Story of Boat hospital

From Memories of Madhavan :

Almost every year river Godavari gets floods. AWARE and Godavari are inter-linked since birth of AWARE Organization. Because AWARE works with tribals of Godavari region from 1975. I have visited almost every tribal hamlets even very interior village from Pamanoor Group of tribal hill habitats villages north of Cherla to the villages of  Bison Hill Range Papi Kondalu, in the  Eastern Ghats, climbing hills to reach them. Not only that I lived with tribals like Koyas Konda Reddys and Nayakpodus several days. I ate  their food slept in the tribal hamlets and (drank) Ambali (fomented millet gruel) hot soup made by tender bamboo shoots and chikkudu kura (been curry i.e big beens boiled in chilli powder with water nothing else )

They know I am a vegetarian. They cook rice ambali ( fomented gruel )bean charu bamboo soup with devotion. They serve me with great devotion: only problem is all men and women sit around me and watch my eating with wonder and devotion. Often I slept in these villages when I was living with them.  I slept on rope cots outside the tribal hamlets whole night looking at dark sky and million sparking stars and I was surrounded by tribal youth and old men to protect me from wild animals and hill evil spirits.

 I walked hundreds of miles to reach these tribal tiny hamlets. (Some times when I reach far away tribal hamlet I found only five families living there and calling themselves as village. Why all such tiny hamlets cannot merge and live making it as bigger village is puzzle to me.  Tribals do not own land but Land owns the tribals.  That is their spiritual relationship.

It was 1983 August-September, river Godavari was in spate. Lots of tribal villages were submerged. Tribals with their essentials climbs to higher area like hills, waits in hunger to recede the river water. When water goes down they come back, dry their things start their life. Someone goes to forest to bring a kill like peacock, forest fowl, a rabbits, stag, lizards some time a big animal like antelope. It is like plucking vegetables from their backyard.  Children go to hill tops to get dry wood for cooking. Women clean house remove mud slit with Godavari water. Life starts. After two or three days government employees first visit villages take survey note down loss like typical mathematics “ number of houses collapsed, partially damaged animals dies human died etc. After two days they distribute 10 kg rice etc. It is more or less ritual of flood relief program. Sometimes team of doctors arrive to give anti cholera injections by a govt medical team. 99% tribals run away seeing them.

Life of Tribals and AWARE is inter woven. AWARE workers live with tribals, follow them during the floods to higher lands. Meanwhile Central Office in communication with State Govt, dist collector, AWARE Regional Office within 24 hours initiates flood relief works. Distribute cooked rice, then flat rice and jiggery, water pockets, rice, salt, dall vegetables tamarind chillies onion match box, candle dress for one pair children men and women and re establish them back to their village. Since AWARE worker lives along with them and pass thru flood experience, distribution of flood relief materials were easy and tribal themselves become volunteers. It goes very systematic. No corruption, no deviation no misappropriation.

In 1983 also AWARE was intensively involved Godavari flood relief work. I myself engaged a boat, loaded with relief materials travelled along with my staff tribal village after tribal village, anchored my boat unloaded the materials as required by the villages. I and my staff lived in the boat for nine days, sleeping eating travelling with boat only. Night boat will not travel. It anchors in a village. While my workers go into the village to sleep, I slept in the boat itself. I was guarded by boat driver sarang cook and an assistant. I used to sleep on the top of the boat looking at clear sky with twinkling stars dead silence hills around dark everywhere. At 11 O clocks I come down and sleep in the cot inside the boat. The boat has attached toilet. A small kitchen for preparation of food. The boat name is “Masara Lakshmi”, hired from Rajamundry.

One of those days, we anchored the boat near Kakisanuru tribal village. Early morning around 5 am i heard a bid noise and crying of women. I asked a lady staff who just reached the boat from the village reason for the cry. She told some one seems to have dead. I immediately put my dress got down and meanwhile all my workers village elders youth reach my boat with head bended. I enquired about the environment.

I was told the village got an isolated house called “Keedu Paka.” (Evil House) When a woman has to give birth to a child, the advanced stage pregnant woman is shifted to that house.  Only one elderly woman keep herself as company, while none will go there, until child is born. If a boy is born umbilical cord is cut with arrow head. If girl is born the cord is cut by sickle. The attending woman will be the midwife. Often due to unhygienic condition children born do not survive. Therefore mortality rate is high among the tribal.

On the day when I was there, an young woman was kept for delivery, developed pains mid night, the older women tried to conduct delivery at mid night with one oil lamp, the child came out crossed way, mother was profoundly bleeding, by 4 am both mother and child died. Neither medical help nor a trained ayah available. The elder woman started wailing, entire women folk flocked the place children girls boys women entire village except men folk   started crying while mother and child lay dead. My staff visited the keedu paka and shocked. I accompanied by entire staff and villagers visited the place and shell shocked to see the mother lay in a horrible way with full of blood around and child is still connected to the body of the mother unable to come out. I cried like a child, whole of my staff men and women cried loud. Women folk of the village joined us in crying. But shockingly men of the village, stood in silence bowing their heads, looks as though they did a great mistake.

