Health Inequities in Conflict-affected Areas: Armed Violence, Survival and Post-Conflict Recovery in the Indo-Bhutan Borderlands 9811605777, 9789811605772

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Samrat Sinha Jennifer Liang

Health Inequities in Conflict-affected Areas Armed Violence, Survival and Post-Conflict Recovery in the Indo-Bhutan Borderlands

Health Inequities in Conflict-affected Areas

November 2020

Samrat Sinha · Jennifer Liang

Health Inequities in Conflict-affected Areas Armed Violence, Survival and Post-Conflict Recovery in the Indo-Bhutan Borderlands

Samrat Sinha Jindal School of International Affairs O.P. Jindal Global University Sonepat, Haryana, India

Jennifer Liang The Action Northeast Trust (ANT) Chirang, Assam, India

ISBN 978-981-16-0577-2 ISBN 978-981-16-0578-9 (eBook) https://doi.org/10.1007/978-981-16-0578-9 © Springer Nature Singapore Pte Ltd. 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore

Foreword

Almost 5 years ago, in October 2015, Jennifer Liang (Jenny to all of us) submitted an Expression of Interest (EOI) to the ‘Closing the Gap: Health Equity Research Initiative, India’ project of Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala. The EOI was to carry out a study on tribal health and health inequities in Bodoland. As the Closing the Gap project’s principal investigator, I watched the project take shape into an in-depth qualitative study on conflict and health inequities in Bodoland. There was a great deal to learn as the study progressed, and Jenny shared her findings periodically. I learnt about the status of the Bodos as a community in a position of power, very different from the stereotypes of ‘tribals’ or ‘STs’ that we tend to have. Jenny and her team’s research dwelt on the layers of inequalities across. The study chose to go beyond the notion of a homogenous and oppressed tribal population at the bottom of India’s many-layered social stratification. The study’s findings illustrated how social conflicts caused immediate trauma and impacted the lives of the victims and the perpetrators for several decades through multiple pathways. Most importantly, the study taught me the fallacy of viewing health inequities merely as ‘gaps’—implying that they are quantifiable and that it was merely a matter of getting from here to there, to ‘close the gap’, as the famous message ‘Closing the Gap in a generation’ from the WHO Commission on Social Determinants of Health’. The lived experiences and stories that informed the study laid bare the many non-quantifiable dimensions of health inequities beyond access to healthcare and morbidity/mortality. The commitment and conviction with which the research team carried out its data collection would be an inspiration to all researchers. The team lived in remote villages, in harsh conditions through many months, and observed, listened and meticulously documented. This was a quest to understand the reality from the lived experiences of people, rather than just another research study that needed to be completed and a report produced. I am delighted to see that the research study has expanded in scope and resulted in this multidisciplinary book, which locates health inequities within its historical, political, social and economic contexts. This book will be a first in India in many v

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respects—in addressing the issue of conflict and health, in adopting a multidisciplinary perspective and in its ability to foreground the voices of the people whose story it tells. TK Sundari Ravindran Retired Professor Sree Chitra Tirunal Institute for Medical Sciences and Technology Thiruvananthapuram, India

Acknowledgements

The development and writing of the book would not have been possible without the support of several individuals and institutions. The authors would like to thank Dr. T. K. Sundari Ravindran who led the project Closing the Gap: Health Equity Research Initiative in India. This was a project of the Achutha Menon Centre for Health Sciences Studies (AMCHS) at Sree Chitra Tirunal Institute of Medical Sciences and Technology (SCTIMST) in Trivandrum, Kerala, funded by the International Development Research Centre (IDRC), Canada. The authors especially acknowledge the contribution of the research advisor Dr. N. Nakkeeran for his invaluable guidance to the study. The book builds on the detailed research report completed by the ant in the course of the project. At the heart of the book is the extensive fieldwork done by the research team for the original study—Dr. Mintumoni Sharma, Balawansuk Lynrah, Jauga Mushahary, Samuel Hasda and Binod Mardi. The book is a testament to their resilience and innovation in extremely difficult and challenging circumstances. Given the extensive narratives documented by the research team in the course of the study, the cumulative effort has evolved into a deep social history of the Bodoland conflict. The book is one of the few in-depth accounts of survivors of 1996 and 1998 conflicts from both the Adivasi and Bodo communities who lived in the relief camps at that time. We acknowledge the extensive contribution of members of the ant, especially Dr. Sunil Kaul, Samar, Rabindra, Pasang, Rhondeni and Sriram (who has contibuted many photographs in the book, including the cover photo). Their immense hard work shows in the strong relationship with every group in the community. We thank the IDeA team based in Guwahati for allowing the time and support needed to complete the book. We wish to especially acknowledge the encouragement provided by the Jindal School of International Affairs (JSIA), O.P. Jindal Global University (JGU) in the writing and completion of this book. We are thankful for the immense help extended by the North East Research and Social Work Networking (NERSWN) and the NEDAN Foundation to the JSIA—the ant Annual Winter Schools. We would like to thank Dr. Ravikant Singh, Sunny Borogohain, Narattam and all members of Doctors For You (DFY)-India and the DFY-Regional Office in Guwahati. We are grateful to several anonymous individuals who over the years and over many rounds of conflicts participated in the humanitarian response in Bodoland. We salute vii

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your invaluable work and for generously sharing your experiences with the authors. We acknowledge the contribution of several individuals across the border in Bhutan for sharing valuable insights, which helped shape different parts of the book. We acknowledge the support extended by Springer-Nature, India and especially thank Satvinder Kaur, Nupoor Singh, Karthik Raj Selvaraj, N. S. Pandian and Jayanthi Narayanaswamy for steering the manuscript through various stages of development. Lastly, the book would not have been possible without the encouragement and unwavering support extended by our respective families, for which we are grateful. Most importantly, we extend our deepest gratitude and respect to each and every respondent in this study—for their trust in sharing their stories and experiences. We dedicate this book to you and to all conflict survivors. We are indebted to you and truly humbled by your strength, spirit and resilience.

Contents

1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 Post-Humanitarian Realities and Entangled Biographies in a Conflict-Affected Borderland: The Hamlet of Sonapur and Its Headman, Nobo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2.1 Life Sketch of Nobo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2.2 In Between Humanitarian Actors, the State and Non-State Armed Groups (NSAGs) . . . . . . . . . . . . . . . . 1.2.3 Post-Conflict Vulnerability and the Fate of a Girl Child in Sonapur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 Conflict in Forgotten Borderlands . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 Organized Armed Violence and Health Inequity . . . . . . . . . . . . . . . 1.5 Situating the Narratives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.6 The Design of the Book and Inclusion of Cases . . . . . . . . . . . . . . . . 1.7 Plan of Chapters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 The Making of Violent Spaces: Conflict and the Search for Peace in Bodoland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 A Brief Description of the Bodos . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 Colonialism, Demographic Transitions and Initial Conditions in the Pre-conflict Phase . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 The Politics of Demography and Pre-conditions for Violent Conflict . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 The Movement for a Separate State of Bodoland and the First Agitation 1987–1993 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 Territoriality, Governance and the Search for Peace in Bodoland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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7 7 8 11 13 15 19 20 23 33 34 38 39 42 48 49

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2.7

Emergence of Armed Organizations and the Rise of Militancy . . . 2.7.1 Patterns of Armed Violence . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7.2 Armed Organizations: A Sociological Understanding . . . . 2.8 Beyond Militant Violence: Humanitarian Crises and Forced Displacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.9 Learning the Language of Guns: A Commander’s Story (1996–2016) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.10 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

52 52 57

3 Researching Fragility in the Indo-Bhutan Borderlands . . . . . . . . . . . . . 3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 A Snapshot of Chirang with a Focus on Health . . . . . . . . . . . . . . . . 3.3 The Research Setting: Forest Governance, Governance of Fragility, Fragility of Governance? . . . . . . . . . . . . . . . . . . . . . . . . 3.3.1 Understanding Villages in the Forest . . . . . . . . . . . . . . . . . . . 3.3.2 Case Studies of Governance: The VCDCs of Milon and Koroipur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4 A Brief Description of the Unrecognized Forest Villages (FVs) from Which Data Was Collected . . . . . . . . . . . . . . . . . . . . . . . 3.4.1 Milon RC (Relief Camp) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4.2 Bogori Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4.3 Fulbari Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4.4 Sonapur Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4.5 Salbari Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4.6 Lalbiti Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5 Methodological Development for Studying Fragility in the Indo-Bhutan Borderland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5.1 Identification and Selection of Villages . . . . . . . . . . . . . . . . . 3.5.2 Research Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5.3 Methodology and Tools Used in the Study . . . . . . . . . . . . . . 3.6 Data Collection: Experiences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6.1 Some Data Collection Sites . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6.2 Challenges of Fieldwork . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6.3 Walking the Fine Line Between Researcher and Activist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6.4 Researcher as an Insider and Positionality . . . . . . . . . . . . . . 3.7 Documentation, Filing and Data Analysis . . . . . . . . . . . . . . . . . . . . . 3.8 Limitations of the Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.9 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appendix 1: A Case Study of Ecological Fragility After Conflict and Displacement [Case Developed from Jennifer Liang’s Field Notes from Fulbari Village] . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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81 81 85 87 89 89 89 90 91 92 92 93 93 94 96 97 98 99 100 100 101 102

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4 Armed Violence and the Breakdown of the Health System: Vulnerabilities of Health Personnel in the Conflict-Affected Borderland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2 A Micro-View of the Effect of Conflict on Health Services . . . . . . 4.3 Socio-Political Changes and the Health System of Assam Until the Assam ‘Agitation’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 Between the Assam Agitation and the Bodoland Movement . . . . . 4.5 Onset of the Movement for a Separate State of Bodoland or ‘Andolan’ and Militant Violence and Its Aftermath . . . . . . . . . . . 4.5.1 Damage to Health Infrastructure . . . . . . . . . . . . . . . . . . . . . . 4.5.2 Security Threats Faced by Doctors and Other Health Professionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.6 The Post-Conflict Phase and the Health System . . . . . . . . . . . . . . . . 4.7 Current Problems of Government Health Centres: A Community Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.8 Paucity of Qualified Health Personnel in the Conflict Areas . . . . . . 4.9 Role of the State, Localized Fragility and the Promotion of Well-Being of Communities in Conflict Areas . . . . . . . . . . . . . . . 4.9.1 Status of Health Promoting Schemes . . . . . . . . . . . . . . . . . . . 4.10 A Case Study of an NRHM Programme Manager: The Possibilities of Transformation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.11 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Surviving Conflict in a Fragmented Borderland: Community Voices on Violence, Dislocation and Ill-Being in the Border Villages of Chirang . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 Micro-Narratives of Violence and Survival of the Earlier Conflicts Between Bodos and Adivasis (1996–1998) . . . . . . . . . . . 5.2.1 The First Big Disruption: Witnessing Violence and Fleeing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2.2 To the ‘Relief Camps’: Visible Safety, Invisible Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.3 Violence and Incarceration: Some Narratives from the Outside . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.4 Displacement and Its Effects of Conflict on Health and Well-Being of Vulnerable Populations . . . . . . . . . . . . . . . . . . . . 5.4.1 Impact on Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.4.2 Impacts on Children—The Youngest Victims of Conflict . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.5 Rehabilitation and Resettlement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.6 Impact of the Conflict on the Host Community in the Indo–Bhutan Borderland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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5.7

Conclusion: The Political Determinants Indirect Mortality in Conflict and the Emergence of Informal Healthcare Provision in Violence Affected Areas . . . . . . . . . . . . . . . . . . . . . . . . . 175

6 Deep Vulnerabilities and Coping After Conflict: Ill-Health, Treatment Seeking Behaviour and Informal Medical Practices in the Borderland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2 Mapping Treatment Seeking Behaviour of Conflict-Affected Communities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2.1 The Story of Binod and Lakhi—An Adivasi Couple in Milon Relief Camp . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2.2 The Story of Mohan and Rupsi: A Bodo Couple . . . . . . . . 6.3 Continuity and Change: Informal Health Practitioners in the Indo–Bhutan Borderlands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.3.1 Traditional and Faith-Based Healers . . . . . . . . . . . . . . . . . . . 6.3.2 Impacts of Conflict on Traditional System and Emergence of Unlicensed ‘Pharmacists’ . . . . . . . . . . . . 6.3.3 ‘Pharmacies’ in Village Markets . . . . . . . . . . . . . . . . . . . . . . 6.3.4 The Entry of NGOs into Healthcare Provision Among Conflict-Affected Populations: The Role of an International Medical Mission (the HFA Foundation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.4 Conclusion: Building Bridges in Formal and Informal Through Mental Health and Emergency Services . . . . . . . . . . . . . . . Appendix 1: A Case Study of Life as a Community Health Worker (CHW) for the International Medical Mission-Some Insights . . . . . . . . . . Appendix 2: Case Study of Traditional System of Justice for Victims of Domestic Violence in a Bodo Village (Names Changed) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 The Transboundary Impacts of Conflict on Bhutan’s Border Districts: Insurgency, Border Malaria and Cross-Border Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2 Chitra’s Story: Loss, Resilience and Reconstructing Fragility Near the Indo-Bhutan Border (Note: Names of Respondent and Some Locations Have Been Coded) . . . . . . . . . 7.3 Beyond the Border Gates: A History from Above . . . . . . . . . . . . . . 7.4 Open Border, Bilateral Treaty Arrangements and Key Achievements in Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5 Destabilization of the Border . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.5.1 The Citizenship Question and Civil Strife in Bhutan . . . . . 7.5.2 Entry of Militant Organizations from India and Armed Conflict in Bhutan . . . . . . . . . . . . . . . . . . . . . . . . 7.6 Conflict and Border Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

181 182 184 185 188 196 196 204 206

209 213 215

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7.7 7.8

Bhutan’s Strategy for Malaria Control . . . . . . . . . . . . . . . . . . . . . . . . Returning Back Across the Border Gate, Health-Seeking Behaviour and Post-Conflict Recovery . . . . . . . . . . . . . . . . . . . . . . . . 7.9 Conclusions: Building a Case for Grass Roots Health Cooperation in the Indo-Bhutan Border Areas . . . . . . . . . . . . . . . . . Appendix 1: Some Photos of the Indo-Bhutan Border . . . . . . . . . . . . . . . . . 8 Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.2 Violent Borderlands: Conflict Between Bodos and Bengali Muslims and the Humanitarian Crisis of 2012 . . . . . . . . . . . . . . . . . 8.2.1 Background to the 2012–2013 Humanitarian Crisis . . . . . . 8.2.2 Scale of the 2012–2013 Crisis and Challenges Faced by Humanitarian Actors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.2.3 Access to Healthcare during the Crisis Phase . . . . . . . . . . . . 8.2.4 Assessment of Water, Sanitation and Hygiene (WASH) in Select Camps in the Post-Emergency Phase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.2.5 Nutritional Assessment in the Relief Camps During the Crisis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.2.6 Measurement Problems in Crisis Situations: The Crisis of Habitat Destruction in 2012–2013 . . . . . . . . . 8.3 The Intervening Years 2013 to 2014 . . . . . . . . . . . . . . . . . . . . . . . . . . 8.4 Violent Borderlands and the Prelude to Peace: Violence Between the Bodo and Adivasi Communities 2014–2015, a New Humanitarian Crisis and Its Aftermath . . . . . . . . . . . . . . . . . . 8.4.1 Camp Locations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.4.2 Access to Healthcare During the Crisis Phase . . . . . . . . . . . 8.4.3 Impact on Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.4.4 Community Perspectives: Conflict Early Warning and Fleeing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.4.5 Community Perspectives: Mapping the Challenges of Post-Conflict Recovery Through the Life History of Roshmi—A Bodo Woman Whose Husband Went Missing in the 2014 Conflict (All Names and Locations Have Been Changed) . . . . . . . . . . . . . . . . . . . 8.5 A Case Study: Challenges in the Planning and Management of Large-Scale Humanitarian Operations in the Aftermath of the Conflicts (2012–2016) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.6 Preventive Measures and Peacebuilding at the Community Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.7 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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9 Conclusion: Towards Post-conflict Recovery, Social Elasticity and Restoration of Health Equity in Bodoland . . . . . . . . . . . . . . . . . . . . 9.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2 Peacebuilding and Health Equity: Going Beyond “Resilience” in Policy Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2.1 Impacts of Armed Violence Are Non-Uniform as Opposed to Universal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2.2 Complex Interplay of Loss and Suffering . . . . . . . . . . . . . . . 9.2.3 Effects Being Non-Linear . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2.4 Indirect, Deep and Long Term . . . . . . . . . . . . . . . . . . . . . . . . 9.3 “Social Elasticity” (SE) as a determinant for Sustainable Everyday Peace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.4 Developing Social Elasticity—Some Experiences . . . . . . . . . . . . . . 9.4.1 Saving the Tractor of an “Antagonist” During 2012 Bengali Muslim–Bodo Conflict . . . . . . . . . . . . . . . . . . . . . . . 9.4.2 Wood Stove Making in Chirang . . . . . . . . . . . . . . . . . . . . . . 9.4.3 Peace School (Suluk-Gwjwn Vidyalaya), Kokrajhar (Established with Support from NERSWNNortheast Research and Social Work Networking) . . . . . . . 9.5 Overcoming the Perils of Rapid Exits: Transitioning Between Humanitarian Action and Long-Term Peacebuilding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.6 State-Led Peacebuilding and Reconstruction: The Need for Convergence and Accountability . . . . . . . . . . . . . . . . . . . . . . . . . 9.6.1 Ensuring Essential Services and Conflict Adaptation . . . . . 9.6.2 Ensuring Food and Livelihood Security . . . . . . . . . . . . . . . . 9.6.3 Education for the Protection of Children . . . . . . . . . . . . . . . . 9.7 Transforming Inequity, Restoring Equity in Healthcare in a Post-Conflict Borderland: Some Pathways . . . . . . . . . . . . . . . . . 9.7.1 Responsive Administration for Restoration of Social Welfare Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.7.2 Promoting Transboundary Cooperation in Healthcare . . . . 9.7.3 Active Community . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.7.4 Responsible NGOs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.8 Mainstreaming Health Equity into Peace Accords: The Memorandum of Settlement (MoS) 2020 and Establishment of the Bodoland Territorial Region (BTR) . . . . 9.8.1 Clause on Financial Compensation for the Next of Kin of Persons Who Lost Their Lives in the Agitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.8.2 Creation of New Medical Training Institutions . . . . . . . . . . 9.8.3 Comprehensive Drinking Water Scheme for Villages Near Indo-Bhutan Border . . . . . . . . . . . . . . . . . . . . . . . . . . . .

307 307 309 309 310 310 310 311 315 315 316

316

317 320 321 322 322 323 325 326 326 327

328

330 330 331

Contents

xv

9.9 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331 Appendix 1:A Case Study: Ultimate Frisbee in Chirang—175 g of Social Transformation [Jennifer Liang’s Process Documentation] . . . . 332 Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339

About the Authors

Dr. Samrat Sinha is a Professor at the Jindal School of International Affairs (JSIA), O.P. Jindal Global University (JGU), India. He is the Executive Director of the Centre for Border Studies- a research centre within JSIA. He has earlier taught at the Jamsteji Tata Centre for Disaster Management (JTCDM), Tata Institute of Social Sciences (TISS), Mumbai. He has been collaborating with civil society organizations in the Bodoland Territorial Region (BTR), Assam since 2012. He has been involved in conducting humanitarian assessments, applied research and peacebuilding projects in the region. At JSIA, he teaches courses on Peacebuilding, Humanitarian Assistance and Disaster Relief. He, in collaboration with the ant and NERSWN, also teaches an immersive field-based course on community development in the Indo-Bhutan borderland regions. His publications include books and research papers in the fields of peacebuilding, conflict and health. He holds a Ph.D. and a Masters Degree in Political Science and International Relations from the University of Delaware, USA. He also has a Masters in Politics (International Studies) from Jawaharlal Nehru University (JNU), New Delhi and an undergraduate degree in History from the University of Delhi. Jennifer Liang completed her Masters in Social Work from Tata Institute of Social Sciences (TISS), Mumbai, and has since been working in the area of health, organisational development and women’s issues. She is Program Lead and Trainer at IDeA—the Institute of Development Action—and Consultant to the Paul Hamlyn Foundation (UK). She is a co-founder of the Action Northeast Trust (the ant), a nonprofit working on rural development in Bodoland Territorial Region (BTR), Assam, since the year 2000. She has also served on the boards of various development organisations in the Northeast region of India. She was awarded the United Kingdom’s Chevening Gurukul Scholarship in 2013. She was also selected as one of 50 emerging women leaders in 2014 by the Women in Public Service Project, an initiative of the U.S. State Department. She directs her academic and social change activities in the following themes: gender equality, the development and rights of children, peacebuilding and organization development.

xvii

List of Figures

Fig. 1.1 Fig. 1.2 Fig. 2.1 Fig. 2.2 Fig. 2.3 Fig. 2.4 Fig. 2.5 Fig. 2.6 Fig. 3.1 Fig. 3.2 Fig. 3.3 Fig. 3.4 Fig. 3.5 Fig. 3.6 Fig. 3.7 Fig. 3.8 Fig. 3.9

Photo of a house in Sonapur Village where families relocated after the 2014 conflict . . . . . . . . . . . . . . . . . . . . . . . . . . Photo of an interior of a “house” of a conflict-displaced family in Sonapur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The political map of the separate state demand of Boroland . . . . Pattern of 11,689 fatalities in militant violence in seven states of Northeast India (2000–2019) . . . . . . . . . . . . . . . . . . . . . Pattern of 8,327 fatalities due to militant violence in Assam . . . . Pattern of 1,804 fatalities in militant violence in the Post-1993 BAC Accord . . . . . . . . . . . . . . . . . . . . . . . . . . . . Injuries due to explosions, arrests and surrenders 2002– 2020 in BTAD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Analysis of injuries due to explosives, surrenders and arrests in BTAD 2000–2020 . . . . . . . . . . . . . . . . . . . . . . . . . . Photo Showing the Milon VCDC Office in the Veranda . . . . . . . The road that goes via Milon area up to the International Border with Bhutan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Photo taken from Milon showing the Bhutan mountains across the border . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Photo of a house in Fulbari Village in the forest next to the Bhutan border . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Photo of children gathered in front of a school run by the ant, the NGO conducting this study . . . . . . . . . . . . . . . . . . Photo showing villagers in Salbari performing a community ritual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Photo of a tea shop in Milon–one of the sites for data collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Clockwise) Photos Showing Challenges the Challenges of the Terrain for Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . (Left) and (right) Photos showing regular review meetings of the research team to review the data, identify gaps and plan out the next steps in the study . . . . . . . . . . . . . . . . . . . . .

