre, to provide healthcare to the victims, despite the fact that they themselves are cyclone distressed victims, in trauma of having lost personal property and assets, at the risk of losing their families- in the crisis but having to work 48 hour shifts to maintain services and the influx of patients with a disturbed mind-set. Having to serve 6 times than usual number of patients in a time when they need their family and their family needs them. Definitely not a pretty picture!

Despite it being six months post the cyclone, a male health worker broke down into tears while narrating his experience of how his house was destroyed, children were forced to go hungry, but he would still report to duty at the health centre. “I was stuck in the dispensary for more than 24 hours, couldn’t find a way back home. The road for commute was washed away by the cyclone and the way blocked by fallen trees. No news about my family, didn’t even know if they survived or not until I got home the next day.” Ramesh (name changed) shared.

An interesting aspect of healthcare facilitation in times of disaster is the level of efficiency that we expect from the health care providers, which is immediate, coherent and lasting. Such expectations add to the burden of the service providers who are already burdened with a heavy influx of victims and the psychological trauma of loss of assets and property and the risk of losing family as a constant prevailing threat.

Moreover, they find themselves at the receiving end of the insensitivity of the authorities despite putting their heart and soul into the cause, essentially putting their life, their families and their livelihoods at stake.

Amit (name Changed) shared, “On my way back home, a tree fell on my leg due to strong winds after the cyclone had passed. I was lucky to survive but my foot was badly injured. I had to be carried back home. Yet my supervisor called me back to the centre. I had to work with an injured foot.”

Even if one could argue that the circumstances called for extraordinary action, the instances should have been excusable in the light of extreme physical pain as well as the mental trauma caused by the cyclone. What happened is inhumane and inexcusable

A pre-requisite in disaster management is maintaining adequate stock of medicines and additional dedication of the human resources to serve in the extra-ordinary situations of a crisis. In the light of such a possibility, mechanisms of seeking aid and qualified personnel from the unaffected areas is established. However, ironically, this is looked at as a burden for the existing functionaries as opposed to offering a hand in support. Additionally, if some medical functionaries do come, the responsibility for catering to the lodging/transportation needs of the newly deployed functionaries falls on the existing ones, who are already functioning with minimal resources.

The above-mentioned instances, scenarios demand a call for higher action and higher involvement of healthcare NGOs. Numerous actions along the lines of assessment of health infrastructure including building of the centre and stock supplies, and a roster of staff deputation to cater to emergency needs can be undertaken to ensure adequate preparedness. Measures should also include psychosocial counseling to the staff to help them cope with the stress levels that the emergency brings about and post trauma stress they might develop. More than adequate breaks and space during times of disasters that the functionaries deserve, due recognition for their acts of exemplary service and strong will should be rewarded. In addition, it is very important that the officers deployed to monitor or review the health service delivery during an emergency are sensitive towards the needs of health functionaries who themselves are severely affected and support them adequately. The due respect and encouragement will further improve the motivation of the staff to deliver their best without hesitation.

In preparation of a disaster of this magnitude, CARE pre-positioned its relief kit stocks to ensure quick distribution. During a response of this nature, CARE is especially sensitive to the needs of most disadvantaged, vulnerable and marginalized populations which include women and girls. CARE has been responding to natural disasters across India for decades including the Super Cyclone in 1999 of similar intensity which ravaged Odisha, with staff trained to respond to emergencies for relief efforts and building resilient communities, so as to ensure a livelihood for those whose lives, literally, get washed away during disasters.

CARE India provided Relief assistance with Shelter, WASH (Water Sanitation and Hygiene) and NFIs (Non-food items) to 2022 Cyclone Fani affected people in Khordha district (500 households).

WASI Md Alam