I looked at a tribal youth  and said can anyone rush to get a doctor ? No one spoke. After a while an elderly tribal said. Doctor ? Where is doctor sir, no doctor will come here. No medical help available for us. We were born in this forest and hills we will die here. Mother forests only nurture us and kills us. Doctor Hospital are all, do not exist here sir. He started sobbing.

I felt helpless pathetic and guilty.

Do not worry I will build an hospital here for you.

Every one looked at my face. There was silence for a few minutes.

Tribals smiled sarcastically. One of the tribal elder said slowly but clearly

“Sir, You can spend lakhs to build an hospital here in our village. You can send costliest medicines. But which doctor will come and stay here? Which doctor will treat us here? It is dream. They need cities and cinema theatres only. They will run away after taking lakhs of rupees from you. No one will come to this forest. No nurse will come to work for us. We are children of the forest. Only mother forests will protect us. We have no hopes. We die hopelessly.”  Average life expectancy in those tribal region was 42 years then : often they die for unknown reason.

His eyes became wet. He was unable to talk due to emotions. Everyone was in deep silence. Wind blows chillingly. Forest, Hills, and people looked at me helplessly. Mocked at my ignorance and enthusiasm.

Unable to give an answer, I walked slowly back to my boat. I had quick bath. Sat in meditation longer than my normal time. All others dispersed while woman family stayed back crying loud and nonstop. Hills are echoing the weeping of the women. 

We have to sail to Koida. Sarang Raghava Rao looked at my face for permission. Staff got into the boat. I was helplessly in silence. “I suggested shall we stay until cremation.”  My Project Office KGNJ Shankar answered “not necessary. By staying we can do nothing. We will proceed to next village to distribute materials or else they will be deprived of timely help.”

I had heavy heart. Boat started slowly and picked up speed. I looked at the village and gradually the village faded away from my eyes which is in tears continiously.

My Program Officer Aruna Kumari, Project Officer KGNJ.Shankar, whole boat crew and staff begged me to eat something. But I could not eat not even a biscut, next two days; I lived drinking only with Godavari mud water filtered by a cloth. I fasted,  searching for the answer to this problem.

Whoever comes to me or meet me I used to narrate what ghastly scene that took place and ask them how I could help with medical service. All used to say ‘this is forest. What can we do. It is their fate”

At the end of my visit four days later of the incident, a bigger tribal gathering was arranged by my Project Officer. Amidst of flood relief work about 80 tribals men women youth children all gathered on the white sands of River Godavari while high green bushy mountains as witness. I explained in my speech that happened a few days ago at Kakesanuru tribal village. Most of the crowd was silent. It gave an indication that tribals of Bison Hill Range will never get any medical help.

I said I will build an hospital for you and provide medical service

One old man said “so kind of you Sir, but which doctor, which nurse will come stay in the forest and give us treatment? Even teachers refused to come and teach our children in the Govt School. All wants ( patnam ) towns hotels, Cinema Halls, English Schools, etc. Therefore our building will remain without a doctor.

Yes what tribal elder said was correct

Discussion took place long and lengthy.

At one moment suddenly i said

“ I will bring every day a hospital, doctor, nurse whole medical team  to you  to treat you”

Everybody looked at me with astonishment deep silence no belief never possible. Chairman is simply telling to give us comfort and hope

I said YES It is possible. I will build an Hospital on a Boat. It will have doctor nurse ayah medicines. My hospital boat will reach every day your village treat people give medicines and move on next village floating Hospital, boat travelling doctor.

Half an hour there was pin drop silence. Even my staff did not understand.

I continued. Hospital means not building. It is service. It is availability of medical treatment. Availability of doctor and medical staff. I was living in this bait since ten days. I was sleeping, taking bath eating food and travelling one village after another with relief materials. Like wise we will make boat like hospital, appoint a doctor other staff. They will travel daily or alternatively on the boat reach your villages provide medical attention.....................do you understand....................do you believe me.........................my words ................................?.

No one picked up my idea. After couple of hours my project officer KGNJ Shankar understood started reacting. Slowly other extension officers joined for discussion. Tribals could not understand even a bit .

As soon as i returned to Hyderabad after flood relief work, i started planning. My staff at Head office looked at my with fun. No one interestingly participated. Often they nod their head in disbelief and consider my views are utopian.

Unmindful of others reaction I started writing Boat Hospital concept paper. Topography tribal people back ground and life, about river environment, life problem of survival. And I explained how tribals are dying pathetically especially Konda Reddy tribal group.

I prepared a project proposal. I myself drawn a boat divided various service partitions into it.