13 13 49 54 55 55 56 56 86 88 88 90 90 91 97 99

101 xix

xx

Fig. 3.10 Fig. 3.11

Fig. 3.12 Fig. 4.1 Fig. 4.2 Fig. 4.3 Fig. 4.4 Fig. 5.1 Fig. 5.2 Fig. 5.3 Fig. 6.1 Fig. 6.2 Fig. 6.3 Fig. 6.4 Fig. 6.5 Fig. 6.6 Fig. 6.7 Fig. 6.8 Fig. 6.9 Fig. 6.10 Fig. 6.11 Fig. 7.1 Fig. 7.2 Fig. 7.3 Fig. 7.4 Fig. 7.5

List of Figures

Tree Stumps after forests are cleared for farming . . . . . . . . . . . . . Trees cut for selling as firewood—cycle-load of firewood every evening is a common sight in the Indo-Bhutan border areas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . River erosion washes away big chunks of land . . . . . . . . . . . . . . . Map of the Location of Major Health Centres in the Study Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Koroipur State Dispensary: The Site for a Micro-institutional history . . . . . . . . . . . . . . . . . . . . . . . . . . . Historical Timeline of the Koroipur State Dispensary (KSD) . . . Effect of Non-Functional Supplementary Nutrition Scheme (ICDS) on Children in the Study Area . . . . . . . . . . . . . . Displacement map of the study area . . . . . . . . . . . . . . . . . . . . . . . Mapping Increased Vulnerabilities of Women Following Conflict . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mapping Impacts on the Rights of Children in Conflict-Affected Areas in the Research Site . . . . . . . . . . . . . . Vulnerability Vortex of an Adivasi Household Following Conflict . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Treatment Seeking Pathway of an Adivasi Family Post the 2014 Conflict . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mapping the Post-Conflict Vulnerability of a Displaced Bodo Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mapping the Pathway of Treatment Sought by a Bodo Conflict Displaced Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Various Treatment Options Used by the Conflict-Affected in the Indo–Bhutan Borderlands . . . . . . . . . . . . . . . . . . . . . . . . . . Photo showing the rate list of the services of a traditonal healer in Milon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Photo of a traditional healer in the middle his practice . . . . . . . . Kerai Puja with a Deodini performing her duties as the mediator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ongoing Diagnosis with a Divination Implement by an Adivasi Healer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Photo of a ‘pharmacy’ found in small and big markets in the Indo–Bhutan Borderlands . . . . . . . . . . . . . . . . . . . . . . . . . . Perpetrator of domestic violence is made to seek forgiveness from victim by village council . . . . . . . . . . . . . . . . . . Map of Bhutan showing Southern Districts (Dzongkhags) . . . . . Analysis of Militant Violence 1992–2012 . . . . . . . . . . . . . . . . . . Slide Positivity Rate for Bhutan 1983–2012 . . . . . . . . . . . . . . . . Photo Showing the Bhutan Border Gate at Gelephu . . . . . . . . . . . Photo Showing a View of the Bhutan from a Border Village on the Indian Side . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

107

108 109 116 117 125 134 155 166 169 184 188 195 195 197 199 199 200 203 208 220 228 251 251 257 257

List of Figures

Fig. 7.6 Fig. 8.1 Fig. 8.2 Fig. 8.3

Fig. 8.4

Fig. 8.5

Fig. 8.6

Fig. 8.7 Fig. 8.8 Fig. 8.9

Fig. 8.10 Fig. 8.11 Fig. 8.12 Fig. 8.13 Fig. 8.14 Fig. 9.1 Fig. 9.2 Fig. 9.3 Fig. 9.4 Fig. 9.5

Fig. 9.6

Photo showing The Concept of Gross National Happiness (GNH) Explained in a School in Sarpang . . . . . . . . . . . . . . . . . . . Results of nutritional assessment in the 2012 conflict . . . . . . . . . Destruction of Houses in Cluster 1 Sub-Division X (with total houses fully destroyed in the cluster being 1,417) . . . Destruction of Houses in Cluster 2 Sub-Division X (with total number of fully destroyed houses in the cluster being 1,072) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Destruction of Houses in Cluster 3 Sub-Division X (with total number of houses fully destroyed in the cluster being 1,860) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Destruction of Houses in Cluster 4 Gossaigaon Sub-Division X (with total number of houses fully destroyed in the cluster being 1,919) . . . . . . . . . . . . . . . . . . . . . . Photo of makeshift camp on edge of Village 54 (built on a destroyed school) as a shelter to host returnees from Relief Camps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Monthly violence August 2012 to December 2014 . . . . . . . . . . . Photo showing relief materials from 2014 conflict in Chirang . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Photo showing a public health centre in Kokrajhar converted to relief camp in 2014–2015 Bodo-Adivasi violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Distribution of 1,121 OOS children by year of study in select relief camps in Milon area after 2014 conflict . . . . . . . . Photo of a “Relief Camp” inside a school building premises in Kokrajhar after the December 2014 conflict . . . . . . . . . . . . . . . Relief camp conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . An armed Santhali man guarding a partially destroyed village in Chirang after the 2014 conflict . . . . . . . . . . . . . . . . . . . Mapping of Post-Conflict Risk and Protective Factors of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fuel Efficient Wood Stove Training . . . . . . . . . . . . . . . . . . . . . . . Suluk-Gwjwn Vidyalaya, Kokrajhar . . . . . . . . . . . . . . . . . . . . . . . Health Equity Recovery Model: Actions for Restoring Health Equity for Vulnerable Conflict-Affected Populations . . . . Children in Milon learn the game of Ultimate Frisbee . . . . . . . . Photo of the ‘spirit circle’ at the beginning and end of a game of Ultimate Frisbee—All players learn to appreciate each other, award spirit point and give constructive feedback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Young multi-ethnic Ultimate Frisbee players of Milon, Chirang District . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

xxi

258 274 275

275

276

276

277 277 285

285 286 287 287 288 294 316 317 325 333

334 335

List of Tables

Table 2.1 Table 2.2 Table 3.1 Table 3.2 Table 3.3 Table 4.1 Table 4.2 Table 5.1 Table 7.1 Table 7.2 Table 8.1 Table 8.2 Table 8.3 Table 8.4 Table 8.5 Table 8.6 Table 8.7

Population distribution of the Bodos . . . . . . . . . . . . . . . . . . . . . . Timeline of the non-violent phase of the Bodoland movement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NFHS-4 data comparing Chirang with other districts in Assam across select development indices . . . . . . . . . . . . . . . . Reserve forests in Chirang District . . . . . . . . . . . . . . . . . . . . . . . . Forest villages in the northern belt of Chirang District close to the international boundary (0–20 kms) . . . . . . . . . . . . . . The Matrix of health facilities available in the villages studied . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Status of critical health promoting services of the government in villages studied . . . . . . . . . . . . . . . . . . . . . . Cases of Domestic Violence Processed by Case Workers under the Avahaan Project of the ant (March 2020) . . . . . . . . . . An Analytical Construct to Understand Overlapping Boundary Relations and Multiplicity of Policy Spaces . . . . . . . . Violence due to Civil Unrest 1990–1998 in Southern Bhutan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Water and sanitation conditions in “Formal” relief camps in Chirang district (February 2013) . . . . . . . . . . . . . . . . . . . . . . . Kokrajhar District: Water and Sanitation Conditions in “Formal” and “Makeshift” Camps (February 2013) . . . . . . . . Results from a Nutritional Assessment during the 2012 Conflict . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Distribution of displaced communities as of 10 January 2015 in Kokrajhar district . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Distribution of 47,718 displaced persons in Kokrajhar sub-division as of 10 January 2015 . . . . . . . . . . . . . . . . . . . . . . . Relief camp details as of 8 January 2015 . . . . . . . . . . . . . . . . . . . Details of additional unlisted camps located during assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

39 43 76 82 84 127 132 165 229 242 272 273 274 280 281 282 282 xxiii

Chapter 1

Introduction

Abstract The introductory chapter begins with a description of the humanitarian situation in the “relief camps” for those displaced by conflict between the Bodo and Adivasi community in 1996 and especially the conditions in the “Milon” camp area (formerly part of Kokrajhar district, Assam) close to the Indo-Bhutan border. The chapter then traces out the two-decade long journey of the Action Northeast Trust (the ant) and its subsequent entry into “Milon” once external NGOs had exited the context more that 15 years ago. This account is juxtaposed with a description of the unforseen resuts a small humanitarian initiative in the aftermath of the humanitarian crisis in late 2014. The conflict in 2014–2015 not only saw the re-emergence of conflict between the Bodo and Adivasi community, but also pro-active parallel efforts by civil society and community based organizations in containing the conflict. The story of rehabilitation and the aftermath of the 2014 conflict is shown through in-depth case studies of individuals who shifted from “relief camps” to an informal settlement in the forest tracts that adjoin the international border between Bhutan and India. The accounts seek to provide pathways that link two aspects of the conflict. We highlight the connections between the more visible events that constituted the Bodoland conflict with the lesser known (and sometimes invisible) impacts that it had on individuals, households and communities. The chapter explores these connections by also showing the trade-offs and dilemmas of development (and humanitarian) programming in conflict-affected communities through these stories. We seeks to interrogate the concept of resilience and highlight the socio-economic and political determinants that constrain household recovery in the post-conflict phase. We find that vulnerabilities (especially in health) worsen in post-conflict phase for all communities and can lead to dire circumstances in the absence of adequate support. In addition to providing readers an understanding of the nature of the conflict at the grass roots level, we also introduce the key thematics that form the basis of the book. The chapter concludes with an explanation of the sequence of the book and a brief description of the content of each chapter. Keywords Bodoland · Conflict · Health inequity · Social determinants of health · Armed violence · Resilience · Suffering

© Springer Nature Singapore Pte Ltd. 2021 S. Sinha and J. Liang, Health Inequities in Conflict-affected Areas, https://doi.org/10.1007/978-981-16-0578-9_1

1

2

1 Introduction

1.1 Introduction Jennifer Liang first stepped into the Milon Relief Camp 20 years ago. This camp for Internally Displaced Persons (IDPs) was situated in what was then undivided Kokrajhar District of Assam. She remembers the exact date, 20 August 2000. It was the day of the funeral of Bineshwar Brahma, the Bodo Sahitya Sabha (Bodo Literary Organization) President, who had been gunned down the previous day in the capital city of Guwahati by a militant group belonging to his own community. The militants had differences with Brahma about the script that the Bodo language should adopt. In the years that followed, Brahma would be one among many Bodo intellectuals and leaders to be killed in internecine fighting among the various armed factions of the community. But on that day, along the highway they saw groups of grieving people gathered around Brahma’s photo lighting incense and lamps, waiting to catch a last glimpse of this popular leader as his body was being brought back 250 kms to his village near Kokrajhar for the cremation. As was the practice, the powerful All Bodo Students Union (ABSU) along with other Bodo outfits called a bandh (strike) to protest the assassination. The atmosphere was sombre and tense but the visit to Milon (located about 12 kms from the Indo-Bhutan border) was out of a sense of urgency. Dr. Sunil Kaul (a former army doctor) and Jennifer had decided to move and start working for development in villages in western Assam and their associate from a locally based Non-Governmental Organization (NGO) whom they were planning to partner with had asked for help. A large number of people were severely ill from diarrhoea and were dying in the Relief Camp and a key official in the district had requested that NGO for assistance. Since Sunil was a public health specialist, they subsequently requested him to assess the situation in the relief camp and advise on the way forward. The large ‘Medical Duty’ sign printed in bold with a big red cross pasted on the windshield of the government vehicle sent to take them to the Relief Camp did little to stop the hostile and angry stares of the grieving people gathered by the roadside. Luckily, their NGO friend was himself a Bodo and the crowds let them pass. The first impression of the Relief Camp was that of impossible numbers of people crowded in a small space, and yes, the stench. Rendered milder by the smell of disinfectant sprayed liberally by the government that morning, yet the stench was strong and cloying. A mix of sweat, unwashed bodies, stagnant water, human and animal excreta. Most of the camp inmates had been living here for four years, since they were forcibly displaced in the first spate of ethnic violence between the Bodo and Adivasi communities in 1996. With more than 250,000 people displaced, it was then an unparalleled but now forgotten humanitarian crisis. Milon was just one of the many sites where communities had taken refuge and the people living in the camps in the area were mainly from the Adivasi community. If the Milon Relief Camp was already crowded with the displaced of 1996, it was made even more so with another 125 families added to the camp by the second wave of violence in 1998. Strangely enough, though they petitioned again and again, the names of these 125 families never got added to the list of recipients of the miserly weekly relief ration of rice

1.1 Introduction

3

from the government. So, apart from sharing the crowded space, the families had been sharing their survival rations for the past two years. Both Sunil and Jennifer went around the camp inspecting the various water points and also doing verbal autopsies with families who had lost members to what they explained to the people was a ‘cholera’ epidemic. Later, standing around a tree stump on the roadside, they had a meeting with some of the Relief Camp leaders and inmates before they left. They explained to them about not defecating next to the well, washing hands with soap and the process of mixing bleaching powder and disinfecting the well and their drinking water. All this was met with blank faces and even blanker stares. As Jennifer recollects: Why did I feel that we were not making much sense to our listeners in the camp that day? For people who have lost all their material goods, forced to survive in inhuman conditions and stripped of every shred of human dignity, I wonder what meaning do lectures on keeping healthy, washing hands and disinfecting water have?

From the relief camp, they went to the Public Health Centre (PHC) less than four kilometres away to check on the cholera preparedness there. They were surprised to find it empty of patients except for one, though there were new mattresses, new bedsheets and the PHC was cleanly scrubbed. With the large numbers of people ill and dying in Relief Camp, they expected the health centre to be overflowing with patients. Something was not adding up. An explanation was given a little later when they were met in the hospital premises by a senior district official. Known for his sensitive and caring personality; he had driven 60 kms (on a road that was then in a pitiable condition) to come and see them. He spoke about his struggles to clean up this remote, completely collapsed health centre and equip it with new beds, mattresses and sheets and get some staff posted to start receiving and treating patients. But apparently, the staff was hesitant to allow patients to lie on the clean new beds and were making them sleep on the floor in the hospital veranda. Patients perhaps felt they were not welcomed and stopped coming. With tears in his eyes, the official asked in a disturbed tone, ‘Now where do I get them nice, clean patients to fill these beds?!’. In the months that followed, the couple started a non-profit development organization and named it the ant (the Action Northeast Trust). The organization was keen to work for justice and development of the conflict affected in the relief camps, which were then located in an area considered extremely remote and dangerous. For instance, a journey between Kajalgaon (the district headquarters of now Chirang District) and Bengtol (which takes about 45 min) would then take 3 h or more through a winding mud road that would frequently get washed away in the monsoons. Though they wanted to, it was extremely difficult to immediately start work in the Milon area. As Jennifer says: We were two complete strangers in unknown territory. We were not from the area, not even from this region, hardly knowing anyone, having no powerful friends, most importantly, we did not yet have the trust of the community. At that time, one could hardly ignore the reported and unreported incidents of violence – big and small – around us. Bombings, killings and revenge killings, kidnappings, extortion, fear and terror were around us even as we went

4

1 Introduction about nonchalantly, choosing to turn a blind eye, and many a times, really being naively ignorant about things. The enormity of what was happening around us was complex and at times incomprehensible. We knew it could be suicidal to straightaway work with the conflict affected in the relief camps. Just a couple of years ago, we had lost a valuable colleague and team leader of the earlier organization. He was kidnapped and killed by a militant group in Upper Assam just on suspicion of being a government agent. It would be a pity if the same were to happen again even before we could do any meaningful work in this new area.

Eventually, seven years later in 2007, the ant established a semi-permanent presence in Milon. In the interim period, setting up an institution from scratch was an interesting challenge and they had to keep innovating new approaches and methods. The organization collectivized women, trained village health workers, established malaria testing centres, and developed sustainable weaving programmes. Through their work, which they chose to keep away from the glare of the media, the organization attempted at securing the trust and credibility of the different ethnic communities. In a highly fragile and conflict-affected environment, the organizational leaders learnt that what needs to be done is not always what can be done. Seven years after starting, the ant bought its first motorized vehicle in 2007. Till then, bicycles for staff members were the primary transport available (which was also contributed to build a more open interface with the communities). One of the first journeys the brand-new motorcycle made was to the Milon Relief Camp. the ant’s local advisory committee had already deliberated and given a green signal for the organization to start working full time with the conflict-displaced populations. But after visiting many camps and trying to meet the camp leaders to gauge their interest, the most positive response received was from the Milon Relief Camp. So, the ant decided to work there. the ant’s entry coincided with many other events—the international NGO providing health services in Milon had just exited, leaving the vacuum to the government health department to fill. Even more significantly, after 11 years of living in the relief camps, finally all the families had received their release money of 10,000 Indian Rupees (around 227 United States Dollars)1 and left the camps after they were officially dismantled. So, even as the ant prepared to make their entry into the relief camp, many families were making their way out. They were going and settling down in freshly cut forests or in the old forest areas where they fled from a decade ago. The ant then decided to follow them to their places of settlement and start working with them there. The first few years in Milon would pass in a blur. It was nearly impossible to get qualified staff from among the Adivasi community, making local ownership of programmes and projects extremely challenging. Instead of taking up big projects without even knowing the area and its needs, the organization chose to do small initiatives with their own meagre resources. the ant started by collectivizing women into saving groups and later introduced the cycle bank where women could purchase cycles on easy loans. This programme became extremely popular as most of the villages were cut off from the main road with no transport. As programmes evolved, it became a parallel process—even as the relief camp returnees were restabilising 1 US

Dollar (USD) rate calculated at conversion rate of INR 44 (Indian Rupees) to one USD in 2007. From now on, we will use the Rupees. US Dollar rates can be calculated accordingly.

1.1 Introduction

5

their lives, the ant was going about establishing its office there and mobilizing the community. If building competencies into the team was difficult, an even bigger challenge was getting qualified people to base themselves in this area to work. Poor roads, spasmodic phone connectivity, erratic moody electricity and presence of armed personnel—both the state and non-state actors—would deter many from joining. Even if the individual was willing to take the risk, convincing their families was difficult. Once a Santhali boy from Orissa with a post-graduate degree from a top-notch university in India came to volunteer. He was slated to leave for work in the United States, but inspired by the work the organization. He volunteered to live for a year and work with the team in the ant’s Milon cluster office. One day, after spending a few months there, he got into an argument with a drunken commander of a nearby paramilitary camp. Unfortunately, the altercation in the presence of amused young girls did not go down well with the inebriated commander. They later picked up the volunteer along with the project coordinator (another Adivasi from a nearby district), and took them to their camp and roughed them up. Fortuitously, the community—led by the women groups that had been set up—came to protest in the camp and the two boys were released before too much damage was done. Such incidents unfortunately reinforced the image of working in the cluster along the Indo-Bhutan border as being highly dangerous. While there were challenges, work in the cluster office at Milon evolved. After the initial trepidation, the response from the community was also positive. In fact, the community pushed the ant to a organize a jan sunwai (public hearing) on the irregularities found in the right to work programme of the government. One of the local armed Adivasi militant groups had been colluding with the contractors, leading to corrupt practices. As the day of the public hearing neared, the situation became tense. The team members had received direct threats on taking this forward and the organization worried for their safety as they went about verifying the data to be presented in the hearing. But with public support, the hearing went ahead, as they wanted answers to their questions. The public wanted to know how the names of children, who were not even alive, were included as workers in the government lists and shown as having worked and received money! They wanted to know how money was put into these fraudulent bank accounts and even withdrawn? Other labourers wanted to know how money was deposited into their account and even withdrawn without them knowing about it. Government officials would be there at the public hearing and so would members of the press and neutral external observers. Little did the organizers know that armed militants would try to block the roads leading to the venue. But again, the women’s groups, risking their lives, took longer but smaller inter-village roads to reach the venue. Hundreds turned up to testify at the public hearing. Later in the evening, the armed militants would chase two of the ant’s staff members who were going home after the hearing and burn one of their motorcycles. But all in all, people’s resilience, trust and support gave the ant strength to continue working. The organization relied on this trust to help in reconciliation. The terror and fear following the Bodo–Adivasi conflict of December 2014 had paralyzed the highway

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to the Bhutan border. The Bodos living next to the border could not access Koroipur market on the Indian side to sell their produce, while the Adivasis could not get to Bhutan for their daily wage labour. An invisible barrier of fear and mistrust had suddenly been erected. Both the communities were suffering, but no one dared to break the lock jam. But the women’s groups took on the challenge. On 8 March 2015 (International Women’s Day), women from all the communities congregated— they celebrated, but more importantly they crossed the invisible divide drawn on the highway. Seeing the initiative of the women, the male leaders of various ethnic communities, including from the two warring groups, the local police and also troops from the paramilitary camp also joined in. The men and the security forces supported the women fully making themselves useful by supplying drinking water and helping cook food for the hundreds of women. From that day onwards, the highway was open. 16 years after Sunil and Jennifer first visited the Milon area and started working there, and several months after the celebration of 8 March 2015 (referred to above), the co-author of the book, Samrat Sinha and BN, his colleague from Chirang, entered the semi-formal forest hamlet called Sonapur in December 2015. This was located 18 kms from Milon. Both BN and the co-author were then associated with a then recently established Mumbai-based disaster relief NGO specializing in public health. The organization had been implementing several health-related programmes in relief camps that had emerged in the aftermath of the 2012 Bodo-Bengali Muslim ethnic riots where nearly 500,000 persons were displaced. In December 2014, a cycle of violence between the Bodo and Adivasi community had displaced nearly 300,000 persons (see Chap. 8). While it had been nearly two and a half years since this organization had been in Chirang, by December 2015, most of the programmes had closed down. Only one programme was still running, i.e. providing some aid to those injured in the 2014 conflict. They learnt that children of Bodo families, who had relocated to Sonapur after leaving Oxiguri relief camp in January 2015, were in dire need of assistance. The small cluster of 15 households had originally lived in a village called Amguri. Though the village headman had got information of a possible conflict between the Bodos and Adivasis, he did not take it seriously and failed to inform his fellow villagers. They were attacked on 24 December 2014 and all of them had to flee. Of the 15 families, 9 came to Sonapur. The others, mostly families who suffered deaths or grave injuries, on receiving bigger compensation could afford land and moved to other places. Thus, both BN and the co-author set out to the new village called Sonapur to do a needs assessment after which some kind of relief programme could be formulated. The residents of the hamlet gave a list of items needed and despite hardly any resources left in the existing project, it was decided that some assistance could be given. One key demand that stood out was simple and doable, i.e. toys for the children and some sports items for the youth. These were rarely given as part of humanitarian and disaster relief work in the area. But with their new location far away from the nearest market and children and youth unable to access school, community members felt it was important to keep children engaged. A few days later, based on the assessment, and in the presence of local leaders of the area, various relief

1.1 Introduction

7

items and sports equipment were handed over and recorded. About a few days later, the duo went to visit Sonapur to check on the use of the given materials. While the headman seemed amicable, yet there was a hesitation and the atmosphere was tense. Unknown to both BN and the co-author, the relief distribution programme was only a small link in a series of related and unrelated events, which eventually influenced the genesis of the book.

1.2 Post-Humanitarian Realities and Entangled Biographies in a Conflict-Affected Borderland: The Hamlet of Sonapur and Its Headman, Noboi 1.2.1 Life Sketch of Nobo By virtue of being the Gaonbura (headman) of a new settlement, Nobo’s position in the newly established village post-2014 was extremely precarious. He had already witnessed the sudden destruction of his village and the death of close friends and relatives. Now as headman, he suddenly became the focal point for all governance and resettlement matters in the village. One of his major roles was reclaiming their lost identity papers and documents for various entitlements. He frequently visited the district headquarters trying to meet different officials, begging them to reissue their papers. As a result of the burning and demolition of houses, people lost their important papers and documents. He himself had written his house number on a kamplai (a low wooden stool mostly found in the Bodo houses). When the conflict broke out, his kamplai went missing. This was a huge loss for him because he needed the house number to again apply for the ration card in order to get government subsidised rice for poor families. Even before his current role as headman, Nobo’s past was full of trials and tribulations. His mother, now the oldest in the village at 65 years of age. Of her six children of whom three survived, Nobo is her youngest. When the children were young, the family kept shifting place to place till opportunities opened in a village where her husband served as the village priest and president of school management committee before he passed away. All her children except Nobo were married by the time she lost her husband. She left that village after her husband’s death and went to live in Oxiguri along with her son Nobo in her daughter’s house. From Oxiguri they eventually found land and settled in Amguri. She was the first to settle in Amguri and remembers that it had thick jungle when she started living there. She sold jou (locally brewed alcohol) and also maintained her kitchen garden and sold the produce in the market. She even kept two cows and they had enough milk to drink and at times even sell the extra milk in the market. She could afford meat regularly and sold jou for a long time to support Nobo’s education but like many Bodo youths of those times, he too discontinued his studies during the Andolan (the agitation for the separate state of Bodoland: see Chap. 2). As a young teenager,

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1 Introduction

he could not go to school due to the presence of security forces and the overall deteriorating conditions. Dropping his studies, Nobo also joined the Andolan. In due course, Nobo got married. His first wife suffered from severe mental disorder that was untreated. She eventually left him with a 4-month-old daughter. His mother adopted the child and brought her up. The girl has now grown up and goes to school. Nobo moved to his mother’s house after his wife left him but hardly went out for work. For three years until he was remarried, his mother supported both the father and daughter. Nobo moved out from his mother’s house susbsequently years later. He remarried and started a new life. Two sons were born to them in few years. Nobo was mainly dependent on daily wage labour to sustain the family. Before the conflict of 2014, Nobo’s wife left for her parent’s home after domestic altercation. Again, this time, he moved to his mother’s house along with his two sons.

1.2.2 In Between Humanitarian Actors, the State and Non-State Armed Groups (NSAGs) Once the emergency situation was over, the community living in the relief camp dispersed into three distinct groups. The larger set of families shifted deep into the forest tracts along the Indo-Bhutan border, 14 kms from Koroipur (which is also the nearest market) and established the village of Sonapur. The others settled within two kilometres of the Koroipur market (who became part of the survivor assistance programme). A much smaller group was resettled just one-and-a-half kilometres from the border. Sonapur was the most remote settlement and the most problematic. This remote location in the Reserve Forest (RF) itself meant that they were far away from the existing government services (especially health and education). Already, health conditions were deteriorating. Two children in one household had died due to malaria, and the kind of access to health institutions available earlier was lost. Furthermore, there was an outbreak of skin infections among the children. People who were sick would go untreated or seek alternatives. As the field notes of the researchers’ state: Somsri is married to KB, they now have three sons and one daughter. She has been suffering from some disease which called “bindisor” in Bodo. Her stomach is protruded, both legs are swollen and she has a burning sensation while passing urine. She endured these symptoms of her illness even before the conflict. Her husband KB could never save enough money to take her to any hospital in the town (Bongaigaon, Kokrajhar). But prior to the conflict, she could buy medicines from the pharmacies in Koroipur. Presently, she has no money to even buy those tablets. In the December 2014 conflict, their house was demolished and the family lost the entire harvest along with their two cows. KB had planned to sell a portion of the harvest and take his wife to the hospital in Balagaon (in Kokrajhar District which was more than 60 kms away). All his plans were shattered as a result of the conflict. From their new village, KB and Somsri have taken up some land as Adi (a share-cropping method a where the owner of the land gets half the produce and the tenent gets only half). Often Somsri is unable to go for work because of her illness. The family has no money to hire wage labourers. To sustain till the crops are harvested, the family borrowed paddy from the landlord. Unlike others in

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the village, KB despises looking for daily wage labour as he hardly finds work. There has been a drastic shift in their lives after the conflict. Before that, the family purchased firewood for cooking, but post-conflict, they started selling firewood to feed themselves. From their previous village, Somsri could access the pharmacies in Koroipur as it was located at a distance of two kilometres. But now their new village located 14 kms away. The doctors, pharmacies and hospitals remained inaccessible and unaffordable to Somsri forcing her to visit the Ojha (traditional healer) for her illness.ii

The establishment of Sonapur village by the new settlers exacerbated tensions with the immediate neighbouring village. Already, other civil society organizations had given some form of relief, and Sonapur was also provided a handpump. People were slowly rebuilding their lives, but underlying the veneer of new found stability, even small and innocuous externally driven initiatives, that introduce new resources (like sports materials) can become major conflicts. Within a few days of the relief distribution and giving of sports equipment, youth from the neighbouring village also wanted to participate and have a share of the sports equipment such as the football and volleyball. Sometimes, they would forcefully snatch these away and then they came and ransacked Nobo, the headman’s hutment where these were kept. At his request, the local unit of the ABSU came to mediate and resolve the dispute and prevent any further violence. A joint agreement with both villages was drawn out after hearing the case. It was felt that the children of the neighbouring villages were not provided sports goods but even they had suffered from the conflict. They had also lost their textbooks and study materials during the conflict and were now unable to study. Hence, it was decided that in the interest of amity and for restoring equity, textbooks and school equipment for the neighbouring village would also have to be provided for by the NGO. For the NGO, this entailed yet another needs assessment and mobilizing of resources from a project, which itself was closing down and on the verge of exiting. It was already stretched in terms of what it was able to do for beneficiaries who were suffering from debilitating injuries. The fragility of the overall situation and small-scale conflicts also arose from two sets of processes and reflect the impacts of what Roger Mac Ginty (2013) calls the ‘hidden’ and ‘non-obvious’ transcripts of peace.iii These transcripts are especially invisible to those implementing externally designed programmes and non-obvious because their discovery requires an immersive understanding of the community, which itself occupies a highly volatile space.iv Survival strategies for conflict-affected communities depend on navigating these spaces. By virtue of a humanitarian mandate, in the case of the sports programme, engagement with the ‘context’ did not necessarily mean entering into deeper questions, thus resulting in the outcomes discussed earlier (where a seemingly ‘neutral’ intervention became part of a deeper local process). This local process, which was also shaped by the influence of two stakeholders, should have been obvious at the outset. These were the counterinsurgency forces and the armed organizations themselves. For this new hamlet, Nobo became the fulcrum on which the balance of fragility rested. One aspect of the location of Sonapur is that the forest tracts along the border (see Chap. 3) became crucial to the politicomilitary survival of the major armed organizations (or Non-state Armed Groups) and