All my imagination including flag, syrun etc was indicated. I could not write about technical details of the boat like length width floors Engine room Engine capacity etc. I visited Visakapatnam, Thallarevu and Kakinada boat building places. Had extensive discussion with boat builders.Most of them are marine boat builders. They did not give proper guidance. Then i went to Narsapuram in West Godavari dist. I met a person called Subba Rao.He has terrible deaf. We have to repeat ten times to make him understand. One full day my conversation gave me confidence. I learnt many details from him.

There was a conference in the Netherlands organized a NOVIB. I was invited. I was in Holland more about two weeks. I discussed with various funding agencies. I did not prepare a budget. I was struck with no answer when they questioned financial need. Meanwhile i met a director of Philipes Co. He has shown interest to support. My answer for financial support was inconclusive and unclear. But he assured that he will build a fiber boat like an hospital including OT and gift it to me for tribals of Bison Hill Range. I was excited. It is a gift from Philieps company. I dreampted a dream boat. I was floating on the sky with my imagination and happiness.

I reached India, went straight to Subbha Rao to get more information to be sent to Philieps. I explained about the gift. He laughed loud for a few minutes. He looked at me pittying my innocenses.

Sir, the boat to be built by foregine people is not suitable for us at all. They will build only marine boats not river boat.In Godavari fibreglass boat will not sustain more than two days. We have sand islands, bolders inside the river and suddenly 20 feet deapth river water will reced to half foot where sand bulge out of water. Therefore marine boat, fiber boat will not survive in our River Godavari.  We have to build our boat only with teakwood, and local materials. Though none used i will fix a 65 HP marine engine and see whether it can sustain. I will buy and fix up layland sealed engine. If it fails I will immediately replace with local engine.

Now what shall I do with boat gift from Netherlands. NOVIB took full interest and supported AWARE initiative as unique proposal. I was in crises. I do not know how far I can depend upon Subba Rao. I did not calculate recurring expenditure. I was with full of confusion.

I got an invitation to attend a meeting in planning commission. I went to Delhi. I happened to meet number of government officials during the meetings. One of the person was joint secretary health. I think his name could be Srinivasan(am not sure). We were discussing during lunch hour. He was so excited to listen my dream project “The floating Hospital”. Since then he was always next to me and continuously shown interest and gathered quite a lot of information from me. We became close friends. He suggested a meeting at my hotel. We sat in the restaurant at 7:30PM and discussion continued until 11:00PM. Next day our meeting and discussion continued from breakfast to lunch.

Conclusion was that the joint secretary assured me that entire project of floating hospital will be funded by Government of India. No need to go to abroad for funds. Do not accept fiber glass boat. Subba Rao is correct. Whatever may be the cost of the project, 75% will be provided by Government of India, balance of 25% will be raised locally. He also assured that he will recruit a deputy secretary in AWARE in Hyderabad. He will prepare hospital proposal ad . he will also meet the state government and obtained NOC.

I couldn’t believe these words coming from a senior most Government official in Delhi. This shows how much important this project generated interest even on Government officials how are known for abstracting any such proposals.

I reached Hyderabad. Next day I spoke to the staff. Many of them are doubtfully that Srinivasan will do exactly what he assured. But surprisingly a Deputy Secretary an old man about to be retired in 9 months landed at our office. He came to my chamber with all his files and started gathering information. I know only macro level details of the area. I asked my staff at Badrachalam project to come immediately with micro details of the region and health infrastructure. Next two days the old man was restless. He doesn’t want to see the city.he doesn’t want to sit in the hotel. He sat in my chamber 9:00AM to 5:00PM looking at my face, watching the proceeding of the Chairman. Though the staff felt uneasy, I tolerated because I felt the boat Hospital is very important for the health reconstruction of the tribal people in Paapikondalu area of Godhavari.

After two days my project officer K G N J Shanker landed with much information along with his extention officer, organiser and village leaders.

Then I encountered another problem. The Deputy Secretary do not want to leave my chamber. He want to discuss with my staff and gather information in front of me in my chamber it self. Thus my room became crowded and whole day the discussion of statistic, etc. it took 12hours a day to complete data collection as per the need of the Deputy Secretary. That week I could not do any job. I went out side to meet other people.

Next week Deputy Secretary made aproject proposal with full of statistics financial layout. Surprisingly I did not see any narrative information with regards tribals, their living conditions etc. when I interving and suggested, the deputy secretary short cut conformed me the data not storied. I became silent. My style of narration of a project is totally different. I compromised, agreed what ever he prepared.

His proposal consist of cost of the boat, cost of the 30 bed hospital including the staff quarters, medical equipments and salary of staff for 3 years. In one stroke he totalled the project 60 Lakhs(1983) and wrote down 25% AWARE contribution. He approached for NOC.the deputy secretary in the state government refused to give NOC. He said evary inch on the state is covered by health program. Therefore the service of voluntary organisation is not necessary. The state government issues NOC it is a shame indirectly admitting that area has deficiency in medical service is adamant.

The deputy secretary central government and explained the state government stand. Shri Narendra Lutha was secretary health. I telephoned him and explained him. Naturally he has to depend on his deputy. Srinivasan spoke to him on Phone. I personally met him along with deputy secretary central government. Before I started explaining about boat hospital proposal he smilingly handed over no objection certificate. After drinking coffee offered by him we both came out of Secretariat. The deputy secretary left Hyderabad by evening 7:00 by the flight.

It is 10 days exercise, full of suffocation, at very successful in preparing project proposal as per the need of the central government.

For the next one and half month nothing was heard. At one stage we lost confidence. But one fine morning an American lady and an Indian consultant landed in our office. They had lengthy of discussion about floating hospital. Next day same old man the deputy secretary landed. Three of them want to go to see the villages where the proposed boat hospital to be launch. They have only 48 hours. But the travel alone will take more than 2 days. Some how we have sent them along with K G N J Shanker. They visited Bhadrachalam and Kunovaram only. 15 minutes in each place. They could not visit the tribal villages to the lack of time. The third day they landed at the Hyderabad, the deputy secretary was silent. The Indian consultant was putting more questions, the American lady is so enthusiastic, and she forgot her assignment and started probing about my life with admiration. At one stage I wondered that she may join AWARE. The entire team took a flight and reached Delhi. Next two month nothing was heard. Everyone forgot boat hospital.

One fine morning we received a communication that the innovative the AWARE floating hospital was approved and first instalment will be released soon and it will be send before March 31^st 1984. It is another challenge. They released about 6 lakhs rupees. I rest to Subba Rao and gave about 1 lakh without a boat plan. I reached the District collector of Khamman. I requested him for 10 acres of land to constructs hospital. The district collector felt happy but expressed his inability to identify and assign a land at Kunovaram. I discussed with him about two hours. Narrated whole sequence of the unique project. After two hours of discussion he advised me to identity a government land around Kunvaram and occupied to start immediately the construction. Our staff at Kunavaram located at higher latitude land. Foru kilometres from Kunovaram. It is a hillock which is known as Kothula Gutta. He deputed our engineer Sharma who started construction activity swiftly and area became suddenly active. The tribals and non tribals are watching with astonishment. Nobady knows what is happening. My staff in the field and in the central office with full of happiness and smiles. Everybody was happy that we are getting 45 lakhs. Nobody ever taught how we can gather 25lakhs as our contribution.

  The second challenge started.

I met some industrialist and business people and ask for donation. They listen to my story and appreciated for my efforts and declined to give the donation starting why government was failed to give 15lakhs.

I met land lords in Khammam district explained the project proposal and requested their contribution. They said that we are working for the tribals. Often you spoke against land loads. He threatened our land will be taken back. You spoke of law. You spoke of justice. Not agreeing the health project is for everyone refused any donation.

I met a few film stars including a cricket captain. First they looked at me with disbelief. They listen to me patiently. They asked me “what do you benefit from this type of work. Social Work. What are your incomes? If you do not get income why do you want to do this work. They could not believe that I work for no monetary of political benefit. Cricket Captain said you can use my name to raise funds. Film actress said how much money you give us, if we raise funds using our name. For all the three persons, I told them I came to them for donation and did not come to them to make use of their name to raise funds. So i could not raise any donation from such so called celebrities.

Now I understood how difficult to raise funds for good cause in India. My dream of Boat Hospital seems to be struck.

Now my worry increased. I was told that foreign funds should not be mixed to this project. To NOVIB the Dutch funding agency & the famous Philips company,  I thankfully explained govt of India is funding the project.

Tribals can not contribute. They are poorest of poor.Rs.15 lakhs in 1984 is a big money. Like a wounded soldier not losing hope went to Koida tribal village. Our staff organized a big tribal gathering. I explained them for an hour whole concept of Boat Hospital. In one word they understood that Hospital will come every day at the door step their village with doctor nurse maternity maid and medicines.

Tribals and Harijans consider me as God incarnate (though I do not subscribe to such belief).

The India Today wrote “For about a million Harijans and tribals in rural Andhra Pradesh, he ( Mr Madhavan) is almost God incarnate. Held in awe by the people, his portraits occupy pride of place in homes alongside gods from the Hindu pantheon. If Pudhucode Kongot Sethu Madhavan, the 47-year-old founder of Action for Welfare and Awakening in Rural Environment (AWARE), is revered to the point of deification, it’s not without reason. Thanks to Madhavan’s tireless efforts, millions of helpless tribals have stepped out of the quagmire of poverty to stand on their own feet.”

Now this God is in trouble.

I raised topic of need of local contribution Rs.15 lakhs. Tribals Koyas & Konda Reddys who never seen a hundred rupee currency could not understand like lakhs and crores. Every one expressed helplessness. A few tribal youth pondered some ideas but that will not yeild such money. Suddenly one youth stood and said.