10

1 Introduction

especially the newer breakaway faction that was opposing the existing ceasefire and peace negotiations. The same forest tracts were also the sites in which counterinsurgency forces, consisting of a composite set of units from the Indian Army, federal paramilitary forces and state police, were operating in the aftermath of the 2014 massacre (and even before that). While in the aftermath of the 2020 final Peace Accord and establishment of the Bodoland Territorial Region (BTR), the major Non-State Armed Groups (NSAGs) have officially dissolved; both the armed organizations and security forces maintained a ubiquitous presence in earlier times. In the case of the armed organizations, their presence was marked by a degree of invisibility, while the latter depended on ensuring a more visible presence through the various armed outposts, bunkers and patrols. They also became part of the everyday existence of the hamlet. At the micro-level, two extracts from field observations highlight these grassroot interactions of the various stakeholders in Sonapur, which contributed to the psychological burden of living in the conflict environment. As a field observation which records interactions of Nobo with the security forces states: Nobo being the headman of the village received pressures and notices from different sides. The previous day he had to produce himself before the security forces. They questioned him about non-state actors visiting their village and he had denied any connection with them (though the non-state actors contacted him regularly). The security forces then asked him to inform the villagers that they should stop going to the forest, avoid carrying knives in their hands and if anyone was found out of their homes in the night they would be shot without any warning. That day when I was reaching the village at around 7:00 pm, I met a group of people returning from the market. Some of them had buckets resting on their hips while others had loads on their heads. All of them walked hastily as if they had to reach their homes early. They needed to reach home as they were scared of the security forces who were carrying out search operations for militants in the area. Most of the villagers sold firewood for their meals and were having a hard time as they could not go to the forest. Even in the day since they were not allowed to carry knives in their hands, three men could not earn their daily wage, as they were jute cutters. The security forces spoke in an alien language (Hindi) to the villagers when they met them on the roads and the villagers tried their best to avoid them.v

Another field observation highlights Nobo’s interactions with the armed organizations: I saw the headman walking while I was going to the village and I offered him a ride. As I started the motorcycle, he told me that he was carrying a huge load of tension on his head. From his voice, I realised that he wanted to share something with me. I began by asking him: Researcher: What is giving you so much tension today? Nobo: (In a soft tone) “They [the Non-State Armed Groups] have sent us a notice, demanding Rupees 1,000 from each family in the village. Since we are occupying the forestland, we have to give them the money. If we do not, give them on time, they can come to our village and make us move out. They had allocated different land for our resettlement but by mistake we came and settled here. I do not know; I think I will have to sell my goat (to pay them). Today was the last date but I begged them for extension of 20 days but they agreed to extend the date for only 10 days”. Nobo received numerous calls as we were riding towards the village. The mobile network coverage was poor and he seemed to not hear the person on the other side audibly. I stopped the bike for him to ease his conversation. Nobo then moved at

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some distance to stop me overhearing the conversation. When we started the ride again, he told me that it was the NSAGs who had called. Nobo was told that they would come and pay a visit to Sonapur. Nobo had requested them not to come that day because I was on the way to their village. The community was ready to pay the amount. They knew that all those who came and settled in forest land had to pay a ‘land fee’ of Rupees 1,000 per bigha. The villagers realised that the group was compassionate towards the communities displaced by conflict hence were asking only Rupees 1,000 Rupees for the total land they hold. He told me that even the lady who had lost her husband during the conflict and whose body was not found had her money ready. She received the money from her daughter who had been sent away to work as a maid servant some 10 days before.vi

Learning to navigate these complex pressures was part and parcel of daily life in the days of militancy. Incidents such as these echo across time. We see an example of a tailor who is arrested and freed in the mid-1990s, which shows continuity of the process mentioned above: My husband was once arrested and taken to the police station. He worked as a tailor to run the family, he was a barber before he changed his profession to a tailor. Once a close friend came to the house and requested him to stitch clothes for the militants in the forest. As it was his profession he went and stitch the dress for them. He had also stitched two caps for the children with the little leftover cloth when he returned home. A few days later the security forces came and surrounded our house. We were having dinner in the house when the security forces arrested my husband. They said “challo” (let’s go) to my husband and took him to the police station. Someone for our community had informed the police that my husband had stitched clothes for the militants. A person working in the police station saved him. He talked with the authorities and convinced them that my husband was a poor and innocent man. It was his profession to stitch clothes and that the curtains in the police station were also stitched by him.vii

1.2.3 Post-Conflict Vulnerability and the Fate of a Girl Child in Sonapur While, caught in the middle of a protracted situation of distress and destitution in the aftermath of conflict, the erosion of a protective environment led to extensive impacts on the children in Sonapur. Years before the conflict, Rani’s family had moved to Amguri and had been living a ‘satisfactory’ life. They cultivated paddy every year hiring their Adivasi neighbours during the transplantation and harvest periods. When conflict of December 2014 broke out, it was the final phase of the harvest season. Besori, the mother of Rani, remembers that the family fled from the village leaving behind all their produce. When her husband returned to the village, he found the entire harvested paddy missing from the field, the livestock had disappeared and the house looted and demolished. The family was dependent on agriculture for their sustenance. They had now lost the entire produce of the year. Besori said her husband sought out daily wage labour in Bhutan to make the ends meet but he could not afford to save any money for his children’s education. Since the day Rani reached the relief camps, she stopped going to school. Unlike their old village, this new place Sonapur had no opportunities for her parents to earn. Then, the distance to the nearest school

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made it inaccessible to the children from the village. Only three children from the village go to Koroipur School, cycling more than 12 kms one way. With no support from anyone and unable to manage, Rani, then 11 years old, was taken away by an elderly Mahajan—a rich man who was introduced to them. He promised that she would be sent to school for helping in his household. But instead of sending to her school, the Mahajan sexually assaulted Rani. Helped by an NGO, Rani was rescued and the Mahajan arrested. Extracts from the initial complaint filed (locations coded) below show the circumstances that led to the arrest (original language and grammar in the police complaint is retained as far as possible): From the Ejahar (complaint) lodged on XYZ date under GSB police station, case number xxxxx. With due respect and humble submission, I like to bring to your kind notice that the facts leading to the lodge of present Ejahar is due to communal violence that arose between Bodos and Adivasi community in 2014, I along my family faced acute financial crisis. In 2015 the accused namely YNYS, [section redacted] and approached to us and made a proposal to bring my daughter namely Rani, aged about-12 years of age (then), with assurance that he would give food, lodging and education as well. Relying on the assurance on this very accused person, and owing to financial crisis, I alongwith my family accepted the proposal. Accordingly, in October [year redacted] the said accused person brought my girl Rani to JBSR, under MNXY district. After bringing my daughter at the residence of accused, the said accused person committed rape on my daughter against her will and consent and sexual abuse on my daughter on number of occasions. Thereafter the said accused used to give medicines without having any diagnosis to my daughter to avoid pregnancy. When my daughter narrated the entire incident to the wife of (the) accused, the wife of accused also (had) brutally beat up my daughter. The accused person used to extend threats to kill my daughter in case the incident is reported to any third person. On xxxxx day, the wife of accused person sent back my daughter to my residence at MDFRX under MNXY district. On reaching the house my daughter narrated the entire incident meted out to her by the accused person, and also brought to my notice that after taking pills provided by the accused person, she had bleeding continuously for one month. After hearing the incident, I along with my family was shocked and surprised. I therefore request you to kindly register my Ejahar (complaint) and take necessary legal action against the accused person and take the culprit into custody as per law.viii

It was not easy for the NGO helping Rani. The family of the accused being fairly influential, threats were made to the family and also to members of the NGO by members of a now former NSAG known to the accused, to withdraw the police case and settle out of court. After much struggle, the accused was jailed. The NGO also helped Rani get into a state run residential ‘bridge’ school for dropout girls but the budget to run the programme was so meagre (Rupees 40 a day for food and stay and everything) that they could hardly afford to feed the children well. Rani soon left the school and returned home to her parents who were themselves still struggling to survive. Though the NGO tried to intervene and help the family, she got married a year later, before she has even turned 15. Figures 1.1 and 1.2 show the struggle of conflict displaced families after they re-settled in Sonapur.

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Fig. 1.1 Photo of a house in Sonapur Village where families relocated after the 2014 conflictix

Fig. 1.2 Photo of an interior of a “house” of a conflict-displaced family in Sonapurx

1.3 Conflict in Forgotten Borderlands The key lesson that can be drawn from the case studies mentioned above is the extreme difficulties in providing a cohesive understanding of how conflict impacts the individual life choices of affected communities and individuals. This is especially true if we examine the context in which many of the research findings are presented. The original study was part of a project known as Closing the Gap: Health Equity Research Initiative in India.xi The authors did not anticipate that it would transform into a deeper social history and that would revolve around the experience of the communities, who were navigating intense conflict and armed violence. This violence occurred in a frontier region, which many scholarly works consider to be an example

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of intense and stable sub-regional cooperation.xii Underlying this calm were decades of violence, terror, invisible humanitarian crises and peacebuilding initiatives that were not necessarily recognized. Only in recent times did Bodoland attract national and international attention (following the ethnic conflicts of 2012 and 2014). The households discussed above were only one of many thousands of families who have experienced decades of conflict (largely low-intensity punctuated by episodes of violence and insurgency). It is also a site in which the Central and State Governments have experimented with efforts at negotiations and setting up of autonomous self-governance institutions for indigenous communities. While the social scientific literature being generated from the outside dismiss these particular experiments as outright failures, they tend to override the complexity of this experience and largely seek to fit the existing facts into theoretical frameworks. In essence, what we find is that the imposition of theoretical positions masks the actual underlying complications of those who are living and negotiating the fault lines on a day-to-day basis. It is also a matter of perspective. The literature on conflict studies is too deeply impacted by the search for political causes of self-determination movements rather than measuring the impacts they engendered.xiii This has led to a weaker consideration for the actual voices from the communities and underestimating the manner in which conflict leads to long-term breakdowns in health, education and other essential welfare services provided by the state. These indirect impacts are much deeper and more difficult to reconstruct after a peace accord, and non-functional governance services in the aftermath of a peace accord itself can generate motivation to participate in armed action. On the other hand, works on public health and conflict, while providing us the tools to build evidence on the impacts of violence, rarely provide casual explanations regarding the motivations of the actors who are committing violence. Nor do we get sufficient understandings of how conflict-affected communities negotiate their survival strategies especially when external support is withdrawn. Then, an international border add further layers of complication to the experience of communities living through conflict. The politics of struggle and the geography of its location creates for communities conditions of its well-being or ill-being. The Indo-Bhutan border district of Chirang under which the Milon Relief Camp and Sonapur fall is one of the four districts of what is now known as the Bodoland Territorial Areas Districts (BTAD). These will now expand and transform into the Bodoland Territorial Region (BTR).xiv The current arrangement was carved out of existing districts in 2003, and essentially made the BTAD region contiguous with a large portion of the international boundary that demarcates India from Bhutan. The institutional arrangements in the BTAD are a result of decades of struggle— armed and unarmed—of the Bodos, the largest indigenous group of people living in the Assam plains. The long history of civil unrest went through many phases, with different actors using different methods and strategies, their demands evolving and changing quite like the state reaction to their demands. Of the many phases of the Bodo movement one segment between 1987 and 2020 caught the maximum attention of state and society: the three decades of violent armed struggle and insurgency. It

1.3 Conflict in Forgotten Borderlands

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was in the beginning of 1990 that certain factions of those in the Bodo struggle decided to also take up arms to press their demands. In 1993, responding to the demands of the movement and to prevent further deterioration of the situation, the Government of India signed the first peace accord with the leaders of the Bodo movement. This accord was to set up an autonomous council having limited financial and administrative powers over some subjects in a demarcated geographical area. Very soon disappointment set in across all sections of Bodo society. One of the most important aspects of the armed movement in Bodoland is that violence against the state, internecine warfare among the Bodo groups and inter-ethnic conflict escalated in the aftermath of this peace accord. The nascent armed organizations went underground and launched a protracted insurgency which resulted in the most brutal phase across a 10-year period till 2003. The nature of violence across this 10-year period and beyond reflected a domain of war characterized as wars of a third kind that are internal wars where, globally, internal domestic strife replaces wars between nations.xv Duncan Pedersen explains that such movements become struggles of resistance and campaigns to politicize the masses whose loyalty and enthusiasm are counted upon to sustain a post-war regime.xvi In these wars of a third kind, the ‘target is the local population, mostly the poor, including those who have an added symbolic value, like local leaders, priests, health workers and teachers’. xvii

1.4 Organized Armed Violence and Health Inequity The definition provided by the World Health Organization (WHO) Commission on Social Determinants of Health (2008) serves as backdrop to the content of the book. In Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health, the Commission states: The poor health of the poor, the social gradient in health within countries, and the marked health inequities between countries are caused by the unequal distribution of power, income, goods, and services, globally and nationally, the consequent unfairness in the immediate, visible circumstances of peoples lives – their access to health care, schools, and education, their conditions of work and leisure, their homes, communities, towns, or cities – and their chances of leading a flourishing life. This unequal distribution of health-damaging experiences is not in any sense a ‘natural’ phenomenon but is the result of a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics. Together, the structural determinants and conditions of daily life constitute the social determinants of health and are responsible for a major part of health inequities between and within countries.xviii

In its three core principles for action, the Commission stresses on building systems of measurement and states that there is a necessity to: ‘Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in the social determinants of health, and raise public awareness about the social determinants of health’.xix Re-affirming the centrality of conflict as a driving factor, the Commission reiterates:

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1 Introduction In conflict settings, people suffer a range of physical and social deprivations including lack of security, displacement and loss of social networks and family structure, loss of livelihood, and food insecurity and poor physical and social environments. The disempowerment of individuals, communities, and even countries that is associated with conflict brings a multitude of health concerns. As with other dimensions of inequity, the needs of people in conflict must be represented in the construction and strengthening of economic and social policy and systems. The disempowerment of individuals, communities, and even countries that is associated with conflict brings a multitude of health concerns. As with other dimensions of inequity, the needs of people in conflict must be represented in the construction and strengthening of economic and social policy and systems.xx

Despite this focus on conflict, the report in essence highlights outcomes, but not causal mechanisms or paths that link health inequity to conflict. Is conflict a cause of health inequity or is the reverse also true. It is in consideration of the measurement problem that there are no clear pathways, being provided, especially when extended to understanding long-drawn-out, sub-national conflicts that also have a significant trans-border component. In the context of the area of study, border areas themselves are remote and difficult to access. The protracted nature of organized armed violence can be partially attributed to problems of topography and porous borders. But this is neither a necessary nor sufficient explanation. It is the view of the book that we enter into a distinct terrain when we combine physical geography with the logic of what has been termed as imaginative geographies;xxi and consider the consequences of this interface as a key determinant of health. In seeking to understand the nature of violence that emanated in the overall area of study (the region where the ant works) and any attempt at breaking down the measurement problem into workable methodologies actually meant revisiting the history of the borderland communities. One of the major problems of measuring health inequity, especially at the local level is where does one begin. How does one even characterize the phenomenon being studied? The report of the Expert Committee on Tribal Health, Tribal Health in India: Bridging the Gap and a Roadmap for the Future (2018) was the first report on Tribal Health commissioned jointly by the Ministry of Health and Family Welfare and the Ministry of Tribal Affairs. In outlining health inequities in the Tribal Areas of what is termed as the northeast, the report said: ‘However, given rapid urbanization, mining and armed conflict in the region, the incidence of non-communicable diseases and mental ailments is very high’.xxii This being a preliminary conclusion is significant, but a thorough reading of the report did not reveal any casual pathways in explaining these impacts. The terminology used is also significant and led to an initial attempt at considering reframing the book purely through the lens of ‘armed conflict’. While trying to understand the issues of civilian protection, it was realized that there is limited applicability of definitions for ‘armed conflict’ arising out of International Humanitarian Law (IHL) and others. The Indian exception pertains specially to the country’s position on situations of Non-International Armed Conflict (NIAC) as defined under IHL. This exception is due to the fact that the country is not a signatory to the Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims

1.4 Organized Armed Violence and Health Inequity

17

of Non-International Armed Conflicts (Protocol II), 8 June 1977.xxiii A complicated relationship between IHL and India’s own security-related legislation exists, of which there is an ongoing domestic debate and an emerging body of jurisprudence.xxiv Moreover, by only looking at NSAGs and their interactions with the state, there would be a significant risk of misreading the dynamics, which especially emanated from a very particular type of self-determination movement that was not secessionist, and in the course of its history started as a predominantly non-violent agitation. Yet, once a part of the movement transitioned, it turned both outward (against the state) and inward (directed against certain social structures). What therefore of situations where there is unrecognized protracted conflict, the use of high-grade weaponry, rise of armed opposition groups (who are ideologically committed) with their own hierarchies and extensive conflict-induced internal displacement? How do you also capture the peace initiatives that also developed following the framework around what has been called everyday peace?xxv In this environment, going beyond these definitional realities meant relying on tools and concepts that accurately capture the experience in the BTAD. The various definitions of ‘armed violence’ in our view provide frames that are broader, as they cover situations seen as internal civil strife and also recognizes instances of de facto armed conflict (versus its de jure version). These definitions also allow for the programmatic focus on localization that is central to the book. For instance, the Organization for Economic Cooperation and Development (2011) defines armed violence as: ‘the intentional use of force (actual or threatened) with arms or explosives, against a person, group, community or state, that undermines people-centred security and/or sustainable development’.xxvi The WHO (2002) also includes a definition of violence and in the World Report on Violence and Health identifies violence as a preventable problem for public health. Similar to the OECD definition, it is slightly broader to take into account some effects. As the report says violence is: ‘The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation’.xxvii Whereas there is a very well-developed literature on armed conflict and public health, the determinates of health inequity in situations of internal conflict and civil unrest are not well known and extremely difficult to measure. In 2016, there were 560,000 overall violent deaths, of which 99,000 fatalities occurred in situations of armed conflict.xxviii The extent of this latter problem is seen in Global Violent Deaths Report (2017) which states that ‘of the five countries with the highest violent death rates in 2016—Syria, El Salvador, Venezuela, Honduras, and Afghanistan—only two had active armed conflicts’.xxix An even more disturbing trend is the loss of life occurring due to indirect consequences, with direct conflict deaths only accounting for 18 percent of the overall burden.xxx Even though these impacts have been studied through secondary sources, there are very few field studies on the long-term effects of conflict on affected households in the specific legal and political context being discussed below. Pederson in his paper also say that in conflict studies and especially studies about trauma related to conflict, one of the most startling observations is that there is a relative absence of studies of

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1 Introduction

the most affected populations in their original locations or countries of origin.xxxi He says that much of the studies are of displaced populations in the country they have migrated to. This could be perhaps due to the danger and risks of carrying out studies in conflict zones and also the lack of easy access to such populations. The risks of accessing households in areas of long-drawn but active conflict or the difficulties in finding families displaced long ago by conflict make it problematic to directly study long-term effects of conflict on households. In their book on fighting poverty and the long-term effects of conflict, Paul Correll et al. (2020) say that there is very little poverty-related data for displaced people. They point out that although data may be available in economies where the displaced people live, they are often not accounted for in household surveys, since individuals living in camps are usually not part of the sampling frame. They argue that though global poverty rates are showing a steady decline but with displaced people worldwide on the rise, this may affect the international estimates of poverty as displaced people would be poorer, be unemployed, suffer greater trauma and stress and be unable to access essential services.xxxii If there is any gap in the literature that the book attempts at filling, it is examining conflict-affected households across a much wider time horizon, emerging from a protracted situation of organized armed violence. This violence was an outcome of mass unrest and civil strife connected with realizing ideas of self-determination for the Bodo community, but which was significantly focused on securing forms of autonomy within the limits of India’s federal constitutional structures and territorial boundaries. These forms of autonomous self-governance would be continuously reworked in different stages of the conflict (as was seen in 1993, 2003 and 2020).xxxiii Therefore, the question of health inequity is not only connected to violence but also the nature of governance that emerged in the course of peacemaking. The Indo-Bhutan borderland becomes a crucial component of this aspirational idea, and we also consider transboundary impacts of conflict especially on Bhutan. This protracted conflict situation, with more than 30 years of insurgency, occurred where the legal positioning as an established democracy (as opposed to a Fragile Conflict Affected State)xxxiv precludes any form of international intervention. These impacts are measured through that trajectory taken by individuals and households. We also study how the response to the conflict was shaped via the existing frameworks and what workable solutions can be recommended, given the evidence collected for the book. While taking all the above insights into consideration, this book attempts to situate the health and well-being of the most vulnerable communities at the centre of a complex interplay of politics, conflict and public health in the setting of a fragile borderland. One of the methodological insights that underlies the writing and research for the book is that it is important to design processes by which the risks can be overcome and long-term tracing of households can be done. This was only possible, because of the ant’s sustained presence in Chirang and the BTAD, which provided the platform. This was further combined, with the wisdom and innovation of an extremely dedicated and committed group of researchers and research advisors who participated in the original study, to collect narratives and engage with the

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context (and overcome those risks). By focusing on a limited set of forest hamlets across the geography of the borderland, the research provided a degree of depth, in a set of locations that are difficult to access. It must be remembered that it is only in 2020 that the armed organizations operating in the borderland came over-ground and joined the peace process. Between 2015 and until recently, their organizational structure was relatively intact, and as shown above, they did exist in the research area.

1.5 Situating the Narratives So, how do people who have suffered such immense loss and disruption survive and rebuild their lives? Much has been said about the resilience of the survivor and of the human capacity to survive adversities of the worst kind. Patricia Justino (2012) says that: ...people that live in areas of enduring conflict display various degrees of resilience: some do well out of conflict, some live in conditions of fear and extreme destitution and others simply get by. Levels of resilience depend on a series of factors both within and outside of the control of those affected by conflict. These factors can be grouped into: (i) the magnitude and duration of the effects of violence; (ii) the type of coping strategies that people are able (or allowed) to access; and (iii) the effectiveness of the strategies adopted to cope with the effects of conflict and violence.xxxv

She also states that: The nature, magnitude and duration of the effects of armed conflict on individuals and households are largely determined by the way in which different people respond and adapt (or not) to violence-induced shocks. Emerging literature on the relationship between violent conflict and development outcomes at the micro-level has significantly advanced understanding of the consequences of violent conflict on local populations, particularly the more direct channels discussed above. In addition, there is now a sizeable body of evidence on how households living in risky economic environments, even the very poor, develop a complexity of (ex ante) risk management and (ex post) risk-coping strategies. Rigorous empirical evidence on mechanisms of coping and adaptation in contexts of violence is, however, only slowly starting to accumulate. This is largely due to the substantial data requirements involved in the assessment of these effects.xxxvi

Yet, on deeper examination, this version of resilience, though useful, assumes it is something that can be measured, analysed and quantified, without accounting for the deeper impact of what is termed as a ‘violence-induced shock’ Thus, where do questions of identity formation and the will to commit (or conversely abstaining from committing) harm fit into such econometric approaches? The ‘violence-induced shock’ is also a fundamentally subjective experience. As our narratives show, is it enough to just build up assets lost in the conflict. What of the ability to bridge divides along identity that start early on in schools itself? How do you reconcile the perpetrators and the victims? Indeed, grit and resilience are seen throughout the chapters

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1 Introduction

of this book. But the other side of resilience is suffering. As researchers studying extreme loss and trauma, are we guilty of belittling the suffering of survivors of violent conflicts by focusing on their resilience and coping? In Kleinman, Das and Lock’s (1997) book Social Suffering, Lawrence Langer, writing on holocaust survivors says: ‘anyone who hears these testimonies will understand that for the witnesses time is durational as well as chronological, and that durational time is experienced continuously, not sequentially as a memory from which one can be liberated’.xxxvii Langer believes that ‘all attempts to investigate the effects of atrocity on a group or a community must begin with the narratives of individual victims, and especially with moments of durational time, which mock the very idea that traumas can be healed’.xxxviii He calls for an ‘alarmed vision’ which will not flinch from representing the miseries that victims go through in language that is ‘untempered by moral meaning, whether plague, poverty, or war, that were so often allied to a language of sanctity, virtue, or sentimental fervour’.xxxix In the same book, Paul Farmer in his essay argues that the sufferers are victims of structural violence and their agency is ‘curbed’ every time they try to rise from the circumstances they are forced into. Therefore, the story of suffering of an individual has to be embedded in the ‘larger-scale historical system where fieldwork site is a part’.xl In order for us to do some justice to the people whose suffering we are recounting: ……the analysis must also be historically deep - not merely deep enough to remind us of events and decisions such as those which deprived Acephie of her land and founded the Haitian military, but deep enough to remember that modern day Haitians are the descendants of a people kidnapped from Africa in order to provide us with sugar, coffee, and cotton and to enrich a few in a mercantilist economy”.xli

Throughout this book, even as we admire the resilience of the survivors, we ask ourselves that for those who have lost everything except perhaps their lives, what is the threshold of resilience? How much must they suffer till they are unable to cope and fall into ill-health and ill-being? For though they are surviving, they are barely doing so. So, what then must be the accountability of a state and society in leaving populations who have suffered intense loss and deprivation not of their own volition, to fend for themselves? Justino in her paper agrees that ‘these populations need serious help and support, and evidence suggests that policy interventions in conflict-affected communities have a long way to go in terms of supporting people affected by conflict and violence, even when these people show resilience in the face of violence’.xlii In Chaps. 4, 5 and 6, we will especially unpack suffering, vulnerabilities, coping and resilience; and, the state and societal response towards survivors of conflict.

1.6 The Design of the Book and Inclusion of Cases The entire process of conceptualizing the book can be traced back to a few years. The original study which was conducted over a year-and-a-half had already ended.