“Sir every time when you visit villages, people put garlands around your neck as gratitude. I have seen some time more than hundred garlands put on to you. May be you visit 5 to 10 thousand villages. Suppose you fix up a rate to garland you, don’t you think we can collect a few thousands every time you visits villages?  We can also suggest people not to buy garlands but give that money to you.”

“That means a person has to buy a ticket to put a garland to Chairman”

My staff interpreted angrily.

“Yes!. Why not? “. “Are we not buying tickets to have Dharsan of Sri Ram God at Badrachalam temple “ the Youth shot back and silenced our staff.

In many more we conducted village meetings, discussed about Rs.15 lakhs deficiency. None understood our problem Nowhere naturally we get solution not to speak of contributions at all.

The 68 feet long Boat arrived from Narsapur West Godavari to Kunavaram where Deaf Subba Rao stood on it like a great captain with pride and dignity. His son too was there. From Narsapur canal boat travelled to Bay of Bengal sea, from there it entered mouth of Godavari and reached Kunavaram sailing opposite to the current of River. A thousand people were watching thus Royal Boat reaching Sangam of River Godavari and River Sabari. People and especially women with lots of colourful flowers bed decked on their head came to receive the Boat  with turmeric water camphor coconut and agarbathis. Boat was received by our staff headed by KGNJ Shankar the Project Officer and tribals from over 40 tribal villages. Bhimireddy the oldest tribal leader who claims to be the contemporary of Great freedom fighter Alluri Sita Rama Raju. headed the tribal groups. Coconuts were broken with competition. Campher burnt with viguar. Flowers were thrown on the massive boat.

Staff insisted that Boat Hospital should be inaugurated by my mother Shrimati Kamakshamma whom everybody treated as their mother. 81 years old orthodox Brahmin woman Kamakshamma travelled to Badrachalam by an Ambulance made night halt, had dharsan of Lord Rama at Badrachalam travelled to Kunavaram next day

1984 June 9^th around 2 pm my mother Kamakshamma, inaugurated JEEVANA SHARAVANTHI AWARE BOAT HOSPITAL at Kunavaram amidst tribal drums, dances songs one side and chanting of mantras by Brahmins on other side. Almost after a year the dream Project THE FOATING HOSPITAL On RIVER GODAVARI became a reality.

After lighting a lamp inside the boat, my mother sat for some time, the huge boat started moving on the water. She has seen mountains, forest  tribals, two rivers Sangam, my staff, enthuisatic people. She dosed off for a few minutes. When she got up she said with staff and to people through a micro phone

“ My life achieved heaven. I never imagined my son will reach such a far interior area to help very poor people. I am blessed. He is not a human being. He is God incarnated to liberate you from poverty and ignorance. He is an avathar. Listen to him, follow him take help from him. All your life will prosper live longer your daughters will get good husbands. In fifty years you all will become rich and prosper.”

This was her message.

Then I addressed the gathering. Thousand eyes fixed at my face. Every word of mine was applauded. It was mesmerise event. Around 4:30PM my extension officer Nageswara Rao took mike and appealed to contribute whatever they can for boat hospital. This announcement was unexpected. Suddenly people rushed to me. I was made to join my palm and it became a cup. People, men, women, children youth and old started pouring coins on my palm cup. In their emotions they gave me all the money they carried as bus charge. 90% were coins only. The biggest currency was Rs.5/- when totalled at the end it was Rs.2,604 may be from 4 to 5 thousand people who attended the inauguration of their FLOOTING HOSPITAL on River Godavari. Everyone went back to their villages by walk since bus fare was donated, maybe some of them have to walk whole night in dark forest.

This magic event entered my spine like electricity. My and my staff eyes were full of tears.

It is unique Project and nowhere in the country that exist a Floating Hospital. It is first of its kind and Govt of India called it as innovative project. Thanks to Govt of India, the joint Secretary the Deputy Secretary and all officials. Perhaps no project was sanctioned earlier in the history of the government with such involvement and perfection and interest.

I came back to square one. Local or AWARE contribution of Rs.15 lakhs. After my failed attempt to raise local contribution as donation I was constantly restless.

I called my printer. I asked him can you print a currency. He was shocked. He did not close his mouth and looked at me with gaze. I told him I want a ticket which resemble Rs.5/- he is afraid. Then I said print one side only. After assuring that I will protect him, he printed a Rs.5 currency but with boat hospital message but looks exactly a five rupee currency printed one side only. At that time no photocopying machine, no scanning, no e-mail, all colours are combined manually. He did well. Currency note looks almost same.

I took it to my friend who was Commissioner of Police and shown to him. He was shocked. He became serious. He told me how could you print counterfeit note?. Taking lunch in his house i explained purpose of printing ticket which will be exchanged with tribals. Those tribals who present Jeevana Shravanthi ticket alone will be allowed to garland Chairman. In brief, first tribal must buy a Jeevana Sharavanthi ticket by exchanging his Rs 5 currency note. Then along with garland he has to show ticket, then he or she are allowed to put garland to Chairman. Commissioner of Police reluctantly approved murmuring. His wife was convinced. She supported me.