1.6 The Design of the Book and Inclusion of Cases

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However, it was observed that the project report by itself, while setting the basis for the book, had to be rewritten, after examining the data, to convey the depth and intensity of the experiences recorded in the communities (and who were part of the original study). Especially, for histories that have occurred nearly 25–30 years ago, this possibly would be the only memorialization of what some of the major communities (Bodo, Adivasi and Nepali) had experienced in the past. Simultaneously, the ant which was also engaging with peacebuilding, disaster relief and humanitarian response (a role especially taken up post the 2012 conflict) was expanding its work into the more remote villages around Milon (as peace slowly came back to Bodoland). With these gradual transformations, despite occasional eruptions of violence, the organization refocused itself on its core strength of development practice. In due course, the ant also co-established a small education initiative, the borderlands studies programme that brought in students from the co-author’s academic institution to study community-based perspectives on international relations at the Indo-Bhutan border, especially people-to-people linkages and socioeconomic interactions. In developing a perspective, the study gradually evolved into a broader interdisciplinary academic work that drew on insights from public health, conflict studies, international relations, border studies and history. Nevertheless, at the core of the academic work were the key voices and experiences of victims and survivors. Some important choices were made in the course of the writing process. One of the major choices is that the Bodoland conflict and the BTAD region are considered on their own terms as stand-alone cases by themselves. This also means, methodologically, as far as possible we have utilized locally available sources and archival material. Taking into account the nature of the complex dynamics of the Indo-Bhutan border region, we have refrained from framing the study as one which highlights conflict effects that are applicable across the entire Northeast. Generalizing from this context would have led to two major methodological fallacies: the first would be ‘conceptual traveling (application of concepts to new cases)’ and ‘conceptual stretching (the distortion that occurs when a concept does not fit the new cases)’.xliii The term Northeast India in essence is a colonial construction that simplifies and overshadows a highly diverse region, and is something that needs to be considered when field-centric locally based studies are conducted in the future.xliv While many of these movements did intersect, they also have distinct histories and causes. Can solutions suggested by the book be extended to other conflict-affected border states, such as Manipur and Nagaland? The answer according to us is mixed. What can possibly work in the BTAD might not be feasible in other contexts. At the same time, there is a glaring necessity to understand and measure health inequities across other surrounding border regions in the states neighbouring Assam, especially through district-level and sub-district-level (block-level) fieldbased studies. The fact that health, education and other government supported social welfare schemes are universal in their scope does allow for some comparative measurement and construction of common indicators. There is virtually no evidence-based long-term and in-depth measurement of how conflict has affected

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1 Introduction

service delivery across these border regions. The book can only suggest that peacebuilding through healthcare has unexplored potentials in multi-ethnic regions and that universalization of public goods is urgently needed. In addition, the book does provide a model and template for cross-cutting collaborations between the communities, civil society organizations and educational institutions to systematically engage in such studies. It is also important to share results state health authorities, involve them in the study design and record their experiences as well. From the perspective of peacebuilding and humanitarian response in the Indian context, there is very little case work on actual ground-level situations that are instructive of dilemmas, trade-offs and negative outcomes, rather than positive stories of success of a particular project. In order to convey the challenges of the field situation, some of the chapters have case studies at the end of the chapters and even interspersed in between. In a way, every narrative included in the book has something to convey. But is hoped that cases will be taken up for discussions in classrooms and other training settings to reflect on the choices that were made. For instance, there is a case on the role of a medical organization and the community health worker in the early 2000s, and also of a humanitarian aid worker, which communicates these dilemmas. We have included cases such as traditional institutions of dispute resolution among many such others. As the earlier biographical sketches in the chapter show, the reality, even for an individual, one household and a single hamlet, was so complex. Is it even appropriate to intervene? What are the alternatives to non-intervention? What is appropriate intervention? In the course of writing the book, the narratives and other supporting documentation also threw up unanticipated results. Of these, the most significant one is was that categories taken for granted in conflict (‘ethnic’, ‘identity’ and so on) are actually extremely ambiguous and layered. If anything, despite extreme brutalities committed by seemingly opposing sides, communities at the grassroot level also cooperate in ways that are not visible to outsiders (see Chap. 8 on Peacebuilding and Humanitarian Response). Another unanticipated result was the role of Traditional Healers and Informal Medical Practitioners who are actually central to health provision in the border area, but were never seen legitimate actors by either the state or other humanitarian response organizations. There is now a full Chap. 6 that discusses their role. An additional unanticipated result was seeing the actual extent of the security problem posed to Bhutan as a result of the armed movements for creating Bodoland and its impacts on the socio-economic and political system of the border districts of South Bhutan (Chap. 7). This was not part of the original study and is indicative of the expanded scope of the work. In order to provide a better idea of the area, we have also included photographs that were taken in the course of various programmatic activities and research. Being an immersive study there are no photos from popular media sources and all photographs were taken in the course of situations seen by the ant, its partner organizations and the authors.

1.7 Plan of Chapters

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1.7 Plan of Chapters One way of understanding the layout of the chapters is that each chapter is linked analytically, and content from the previous chapter blends into the subsequent chapter. The chapters are organized in a logical structure, which also coincides chronologically with the various stages of the conflict. While this chapter, Introduction, serves a brief introduction to the book, the subsequent chapters provide insights that revolve around the key objectives of the research. Chapter 2, The Making of Violent Spaces: Conflict and the Search for Peace in Bodoland provides a history and background of the Bodoland movement in both its non-violent and violent forms. The chapter especially utilizes two lenses to assess the movement. In the first case, we trace out the historical grievances underlying the Bodoland agitation and the eventual formation of the armed organizations. What makes armed movements in the Bodoland agitation unique is that it built on a halfa-century long non-violent socio-political and cultural movement for constitutional protection from the Centre. These movements sought protection for indigenous practices, land rights and equality in developmental entitlements. By tracing out the earlier phase, which has been overlooked by the recent literature on conflict in Bodoland, we see the determinants of future demands of self-determination. The major shift occurred, when an aspirational idea for protection and equality, transitioned into mass mobilization for a territorial conception of a separate state called Bodoland (in 1987). The chapter then briefly understands the territorial failure of the 1993 Peace Accord with ABSU, in which exclusion of the Indo-Bhutan border areas (which were seen as part of a homeland for the Bodos) became a major point of contention. This is then subsequently followed by a review of the 2003 Tripartite Memorandum of Settlement (MoS) with the Bodo Liberation Tigers Force (BLTF) that extended the Sixth Schedule into the plains areas of Western Assam, and led to the creation of the Bodoland Territorial Council (BTC). We also briefly look at sociological functions of the armed organizations. The second lens is that of the role of individual participation in violent acts. We try and see the manner by which identity formation impacts the individual psyche, and show a tentative link between identity formation at a more macro-level and how its internalization leads ordinary people to engage in violence. The chapter also includes a narrative that shows the origins of an Adivasi armed group, which is currently on ceasefire with the government. Building on the history and background outlined in Chap. 2 we transition into Chapter 3, Researching Fragility in the Indo-Bhutan Borderlands. The chapter provides insights into the systems of governance, across the areas of study. The chapter looks at the developmental profile of Chirang District, which was established after the 2003, MoS, and the sub-district local governance institutions such as a Village Council Development Committees (VCDC) that replaced the Panchayati Raj System (PRS). The underlying theme of the chapter is the problem of fragility, and we especially provide an outline of the problem of Forest Governance as being a central driver of the conflict in the Indo-Bhutan border areas. We derive a definition of fragility, which in essence refers to the traversing of the boundaries between formal

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1 Introduction

systems of governance and informal practice. The chapter specifically describes the research setting and the challenges of data collection in a conflict-affected area. Based on Jennifer Liang’s field notes, a Case Study on Ecological Fragility in the Borderlands is provided, whereby those displaced due to conflict such as those residing in Sonapur are pushed deeper into the restricted Reserve Forests (RFs) along the border. The case study considers the trade-offs being made between survival goals, the search for livelihoods and ecological deterioration as a result of these survival goals. With the Reserve Forests (RFs) supporting thousands of families, what are the alternatives and out-of-the-box solutions that can be provided, which ensures that these families living in a protracted informality, without access to government services as a result of non-recognition, can enjoy rights and entitlements due to citizens. Having set the context, the chapters from now onwards, specifically describes the major findings of the research. Chapter 4, Armed Violence and the Breakdown of the Health System: Vulnerabilities of Health Personnel in the Conflict-Affected Areas, brings out the effects of conflict on the state health system, along the entire conflict timeline. The key concern of the chapter was the lack of protection afforded to health personnel. The major public health centres were impacted by political unrest and militant violence, and became non-functional, a pattern that echoed across all the affected areas. With the destruction of health institutions, threats and attacks on medical personnel, a system that was functional in the 1970s and early 1980s, and even before, slowly deteriorated. A case study shows the disintegration of the major PHC (Public Health Centre) that catered to the borderland population. As a consequence, the conditions in the various Relief Camps in the Milon and Koroipur area deteriorated after the 1996 and 1998 conflicts. The chapter shows that even in contemporary times the health system in the study area was unable to recover. An assessment of health access of the study area is also done. Despite resource allocation under the National Rural Health Mission (NRHM) which became operational in the area in 2007, the major barrier to health was not necessarily actual physical violence, but the perception of the region being unsafe. Medical personnel, especially doctors, do not prefer to serve in the area. Another major issue that the chapter highlights is the poor implementation of critical government welfare schemes related to food, guarantees of employment, supplementary nutrition of young children, school midday meals, and provision of safe drinking water and sanitation. These services are critical to supporting health and well-being of the population. Rather than building back better, the post-2003 governance mechanisms led to the creation of these support systems that were fragile and vulnerable to disruption. At the same time, we do take into consideration that the situation is slowly changing, and a case study of how the health system was revived, in recent times, in another district of the BTAD is also discussed. A key learning from the case is the unconventional approach taken by key personnel to reassure and motivate their staff members and to continue working in their institutions (in addition to building some degree of consensus with the Bodoland Territorial Council and district officials).

1.7 Plan of Chapters

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Having discussed the breakdown of the PHC, Chapter 5, Surviving Conflict in a Fragmented Borderland: Community Voices on Violence, Dislocation and IllBeing in the Border Villages of Chirang, provides a detailed account of the conditions in the Relief Camps after the 1996 and 1998 ethnic violence between the Bodos and Adivasi communities. There are no historical records of the number of deaths due to the spread of disease (communicable and non-communicable) in the camps at that time, nor are their records of the people who died due to armed violence, outside the camps. The chapter design relies primarily on the voices and narratives of those who lived through the camps and examines the entire cycle from fleeing to living in the camp and rehabilitation. Militarization, insecurity and daily violence were woven into the fabric of everyday life. Using diagrams and conceptual maps drawn from thick life histories, we try to understand how conflict-affected families interpreted the reality of violence and coped with their losses in changed circumstances. The chapter shows the effects on highly vulnerable populations such as children, women, the elderly and the disabled. A large portion of the population that was living in these conditions since 1996 and 1998 were unable to return, and with that, the social composition of the borderland was altered. Conditions in the camps were dismal, and deaths that were preventable were continuously occurring. Conditions in the camp were bad but they could not even leave. Fear of attacks and a hostile envnvironment outside made survival all the more difficult. The narratives also show that differences between the ethnic groups were not necessarily rigid, and that it is difficult to actually categorize the extent to which people behave according to a certain ascribed identity. We see initial examples of what we eventually term as Social Elasticity (SE), a concept that holds the promise of building bridges between seemingly polarized communities. We do not only see the communities exclusively as either victims or perpetrators. Creating such binaries is a major conceptual anomaly that exists in the manner in which scholars have dealt with the subject. Rather, the conditions that were brought on by the conflict led to a highly ambiguous moral fabric, where at times individuals who were seen as victims, themselves, became perpetrators of extreme brutality. Alternatively, people in the same sequence of events would be both perpetrators and saviours at the same time. The chapter also provides insights into the role of the host community (i.e. the Nepali community) who saw themselves as the original residents of the Milon Forest Village. The chapter also shows that community links between the Bodos and Adivasis were strong enough, to possibly enable some kind of revival, despite the extreme positions taken by the armed militants on both sides. With the breakdown on healthcare provision by the state on one hand, and the inability to access health institutions across the border in Bhutan on the other hand, the choices for those surviving in the Relief Camps were seemingly every limited. On deeper examination of the data, we found that the terrain of healthcare which seemed absent was filled with a number of informal and semi-formal actors. These informal actors became the frontline in health services provision and are still the first choice for those residing in the borderlands of BTAD, and especially in the area of study.

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Chapter 6, Deep Vulnerabilities, Ill-Health and emergence of Informal Medical Practitioners: Coping and Treatment Seeking Behaviour among Conflict-Affected Families, examines the role of three types of practitioners Traditional Healers (Ojhas), local informal ‘Pharmacies’ and NGOs. The chapter starts with detailed life histories of the two families (one Adivasi and one Bodo) to show how families, due to necessity, attempt at accessing all the types of choices available, rather than privileging one option over the other. In fact, the failure of the public health system is that it is considered the penultimate choice. The Traditional Healers and Pharmacies constitute a distinct sub-system by themselves, and there is also a rudimentary referral system between them. Very little is actually known about their work. In addition, legitimacy emanating from tradition is a major determinant of health-seeking behaviour which makes traditional healers an important stakeholder in the practice of medicine. There are unexplored potentials of incorporating them into programmes, especially connected with mental health, and some details of one such attempt are provided. Even the role of Pharmacies as potential humanitarian actors does exist, but there are very few connections or enabling mechanisms that would allow for such bridges to be built. In the case of NGOs, we document a medical mission that was established by an international NGO. The organization provided high-quality services that reflected their level of professionalism and expertise, but we leave the question of the manner in which humanitarian agencies exit as open ended. The problem of humanitarian exit is a major one in addition to accountability to the communities being served. We include the Case of a local Community Health Worker recruited by the organization, to show the ambiguity of responding to conflict, which leaves all stakeholders with sub-optimal choices. Until now, the book has mainly dealt with the developments in Milon and Koroipur, which are on the Indian side of the border. In Chapter 7, The Transboundary Impacts of Conflict on Bhutan’s Border Districts: Insurgency, Border Malaria and Cross-Border Healthcare, we explore developments that occurred in locations just across the border gate in Sarpang, the major Dzongkhag (district) of Bhutan that is contiguous with Chirang and Kokrajhar. The chapter relies on Baud and Schendel’s (1997) Cross-Border Perspective to analyze events across the border gate in Bhutan, and treating both sides of the border as a holistic, interrelated unit of analysis.xlv As one of the most important southern border districts, it is also the site of Bhutan’s flagship Vector Borne Disease Control Programme (VDCP). The chapter begins with the narrative of a family from the Milon Relief Camp, whose life was closely intertwined with the border. In the absence of any support from the state, the open border regime and the availability of opportunities for daily wage labour inside Bhutan were important components of the informal post-conflict recovery cycle for those displaced after the 1996, 1998 and 2014 conflicts. At the same time, as will be seen, this model itself significantly enhanced the vulnerabilities of the affected communities. In the chapter, we provide a preliminary assessment on the impact of the civil strife and insurgency in Assam and Bodoland, on Bhutan’s health system. The chapter looks at the spillover effects of the conflict including attacks on Bhutanese civilians, inside Bhutan and in India. The chapter shows that the influx of militants into Bhutan and establishment of training camps

1.7 Plan of Chapters

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were immediately preceded by a period of ethnic conflict in Bhutan. The presence of NSAGs from India became Bhutan’s largest security crisis, since the invasion by the British expeditionary armies in 1864–1865. At the peak of the crisis, more than 3,000 well-armed militants were based in camps across the entire Southern Border with India. The militant presence was gradually established over nearly a decade in the transboundary forest areas along the international border. This culminated in an extensive military operation conducted by Bhutan’s security forces in 2003 which led to the expulsion of the militant groups from the country. Sarpang was a significant frontline and one of the sites of this military operation. Although malaria control was impacted by conflict on the Indian side, by the time of 2003, the health system in Bhutan (especially Vector Borne Disease Control Programme) was strong enough to withstand the effects of the conflict. By then important reforms, including restrictions on cross-border healthcare access were enacted. This particular reform was especially important from Bhutan’s perspective, as by 1996, the hospital in Gelephu, the town, just a few kilometres away, was overwhelmed with patients from India seeking treatment for malaria. This correlates with the first displacement in 1996, and the setting up of Relief Camps in Milon. The chapter concludes with the necessity to build grassroot cross-border cooperation, especially for maternal and child health and in emergency management. Chapter 8, Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland, provides an overview of the two recent humanitarian crises, in which overall 800,000 people were internally displaced. In the first instance, violence between the Bodo and Bengali Muslim communities led to nearly 500,000 people being internally displaced, while in 2014, another round of conflict, between the Bodo and Adivasi communities, led to nearly 300,000 people belonging to both communities fleeing their homes. Unlike the crises after the 1996 and 1998 conflicts documented in the book, the two recent conflicts were marked by a substantive change in the information landscape. The 2012 crisis marked the entry of large humanitarian organizations, some of whom responded to the 2014 crisis as well. We focus especially on the 2014 crisis (that affected Sonapur), as it marked the return of conflict between Bodos and Adivasis. The chapter especially provides a map of household-level impacts and shows how overall well-being was irrevocably damaged by the conflict. Again, the recurrent theme is that eventually both the state and humanitarian organizations rarely track individual households that are the most severely impacted, over the long term, especially in the post-emergency phase. In this case, we provide the life history of a Bodo woman (who is now residing in Sonapur) whose husband was missing since the 2014 conflict. As the body of her husband was not found, she was ineligible for the government rehabilitation. Countless such cases exist through the conflict-affected areas, where existing entitlements are denied, due to rigidity and insensitivity of the government norms, whereby victims have to prove their eligibility for compensation, rather than district authorities actively seeking out, identifying and supporting these highly vulnerable populations. In the chapter, we also examine one of the most overlooked aspects of writings and analyses of the 2014 conflict. These were examples non-traditional peacebuilding where the student unions, political parties,

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community-based organizations and ordinary people (including former militants) united to condemn and control the outbreak of violence. Included in the chapter is the Case of a Humanitarian Aid Worker that provides some important lessons in the management and planning of a humanitarian response, including the underlying negotiations. As the example shows, the dual system of governance in a Sixth Schedule Area even made routine humanitarian activities (such as installation of water points) problematic. As will be seen, if these are carefully managed, even seemingly ordinary activities can lead to informal peacebuilding. In Chapter 9, Conclusion: Towards Post-Conflict Recovery, Social Elasticity and Restoration of Health Equity in Bodoland, we seek to consolidate the major findings of the book and provide recommendations based on the analyses done until now. In a situation where international agencies cannot intervene, to facilitate reconciliation and peacebuilding, it is important to rely on existing structures and processes of governance to bring about a long-lasting peace. The most recent Memorandum of Settlement (MoS) that was signed in 2020, and for all its perceived limitations did have one important achievement. The agreement was able to draw out the remaining cadres of the anti-talk faction of one of the oldest and most well-armed organizations, the NDFB (all the factions of which have now been dissolved). It must be remembered that the group was in existence for nearly 34 years. One of critical aspects of the MoS is the importance attributed to education and healthcare in the clauses of the agreement that have been absent in sub-national peace accords until now in the Indian case. The template provided by the 2020 MoS has the potential to become a benchmark in peacebuilding for other similarly affected areas in adjoining states, but only if implemented successfully in a transparent and accountable manner. In fact, it can be said that with the dissolution of the armed component, the Bodoland movement has actually entered its most difficult phase, where the vision for peace must be translated into reality. The success of the developmental vision of the MoS rests most importantly on the outreach that can be done with all other ethnic groups living in the BTR. The chapter argues that sustainable long-term interventions which enhance grassroot inter-community cooperation and build on Social Elasticity (SE) through revival of local markets, education, sports, cultural exchanges and other arenas, not traditionally seen within the ambit of peacebuilding, would significantly enhance the probability of the peace process. Most importantly, by being in borderland, with the onset of peace, significant gains from the local border trade and market linkages with Bhutan could provide another platform for enhancing the welfare outcomes of communities in the area of study. Lastly, the public health institutions, which are supposed to be cross-cutting and universal in nature, also have the potential to create these linkages. Given the burdens of conflict discussed until now, these institutions must be revived locally, with potential for drawing on lessons and collaborating with from Bhutan’s functional health system, just across the border gate. Notes i

Multiple round Interviews of Respondents by researchers [name undisclosed]. Date of Interview. 03 June 2016–25 August 2016. Sonapur Village, Chirang, BTAD (Assam).

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Multiple round Interviews of Respondents by researchers [name undisclosed]. Date of Interview. 03 June 2016–25 August 2016. Sonapur Village, Chirang, BTAD (Assam). Date of Interview: 25 August 2016. Mac Ginty, Roger. 2013. Introduction: The Transcripts of Peace: Public, Hidden or Non-obvious? Journal of Intervention and Statebuilding 7(4): 423–430. p. 425. https://doi.org/10.1080/17502977.2012.727535. Ibid. Field Diary and Observations. 25 August 2016. Field Diary and Observations. 25 August 2016. Interview with Respondent DNN. Interviewed by Researcher [Undisclosed]. Date of Interview. 8 July 2016. [Location Unspecified], Chirang, BTAD, (Assam). Text of Complaint. All details are coded. Field Photo. Field Photo. Ravindran, T.S. and T.A Seshadri. 2018. Health equity research agenda for India: results of a consultative exercise. Health Research Policy and Systems 16(94). https://doi.org/10.1186/s12961-018-0367-0. See Chap. 7. Valentino, Benjamin. 2014. Why We Kill: The Political Science of Political Violence against Civilians. Annual Review of Political Science 17: 89–103. https://doi.org/10.1146/annurev-polisci-082112-141937. See Chap. 9. Pedersen, D. 2002. Political violence, ethnic conflict, and contemporary wars: broad implications for health and social well-being. Social Science & Medicine 55(2):175-190. p. 176. https://doi.org/10.1016/s02779536(01)00261-1. Ibid. Ibid. World Health Organization (WHO), Commission on Social Determinants of Health. 2008. Closing the gap in a generation Health equity through action on the social determinants of health. p. 2. https://apps.who.int/ iris/bitstream/handle/10665/43943/9789241563703_eng.pdf;jsessionid= 214D30EDA20DCDD2698E9ABED3D18AEF?sequence=1. Accessed 2 July 2019. Ibid. Ibid., 157. See Desbiens, C. 2017. Imaginative Geographies. In International Encyclopaedia of Geography: People, the Earth, Environment and Technology, eds. D. Richardson, N. Castree, M.F. Goodchild, A. Kobayashi, W. Liu and R.A. Marston). https://doi.org/10.1002/9781118786352.wbieg0865. Also see Chap. 2 that provides a timeline of the Bodoland conflict and how questions of geography were linked to peace accords.

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Expert Committee on Tribal Health (Ministry of Health and Family Welfare and Ministry of Tribal Affairs), Government of India. 2018. Tribal Health in India: Bridging the Gap and a Roadmap for the Future. p.66. See Ahmed, Ali. 2011. Reconciling AFSPA with the Legal Spheres. Journal of Defence Studies 5(2): 109–121. p. 115. Ibid. See Chap. 9. Organization for Economic Development and Cooperation. 2011. Investing in Security: A Global Assessment of Armed Violence Reduction Initiatives. Conflict and Fragility: OECD Publishing. p. 18. https://dx.doi. org/10.1787/9789264124547-en. World Health Organization. 2002. World report on violence and health: summary. Geneva, World Health Organization. p. 4. https://www.who. int/violence_injury_prevention/violence/world_report/en/summary_en. pdf?ua. Accessed 1 March 2019. Mc Evoy, Claire., and Gergely Hideg. 2017. Global Violent Deaths: Time to Decide. p. 11. https://www.smallarmssurvey.org/fileadmin/docs/U-Rep orts/SAS-Report-GVD2017.pdf. Accessed 1 February 2019. Ibid., 10. Ibid., 11. Pedersen, D. 2002. Political violence, ethnic conflict, and contemporary wars: broad implications for health and social well-being. Social Science & Medicine 55(2):175-190. p. 182. PII: S 0277-9536(01)00261-1 Corral, Paul, et al. 2020. Fragility and Conflict: On the Front Lines of the Fight against Poverty. Washington, DC: World Bank. https://doi.org/ 10.1596/978-1-4648-1540-9. License: Creative Commons Attribution CC BY 3.0 IGO. See Chap. 2. See World Bank. 2020. FY20 List of Fragile and Conflictaffected Situations. https://pubdocs.worldbank.org/en/179011582771134 576/FCS-FY20.pdf. Accessed 6 April 2020. Justino, Patricia. 2012. Resilience in protracted crises: exploring coping mechanisms and resilience of households, communities and local institutions. What can governments, aid agencies and donors learn from the steps taken by crisis-affected individuals, households, communities and institutions to cope and build their own resilience in the context of protracted crises? p.1. http://www.fao.org/fileadmin/templates/cfs_ high_level_forum/documents/Resilience_in_protracted_crises_PJustino_ 01.pdf. Accessed 6 April 2020. Ibid., p. 4. Kleinman, Arthur, Veena Das, Margaret M. Lock. 1997. Social Suffering. University of California Press. p. 55. Justino, Patricia. 2012. Resilience in protracted crises: exploring coping mechanisms and resilience of households, communities and local institutions. What can governments, aid agencies and donors learn from

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the steps taken by crisis-affected individuals, households, communities and institutions to cope and build their own resilience in the context of protracted crises? p. 15. https://www.fao.org/fileadmin/templates/cfs_ high_level_forum/documents/Resilience_in_protracted_crises_PJustino_ 01.pdf. Accessed 6 April 2020. Ibid., p. 55. Ibid., p. 53. Ibid., 273. Ibid., p. 274. Collier, D., and J. Mahon. 1993. Conceptual “Stretching” Revisited: Adapting Categories in Comparative Analysis. The American Political Science Review 87(4): 845–855. p. 845. https://doi.org/10.2307/2938818. See Chap. 2. See Baud, Michiel., and Willem Van Schendel. 1997. Toward a Comparative History of Borderlands. Journal of World History 8(2): 211–42. p. 212.

Chapter 2

The Making of Violent Spaces: Conflict and the Search for Peace in Bodoland

Abstract For people struggling for survival in the Indo-Bhutan borderlands in Assam, episodes of violent conflict and forced displacement were catastrophes they could barely recover from. For more than three decades, Western Assam witnessed several waves of ethnic conflict that fuelled armed militant struggles. The long-drawn but largely low-intensity conflict, punctuated by episodes of intense violence, weakened the local economy, administration and society. Essential services including health and education systems in the area of study had collapsed. What then were the determinants of the conflict? The chapter begins by tracing out the history of the conflict and examines both the long non-violent phase prior to militancy and the onset of organized armed violence. Contemporary research on Bodoland does not attribute much importance to this earlier phase. In fact, as the chapter shows, the resort to arms was preceded by nearly 50 years of social reform with mass movements for cultural and territorial protection for the plain tribes of Assam. The situation was further complicated by the long-term population pressures exerted due to migration into the region (which accelerated during British rule) and limitations in access to land for the practice of traditional systems of agriculture. In later stages, we see the conflation of the protection for rights (including land rights) and developmental aspirations with territorial goals; this eventually translated into the search for political autonomy. The process of actualizing these territorial conceptions transformed the earlier efforts at social reform and catalysed the process of identity formation. 1987 was a crucial turning point with the rise of the ABSU-led Separate State Movement. It set the stage for introducing idea of Bodoland. The forest tracts along the Indo-Bhutan border became politically salient at this juncture. The chapter briefly examines the two major peace accords that were signed in 1993 and 2003. As will be seen, the failure of the 1993 Accord can be partly attributed to an incomplete form of autonomy without a clear-cut demarcation in territorial boundaries. This engendered massive internal violence among the stakeholders who were spearheading and participating the Bodoland agitation; and, also between the ethnic groups who were to be included under the new semi-autonomous institution called the Bodoland Autonomous Council (BAC). It is from now on that we see recurrent humanitarian crises and instances of large-scale protracted conflict-induced internal displacement, a trend that continued even after the formation of the Bodoland Territorial Council (BTC) in 2003. Seeking to return to the micro-level, the chapter also attempts to © Springer Nature Singapore Pte Ltd. 2021 S. Sinha and J. Liang, Health Inequities in Conflict-affected Areas, https://doi.org/10.1007/978-981-16-0578-9_2

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understand the psychological dimension of violence. The chapter provides some insights on the nature of armed group formation and provides the background to the localized fragility underlying the dual system of governance in a Sixth Schedule area (a system that will be explored in more depth in the next chapter). Keywords Colonialism · Demography · Social reform · Bodoland agitation · Bodoland movement · Conflict in Bodoland · Autonomy · Peace accords · Armed movements

2.1 Introduction It is extremely difficult to encapsulate the complex history of both violence and peace, in what is now called the Bodoland Territorial Autonomous Districts (BTAD) without confronting many difficult questions on the true nature of violence itself. Writings on the nature of conflict in the ‘Northeastern’ region of India which broadly comprise Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland and Sikkim provide useful insights on the causes of these conflicts. These works outline the long and chequered history of insurgency (excluding Sikkim), conflict dynamics and peace processes that have been experienced in the region. Nonetheless, as many of these works show, conflicts are deeply connected to issues of land, identity and cultural protection. Furthermore, the conflicts can be both external and internal. These can occur with regard to carving out an autonomous space within the existing boundaries of the nation state or establishing a notion of ethnic homeland that transcends the modern political boundaries, i.e. boundaries which emerged during British imperial rule. What is established is that, across the entire region the process of statebuilding in the post-colonial era has been punctuated by a duality of intense violence and peace negotiations that in most cases parallel one another. Constructing a cohesive and concise historical narrative on violence in the ‘Northeast’ is extremely problematic for a number of reasons. The most critical among these is the fact that a political narrative is in essence a simplification of an extremely intricate set of processes. Authors who are writing from a standpoint of being ‘outsiders’ cannot accurately capture the internal logic of the forces that govern politics specific to these context. Moreover, it is also very difficult to generalize across the conflicts that occurred in each of the states mentioned earlier. As Samir Kumar Das states: Social scientists working on the region have a tendency of blowing conflicts out of proportions in a way that interethnic conflicts are conventionally taken as the mark of the society and politics of the northeast. Conflicts are sanitized of their complexities and are defined in simple black and white terms. The absence of conflicts is read as cooperation and vice versa. We on the other hand plot conflict and cooperation along a continuum and there are vast grey areas that spans between them. If there is one hallmark that is said to characterize these societies, it is conflicts between communities in the region. The history of conflicts in the region written by the scholars becomes so overbearing that it hides the history of cooperation and turns our attention away from the intricacies of conflicts that may have told a different

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story had they been studied in depth. Seldom are their works informed by any microstudies in conflicts and violence in the region.i

The problem of essentialism was highlighted by Pradip Phanjoubam (the Editor of the Imphal Free Press) who, in the context of Manipur, states: The broad brush, any painter will testify, is a tool often used to shroud and mystify a subject so as to disguise and give credence to ignorance of the inner dynamics of the subject. And so, in the portrayal of the insurgency in not just Manipur but the entire northeast region, the popular resort has been to rely on images of primitive clannish tribal loyalties, mutual and irreconcilable atavistic hostilities among tribal groups, primordial xenophobia reminiscent of the days of savagery, etc. This approach leaves little room for a resolution apart from keeping the warring parties separated from each other (just as the instinctually determined hostility between cats and dogs is resolved by keeping them apart). This approach is quite unlike in the case of other deadly conflicts, such as was seen in Punjab. In these situations, the same analysts would put forward economic and political causes and consequences profoundly actionable economic and political solutions.ii

These critiques are extremely important, as we consider the content of the book and nature of history being written. The Bodoland conflict is a highly complex and multi-faceted. It is therefore necessary to study its history on its own terms by sketching out some of the intricacies of the movement. There have been a recent set of studies that seek to broaden the scope of interpreting the Bodoland situation and the multifarious insurgent groups by including ecological and demographic analyses.iii While insightful, the works underestimate the degree of social suffering that occurred in the course of the conflict. The treatment of victimization and forced displacement as incidental to the conflict is misleading and is not a core concern, given that they privilege political and institutional analysis that address more theoretically oriented questions. The book adds to this literature through a more nuanced view of the field which does not interpret the ethnicities living in the BTAD as purely engaged in an unending conflict. We provide a programmatic and pragmatic lens. Given that the work emanated from the complex problems arising out of implementing grassroot development and peacebuilding work, we see possibilities of ethnic boundaries being much more fluid unlike what is characterized by these recent studies. The authors have been witness to the changes in BTAD and there has also been substantive progress even within the years of conflict and intense violence which does not get specified in the literature above. Because these are less visible and do not get measured they tend to be overshadowed. While we write in the community experiences as a central part of our analysis we avoid writing out change stories. Individuals can also break out of the conditions or ethnic polarization in seemingly small and ordinary ways, which do not fit in with the more deterministic view of human nature that is taken by these works. The methodology of synthesizing a purely research lens with a programmatic one allows for documentation of these unexpected outcomes. These experiences provide a backdrop to the content of the book. The mainstay of the work is an extensive body of qualitative data collected in the course of the project Closing the Gap: Health Equity Research Initiative in India (a component of which was conducted in Chirang District). However, by virtue of the ant’s experience in the area (of more than 20

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years) and programming locations, which are located close to the Indo-Bhutan border, the engagement with the data went beyond the time and scope of the study. In fact, despite the important claims made in these studies cited earlier, one can go so far as to say that a lot about the actual conflict will never be known. A multitude of decisions were taken in closed settings, by both leaders and participants. The Bodoland agitation saw the rise of various armed organizations and these are indeed central to the story of the conflict. In fact, the decision to resort to arms, for many of the individuals, was in all probability a difficult one. Given, the scope of the book, we are only studying the outcomes of armed violence and its impacts, which can be recorded and documented. Yet the social history of those participating in these armed organizations should indeed be a core concern for analysts. The purported linkages provided by these studies between the stated causes of insurgency (of which only a small proportion are publicly known), the individual motivations behind joining an insurgency (as well as recruitment processes) and the actual determinants of the use of force are at best tenuous.iv While we agree with interpretations that violent events which occurred in recent history of the BTAD region were driven by broader structural factors such as competition over land resources and identity formation, there are still several meso-level and micro-foundational processes that these works do not address. The actual organizational-level decisions and psychological dimensions of direct participation in violence are important explanatory variables which are somewhat missing in these studies. Violence against the ‘other’ in the context of the study area does not necessarily imply directing hatred against another unknown person who is remote and distant. It can also mean acting against people (and communities) who were former neighbours and lived in close proximity to the perpetrators. The de-personalization of victims can occur through a mixture of socialization (which involves organizational influences by virtue of belonging to a militant group) but there are also individual factors at work. Some of these are highlighted by R.L. Kapur and Biswajit Sen in A Psychosocial Study of Alienation Amongst Indian Youth by the National Institute of Advanced Studies (NIAS: Date Unspecified). This was an unpublished comparative study of violent activists (including former militants from Punjab, Assam and Andhra Pradesh) and non-violent activists. We get a glimpse of the mental makeup of the violent actors. Extracts from the transcript of an interview with a former member of the People’s War Group (PWG) of Andhra Pradesh are reproduced below: Q. Tell me sir, you come across as such a warm, sincere, kindly and deeply loving person (at this point he blushed with embarrassed pleasure), please tell me how you came to give orders for killings, some of the victims being clearly innocent of wrongdoing? The flush of embarrassed pleasure disappeared immediately. He visibly stiffened. His eyes which wereover the past few days- so warm and cooperative became blank. As he started speaking, it was as if he had become a totally different individual. He spoke coldly even menacingly. “Give me an example of a successful revolution which has taken place without violence.”v

The report also shed light on group identity and participation in militant violence. As the authors state: ‘Paradoxically, a consciously undertaken involvement in a violent activity may in fact be the result of a great love for others’.vi In writing

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about the former militants of Punjab and Assam (from ULFA: United Liberation front of Assam): The anger is even more visible in the Assam and Punjab militants. Here the anger is not on behalf of humanity at large, not because of injustice and exploitation against the voiceless and defenseless poor but on behalf of their own ‘people’, the ethnic group they belong to.vii

Another interesting finding from the study has implications for peace design and allows one to understand some layers of the psyche of the former militants. As stated by the authors: ‘our study also shows that those who took to violence share very psychological characteristics with those who adopted non-violent methods for social reform’.viii Describing these findings in greater detail: It is very interesting that the violent and non-violent protestors are not very different from each other in their social concern and the ‘pain’ they feel. This indeed is a sign for hope for if properly guided many of the violent protestors could in fact become non-violent protestors. The nation should take cognizance of this possibility and undertake measures to channelize their energies towards constructive activities. Their being ‘anti-establishment’ should not worry or frighten us: progress is always initiated by such people, not by those who adjust. History bears witness to this simple truth.ix

In setting some of the theoretical, methodological and empirical standpoints, it must be articulated that the communities in the study area and the broader BTAD were not necessarily in conflict with each other in the distant past and the struggle for self-determination of the Bodos went through a long non-violent phase. There is also no doubt that the legacy of colonial intervention fundamentally restructured the relationship between all these communities. Zou and Kumar, in critiquing modernday colonial cartographic representations of the ‘Northeastern’ region, state that colonial mapmaking was done ‘not as a timeless mode of describing colonized objects (people or places), but as a specifically modern process of enumerating, calibrating, or reinventing previously fuzzy ideas of space and culture into consciously rational ends’.x In examining aspects of this transformation with reference to the India–Bhutan boundary, we make a minor modification to this explanation. The communities who once lived in the Indo-Bhutan border zone were seen as frontier communities, living on the edge of imperial boundaries and occupied a space in between Bhutan and British India. They were also considered outside mainstream and historically marginalized. The formation of limited representative institutions under the colonial regime and the subsequent establishment of full-fledge constitutional democracy in post-independence India were only one part of the story. The process of constructing the cartographic imagination of formerly excluded identity groups, such as the Bodos, was also very much a grassroot process that involved mass mobilizations connected with a much deeper political consolidation. This aggregation of interests occurred in phases initially through non-violent means and subsequently utilizing forms of violent protests, of which the rise of militant organizations attracted the maximum attention. The modern political history, a segment of which is the central focus of the book, only constitutes a small portion of a much deeper and variegated set of developments.

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It is therefore imperative that the civilizational and cultural history of the community be used as a reference point before any attempt is made to understand contemporary political processes. As the pre-conflict timeline will show, it is precisely this perspective that allowed us to examine earlier developments.

2.2 A Brief Description of the Bodos The origin of the Bodos is currently subject to extensive historical research; however, for our purposes, it is important to note that the term Bodo (also Boro or Borofisa) ‘denotes a race or a speech community speaking the Sino-Tibetan Bodo Language’.xi The Bodos are also connected linguistically and culturally to other major tribes in the region such as the Rabhas, Mech (of North Bengal), Dhima, Solanimiyas, Mahaliyas, Phulgariya, Saraniyas, Dimasas, Hojai, Lalung, Garos, Hajongs and Tripuris.xii What is well known is that the community was recognized as one of the first settlers of the Brahmaputra Valley of Assam and ruled large tracts of the land. Shifting power relations led to the migration of the Bodos deeper into the densely forested areas of the Bhutan foothills. Writing on the Bodos (who have been called Kacharis especially by colonial authorities), Rev. Sidney Endle in 1910, provides the beginnings of a structural logic, which led to the development of Bodo settlements, inside the Southern Frontier Regions of Bhutan. According to Endle, the earlier Ahom conquests and dissolution of the various Kachari kingdoms were a catalytic factor in driving the Bodos and the related tribes into newer areas. While a portion of the population submitted to the Ahom conquerors a large portion of population moved continuously: ……the stronger and more patriotic spirits among them, influenced by that intense clannishness which is so marked a feature in the Kachari character, withdrew to less favored parts of the Province, where their conquerors did not care at once to follow them up; i.e., the Southern section of the race may have made its way into the districts known as the Garo Hills and North Cachar; whilst the Northern section perhaps took up its abode in a broad belt of country at the foot of the Bhutan Hills, still known as the “Kachari Duars,” a region which, being virtually “Terai” land, had in earlier days a very unenviable reputation on the score of its recognized unhealthiness. And if this view of the matter be at all a sound one, what is known to have happened in our own island may furnish a somewhat interesting “historical parallel.” When about the middle of the fifth century the Romans finally withdrew from Britain, we know that successive swarms of invaders, Jutes, Danes, Saxons, Angles, &c., from the countries adjoining the North and Baltic seas, gradually overran and occupied the richer lowland of what is now England, driving all who remained alive, of the aboriginal Britons to take refuge in the less favored parts of the country, i.e., the mountains of Wales and highlands of Scotland, where many of the people of this day retain their ancient mother speech: very much as the Kacharis of Assam still cling to their national customs, speech, religion, &c, in those outlying parts of the Province known in modern times as the Garo Hills, North Cachar and the Kachari Duars of North-West Assam.xiii

The southern border of Bhutan provides a useful spatial reference to understand the distribution of the Bodo population. While the community lives in pockets in Nepal, North Bengal and Bangladesh, we use the work of Anil Boro (2010) to derive the demographic distribution of Bodos in Assam and neighbouring areas. He

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Table 2.1 Population distribution of the Bodosxv Tract

Concentration of population

Bodos in the Northern Tract

The Northern and Eastern Part of Dhubri District (that borders Bangladesh) Whole of Kokrajhar District and parts of Bongaigaon (out of which Chirang District was created in 2003) Northern parts of Barpeta, Nalbari and Kamrup Districts (now under Baksa District after 2003) Northern parts of Darrang (now Udalguri District after 2003) and Sonitpur District (especially near the Arunachal border) Northern parts of North Lakhimpur and Dhemaji

Bodos in the Southern Tract

Dudhnoi and Dhupdhara areas in Goalpara District Boko-Chayygaon and Rani in Kamrup (Rural) District South-Guwahati, Sonapur and Khetri Jagiroad-Morigaon areas in Morigaon District Rupahi Dhing Area in Nagaon District Southern part of Sibsagar District Howraghat-Langin areas of Karbi Anglong District Northeastern Part of Dibrugarh District

Bodos in Neighbouring States

Tikrikilla area of Garo Hills in Meghalaya Dimapur in Nagaland Northern part of Jalpaiguri in West Bengal

divides the population into those residing in the Northern Tract, the Southern Tract and Neighbouring States. The Census of India in 2001 provides a rough estimate of the population, whereby the community numbered approximately 1.35 million overall spread through an area of roughly 14,700 square kilometres in the areas of the Northern Tract.xiv It is this Northern Tract, where the demand for autonomy and experiments with institutional configurations under the BAC, BTC and BTR have also been concentrated (Tables 2.1).

2.3 Colonialism, Demographic Transitions and Initial Conditions in the Pre-conflict Phase The geographic spread of the Bodo community in the Northern Tract gives some idea of the scale of the political imagination that drove mass mobilization which occurred in the course of recent history. Bodos themselves are not a homogenous group, with many having converted to Christianity during the colonial period, others joining the ‘Brahma’ Hindu sect from the early twentieth century, and yet others practicing the

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traditional ‘Bathou’ faith often alongside Hinduism (see Chap. 6 for a case study on the role of traditional institutions for resolving a domestic violence case).xvi In spite of differences on methods to achieve self-determination, however, it was remarkable that these diverse groups were able to align around a notion of a unified ‘Bodo’ identity. What started as non-violent demand for socio-economic and political rights turned into a full blown movement for self-determination and autonomy with a section taking up arms to realize their demands. One important finding from the timelines being discussed below is that organized violence, as an instrument of securing political aims was a much later development. Since the early twentieth century and till around the late 1980s (for more than 50 years) the forms of protests did not necessarily translate into large-scale ethnic violence, nor did it lead to armed insurrection. In understanding the manner in which these diverse interests were aggregated, it is necessary to trace out the era before militant violence (and which is substantively missing from the literature cited earlier). As Endle’s account shows, Bodo settlements were scattered deep within the forest areas in the Bhutan foothills. The advent of colonialism fundamentally reordered the socio-economic and political fabric of the region of Western Assam that were to irrevocable consequences in and set the stage for future ethnic violence. Several changes were brought about in the land use patterns which rapidly transformed the demographic makeup of the region. These developments in the nineteenth century were to have severe consequences in the future. The presence of the Bengali Muslim, Adivasi and Nepali communities in Western Assam can be connected to the expansion of four major activities: Forest Clearance for Agriculture, Forest Clearance for Extraction of Timber (especially for railways) and the expansion of Tea Plantations. The entry of Bengali Muslims from the districts of East Bengal was connected to the necessities of revenue expansion from land settlement and agriculture.xvii Migration from Nepal was connected to the search for opportunities in agriculture, dairy farming, livestock rearing and cattle grazing, tea, rubber tapping and military service.xviii A portion of this migration was also towards the foothills of South Bhutan. The presence of the tribal communities such as Santhali, Khond, Oraon and Munda (and who are collectively called Adivasis or Tea Tribes in Assam), among many others from modern-day Chhattisgarh, Jharkhand, Orissa and West Bengal can be further attributed to three factors. The first was for the provision of labour in the rapidly expanding tea plantation economy across North Bengal and Assam. This was done through a mixed system of bonded labour, free labour and unaided free immigration labour.xix A second pattern of migration, which was very specific to Western Assam, was the forced dislocation of Santhalis as a consequence of the Great Santal Rebellion (Santal Hul) of 1855– 1856.xx They were settled in the fringes of then undivided Goalpara (which would also coincide with the forest tracts of the borderland). A third out-migration occurred as a result of famine in the Chotta Nagpur Region in the late 1890s.xxi Conditions for communities living in the Tea plantations of Assam and North Bengal were extremely precarious, with high rates of mortality, arising out of inhuman labour conditions and disease. This can be gauged by the fact that out of 84,915 immigrants who entered the Tea Districts between May 1863 and May 1866, over 35,165 had either died or

2.3 Colonialism, Demographic Transitions and Initial Conditions …

41

deserted.xxii Mortality rates documented by an Inquiry Commission in 1868 ranged from 137.6 per thousand to 556.6 per thousand.xxiii According to Udayon Mishra, the colonial regime’s preference for settled agriculture, which was practiced by ‘immigrants’ and more easily facilitated collection of land revenue, over the shifting cultivation practiced by Bodo tribals, meant that the land resources of the Bodos (and other plains tribals) did not necessarily receive the same degree of protection as the areas occupied by the hill tribes.xxiv The policy towards the hill tribes (such as the Nagas, Lushai, Khasis, Jantias, Garos, among many others) were governed by various frontier regulations such as the Schedule Districts Act of 1874, The Frontier Tract Regulation of 1880 and the Bengal East Frontier Regulation of 1873.xxv These regulations (including the Inner Line system) essentially implied a minimal degree of interference in customary law and traditional modes of land ownership, with strict prohibitions on the settlement and purchase of land by outsiders. Elements of these policies were continued post-independence era through various mechanisms. For instance, institutions such as the Autonomous District Councils (ADCs) were provided to Karbi Anglong and North Cachar Hills (NC Hills) in the 1950s.xxvi Nagaland was created in 1963xxvii while the status of Union Territory was provided to Mizoram in 1972 and full-fledged statehood for Meghalaya in 1972.xxviii These former Hill Districts of Assam were detached through constitutional mechanisms (after prolong civil strife and agitation). The example set by earlier autonomy movements in the hill districts showed that administrative reorganization and even statehood could be secured and subsequently influence movements by the plains tribes. In contrast, the limited protection available through the Line System of 1920–21 in areas of the plains tribals was further weakened by the perceived failure of Chapter X of the Assam Land and Revenue Regulation 1886 (which was enacted in 1947).xxix These regulations enacted by the state to prevent land transfers to non-tribals in areas that were designated as Protected Tribal Belts and Blocks. Yet, many of the regulations were bypassed, due to the connivance of low-level revenue officials which led to several corrupt practices. These facilitated illegal acquisitions at the expense of the tribal communities. Of the 37 Tribal Blocks and Belts identified under Chapter X, in 1 year alone between 1973 and 1974, it was found that 2,000 hectares of patta land had changed ownership from tribals to ineligible non-tribals.xxx In addition to identifying the problem of land resources and migration, there is also a literature which delves into the ecological determinants of identity mobilization. Nel Vandekerckhove and Bert Suykens (2008) use the term tribal entrapment to explain the consequences of the colonial approach to forestry in Assam, which continued through post-Independence India.xxxi They attribute the gradual loss of rights over the forest areas for the Bodos through laws such as: The Bengal Forest Act of 1865, the Assam Forest Regulation Act of 1891, National Forest Policy 1952, Wildlife Protection Act 1972 and the Forest Conservation Act of 1980.xxxii The Bodo community, which historically enjoyed access to the forest areas, and whose traditional practices (such as shifting cultivation) were closely linked to life in the forest now became ‘ensnared

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by a strangling dichotomy of restrictive forestry structures, policies and processes, and the rising livelihood demands of an expanding population’.xxxiii Escaping this notion of entrapment and increasing access to resources that were historically open to community usage, in their view, were the central reasons for mass mobilization and violent confrontation with the state. Based on this framework, their study clearly outlined how the Manas Forest and Tea Gardens became contested in the struggle over forest and land resources, in the course of militancy. The work also provides insights into the manner in which these factors that transformed the movement into an inter-ethnic conflict. Yet, explanations that only account for the Bodo movement through the lens of migration and ecology do not allow for understanding transitions within the armed movement itself. Very little attention is drawn to the early phases, when political consciousness for the plains tribes was gradually built through social reform, education and linguistic preservation. By utilizing multiple sources, we construct a brief timeline of the long pre-conflict non-violent phase of the movement (Table 2.2).