Project staff started selling Jeevana Shravanthi currency tickets. Tribal used to say AWARE Money. Believe me we could collect Rs.12,08,000 in a period of 6 years from garlanding Chairman. Just a calculation. Annually i might have received, 40,000 garlands from these tribal and harijan villages. At the rate of 30 garlands in a village, and I would have visited about 1400 villages annually.

This is also unique. Poor tribals not only contributed Rs.12 lakh, but also garlanded Chairman with 40,000 garlands by buying a ticket of Rs.5/- Perhaps never heard off such episode in the village.

Funds came from Govt., Local contribution received from poor tribals. Now we need a qualified doctor. We need a building to manage hospital untill our own building is ready. Local boat managing association handed over their building to establish hospital. Equipments were purchased. Nurses, compounder, wounds dressing person, maid etc were appointed. Until our own boat was ready we hired a local boat for three months..

One doctor stays in the building at Kunavaram which is called base hospital and attends patients. Another doctor, nurse, para medical, boat crew leaves morning with medicines. Boat stops on the bank of a tribal village. Syrun noise, is made, big bell is gangs calling people that Boat Hospital has arrived. Dr and staff treat patients first at the boat itself then for old people and for nearby villages staff, alights boat go to village where health shelter is built and treat. Every village is having health worker to organize and follow up. A cycle also kept in each village where boat hospital will stop, in case of emergency doctor or medical assistant can go to further up villages to give first aid and bring the patient to health shelter or the boat. Each village on the bank of River Godavari was given a small boat. They  use it to bring patient in emergency to boat hospital or to the base hospital.

Medical team available at base hospital round the clock.

Boat travels first day and stops at five places. Night it makes a halt at Kovur a tribal village where River Godavari turn to east to go to West Godavari region. The village is located with dark tall forest with deep silence. Trees and hills touch the sky. Water of Godavari circles and turns to east. There was a hut built for Doctor to stay and there was a dormitory where others sleep. Nurse sleeps in one of the tribal family.

The Boat Hospital service was much appreciated by not only tribals but non tribals also. When program was at its peaks, suddenly one doctor put his resignation. He said he has to return to his place as his mother is sick. With great reluctance, we relived him. To our fortunate a doctor couple joined us. Wife and husband doctors. It thrilled us. Tribal women was very happy. The doctor couple became very much acceptable. In base hospital patient strength increased to 120 to 150 members per day. It functioned 8 am to 8 pm.  We have now three doctors.

Suddenly we found first doctor who resigned set up a private medical clinic in the same locality. He is known as patient friendly doctor. Tribal developed a confidence in him. He started asking tribals to come to his clinic and started charging fee while AWARE was giving free treatment. Tribals initially thought his clinic is also AWARE clinic; Pay clinic; he started exploiting innocent tribals and emergency non tribal patients.

Our staffs was confused. Tribals also was not able to decide. Non-tribals played a durty game motivatiog tribals to go to fake clinic not AWARE base hospital. They said by paying you get best treatment. AWARE base hospital medical treatment is free and they will give out dated medicines. When the boat hospital in the villages did not effect. Base hospital got effected. AWARE staff organised a tribal meeting and explained that the pay clinic is not of AWAREs and doctor is exploiting the innocence of tribals. Only 50% of the tribals could understand while others were still trusting the first doctor. The non-tribals are fully backing first doctor pay clinic to sabotage AWARE base hospital treatment.  AWARE staff could not reconcile. One evening AWARE staff and large number of tribal leaders raided first doctor pay clinic. Destroyed the furniture, thrown the medicines, physically put him in the bus, sent him to Rajamandry with a warning to not to return. Surprisingly non-tribals were salient, hiding, did not come to the risk of the first doctor.

Next week onwards project officer, extension officer and other staff conducted a tribal meeting and announced that every patient has to contribute what ever they can and there will be no free treatment at all. Then onwards a base hospital started collecting patient contribution from Rs 1 to Rs 5 per patient per day. However the boat hostipal JEVANA SRAVANTHI continue to treat patient at tribal villages with out collecting any patient contribution. In due course both tribals and non tribals accepted and appreciated the system of patient contribution. This arrangement was started from July 1985 onwards

This was the arrangement. Things going on very well. Tribals felt secure and happy.

Thirty beds AWARE base hospital with six staff quarters were ready on Kothula Gutta opposite to JAggaram Village, three kilometres away from Kunovaram. When we were planning to shift the base hospital, suddenly Godhavari had floods. This was the flood of the century. More than three hundred villages were submerged. The flood water submerged hillock where Bhadrachalam Sri Rama Temple is located. About 6 lakh people were homeless. The Godavari water touched the Godhavari bridge, terribly shacking the Godavari bridge. The silt of the Godavari was 8 feet and entire AWARE base hospital was submerged. The river Sabari wasn’t spate. The water reached and submerged chatty and Chintoor villages and water spread into Kunta village in Madhya Pradesh. AWAREs flood relief work was so systematic. That the state government handed over three Helicopters to AWARE for food dropping. The service rendered by was big story. It can be discussed in another chapter. The state Governor appreciated the service of AWARE Chairman and gave an Award for a courageous and selfless service. The tribals took shelter in the newly constructed AWARE base hospital. The AWARE boat saved 20 thousand people from the submerged villages working 24 hours in risking the people. Bring the people to the higher altitude and thus saved hundreds of lives. Even today the boat is venerated as a savvier of tribals life. When boat reaches a village people breaking a coconut and worships as a goddess of river godavari.

When base hospital at Kunovaram was submearged and bareed in silt, all the equipment of medical was damaged. After cleaning we handed over building to the association with gratitude. The hospital was shifted to our own building at Kothula Gutta. New equipments were perchased. Base hospital started function. Boat hospital continued it service.

Then comes to a challenge.

The doctor couple and one more doctor resigned and they wish to go away. They were shock to see the floods. The lady doctor developed fear psychosis. We could not convince her. However doctor Subba Rao from Tirupathi joined and one more doctor was recruited without break of medical service. Their families were so happy. They got the quarter and AWARE was appreciated everywhere. Doctor Subba Rao was a dedicated doctor, hard working, friendly and his wife worried always about childlessness. This was the topic they always talk to Chairman. Dr. Subba Rao became famous, friendly and every tribal wish to have treatment only from Dr. Subba Rao. There was always a demand that he should be at boat hospital and he should be at base hospital.

“Jeevana Shravanthi”, AWARE Boat Hospital or Floating Hospital Kunavaram Khammam district drawn attention of the country. News papers wrote articles. Only electronic media then was the Doordarsan TV owned by Govt telecasted 20 minutes program. Even some foreign media (I do not whether it is BBC) telecasted floating hospital. Officials, judges, politicians, film stars all travelled in the boat to see unique medical service but also enjoy Papikondalu Forests Hill range the most beautiful and attractive places. It became in due course nuisances and hindrance to medical service for tribals.

Ford Foundation published a book called Anubhav. Dr. Neera Soni who visited Boat Hospital wrote in Anubhav as  follow.

 “If innovative methods are a yardstick, AWARE's boat hospital or floating CHC operating out of Kunavaram village is a winner. In the rugged Bison Hill range, on either side of the river Godavari, AWARE has a novel strategy for reaching health care to the Koyas and Konda Reddis—two key tribal groups. Living in 300 odd villages along the river, these  tribes  have been boycotted for decades both psychologically and in terms of service infrastructure. There are no roads nor any other means of easy access through the Bison Hill terrain. The only communication possibility and one which AWARE grabbed eagerly was the mobility offered by the river.

 It decided to set up a floating hospital. The Government of India and the state government were per­suaded by AWARE to finance the cost of a mobile health programme located on a launch. The hospital floats on the river every day. Beginning at 7:00AM, it touches 5 centres on-one of the banks each day. The medical crew halt overnight at a place called Kolhur. The following morning, the cruise is resumed with the boat stopping at another five centres located on the other bank. The boat has facilities for minor operations, inpatient care, and a laboratory for urgent diagnostic work.  There is a doctor on board who is aided by the ANM and a com­pounder. The crew is efficient and knowled­geable in boat maintenance and repair. A talented cook turns out delicious local cuisine.

Over the years, Prakash Rao one of the sarangs (boatmen) has acquired enough medical savvy through formal and informal learning to be engaged as a para­medic. He had the chance to see one of his children being delivered in the boat hospital and that too, in the midst of a fuming Godavari. The boat berths on the river side at a designated place. Outpatient services are delivered on the boat except to the aged and the infirm that are unable to come person­ally and are therefore, visited in their homes by the roving medical team. The tribals come down from hills slopes to get immunization, first aid, prenatal and postnatal check-ups or general health services.

Routinely, before the outpatient clinic is held, the doctor and his crew climb up the steep hillside to a health 'shelter' or 'outpost'. Here, some of those who live within the jurisdiction of the outpost (8 villages) gather to chat with the doctor and his team. The village health worker, the motivator, the Dai. AWARE's development project staff, leaders of mahila mandalis and youth mandalis, caste elders, and a mix of women, men and children—all sit together to go over any pressing problem in health or other fields.

Women speak freely of their hassles not only with the lack of medical facilities but with socio-economic programmes, the availability of loans, the problems of debt, irrigation or seed supply, repair of dwellings, cattle, poultry, and pre­valence of malnutrition.