2.4 The Politics of Demography and Pre-conditions for Violent Conflict The Assam Agitation between 1979 and 1985 that was led by the All Assam Students Union (AASU) represents a major turning point for the movement towards Bodo autonomy. The initial years of the AASU-led movement marked a temporary convergence between those attempting to forge a sub-nationalist ethnic Assamese identity and those political forces connected to defining the separateness of tribal identities. The problem of immigration into Assam was not a new one and was recognized as far back as the early census exercises conducted under colonial rule. It was also an issue that was detrimental to both pre-independence and post-independence electoral politics. Of all the communities, who had migrated into Assam under colonial rule, attention was specially drawn to immigration by Bengali Muslims from East Bengal. Subsequently in post-Independence, migration from the erstwhile East Pakistan (now Bangladesh) was always a consistent theme of the discourse.lvii The aftermath of the 1971 war further complicated this, with the entry of East Pakistani refugees into Assam (including a sizeable population of Bengali Hindus). The history of the Assam Agitation has been very extensively documented and it underwent several phases.lviii One of the primary demands of the Assam Agitation was the identification and deportation of ‘illegal immigrants’, particularly those who arrived after the creation of Bangladesh in 1971, which, the movement’s leaders pointed out, represented a burden borne disproportionately by Assam in contrast to the rest of India.lix In revisiting the period of 1979–1987, the Assam Agitation and Assam Accord lx that was signed in 1985, it can be said that the movement fundamentally restructured

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Table 2.2 Timeline of the non-violent phase of the Bodoland movement Timeline

Event/Process

Significance

Early twentieth century Social Reform movement by Gurudev Kalicharan Brahma

Movement popular among the educated youth led to the establishment of educational institutions, such as primary schools, cooperatives.xxxiv Also coincides with writings of followers being published in Bibar discussing issues of health, hygiene, relationship with neighbouring communitiesxxxv

Early twentieth century Movement of Christian Missionaries

Baptist and Catholic Missions develop schools, hospitals and leprosy homes in Bodo-dominated areas of colonial Assam in districts of Darrang and Goalparaxxxvi

1929

Gurudev Kalicharan Brahma submits the following demands to the Simon Commission: ‘(i) A separate electorate for the Bodo Kocharis. (ii) Creation of Bodo Regiment. (iii) Reservation of one seat for the Boros of Assam in the legislature. (iv)Provision of Boro representative in the councils as well as local boards of Goalpara and Dhubri. (v) Provision for free, and compulsory, primary education, and scholarship for Boro students. (vi) Reservation of executive posts in provincial services for educated Boros. (vii) The memorandum also opposed the transfer of Goalpara district from Assam to Bengal’xxxvii Assam Kachari Jubok Sanmilan raises questions on tribal identity and the problem of indignity. Submits a memorandum opposing tribals being counted as low-caste Hindus in the census: ‘for the latter do not receive them into their society, do not dine with them and are mostly unsympathetic with their ideas and aspiration’xxxviii

Memorandum to the Simon Commission

(continued)

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Table 2.2 (continued) Timeline

Event/Process

Significance

1929

Tenth Convention of the Assam Bodo Chattra Sanmilan in 1929

Decision to combat illiteracy and set up schools without waiting for government assistancexxxix

1931

Census of India

Identifies problems of migration and shrinking of cultivable land open to indigenous communitiesxl

1933

Formation of the Tribal League

Raises problems on implementation of the Assam Land and Revenue Act 1886 and demands for a separate territory for the Plains Tribals of Assam. Sends representatives to the Assam Legislative Assembly after, 1935 Government of India Act and advocates for recognition of a ‘tribal identity’, entry into temples, access to land and programmes for social upliftment through educationxli

1935

Government of India Act of 1935

Provides Plains Tribes a separate Constituency. Leaders of the Tribal League enter legislative politics and the Assam Legislative Assemblies of 1938 and 1939xlii

1941

Census Exercise in Assam in 1941 Plains Tribals are counted as a separate category and the Census is conducted on the basis of race, tribe and caste. Tribal League broadens definition of tribal identity as customs, rules and cultural practice, as opposed to religious practicexliii

1946

Tribal League Merges with Congress

Merger of the Tribal League with Congress and conversion of Tribal League into Tribal Sangha a socio-cultural movement. Results in no official representation of Plains Tribals in the State Assemblyxliv (continued)

sub-regional politics through three different ways. The first was that as a tool of agitation, it provided a successful template for mass mobilization and achieving political goals. This template went beyond simple non-cooperation. It involved the design of a total society-wide mobilization that in effect could shut down the state machinery and halt state-wide economic activities for a prolonged period of time. Second, the

2.4 The Politics of Demography and Pre-conditions for Violent Conflict

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Table 2.2 (continued) Timeline

Event/Process

Significance

1948

Enactment of Chapter X of the Assam Land and Revenue Act of 1886

The act recognizes Protected Belts and Blocks. It builds on a land policy of 1939. Key points included protection of grazing and forest reserves, eviction of those encroaching on these categories of land use, creation of prohibited areas for tribals, creating a land reserved for tribal population and settlement policy for indigenous communitiesxlv

1948–1951

Sharecroppers Movement

Agitation by landless peasants including Bodos and Rabhasxlvi

1951

The Immigrants (Expulsion from Assam) Act 13 February 1950

Results in out-migration of a number of Bengali Muslims into East Pakistan but a reverse flow of Bengali Hindus. In the 1951 census, there were 2,74,00 Bengalis from erstwhile East Pakistan Hindus Identifiedxlvii

1952

Formation of Bodo Sahitya Sabha The Bodo Sahitya Sabha (BSS) was created to protect and promote the Bodo literature, language and culture. It advocated for the use of Bodo language as a medium of instruction in schools. BSS also advocated for the development of the Bodo language through adoption of scripts. It launched the Roman Script Movement which culminated in mass mobilization of volunteers across Bodo areas in 1974. In 1975, negotiations between Central and State government and BSS led to adoption of Devnagri Script. BSS was also instrumental in the Bodo language as medium of instruction in primary, higher secondary, M.E. and high schoolsxlviii

1960

Official Language Act of 1960

Assamese is declared as the Official Language of the State and sparks unrest in tribal areas in both plains and hillsxlix

1967

Re-organization of the State of Assam on Federal Basis

The policy is announced by the then Prime Minister Indira Gandhil (continued)

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Table 2.2 (continued) Timeline

Event/Process

1967

Formation of the All Bodo Student Formation of ABSU and then Union (ABSU) and the Plains PTCA in February 1967.li The Tribal Council of Assam (PTCA) PTCA with ABSU support highlighted the problems related to land issues as well as linguistic preservation. Demanded a Union Territory for all plains tribals called Udyanchal. This was based on consolidating based on the existing distribution of Tribal Blocks at that timelii

Significance

1978

Assam Schedule Caste and the Scheduled Tribes Act, 1978

This is passed by the Janta Party Government in alliance with PTCA and recognizes reservations in government posts for tribal communitiesliii

1979

PTCA splits due to halt of Udyanchal Movement and PTCA (P) is formed

Creates a demand for Mishing Bodoland. Autonomy demands are temporarily subsumed with the beginning of Assam Agitationliv

1984

United Tribal Nationalist Liberation Front (UTNLF) is formed

Introduces a demand for the state of Tribal Land lv

1985–1988

Assam Accord is seen to exclude interest of tribal communities.

Formation of ABSU-Bodo People’s Action Committee (BPAC) and also All Assam Tribal Women’s Welfare Federation (AATWWF). Under leadership of Upendranath Brahma. On 2 March 1987, the demand for a ‘separate state’ of Bodoland is launched. A charter of 92 demands is submittedlvi

Assam Agitation was also youth-led, which forged new forms of leadership, outside of the realm of electoral politics (which until then was the dominant route to political power). Third, it provided a new set of conditions and social norms where successful mobilization could lead to the underlying cultural and societal order becoming more significant in peoples’ lives than formal political institutions.lxi With the breakdown of the state machinery, around the 1983 Assembly Elections, we also see in this time period incidents of mass killings such as the Gohpur and Nellie massacre that introduced a completely new dimension to the normative positioning of violence in the build-up of this informal order.lxii From the perspective of tribal leaders (both hills and plains) who had temporarily lent support to AASU, the problem of separateness became even more acute in the aftermath of the Assam Accord of 1985.

2.4 The Politics of Demography and Pre-conditions for Violent Conflict

47

It is also in this time period that we locate a particular logic that is recurrent across such Peace Accords. Regardless of attempting for a consensus in the text of an agreement, they do not adequately accommodate the new social forces that emerged in the conflict. These Peace Accords created conditions of exclusions or unfulfilled aspirations that incentivized post-Accord violence. Moreover, these Peace Accords themselves lead to vertical and horizontal splits, often within the negotiating parties. Sometimes differences emerged between those conducting the negotiations and the constituencies they seek to represent.lxiii The Assam Accord, though successful in bringing to the fore enhanced protections for Assamese identity and culture, as well as economic benefits, was interpreted as a major setback. It led to three distinct aftermaths. The first result was the political emergence and popularity of the United Liberation Front of Asom (ULFA) as an armed militant movement, which sought to establish a sovereign Assam reorganized on ideological lines.lxiv The resultant violence tore apart the social fabric and set the stage for militarization across the state. Second, the divergence between aims of the Asom Gana Parishad (AGP), a political party that emerged out of AASU, which came to power in the 1985 Assembly elections, and the leaders of ABSU.lxv Third, the divergence between the new AGP government of 1985 and leaders of the movements in the tribal hill districts of Karbi Anglong and North Cachar Hills (NC Hills).lxvi Both sets of divergence contributed to the preconditions for the emergence of a long phase of protracted armed violence and ethnic conflict in areas populated by plains and hill tribes. In considering the various demands for separate states after 1985, Monirul Hussain (1992) identifies the factors behind the emergence of these movements. The special character of these movements was that the definition of a separate identity did not imply the ‘repulsing of social, political and economic modernisation’.lxvii Rather the ‘increasing political mobilisation was mainly aimed at overcoming their socio-economic oppression’.lxviii The Assam Agitation by mobilizing solely around Assamese identity did not lead to a reworking of the structural inequities that the tribal communities sought to overcome. For instance, in 1988, it was found that more than 10,000 jobs in government service that were reserved for Scheduled Tribes and Scheduled Castes were not allocated.lxix Out of 267 faculty members employed in Guwahati University, only one seat was allocated to a member of the Schedule Tribes.lxx Writing about the situation of Bodo Medium Schools in 1992 the author states: The Bodo language attained the status of medium of instruction in primary and secondary schools after a long struggle. Though the Bodos succeeded in securing officially the rightful place for their language, their success was severely qualified by the pathetic plight of Bodo medium schools. Schools which accepted Bodo as medium of instruction have been facing severe discrimination from high-caste educational planners and administrators. Most Bodo schools are understaffed and ill equipped to meet the challenge of tribal education.lxxi

In terms of the text of the Assam Accord, interpretations on two sets of clauses became problematic. Clause 6 of the Accord which sought appropriate constitutional, legislative and administrative safeguards to be provided to ‘protect, preserve and promote the cultural, social and linguistic heritage of the Assamese people’.lxxii What

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constituted Assamese identity itself became contested. Another point of contention was Clause 10 which read: ‘It will be ensured that relevant laws for the prevention of encroachment of Government lands and lands in tribal belts and blocks are strictly enforced and unauthorized encroachers evicted as laid down under such laws’.lxxiii Given the increasing landlessness experienced by the tribal communities, many moved into forest areas and ironically became considered as encroachers.lxxiv It is to be noted that in that period nearly 600,000 acres of tribal land were appropriated for government projects.lxxv

2.5 The Movement for a Separate State of Bodoland and the First Agitation 1987–1993 The basis for expanding the scope of the Bodoland movement was already established by 1985. The geographical basis for the idea of an autonomous space was also getting well defined in terms of existing areas constituted by the protected Tribal Belt and Blocks. The original ABSU vision of the separate state of Bodoland was to consist of nearly 25,500 square kilometres to include 32 Tribal Belts and Blocks, approximately 200 tea plantations as well as Reserved and Unreserved Forests (see next chapter for aspects of Forest Governance).lxxvi This included areas contiguous with Bhutan on the Northern Bank of the Brahmaputra. In addition, a cultural revival marked by awareness on Bodo history and society was also taking place. By the 1987 the demand for the state of Bodoland by ABSU had a much wider acceptance and a more focused appeal, as opposed to the creation of a geographic unit composed of all the plains tribes. The 92-Point charter put forward set very clear objectives on the achievement of the state, the viability of the future territorial unit and its broad geographical boundaries.lxxvii The launch of the agitation in 1987 was therefore unprecedented and went beyond the earlier types of mobilizations (as was seen in the Language Movements in Bodo area). In essence, it involved utilizing the tactics of the Assam Agitation but with a much sharper focus on a very specific set of demands. Also to be noted is that the ABSU-led movement was not only supported by Bodos but also had support from a number of other ethnic groups living in the area.lxxviii It must be remembered that by virtue of being located immediately adjacent to West Bengal (after Serampore), the flows of goods and people into Assam and all the adjoining states are through Kokrajhar and its adjacent districts. The enforcement of bandhs and highway closures by ABSU had ripple effects across the region (and even into Bhutan which will be discussed subsequently). The intensity of the agitation which began in 1987 across Bodo-dominated areas can be gauged by the following numbers. One account states that between 1987 and 1993, there were 1783 h of Alternative 4 Days Bandh, 1151 h of All Assam Bandh, 84 h of Tribal Area Bandh, 48 h of Rail Roko Bandh and 48 h of National Highway Bandh.lxxix In addition, there were 79 instances of setting ablaze of buses, houses, trucks and oil tankers.lxxx In another account, we see that the area witnessed

2.5 The Movement for a Separate State of Bodoland and the First Agitation …

49

Fig. 2.1 The political map of the separate state demand of Boroland lxxxiv

753 incidents of damage to property, 269 incidents of bomb blasts, 438 incidents of police firing and 130 kidnappings between 1990 and 1991.lxxxvi The key critical juncture for our purposes was the response of the state to the intensity of agitation in Bodo-dominated areas that forced the leaders of ABSU to move underground. The government response was to call in state police and paramilitary forces as well as enforcement of the Terrorist and Disruptive Activities Prevention Act (TADA). Subsequently, in the course of the movement, more than 3,000 activists of ABSU-BPAC were imprisoned.lxxxii There was also extensive damage to the education system with several educational institutions closed. An interesting perspective was given by a respondent who mentioned that one of the reasons why ABS-BPAC signed onto the 1993 accord by the ABSU-BPAC was due to the adverse impacts of the movement on schooling, and recognition of the future consequences of this for the larger Bodoland movementlxxxiii (Fig. 2.1).

2.6 Territoriality, Governance and the Search for Peace in Bodoland The multi-ethnic fabric of the areas of Western Assam under consideration is in the process of healing and reconciling. While we have identified some of the important pre-conflict factors, it is extremely important to revisit the manner by which territoriality and identity are inherently linked. It is also important to point out that protracted negotiations that occurred parallel to the agitation to find a solution also formed an important backdrop in shaping the structures of territory and governance

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in Bodoland. An examination of the text of both 1993 and 2003 settlements indicates that the terms of negotiations were completely transformed in a decade (which can be attributed to the increased role played by the major armed organizations). The one trend that has been excluded by the studies referred to above is the incremental shift towards the Centre as a guarantor of the socio-economic, political and linguistic protections of the Bodo community. The BAC was supposed to be based on Act of the Assam Legislative Assembly and was a bilateral agreement between the ABSU/BPAC and State Government. The 2003 MoS was a tripartite agreement, with the Centre as a signatory. It also required a Constitutional Amendment to the Sixth Schedule through an Act of Parliament. The Sixth Schedule until then was extended only to the hill tribes and the creation of the Bodoland Territorial Council (BTC) was the first time that the institution was extended for plains tribes. Another dimension that is extremely relevant is that the post-2003 demarcation officially made the new autonomous districts of Baksa, Chirang, Kokrajhar and Udalguri contiguous with the international boundary shared with Bhutan. This implied that ethnic groups living close to the boundary now became informal mediators in the everyday international relations of the borderland region. This also had implications for Bhutan’s own border communities living just across the international boundary. The restructuring post-2003 added a new dimension to the manner in which bilateral relations were now conducted and the sub-regional security architecture that developed (see Chap. 7). In essence, the main demands in 1987 form a useful starting point to assess both agreements. In 1987, the demand included a) the formation of a separate state named Bodoland on the north bank of the Brahmaputra; b) establishment of autonomous district councils in the tribal-dominant areas on the south bank of the Brahmaputra; and c) incorporation of the Bodo Kacharis of Karbi Anglong in the Sixth Schedule of the Indian Constitution. While ratified by law, the BAC was rejected by all the major stakeholders in the movement. The BAC became an area which neither had boundaries nor did representatives get elected to the BAC. Under Clause 3B, the Executive Council constituted by the BAC would have no legislative powers, but rather the ability to only ‘make bye-laws, rules and orders for application within the BAC area on the subjects enumerated’.lxxxv Land and revenue was not included in the list of subjects and under Clause 5 the BAC Executive Council only had powers of appointment for Class III and Class IV employees.lxxxvi There was no specific programme for central developmental assistance and financial arrangements were left open ended. The issue of language was left unaddressed and the text only shows that Bodo would possibly be a medium of instruction in official correspondence within the BAC area.lxxxvii The extension of the Sixth Schedule for Bodos living in Karbi Anglong was dropped altogether. A major drawback that led to the unpopularity of the Accord was the territorial question. In 1993, ABSU/BPAC provided the initial principles around which villages could be included or excluded within the jurisdiction of the BAC. In terms of negotiations, this represented a substantial reduction in the original territorial demand. Clause 3A of BAC Accord stated:

2.6 Territoriality, Governance and the Search for Peace in Bodoland

51

There shall be formed, by an Act of Assam Legislative Assembly, a Bodoland Autonomous Council (BAC) within the State of Assam comprising contiguous geographical areas between river Sankosh and Mazbat/river Pasnoi. The land records authority of the State will scrutinize the list of villages furnished by ABSU/BPAC having 50% and more of tribal population which shall be included in the BAC. For the purpose of providing a contiguous area, ever the villages having less than 50% tribal population shall be included. BAC will also include Reserve Forests as per the guidelines laid by Ministry of Defence and Ministry of Environment and Forests, Government of India, not otherwise required by the Government for manning the international border and tea gardens located completely within the BAC contiguous area.lxxxviii

According to S.J. George (1994), despite the stated rules outlined in the BAC, the net result of the envisaged autonomous area did not impinge on the territoriality of the state. Thus, an incomplete form of autonomy was envisaged, whereby Unlike autonomous district councils in the two hill districts, Karbi Anglong and North Cachar, whose authority is coterminous with the district boundaries, the proposed BAC was to cover seven districts (Dhubri, Kokrajhar, Bongaigaon Barpeta, Nalbari, Kamrup, and Darrang) but leaving intact the existing political and administrative structures.lxxxix

Further the jurisdiction of the BAC excluded a ten-kilometre-wide belt adjacent to the international boundary with Bhutan. In its entirety, the BAC covered an area of 5,186 square kilometres.xc Of the 4,635 villages identified, 2,750 villages were given while 515 ‘contentious villages’ remained disputed, which was to mark the southern boundary.xci It is this demarcation that triggered the 1993 conflict (see below). The 1993 BAC Accord though setting the basis for the 2003 arrangements, in terms of the principle of demarcation, was rejected by a majority of Bodo leader, and set the conditions for emergence of two major armed organizations BLTF (Bodoland Liberation Tigers Force) and NDFB (National Democratic Front of Boroland). We also see cycle of violence that lasted nearly 10 years. By 1999 after the onset of the Kargil War, we see a mutual outreach between the BLTF and Central Government (with ABSU playing some role as a mediator).xcii This led to a Ceasefire and protracted negotiations, which ultimately resulted in the signing of the tripartite Memorandum of Settlement (MoS) of 10 February 2003.xciii The MoS established the Bodoland Territorial Council (BTC) and extended the Sixth Schedule of the Indian Constitution (Provision as to the Administration of Tribal Areas in the States of Assam, Meghalaya, Tripura and Mizoram).xciv The 2003 MoS was qualitatively different from the BAC Accord as it partially resolved the territorial question. Under Paragraph 2 of the MoS, an Autonomous Self-Governing Body was to be created known as the Bodoland Territorial Council. Constitutional protection under the Sixth Schedule was to be provided to the Autonomous Body whose main role ‘was to fulfil economic, educational and linguistic aspirations and preservations of the land rights, socio-cultural and ethnic identity of the Bodos; and to speed up infrastructure development of the BTC area’.xcv Under Paragraph 5 Legislative, Executive, Administrative Powers were granted in subjects transferred to it (although Laws made by the BTC needed the Governor’s Assent).xcvi Paragraph 5.3 provided control over officers and staff for the delegated subjects.xcvii Under Paragraph 4 the MoS transferred the functions of the Panchayat

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Raj Institutions (PRIs) to the Council and dissolved the PRI system.xcviii This also set the basis for emergence of the Village Council Development Committees (VCDC) that become central to understanding the fragile nature of governance in the area subsequently. In Paragraph 8, the Government of India (GoI) agreed to ‘consider sympathetically the inclusion of Bodo Kacharis living in Karbi Anglong and NC Hills Autonomous Council Area in the ST(Hills) List of Assam’ while in Paragraph 9 the GoI assented to ‘consider favourably the inclusion of Bodo in Devnagri Script in the Eight Schedule of the Indian Constitution’.xcix Another major outcome of the 2003 MoS was the reconfiguration of the territorial concept in Paragraph 3.1 whereby areas and villages covered in the negotiations were to be divided into four contiguous districts within 6 months.c These districts covering 3,082 villages are the modern-day districts of Baksa, Chirang, Kokrajhar and Udalguri.ci

2.7 Emergence of Armed Organizations and the Rise of Militancy 2.7.1 Patterns of Armed Violence The origin of the armed organizations (who emerged in the course of the demand for a separate state for Bodoland) and the politics they stood for were closely linked to how the leadership and general combatants of these organizations perceived the ‘nationality’ question. Was the purpose of politics securing autonomy within the existing system or was it to define an ethnic homeland? Was it complete autonomy in terms of a separate state or was the question of self-determination one of sovereignty? The near absence of detailed narratives of those who actually chose to participate in armed organizations always leaves room for uncertainty in the explanations on the causes of the conflict discussed thus far. It also questions long-held assumptions about the determinants of violence itself. Very little is actually known about the decisionmaking process that led to the use of force (which in many cases did involve targeted violence). We also don’t know, for instance, whether leaders completely anticipated the exact consequences of their decisions. Lastly, to what extent was violence localized. If we were to disaggregate overall patterns of violence, to what extent could one distinguish between strategic uses of violence and violence that was highly localized (and mainly emanating from interpersonal factors)? Moreover, at what point do these forms of violence overlap? We see a number of interlocking layers of violence: (i) violence that was directed towards the law and order machinery of the state government; (ii) violence against federal security forces (including the Indian Army) once large-scale counterinsurgency campaigns were launched post-1990; (iii) acts of violence committed by security forces in the course of counterinsurgency; (iv) strategic violence that was directed towards other ethnic communities; (v) localized violence due to interpersonal disputes; (vi) violence that was internal (through the

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social and policing functions) and (vii) inter-group violence as a result of ideological differences aims of the movement. The origins of the armed element can be partially traced to the establishment of the ABSU-Bodo Volunteer Force (BVF) after 1987. BVF was created as an armed vanguard for the ABSU. Declared as an underground organization, it officially disbanded in 1993. The work of Sucheta Sen Chaudhuri (2004) provides some rich and unknown details of the BVF, especially the role of women recruited as nurses for the force. Their role is specifically brought out in the text below: Some Bodo girls were given nursing training by doctors in different primary health centers. During 1989–1990, not less than 30 to 40 Girls from each village council received nursing training. Out of 170 informants of Darrang district, there were around twenty women who said that they received nursing training. The informants of Darrang district who received nursing training stayed at Kapurpura village of Darrang for three months in 1989. The training was based on courses, which are actually given to the nurses. The course was as follows: (i) First Aid: learning to bandage on different parts of the body, stop bleeding, take out bullets from any parts of the body, operation in case of bullet injuries. (ii) Pharmaceutical training was also provided. They were taught to identify the causes of disease, nature of treatment and the names of medicines used for diseases like gastroenteritis, diarrhea, fever, viral infection, acute allergy, bedsore, malaria, general weakness and jaundice. (iii) Training was given to handle burn cases. (iv) Training was provided to manage the patients suffering from psychological disorders such as insomnia. (v) Advance first aid training was given on different types of bullet injuries and proper treatment of wounds in case of profuse bleeding, removal of bullets and treatment. The whole management of operation, treatment of old bullet injuries, fractures, sprain bleeding, unconsciousness, vomiting, acute pain, burning, muscular pain, glanduleria, etc. was taught. Use and function of different surgical instruments, techniques of pushing saline water, etc. was also taught. (vi) Basic knowledge of human anatomy was also taught to them. They held practical classes and they had to nurse a patient of acute burn and other patients during their stay at Kapurpara.cii

The training was closely linked with the political aims of the movement. As explained by the author: The girls attended the classes regularly. The classes were held on topics like ‘Women’s role in the ‘Bodo National Movement’, ‘Aims and Objectives of Bodo Movement’, and ‘Women Role in Different Phases of Movement’. They were taught to explain the ABSU’s role to the children as well. The aim such a training was to help the ABSU and ABSU VF activists in time of need. The trained girls were instructed, that wherever and whenever they would come to know about injured persons and activists, they must nurse them. The girls proved very helpful during the movement. One of the AATWWF leaders, who was the head of the nursing team in Kokrajhar, told that during the peak years of the movement of (1989–1991) most doctors left their jobs and the primary health centers of Bodo dominated areas were deserted. Even medicine was not available. At that time the trained girls were helpful to the villagers. Apart from nursing the activists they performed duties of doctors. In the village these girls were doctors cum pharmacists. Some of them showed considerable efficiency in nursing activities including operations. From 1989 onwards girls began to receive training in the use of firearms. Such training was given in the remote villages of Bodo dominated areas. The aim of such training was to provide some measures for their safety. There was no plan to bring them to armed action. But they were told that of the situation so demanded they would be called in. Most of the time the ABSU VF moved in small groups. It was the duty of AATWWF members to arrange food or water for them. Sometimes the AATWWF members went to hideouts to prepare food for them. The VF members entered villages during the

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2 The Making of Violent Spaces … night. They spread themselves to various houses at the time of food for the advantage of logistics as well as to avoid being arrested together.ciii

Another group of youth, centred especially around modern-day Udalguri, constituted the Bodo Security Force (BdSF). While the organizations intersected at their point of origin, they reflected two major streams of thought on the question of selfdetermination. BVF subsequently became the Bodoland Liberation Tigers Force (BLTF) that consisted of BVF cadres opposed to the 1993 Accord.civ They were discontented at the restricted autonomy under the BAC and broke away. They aimed for a separate state. BdSF renamed itself as the National Democratic Liberation Front of Boroland (NDFB) and chose to fight for sovereignty. Both organizations developed formidable combat capabilities and financial resources. NDFB especially traversed a wide geographical landscape and their area of operations spread not only across several districts of Assam but also the adjacent states. The group also established networks in adjoining countries such as Bangladesh,cv Bhutan,cvi Myanmarcvii and Nepal.cviii There was a long spell of internecine violence between NDFB and BLTF arising out of competition for territorial control and expansion of their political programmes. NDFB itself split into various factions after a Ceasefire in 2005.cix By 2003 BLTF had disbanded after joining the peace process and became a signatory to the MoS creating the BTC. Many members of the BLTF then shifted into electoral politics and established the Bodoland Peoples’ Progressive Front (BPPF).cx Eventually, after a series of re-alignments, the Bodoland People’s Front (BPF) came to form the majority in the BTC and remained in power till 2020.cxi Directly, the militancy and the countermeasures used by the state caused fatalities and injuries among members of armed organizations, civilians and security forces. Protracted forced displacement and collapse of public services were indirect consequences which caused immense suffering but do not find place in existing statistics of 600 500 400 300 200 100 0

Arunachal Pradesh

Assam

Manipur

Meghalya

Mizoram

Nagaland

Tripura

Fig. 2.2 Pattern of 11,689 fatalities in militant violence in seven states of Northeast India (2000– 2019)cxii

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600 500 400 300 200 100 0

Civilians

Security Forces

Suspected members of NSAG

Not Specified

Fig. 2.3 Pattern of 8,327 fatalities due to militant violence in Assamcxiii

350 300 250 200 150 100 50 0 1992

1993 Civilians

1994

1995

1996

Security Forces

1997

1998

1999

2000

2001

Suspected Members of NSAGs

Fig. 2.4 Pattern of 1,804 fatalities in militant violence in the Post-1993 BAC Accordcxiv

violence. In order to provide some context of the scale of direct aggregated statistics on fatalities in the years of militancy, some data is presented below. Five types of statistical data are provided in order to show the historical context of the militant violence: (i) fatalities across seven states that constitute what is termed as ‘northeast’: Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland and Tripura; (ii) overall fatalities in the State of Assam from 1992 to 2020; (iii)

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90 80 70 60 50 40 30 20 10 0

Baksa

Chirang

Kokrajhar

Udalguri

Fig. 2.5 Injuries due to explosions, arrests and surrenders 2002–2020 in BTADcxv

Analysis of Injuries Due to Explosives, Surrenders and Arrests in BTAD 2000-2020 Udalguri

Kokrajhar

Chirang

Baksa 0

500

1000 Arrests

Surrender

1500

2000

2500

3000

Injury VicƟms[Explosive]

Fig. 2.6 Analysis of injuries due to explosives, surrenders and arrests in BTAD 2000–2020

fatalities due to militancy connected to Bodoland movement between 1992 and 2000; (iv) fatalities between 2000 and 2020 in BTAD (to specially assess post-2003 militant violence) and (v) injuries from explosions, numbers of surrendered militants and arrests occurring in BTAD since 2000 (See Figs. 2.2, 2.3, 2.4, 2.5 and 2.6). The singular trend that is visible is an overall decline in militancy-related casualties since 2015 across all states, a trend also reflected in Bodoland.

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2.7.2 Armed Organizations: A Sociological Understanding An examination of the armed organizations, purely through a security-oriented lens, excludes their sociological function. Being deeply embedded in a dense network of social relations enabled survival of the organizations and the individual combatants. Integration into the social structure of the community also enabled a wider reach of their ideological stance. They also performed judicial functions, normative functions (of enforcing moral behaviour) and protective functions (as armed custodians of the community). There were distinct causal factors behind the rise of these organizational forms, which also brought with them methodologies which they sought to give a concrete shape to their ideas and territorial imaginations. At the community level, in the area of study (which was till 2003 a part of Kokrajhar District), a fundamental change in social relations occurred with the advent of militancy. As a respondent who had lived through the years said: ‘people began to hate whatever was anti-social and a threat to the community’.cxvi Internal violence aimed at creating a new moral fabric and the creation of a social order became a functional role for all armed organizations. Names of all the militant organizations have been coded throughout the primary narratives in this book from this point onwards, due to the sensitivity of the information presented. As stated by a respondent: When the movement was spearheaded by the militant organizations its violent nature had implications on the society. For instance, the phenomenon of “dyna” (practitioner of black magic or sorcery) existed even before the movement started in 1987. But earlier, there were no incidences or records where a person suspected of practicing black magic was killed. The mechanisms of dealing with the issue of “Dyna” did exist in the society. But it did not include capital punishment. After the agitation it was somewhat legitimized to kill a “Dyna” from the society. Feelings began to develop into people’s mind that whatever was anti community should be finished off.cxvii

In another instance, punishment was meted out to persons for collecting money on behalf of a group decades ago: Some persons who were staying in the relief camp (created after the 1998 violence) were once tortured by the group VXYZV and later killed. This group extorted some money from a merchant in the area. The merchant was a regular “tax” payer to the VXYZV but that year when he was served a demand letter for the second time, he grew concerned and contacted the VXYZV to check if it was really them asking for the money. He had already given a certain amount of money to the extortionists who did not realise that they had been identified by someone who accompanied the merchant to hand over the cash. The next day the militants appeared in the camp and ordered the people to hand over the imposters to them. They were taken to some village where they were tortured to death and were buried. The relief supplies were not adequate and there was no work available from which people could get any cash. This group thus came up with the idea and forced a person to write the extortion letter. A person from the group narrowly escaped as he was late on the day of handing over the money. Since there was huge crisis and lack of opportunities to work, they must have taken to such action.cxviii

Yet, the life sketch of an individual R killed in the same incident above shows individuals caught up in a set of events induced by the conflict that were well beyond

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their control. In most cases, the suffering and the burden on survivors extended throughout most of their lifetime and across generations: My husband R was a cultivator and we were slowly becoming prosperous because of his hard work. After our house in Milon was destroyed in the conflict of 1996, we fled to the village where my father-in-law had a big plot of land and was serving as the headman. We tried to return to Milon when hostilities ceased but the conflict of 1998 again forced us to flee and we never returned again. During the conflict, announcements were made saying that people who did not come to the relief camp would not be entitled for the relief materials and compensation. So, while I went to live with the in-laws, my husband R went back to stay in the relief camp to avail the compensation. While he was in the relief camp we were told that he aligned with some other men from the relief camp and served extortion notices to the nontribal merchant living in Sudempur. When the militants discovered that they were taking the fake identity of the group, they apprehended and killed them. We could never accept the fact that he could have committed such a crime, we know that he was a simple and hardworking man who was totally illiterate. After the incident, I lived for few years in the land allocated by my father in-law. By the next year I returned to my parent’s house along with her three children. That year I went out to work as a house maid leaving my sons with my parents. The following year I returned to build a house of my own and lived with my three sons. I kept the family by going for daily wage work for which I would get Rupees 30 a day. Since I could not afford to send her children to school, I put them to work as cowherds. This also reduced my burden to feed the children. I struggled alone; many times, I would go to the forest to collect firewood for sale. Two years ago, I was diagnosed with tuberculosis. I got free medicines from Sudempur SD and got cured. My struggle has now eased as my three sons have migrated to different states (Kerala, Tamil Nadu and Andhra Pradesh) to earn. I am now freed of doing daily wage labour. With the money my sons send, I have decided to build a new house.cxix

In a situation, where there was a large presence of individuals with weapons, misperceptions could be lethal. A killing attributed to the RSTY, a rival group of VXYZV. A respondent recollects: Sometime before 2003, a young boy from a village was abducted by the militants as he was walking on the road towards his village. The young boy had come to the village for vacation. He had stayed in the house of a relative in Kokrajhar to pursue his studies. The villagers suspect that the young boy was killed because he was dressed in good clothes and wearing a wrist watch.cxx

It is this de-personalization of the victims and killing at close quarters that make peacebuilding at the individual level, problematic. An account from a survivor from the 23rd December 2014 massacre which occurred across Sonitpur, Biswanath Chariali, Kokrajhar and Chirang Districts (which is the subject of Chap. 8) provides a detailed first-person account of the nature of this coordinated killing (where overall 82 persons were killed overnight): It was 4.00 pm on Tuesday. Some villagers were returning from the hills after collecting hay and firewood. Some were threshing paddy in their courtyards. Maitulu Bosti, on the AssamArunachal border, is around 30 km from Biswanath Chariali. I was talking to a friend near my house when we spotted a group of people descending from the Arunachal hills. They were around 20/25 men, all but one, dressed in army fatigues. The civilian accompanying them was a Santhali. He was apparently brought along as a guide to show them the route. The group stopped at the entrance of a house. They were whispering something among

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themselves, which we could not make out. All the people had sophisticated weapons with them. A couple of them inquired if there was anyone in the house. When one of the owners of the house came out, they asked for some water. The owner a middle-aged lady, brought them a jar of water which was shared by a group. Though initially I thought that they were army men, I had a hunch that something was fishy. Immediately after drinking the water, they got into combat mode and shot dead the Santhali who they brought along with them. Then they opened indiscriminate firing. As they opened fire, I ran into the fields and took cover amid the tall bushes. Perhaps they did not notice me as I was 200 meters away from them. There were other villagers moving around……all ran helter-skelter as the shooting spree continued. I could see some of the cadres barging into houses and shooting at the occupants - women, infants alike. They did not look at anyone’s face…they just went killing one after another. Those who could flee, saved themselves. Many were left wounded. They even gunned down villagers who were returning home from the hill side. Those who were threshing paddy were shot down from point blank range. The gunshots boomed for over 45 min then, there was silence. They left after that.cxxi

2.8 Beyond Militant Violence: Humanitarian Crises and Forced Displacement Within the conflict, which itself is composed of thousands of discrete events and decisions, militant violence is only a part of the overall burden. The knowledge on their sociological role is extremely limited, but it can be stated that in terms of importance, it possibly matched the military component. By their very nature, these organizations were embedded within social structures. Their military operations did not necessarily involve capturing and holding well-fortified military outposts. In fact, the mutability of their organizational frameworks were geared towards de-territorialized forms of functioning. The territorial objectives while providing a singular focus on concrete achievable aims could only be secured by controlling a more metaphysical terrain where individualism would be subsumed into the ‘community’. This partially accounts for the resilience of the major armed organizations who were able to sustain continuous casualties (and were still able to recruit) over the entire timeline of the conflict (despite the military setback in Bhutan: see Chap. 7). This focus on shaping societal control also meant that violence directed against civilians occurred as a result of localized and highly strategic calculations that far outweighed attacks against the security forces who were brought in from outside. ‘Military’ objectives were shaped by strategic choices that actually extended over a much wider time horizon than is normally thought. In fact, one key characteristic of the armed organizations is that they did not go for an open-ended revolution, whereby the state is complete overthrown. Rather, by framing territorial objectives (even if aimed at sovereignty) they were able to demarcate their objectives when it came to formal negotiations. This territorial demarcation though came with the recurrent risk of armed action to secure these aims. With the increasing availability of sophisticated weapons, ethnic tensions thus erupted and assumed proportions that were never seen earlier. Between 1993 and 2015, in addition to militant violence directed against state forces, we

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see cyclical recurrence of ethnic violence, massacres and forced displacement. The magnitude of this forced displacement is not captured in the SATP data cited earlier. The core content of the book especially deals with the nature of this protracted forced displacement and its long-term consequences. The scale of displacement can be seen by the recurrence of humanitarian crises that punctuated the low-intensity violence discussed earlier. Some of the past crises are summarized below: • In September and October 1993, riots between the Bengali Muslim community and Bodos occurred, which led to the fleeing of about 30,000 persons into relief camps, and the death of 19 persons.cxxii • In May 1994, riots again broke out between Bodos and Bengali Muslims in Kokrajhar, where 22 people were killed and several thousand were displaced.cxxiii • In July 1994, violence broke out between Bengali Muslims and Bodos across seven districts of the North Bank of Brahmaputra claiming over 100 lives. In an incident at Bashbari, near Manas Wildlife Sanctuary, 68 people were killed and more than 70,000 displaced.cxxiv • In May 1996, more than 200 people were killed and over 200,000 displaced in widespread clashes between Bodos and Santhals in Kokrajhar and Bongaigaon Districts, among them both Adivasis and Bodos.cxxv • Several hundred were estimated to be killed in a series of fresh clashes between Bodos and Santhals between May and September 1998 and nearly 80,000 were displaced.cxxvii • Between August and October 2008, an estimated 70 people were killed in clashes between Bengali Muslims and Bodo in Udalguri and Darrang. Over 100,000 people were displaced.cxxvii • Between July and August 2012 riots between Bodos and Bengali Muslims broke out across Baksa, Chirang, Kokrajhar, Udalguri and Dhubri, leading to more than 110 lives lost and nearly 500,000 being displaced.cxxviii • In December 2014, violence between Bodos and Adivasis in the aftermath of a massacre of 66 Adivasis by militants, across Sonitpur, Chirang and Kokrajhar, led to the displacement of more than 300,000 persons.cxxix It would also be problematic to conceptualize the direction of violence as leaning either towards sudden intense outbursts or protracted low intensity violence. What about the status of people returning after displacement? It was estimated that after the clashes of 1996 and 1998, as late as 2003, there were 47,465 people still living in Relief Camps in Kokrajhar sub-division and 101,660 persons in Gossaigaon subdivision.cxxx In terms of food rations, the situation was described as thus: ‘In the name of relief, district administration is providing the Adivasi refugees only rice for ten days in a month—600 grams for each adult and 400 grams for each child’.cxxxi Preventable deaths due to malnutrition, communicable and non-communicable diseases in the camps were overwhelming and the numbers remain unknown to this day. None of the recent works that were cited specific to Bodoland actually analysed these community impacts, thus overlooking the depth of social suffering and underestimating the deeper and more long-term consequences. The qualitative

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data that form the basis for the chapters of the book also shows that the ordinary people’s thoughts and actions were an outcome of a distinct socialization process. It resulted in an alteration of the individual psyche, where the abstract notions of a living space or homeland were seemingly actualized through individual or collective acts of violence. In most instances, this was directed against identity groups who were themselves equally destitute and deprived of their rights. The incident below, involving a woman resident of a relief camp (post-1996 conflict) in the study area, also shows how situations could change so rapidly on a seemingly normal day well after the episode of displacement. It also shows a typical incident which would go unrecorded in any statistical analysis related to the conflict: One day my husband had food in the morning but there was no food left for the rest of the family members. He decided to go out for work that day and told us to go to the tea shop to have tea and something to eat. He also told me to wait for him till he returns from work. While he was entering the mini bus, there were some young men of the other community in the bus. I was about to enter the tea shop when I heard the scream of my husband. They had pushed him out of the bus. He fell down on the road. As he fell down, a vehicle that was coming behind the mini bus hit him. I saw he was badly injured. The police came to beat the drivers and the mini bus helper. The police also seized the vehicle by which he was crushed and also told the vehicle owner to take me and my husband to the police station. When we went to the police station, my husband was given some medicines and the vehicle owner took the responsibility to give the treatment to my husband. He also took us to a hospital in Kokrajhar. I do not know which hospital exactly. This was on a Sunday evening in Kokrajhar. When we reached Kokrajhar it was dark. He got admitted in the hospital. We stayed for two days in the hospital. That was Sunday night and Monday whole day and on Tuesday morning he passed away. He was taken to cemetery in Kokrajhar and buried there. I was given Rupees 800 for a short ritual for my husband by the vehicle owner who promised me some more money to fulfil the other rituals. But after returning to the relief camp no one helped me to go and collect the money from the vehicle owner.cxxxii

The study area situated in the Indo-Bhutan border was especially affected by the crises of 1993–1994, 1996, 1998 and 2014 (apart from having witnessed militant violence in the years between). Of these, the 1996, 1998 and 2014 conflicts affected the area intensely, and it is those impacts that were recorded in the course of the book. In the course of the conflict, the forest tracts along the Indo-Bhutan border became extremely important as an area for seeking refuge: both for the militants and those who were permanently displaced. It also became a site for a territorial contestation between the major signatories that eventually led to the collapse of the BAC Accord and the 1993–1994 outflow of the Bengali Muslim community from the forest villages near the boundary. The cycle of violence also engendered competing imaginations of territorial claims. Apart from BVF, NDFB and BLTF, two other sets of organizations are important. The first is the Kamatapur Liberation Organization (KLO) which is currently active and seeking a territorial claim for the Koch-Rajbongshi community.cxxxiii The community does not have Scheduled Tribe (ST) status in the current BTC and is a grievance that taken up the All Koch Rajbongshi Student Union (AKRSU) and other related community-based organizations. The territorial claim spans North Bengal and parts of modern BTAD. The group essentially seeks to recreate the territory of the former Koch Kingdoms (albeit in a modern form). The KLO sought refuge

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inside Bhutan in the 1990s (which will be discussed in Chap. 7). The second are the Adivasi armed organizations, which are currently on ceasefire with the state and central government (and who were functioning in both Upper and Lower Assam). The major groups are the Adivasi Cobra Militant Army (ACMA), All Adivasi National Liberation Army (ANLA), Birsa Commando Force (BCF), Santhal Liberation Tigers (SLT), Adivasi People’s Army (APA), Adivasi Security Force (ACF) and All Assam Adivasi Suraksha Samiti (AASS).cxxxiv

2.9 Learning the Language of Guns: A Commander’s Story (1996–2016) It is very difficult to attribute the root causes of the 1996 conflagration between the Adivasi and Bodo communities. Multiple interpretations of the proximate cause exist. There is some agreement that both communities shared responsibility for the uncontrolled violence that emerged in the course of the riots. One structural cause was the emergence of a possible claim of an Adivasi Santhali homeland being established between the Sankosh and Bhur Rivers before 1996 and a spurt of settlements in that area. 1996 marked a possible point of rupture for the relations between the Santhali community and Bodos. Both tribal communities were at the margins of the colonial state and shared a common legacy of discrimination and deprivation. Community relations were also amicable as can be seen in the narrative below. In 1998, when those displaced in 1996, primarily Adivasi, began to return home, they were targeted once again. The aftermath of this violent upheaval also saw the emergence of militant groups among the Adivasi community. In August 2006, more than 54,700 people, mostly Santhals and Oraon, were still living in these Internally Displaced Persons (IDP) camps.cxxxv These inhabitants were unable to secure much assistance from the state, whether at the central, state or council level. In many instances, their rehabilitation is deemed impossible as it would imply a legitimisation of encroachment of forest lands, as their settlements are not officially classified either as revenue villages or recognized forest villages. Basen Murmu (name changed) is the commander of a battalion of the DEFG, an armed militant group of the Adivasi community. He is from a village near Milon and was 22 years old when the 1996 conflict broke out. Their village was burnt down and his family lost their home, crops and everything they owned and was driven to the Relief Camp. He went on to gather and join other young men to form an armed militant group to protect the Adivasi relief camps from attacks by the VXYZV militants belonging to the Bodo community. He was on the run for 5 years— organizing, attacking, escaping and hiding in jungles. In 1999, a personal tragedy struck as his 6-year-old son died from an illness while he himself was hiding in the jungle. After fighting for 5 years, the group signed a ceasefire pact with the Indian government in 2001. He continued living in the relief camp and his family returned to their village ten years after they fled. Since then he lives in the village and is a

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farmer though he is still the commander of his battalion awaiting a settlement with the government. He is currently championing the cause of Voters Party International, a group/‘party’ which is supposedly fighting for political reforms in the country but with dubious and controversial credentials. Excerpts from his narrative is reproduced below: Before the Bodo-Adivasi conflict, I had even helped VXYZV people and was like a part of them. They used to come to our house and we would give them food and shelter and even help them hide their weapons when they were being chased by security forces. Both Bodos and Adivasis were really close but we had absolutely no warning that we would be attacked. On the 15 May 1996, violence broke out and we were driven out of our homes into camps. I was 22 years and felt that we needed to protect ourselves from attacks from VXYZV. On 30th June 1996, I took off for Srirampur and on 7th July 1996, DEFG was formed with a handful of boys there. We attacked a local police station and snatched away some rifles. Like this, we also attacked some others and got weapons and thus armed ourselves. Another group of Adivasis called RFBG was formed earlier before us. They were formed before the 1996 conflict but were unarmed and mainly for demanding a separate land for the Adivasis. But they failed to protect the community during the conflict. I was also part of another organisation called KUJM but they were also unarmed. We felt that all these would not do and so decided to make a new organisation and use weapons. The other groups could not protect our people and only became active later. I had learnt survival and defense skills in my youth from the month-long training camps for students run by a paramilitary force. Also, I had an uncle who was a policeman. While I would visit during holidays, he would show me the.303 rifle and how to hold it, load the cartridge, point the gun etc. That’s how I knew a bit about guns and this became useful later on. But it (being a militant) was extremely risky and we were in danger everywhere. We could not live inside the relief camps because the security forces were out to catch us. We could not go deep into the jungles because the VXYZV was there. So, we had to keep moving from place to place. We organised into small groups to guard the relief camps from attacks. We kept one gun and a group of 15–20 young boys would be guarding with bows and arrows. If we had not been formed, our entire community would most probably would have been killed or forced to move elsewhere. Conditions were extremely terrible because people were not allowed out of the camp even for short distances. When we started guarding our camps, we managed to keep VXYZV away for a short while and our people could move out a bit. Our group signed a ceasefire agreement in 2001 with a demand for ST (Scheduled Tribe) status and proper rehabilitation. We get Rupees 3,000 a month as living allowance for each of our cadres and every six months, we have to sit with the government and renew our ceasefire term agreement. They keep telling us to be patient.cxxxvi

2.10 Conclusion The MoS of 2003 was considered only partially successful as groups such as the ABSU and various NDFB factions did not sign onto the accord. The BTR Accord of 2020 is significant as it is a negotiated settlement, involving all the major stakeholders. Further, the Accord embodies a distinctive model that contradicts certain assumptions made by recent scholarship that has emerged on the dynamics experienced in the BTAD. In other words, most of the recent literature utilized rationalist lenses, and assumed that the intra-movement differences, which defined the extreme violence experienced in the region, were fixed and permanent. Furthermore, they assumed

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that these differences could not be bridged, as the fault lines between these political organizations had spanned generations and encompassed nearly three decades of inter-organizational violence. None of the works also address community-based efforts for peace and reconciliation between the various ethnic groups. The three accords in their totality can be seen as important milestones in the overall movement, with each generation of peacebuilding, leading to new fractures and newer institutional configurations as a response to violence. The 2020 Accord, however, has gone a step further, in its stated intent to permanently delineate or reconcile a geographical or territorial configuration, to an identity claim i.e. recognition and protection of the Bodo tribal identity (both inside and outside the stated territorial limits of the new Bodo Territorial Region). It was disjuncture of territory and identity combined with severe underdevelopment that provided some basis for systemic grievances and organized violence that punctuated the various inter-accord years. The 2020 settlement tentatively attempts to providing a pathway on the question of carving out a completely separate state (or province) outside Assam; and, a permanent closure on a demand for sovereign territory outside the limits of the Indian constitution. As the next chapter will show, however, the development of localized fragility in the BTC-governed areas was a key result of the conflict, a legacy that will be very difficult to overcome. The indirect consequence of this fragility is seen in negative outcomes in terms of access to basic developmental entitlements. While this chapter until now has sought to outline the broad causes of the conflict, from the next chapter onwards, we specifically attempt describing its empirical outcomes and deeper impacts. Notes i.

ii.

iii.

Das, Samir Kumar.2009. Land Identity and Conflicts: A Plea for Rebuilding Civil Society in Manipur. In Tribalism and the Tragedy of the Commons: Land, Identity and Development: The Manipur Experience, ed., Priyoranjan Singh. New Delhi: Akanksha Press. p, 30. Phanjoubam, Pradip. 2009. Fragmented Civil Society: Problems and Prospects. In Tribalism and the Tragedy of the Commons: Land, Identity and Development: The Manipur Experience, ed., Priyoranjan Singh. New Delhi: Akanksha Press. p, 75. See, for instance, Dutta, Anwesha. 2018. Rural informalities and forest squatters in the reserved forests of Assam, India. Critical Asian Studies 50(3): 353–374. https://doi.org/10.1080/14672715.2018.1479646; Bhattacharyya, Harihar, and Jhumpa Mukherjee. 2018. Bodo ethnic self-rule and persistent violence in Assam: A failed case of multinational federalism in India. Regional & Federal Studies. https://doi.org/10.1080/135 97566.2018.1478293; Saikia, Smitana. 2015. General elections 2014: Ethnic outbidding and politics of ‘homelands’ in Assam’s Bodoland. Contemporary South Asia, 23(2): 211–222. https://doi.org/10.1080/095 84935.2015.1029435; Vandekerckhove, Nel., and Bert Suykens. 2008. The Liberation of Bodoland’: Tea, Forestry and Tribal Entrapment in

2.10 Conclusion

iv.

v.

vi. vii. viii. ix. x.

xi. xii. xiii. xiv. xv. xvi. xvii. xviii. xix.

xx.

xxi.

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Western Assam. South Asia: Journal of South Asian Studies, 31(3): 450–471. https://doi.org/10.1080/00856400802441961. Sinha, Samrat. 2017. Surrender & Rehabilitate: Insurgent Demobilization & Reintegration in Northeast. http://www.indiandefencereview. com/news/surrender-rehabilitate-insurgent-demobilization-reintegra tion-in-northeast/. Accessed 12 May 2020. R.L. Kapur, R.L., and B. Sen. Year Unspecified. A Psychosocial Study of Alienation Amongst Indian Youth. National Institute of Advanced Studies: Bangalore. p, 102. [Unpublished Manuscript]. Ibid. Ibid., p. 103. Ibid., p. 125. Ibid., p. 120. Zou, D.V. and M. Satish Kumar. 2011. Mapping a Colonial Borderland: Objectifying the Geo-Body of India’s Northeast. The Journal of Asian Studies 70(1): 141–170. p. 144. https://doi.org/10.1017/S00219118100 02986. Boro, Anil. 2010. Folk Literature of Bodos. N.L. Publications: Guwahati. p. 5. Endle, S. 1990. The Kacharis (Bodo). Delhi: Lowprice Publications. p. 5. Originally the text was published in 1910 and reprinted in 1990. Ibid., p. 8. Boro, Anil. 2010. Folk Literature of Bodos. N.L. Publications: Guwahati. pp. 8–9. Ibid. Brahma, Sekhar. 2006. Religion of the Boros and their Socio-Cultural Transition. Guwahati: DVS Publishers. Pathak, Suryasikha. 2010. Tribal Politics in the Assam: 1933–1947. Economic and Political Weekly, 45(10): 61–69. Devi, Monimala. 2009. Economic History of Nepali Migration and Settlement in Assam. Economic and Political Weekly, 42(29): 3005–3007. Behal, Rana P. 1985. Forms of Labour Protest in Assam Valley Tea Plantations, 1900–1930. Economic and Political Weekly, 20(4): 19–26. p. 19. Also see Behal, Rana P. 2010. Coolie Drivers or Benevolent Paternalists? British Tea Planters in Assam and the Indenture Labour System. Modern Asian Studies 44 (1): 29–51. We are indebted to Indradeo Kumar, Project Coordinator at the ant for directing us to this connection. For insights, please see Gohain, Hiren. 2007. A Question of Identity: Adivasi Militancy in Assam. Economic and Political Weekly 42(49): 13–16. p. 13. Also see Xalxo, Abha. 2008. The Great Santal Insurrection (Hul) Of 1855–56. Proceedings of the Indian History Congress 69: 732–55. Damodran, Vinita. 1995. Famine in a Forest Tract: Ecological Change and the Causes of the 1897 Famine in Chotanagpur, Northern India. Environment and History 1(2)1: 129–58.

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xxiii. xxiv. xxv. xxvi.

xxvii.

xxviii. xxix.

xxx. xxxi.

xxxii. xxxiii. xxxiv. xxxv.

xxxvi.

xxxvii. xxxviii. xxxix.