At one of these meetings at Sriramgiri, Mr. P. Raghavayya. a paramedical worker. Began with a discussion of unhygienic foods. He went on to discuss scabies and how the lack of personal hygiene causes it. The benefits of immunization against polio and other diseases were emphasized next and finally, he spoke of smokeless cooking stoves. The presentation was participative and encouraged those assembled to supplement what Mr. Raghavayya was saying. Later, a group of dais explained to the visitors how AWARE had brought safer birth practices to the tribals. Since the villagers did not know how tetanus is caused, many cases went undetected result­ing in loss of life. Now (that loss is prevented; deliveries are generally safer also because the primitive instruments such as sickles, arrows and heavy stones used for cutting the umbilical cord earlier have been merci­fully replaced with the modest sterilized delivery kit provided by AWARE.

According to Seethamma, immunization is accepted by many more expectant women today than before. AWARE estimates current immunization coverage at two of its CHCs at around 40 percent as against 4 percent initially, Suramma, who is a village health worker (VHW), confirms Seeth-amma's assessment of the changing health habits and status of the villagers. An old woman, she explains her desire to assist AWARE as the least she can do for those who have set out to help her people. "I want to help them to help us." says Suramma with a touching directness and a dignified mix of gratitude and pride

The boat repeats this shelter drill ten times during a 48 hour period. Through each shelter or outpost, the population of 8 villages is expected to be covered, in all, through 10 outposts, 80 villages or a total tribal population approximating 40,000 is intended to be reached.

Each shelter is manned by a paramedical worker and is regularly visited by the floating health cen­tre. Bicycles and mopeds are being slowly added to ensure mobility and outreach for the health shelters. A country boat is also provided at each health shelter for trans­porting patients to the base hospital at Kunavaram in case of emergency. With 6 beds, a labour room, a minor operation theatre, a clinical laboratory and a training centre, the base hospital is equipped to act as a referral centre. Each of the 80 villages has a trained VHW to meet the first aid needs of health and family welfare services. In addition, a trained Dai is expected to be available to each of the 80 villages. The recruitment of dais has not been easy. At present, there are 30 daises who are serving the 80 villages on a cluster basis. AWARE is conscious of this shortfall and is making a vigorous effort to fill this gap.

The two teams of doctors oversee the health shelters; supervise the dais, village health workers, and paramedical workers. And manage the floating health facility and base, hospital. Assisting the doctors are ANMs who are locally recruited women who have received six months' training with AWARE. There is also provision for a health programme officer (a position yet to be filled) with a background of health educ­ation to assist the health education activities in the Kunavaram project area.

Even with two teams and their supporting staff alternating, life on or off shore can never be easy. But Dr. Subba Rao, presently in charge of the Kunavaram CHC, speaks softly of deeper compensations and of pro­mises to his health constituency. Sitting in his inspiring presence, with the contours of the Bison Hills silently backing the cou­rageous little hospital boat anchored in the shimmering waters.

As a qualified medic, Dr. Rao is hardly naive to or unaware of the market value of his skills or those of his colleagues. In fact, ten doctors have left the scene since he joined but he has stayed on, despite grave personal difficulties in terms of housing, and other amenities of life possible in the modest setting of Kunavaram.

There are additional contingencies which one must learn to cope with. Over a year ago, when the base hospital and referral centre set up by AWARE at Kunavaram stood submerged under 20 feet high water, Dr. Rao and his team ran the boat as a major rescue and flood relief operation. AWARE won formal recognition in terms of a state award for helping to rescue over 20,000 stranded victims of flood. Soon after the flood waters receded, the team that helped AWARE, earn the award was engaged in reclaiming the health records and equip­ment from the water-soaked CHC. Today, just over a year later, there are no visible signs, nor sorrow over what was lost or what could have been. Along with the tribal hamlets and the rest of the landscape, the CHC stands resurrected in total defiance of nature's intimidating power.

Dr. Rao and team worked in the boat hospital since 1986 to 1999. Then due to sudden family problem he left to Tirupathi sadly. However the boat hospital and base hospital rendered his service with same dynamism but different who worked temperierly.

Mean while the government infrastructure improved. They constructed a bridge across the Shabari river connecting Kunovaram to Vara Rama Chandrapuram. Know until that the other side of the river bank government build all weather road connecting to Burgampad to Aswaraopet. 40 villages were connected with transport service. Government build a 30 bed hospital at Kunovaram. Though often doctors were missing. A medicine were not available. Tribals are able to move fast and their living condition were improved due to AWARE tribal development program and government tribal development program. However AWARE boat hospital reduced his journey alternate days to one day a week. The base hospital was serving including impatient facilities.

In 2012 December. When the Godhavari water receded the new boat driver struck the JEEVANA SRAVANTHI boat and to a rock and struck in sand dune causing a major break down. The boat was dragged by another boat and taken to Davaleshwaram for major repair. The base hospital got continued it service in a much lower level due to often change of doctors and lack of qualified medical doctors.

AWARE which has a sentiment to boat hospital and people who are attached to boat hospital are trying to bring back to its glory and further strengthening of unique boat hospital which is one of its kind in the country.