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Behal, Rana P. 2010. Coolie Drivers or Benevolent Paternalists? British Tea Planters in Assam and the Indenture Labour System. Modern Asian Studies 44 (1): 29–51. p. 37. Ibid. Misra, Udayon. 2012. Bodoland: The Burden of History. Economic and Political Weekly 47(37):36–42. Baruah, Sanjib. 1999. India against itself: Assam and the politics of nationality. Philadelphia: University of Pennsylvania Press. pp. 28–29. Barpujari, H. K. 1995. General President’s Address: North-East India: The Problems and Policies Since 1947. Proceedings of the Indian History Congress 56: 1–73. p. 7. Means, Gordon P. and Ingunn N. Means. 1966. Nagaland-The Agony of Ending a Guerrilla War. Pacific Affairs 39(3/4):290–313. p. 298. https:// doi.org/10.2307/2754274. Rao, V. Venkata. 1972. Reorganization of North East India. The Indian Journal of Political Science 33(2):123–144. p. 127. See Government of Assam. 2020. The Assam Land and Revenue Regulation. https://landrevenue.assam.gov.in/sites/default/files/The% 20Assam%20Land%20And%20Revenue%20Regulation%201886.pdf. Accessed 8 June 2020. Hussain, Monirul. 1992. Tribal Question in Assam. Economic and Political Weekly 27(20/21): 1047–050. p. 1049. Vandekerckhove, Nel., and Bert Suykens. 2008. The Liberation of Bodoland’: Tea, Forestry and Tribal Entrapment in Western Assam. South Asia: Journal of South Asian Studies, 31(3): 450–471. https://doi.org/10. 1080/00856400802441961. Ibid. p. 455. Ibid. Brahma, Sekhar. 2006. Religion of the Boros and their Socio-Cultural Transition. Guwahati: DVS Publishers. p.89. Chaudhuri, Sucheta. 1999. Women’s Participation in the Bodo Movement. p. 45. https://pdfs.semanticscholar.org/c0f1/6234d97dde63d2569e 271429fb9bd5f1281d.pdf. Accessed 8 June 2020. Sarmah, Satyendra Kr. 2012. Modern Education and the Anglican Missionaries Among the Bodos of Darrang (Assam) In The 19th Century. Proceedings of the Indian History Congress 73: 1438. Also see Syiemlieh, David R. 2012. Sectional Presidents Address: Colonial Encounter and Christian Missions in North East India. Proceedings of the Indian History Congress 73: 509–27. Brahma, Sekhar. 2006. Religion of the Boros and their Socio-Cultural Transition. Guwahati: DVS Publishers. p. 132. Pathak, Suryasikha. 2010. Tribal Politics in the Assam: 1933–1947. Economic and Political Weekly 45 (10):61–69. p. 62. Ibid.

2.10 Conclusion

xl.

xli. xlii. xliii. xliv. xlv.

xlvi. xlvii.

xlviii. xlix. l. li. lii. liii.

liv.

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Ibid., p. 63. Also see Ahmed, Shahiuz Zaman. 2004. Inter State Migration (Erstwhile East Bengal and Assam), Enforcement of ‘Line System’ And Question of Settlement (1920–1950). Proceedings of the Indian History Congress 65 (2004): 573–85. Pathak, Suryasikha. 2010. Tribal Politics in the Assam: 1933–1947. Economic and Political Weekly 45 (10):61–69. p. 66. Brahma, Sekhar. 2006. Religion of the Boros and their Socio-Cultural Transition. Guwahati: DVS Publishers. p. 134. Pathak, Suryasikha. 2010. Tribal Politics in the Assam: 1933–1947. Economic and Political Weekly 45 (10):61–69. p. 64. Brahma, Sekhar. 2006. Religion of the Boros and their Socio-Cultural Transition. Guwahati: DVS Publishers. p. 135. Ibid., 135. Also see Government of Assam. 2020. The Assam Land & Revenue Regulation (Amendment) Act, 1947. https://legislative.assam. gov.in/sites/default/files/swf_utility_folder/departments/legislative_med hassu_in_oid_3/menu/document/The%20Assam%20Land%20%26% 20Revenue%20Regulation%20%28Amendment%29%20Act%2C%201 947.pdf. Accessed 3 April 2020. Saikia, Arupjyoti. 2016. A Century of Protests Peasant Politics in Assam Since 1900. New Delhi: Routledge India. p.150. Weiner, Myron. 1983. The Political Demography of Assam’s AntiImmigrant Movement. Population and Development Review 9(2): 279– 92. p. 285. https://doi.org/10.2307/1973053. Sarmah, Satyendra Kumar. 2014. Script Movement Among the Bodo of Assam. Proceedings of the Indian History Congress 75: 1335–340. Hazarika, Niru. 1994. Politics in Assam. The Indian Journal of Political Science 55(3):211–20. p. 212. Mukherjee, Dilip. 1969. Assam Reorganization. Asian Survey 9(4): 297– 311. https://doi.org/10.2307/2642547. All Bodo Student Union. 2017. History in Glimpse: ABSU 1967–2017 A Journey of Struggle. pp. 7–9. Brahma, Sekhar. 2006. Religion of the Boros and their Socio-Cultural Transition. Guwahati: DVS Publishers. p. 138. Das, Jogendra Kr. 2005. Assam: The Post-Colonial Political Developments. The Indian Journal of Political Science 66(4): 873–900. p. 882. Also see Government of Assam. 2020. Assam Scheduled Castes and Scheduled Tribes (Reservation of Vacancies in Services and Posts) Act, 1978. https://legislative.assam.gov.in/sites/default/files/swf_ utility_folder/departments/legislative_medhassu_in_oid_3/menu/doc ument/The%20Assam%20Schedule%20Caste%20and%20Schedule% 20Tribe%20%28Reservation%20of%20Vacancies%29%20in%20Serv ices%20amendment%20posts%29%20Act%2C%201979.pdf. Accessed 6 March 2020. Udayon Misra. 1989. Bodo Stir: Complex Issues, Unattainable Demands. Economic and Political Weekly 24(21): 1146–149. p. 1147.

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lv. lvi.

lvii.

lviii.

lix. lx.

lxi.

lxii.

lxiii.

lxiv.

lxv. lxvi. lxvii. lxviii. lxix. lxx. lxxi. lxxii.

lxxiii. lxxiv.

Brahma, Sekhar. 2006. Religion of the Boros and their Socio-Cultural Transition. Guwahati: DVS Publishers. p. 140. All Bodo Student Union. 2017. History in Glimpse: ABSU 1967–2017 A Journey of Struggle. p.9. Also see Chaudhuri, Sucheta Sen. 2004. The Bodo Movement and Women’s Participation. New Delhi: Mittal Publications. Weiner, Myron. 1983. The Political Demography of Assam’s AntiImmigrant Movement. Population and Development Review 9(2): 279– 92. Also see. Baruah, S. 1986. Immigration, Ethnic Conflict, and Political Turmoil– Assam, 1979–1985. Asian Survey 26(11): 1184–1206. https://doi.org/10. 2307/2644315. Boruah, Kaustavmoni. 1980. ‘Foreigners’ in Assam and Assamese Middle Class. Social Scientist 8(11): 44–57. Government of Assam. 2020. Assam Accord and its Clauses. https://ass amaccord.assam.gov.in/portlets/assam-accord-and-its-clauses. Accessed 2 April 2020. See Worrall, James. 2017. (Re-)emergent orders: understanding the negotiation(s) of rebel governance. Small Wars & Insurgencies 28(4–5):709– 733. Barpujari, H. K. 1995. General President’s Address: North-East India: The Problems and Policies Since 1947. Proceedings of the Indian History Congress 56: 1–73. p. 32. Sinha, Samrat. 2017. The Strategic Use of Peace: Non-State Armed Groups and Subnational Peacebuilding Mechanisms in Northeastern India. Democracy and Security. 13(4): 273–303. Baruah, S. 1994. The State and Separatist Militancy in Assam: Winning a Battle and Losing the War? Asian Survey 34(10): 863–877. p. 871. https:// doi.org/10.2307/2644966. Hussain, Monirul. 1992. Tribal Question in Assam. Economic and Political Weekly 27(20/21):1047–1050. p. 1049. Ibid. Ibid. Ibid. Ibid. Ibid., 1050. Ibid. Also see Hussain, Monirul. 1987. Tribal Movement for Autonomous State in Assam. Economic and Political Weekly 22(32):1329–1332. See Government of Assam. 2020. Assam Accord and its Clauses. https:// assamaccord.assam.gov.in/portlets/assam-accord-and-its-clauses#Cla use%206%20:%20Constitutional,%20Legislative%20&%20Administra tive%20safeguards. Accessed 2 March 2020. Ibid. George, S. 1994. The Bodo Movement in Assam: Unrest to Accord. Asian Survey 34(10):878–892. p. 881. https://doi.org/10.2307/2644967.

2.10 Conclusion

lxxv. lxxvi. lxxvii. lxxviii. lxxix. lxxx. lxxxi.

lxxxii. lxxxiii. lxxxiv. lxxxv.

lxxxvi. lxxxvii. lxxxviii. lxxxix. xc. xci. xcii. xciii.

xciv.

xcv.

xcvi.

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Ibid. Ibid., p. 886. All Bodo Student Union (ABSU). 2017. History in Glimpse: ABSU 1967– 2017 A Journey of Struggle. p. 10. Chaudhuri, Sucheta. 1999. Women’s Participation in the Bodo Movement. p. 115. https://pdfs.semanticscholar.org/c0f1/6234d97dde63 d2569e271429fb9bd5f1281d.pdf. Accessed 8 June 2020. Ibid. Narzary, Raju Kumar. 2005. Impact of Bodoland Movement on the Health Seeking Behavior of the Bodo Community. Mumbai: Tata Institute of Social Sciences. [Unpublished Dissertation]. For a chronology of events during the first phase. p. 20. Also see All Bodo Student Union (ABSU). 2017. History in Glimpse: ABSU 1967–2017 A Journey of Struggle. pp. 10–18. George, S. 1994. The Bodo Movement in Assam: Unrest to Accord. Asian Survey 34(10):878–892. p. 883. https://doi.org/10.2307/2644967. Interview of Respondent CMS. Interviewed by MJM. Date of Interview. 19 December 2016. Komlaguri Village, Chirang, BTAD (Assam). Field Photo(Author). 2017. United Nations Mediation Support Unit (MSU).2020. Memorandum of Settlement (Bodo Accord) signed in Guwahati, Assam on 20 February 1993). p. 1. https://peacemaker.un.org/sites/peacemaker.un.org/files/IN_ 930220_BodoAccord.pdf. Accessed 3 March 2020. Ibid., p. 2. Ibid., p. 3. Ibid., p.1. George, S. 1994. The Bodo Movement in Assam: Unrest to Accord. Asian Survey 34(10):878–892. p. 889. https://doi.org/10.2307/2644967. Ibid. Also see All Bodo Student Union (ABSU). 2017. History in Glimpse: ABSU 1967–2017 A Journey of Struggle. p. 10. Ibid. All Bodo Student Union (ABSU). 2017. History in Glimpse: ABSU 1967– 2017 A Journey of Struggle. p. 24. United Nations Mediation Support Unit (MSU).2020. Memorandum of Settlement on Bodoland Territorial Council (BTC) New Delhi, 10 February 2003 p. 1. https://peacemaker.un.org/sites/peacemaker.un.org/ files/IN_930220_BodoAccord.pdf. Accessed 3 March 2020. p.1. Ministry of External Affairs (Government of India). 2020. Sixth Schedule of the Indian Constitution (Provision as to the Administration of Tribal Areas in the States of Assam, Meghalaya, Tripura and Mizoram). https:// www.mea.gov.in/Images/pdf1/S6.pdf. Accessed 28 February 2020. United Nations Mediation Support Unit (MSU).2020. Memorandum of Settlement on Bodoland Territorial Council (BTC) New Delhi, 10 February 2003 p. 1. Ibid., p. 2.

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xcvii. xcviii. xcix. c. ci. cii. ciii. civ.

cv. cvi.

cvii.

cviii. cix.

cx. cxi. cxii.

Ibid., p. 3. Ibid., p. 2. Ibid., p.5. Ibid., p.1. Ibid. Chaudhuri, Sucheta Sen. 2004. The Bodo Movement and Women’s Participation. New Delhi: Mittal Publications. pp. 94–96. Ibid. Choudhury, P. Brahma. 2007. Pioneer of Bodo movement dead - A time to remember. https://www.telegraphindia.com/states/north-east/pioneerof-bodo-movement-dead-a-time-to-remember/cid/720466. Accessed 7 June 2018. Hussain, Wasbir. 2010. Dhaka Arrest Terror. https://www.outlookindia. com/website/story/dhaka-arrests-terror/265323. Accessed 1 June 2018. Karmakar, Sumir. 2 February 2020. After laying down arms, Assam insurgents brace up for ‘new life’. https://www.deccanherald.com/nat ional/national-politics/after-laying-down-arms-assam-insurgents-braceup-for-new-life-800743.html. Accessed 16 March 2020. Dutta, Pullock. 5 August 2010. https://www.telegraphindia.com/states/ north-east/ndfb-scours-nepal-for-land-outfit-plans-to-set-up-base-innew-country/cid/490715. Accessed 1 June 2018. Ibid. For Ceasefire processes see Sinha, Samrat. 2017. The Strategic Use of Peace: Non-State Armed Groups and Subnational Peacebuilding Mechanisms in Northeastern India. Democracy and Security. 13(4): 273–303. All Bodo Student Union (ABSU). 2017. History in Glimpse: ABSU 1967– 2017 A Journey of Struggle. p. 25. Ibid. Compiled from open access data available at South Asia Terrorism Portal (SATP): https://www.satp.org/datasheet-terrorist-attack/fatalities/indiainsurgencynortheast-arunachalpradesh; https://www.satp.org/datash eet-terrorist-attack/fatalities/india-insurgencynortheast-assam; https:// www.satp.org/datasheet-terrorist-attack/fatalities/india-insurgencynorth east-manipur; https://www.satp.org/datasheet-terrorist-attack/fatalities/ india-insurgencynortheast-meghalaya; https://www.satp.org/datasheetterrorist-attack/fatalities/india-insurgencynortheast-mizoram; https:// www.satp.org/datasheet-terrorist-attack/fatalities/india-insurgencynorth east-nagaland; https://www.satp.org/datasheet-terrorist-attack/fatalities/ india-insurgencynortheast-tripura#. Accessed 1 January 2020.

2.10 Conclusion

cxiii.

cxiv. cxv.

cxvi. cxvii. cxviii. cxix. cxx. cxxi. cxxii. cxxiii. cxxiv. cxxv.

cxxvi. cxxvii.

cxxviii. cxxix.

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SATP. 2020. Datasheet – Assam. https://www.satp.org/datasheetterrorist-attack/fatalities/india-insurgencynortheast-assam. Accessed 1 January 2020. Compiled from SATP. 2020. http://old.satp.org/satporgtp/countries/ india/states/assam/data_sheets/ndfb/casualties.htm. 2 January 2020. Compiled from SATP. 2020. https://www.satp.org/datasheet-terroristattack/explosions/india-insurgencynortheast-assam-baksa; https://www. satp.org/datasheet-terrorist-attack/arrest/india-insurgencynortheastassam-udalguri; https://www.satp.org/datasheet-terrorist-attack/explos ions/india-insurgencynortheast-assam-chirang; https://www.satp.org/dat asheet-terrorist-attack/fatalities/india-insurgencynortheast-assam-kok rajhar; https://www.satp.org/datasheet-terrorist-attack/surrender/indiainsurgencynortheast-assam-udalguri;https://www.satp.org/datasheetterrorist-attack/arrest/india-insurgencynortheast-assam-baksa; https:// www.satp.org/datasheet-terrorist-attack/arrest/india-insurgencynorth east-assam-chiran; https://www.satp.org/datasheet-terrorist-attack/arr est/india-insurgencynortheast-assam-kokrajhar. Accessed 4 January 2020. Interview with Respondent CDV. Interviewed by MJM. Date of Interview. 19 December 2016. GSLMRI Village, Chirang, BTAD (Assam). Ibid. Interview with Respondent [All details Undisclosed] Date of Interview. 8 September 2016. [Location Specified] Village, Chirang, BTAD (Assam). Ibid. Ibid. Correspondent. 25 December 2014. First Person Account. The Sentinel, December 25. George, S. 1994. The Bodo Movement in Assam: Unrest to Accord. Asian Survey 34(10):878–892. p. 890. https://doi.org/10.2307/2644967. Ibid. Ibid., pp. 890–891. Murmu, Tonol. 2009. Bodo-Santal conflicts in Assam: the evil designs, silent sufferings and the process of reconciliation. In Violent conflicts, ceasefires and peace accords through the lens of Indigenous Peoples. University of Tromso. p. 12. https://uit.no/Content/224266/forumreport_ 2009.pdf. Accessed 21 March 2020. Ibid., p.14. Bannerjee, N. 2011. Tribal Land Alienation and Ethnic Conflict: Efficacy of Laws and Policies in BTAD Area. Refugee Watch 37: 44– 54. http://www.mcrg.ac.in/rw%20files/RW37/4.Nirmalya.pdf. Accessed 7 June 2020. See Chapter Eight for details and an in-depth discussion on the 2012 and 2014 crises. See Chapter Eight for details and an in-depth discussion on the 2012 and 2014 crises.

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cxxxv.

cxxxvi.

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Murmu, Tonol. 2009. Bodo-Santal conflicts in Assam: the evil designs, silent sufferings and the process of reconciliation. In Violent conflicts, ceasefires and peace accords through the lens of Indigenous Peoples. University of Tromso. pp. 14–15. https://uit.no/Content/224266/forumr eport_2009.pdf. Accessed 21 March 2020. Ibid., 16. Interview with Respondent STRS. Interviewed by HLS and KLB. Date of Interview. 24 August 2016. PMNR Village, Chirang, BTAD (Assam). Das, Arupjyoti. 2009. Kamatpur and the Koch Rajbanshi Imagination. Guwahati: Montagemedia. At one point, the BTAD also has one of the highest concentrations armed groups. Some of these included: National Democratic Front of Bodoland, Adivasi Cobra Force, Kamtapuri Liberation Organisation, Muslim United Liberation Tigers of Assam, All Adivasi National Liberation Army, Adivasi Cobra Military of Assam, Birsa Commando Force, Santhal Liberation Tigers and Adivasi Peoples Army. Other insurgent groups included the Adivasi Security Force, All Assam Adivasi Suraksha Samiti, Islamic Liberation Army of Assam, Islamic Sevak Sangh, Islamic United Reformation Protest of India, Koch-Rajbongshi Liberation Organisation, Muslim Liberation Army, Muslim Security Council of Assam, Muslim Security Force, Muslim Tiger Force, Muslim United Liberation Front of Assam, Muslim Volunteer Force, People’s United Liberation Front, Revolutionary Muslim Commandos, United Muslim Liberation Front of Assam. See Asian Centre for Human Rights (ACHR). 2012. Assam Riots: Preventable but not Prevented. p. 8. https://reliefweb.int/report/ india/assam-riots-preventable-not-prevented. Accessed 10 January 2020. Vandekerckhove, Nel., and Bert Suykens. 2008. The Liberation of Bodoland’: Tea, Forestry and Tribal Entrapment in Western Assam. South Asia: Journal of South Asian Studies, 31(3): 450–471. https://doi.org/10. 1080/00856400802441961. p. 463. Confidential Interview with Respondent.

Chapter 3

Researching Fragility in the Indo-Bhutan Borderlands

Abstract What is it like to research in difficult to access conflict-affected communities? How can the voices of those who have suffered tremendous loss be recorded with sensitivity and without compromising their dignity? The chapter provides an introduction to the district of Chirang and the forest tracts of the borderland which forms the basis for a significant portion of the book. A snapshot of Chirang District is given and then using various development indices, a comparison of its development with other significant Districts of Assam is drawn up. The authors using maps, photographs and diagrams introduce the economic and socio-political realities of the Indo-Bhutan borderlands and the six main sites of the study (these include both Bodo and Adivasi villages). The chapter specifies the nature of governance at the grassroots especially in a Sixth Schedule Area. The chapter then examines in detail, the administrative structures most crucial to the study area. First, we consider the problem of forest governance that contributes to specific type of protracted localized fragility. We then look at Village Council Development Committees (VCDC). The last section in this chapter details out methodological development. The chapter outlines the challenges of fieldwork in a conflict-affected area that is undergoing a transition to peace. It also addresses the struggle of largely activists in being researchers. In addition, the chapter includes a case study revolving around a single unrecognized forest village (or encroached forest village) occupied by those formerly displaced in the conflicts of 1996 and 2014. The case study blends in all of these thematic areas and highlights the overlapping of political and ecological fragilities (especially the trade-offs made by individuals between basic survival in the forest areas, the struggle for livelihoods and long-term ecological deterioration). Keywords Localized fragility · Sixth schedule · Village Council Development Committee (VCDC) · Forest governance · Ecology · Research methods · Researching conflict

© Springer Nature Singapore Pte Ltd. 2021 S. Sinha and J. Liang, Health Inequities in Conflict-affected Areas, https://doi.org/10.1007/978-981-16-0578-9_3

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3.1 Introduction It is very difficult to trace out the origins of the word Chirang or to identify the process by which the name of the district came about into common usage especially in administrative circles. Whether the name Chirang is a derivative of the Tsirang River in Bhutan (after which Bhutan has named a district Tsirang which is also called Chirang in common usage) is yet to be known. Another possibility is that the name was derived from an older revenue tract called Chirang Tract under British rule. The name can also possibly be attributed to Chirang Duar. The word Duar is a historical term to signify a ‘gateway’ into the Kingdom Bhutan in pre-colonial Bengal and Assam.i What we know officially is that Chirang District was created through a notification GAG (B)0.137/ 2002/ Pt/ 117 on the 30 October 2003 within Assam, under Clause 6 of Article 332 by the 90th Amendment Act, 2003 of the Constitution of India under the provision of the Sixth Schedule.ii The district began from the 4 June 2004. It was further carved out of the districts of Kokrajhar, Bongaigaon and Barpeta. Kajalgaon is the District Headquarters. It consists of two sub-divisions Kajalgaon and Bijni. About 67 kms the district falls along the international boundary. Of these 25 kms falls under the Borobazar Development Block while a 42-kms stretch falls under Sidli-Chirang Development Block.iii In order to gain an insight into the developmental profile of Chirang, a comparative analysis is done in the next section, where Chirang is compared to other districts in Assam. Based on a macro-view we then move towards an understanding of the research site. We situate the border area within an understanding of fragility through an examination of some key determinants. While the political context and governance system have been described earlier, we provide an idea of how these structures are experienced at the micro-level. We also highlight the challenges in researching fragility, where methodologically researchers have to traverse a complex ethical terrain. In most cases, there were ‘research sites’ that exist in reality but by virtue of their positioning (as encroached villages) are not eligible for any government service and are more or less viewed as illegal settlements.

3.2 A Snapshot of Chirang with a Focus on Health Poor access to healthcare is a reflection of underdevelopment and marginalization. Viewed from the lens of post-conflict recovery, it is generally expected that health outcomes improve in the aftermath of Peace Accords or Comprehensive Peace Agreements (CPA). Despite 16 years after the signing of the 2003 Memorandum of Settlement (MoS) which established the BTC, health outcomes in far-flung areas remain extremely problematic. In fact, the health system before the start of the conflict was functional and our findings points to a logic that is counterintuitive. We therefore see the slow erosion of a health system that continues in the post-conflict phase. A recent

3.2 A Snapshot of Chirang with a Focus on Health

75

study by Madhav Joshi in 2015 on the connections between under-five mortality and Comprehensive Peace Agreements (CPA) finds a significant reduction in under-five mortality with the signing of CPAs. Nevertheless, there were significant limitations in making an authoritative correlation: First, the infant mortality data used in the analysis was macro-level or national level data. For this type of study, it is ideal to analyse micro-level data from those specific communities affected by armed conflict because the national level data may mask community-level health performance. Annualized child mortality data for all conflict-affected communities around the globe however do not exist. Second, data coming from rural villages or remote parts of the country are expected to be faulty, incomplete or non-existent. While faulty data from few communities are less likely to influence the general and aggregate national level data, faulty data from many villages or communities can influence the aggregated national level data.iv

In studying data at the district level within the BTAD itself, Chirang’s comparative performance in key indicators is lagging behind (Table 3.1). While the data is illuminating and the various National Family Health Surveys (NFHS) are considered credible sources of health-related data in India, attention should still be drawn to possible inaccuracies and discrepancies. For example, there is a difference of 178 points between the sex ratio of the total population and sex ratio of girls born in 5 years or what is known as Under-Six Sex Ratio. This is a huge difference and becomes even more stark when compared to neighbouring Kokrajhar District with Under-Six Female Sex Ratio of 852 having similar sociopolitical-economic and demographic contexts. However, the data does show that while Chirang District does fairly well in some areas—like in female sex ratio and also in preventing child malnutrition and stunting, overall, it does much worse than districts in Upper Assam. The neglect is evident where provision of services by the state like electrification, safe drinking water, sanitation or schooling is concerned. With the exception of Karbi Anglong District, another Sixth Schedule Area (which has also seen continuous armed and ethnic conflict), Chirang, is the worst off when it comes to households with improved sanitation and drinking water sources. The status of women and girls remains poor in Chirang when compared to other districts in Assam. Even compared to districts in adjoining states, Chirang seems to have the highest number of girls above 6 years who have never attended school, and hence one of the highest female illiteracy rates. Women also have a low Body Mass Index (low BMI) and suffer high anaemia. The poor state of essential health services is evident when we look at some of the health data. Chirang (in addition to Karbi Anglong) is one of the lowest performing districts in terms of maternal and child health services. It has some of the lowest number of children getting fully immunized (40 percent) or women receiving full ante-natal check-ups (11.7 percent) and women safely giving birth in hospitals (59.9 percent). Hence, Chirang District on this side of the Indo-Bhutan border is not one of the most developed or healthiest places to live in. The state of health services in villages on this side of the border can also be seen from an on-the-ground example of epilepsy. the ant vi finds that the largest number of patients seeking treatment in their mental

911

85.2

Sex ratio at 927 birth for children born in the last five years (females per 1,000 males)

61.5

63

Women who are Literate (%)

Female age 6 years and above who ever attended school (%)

77.2

944

1009

Sex ratio of the total population (females per 1,000 males)

79

81.7

962

1030

73

69

945

993

66.5

62.3

1153

975

68

63.7

852

1009

Data Source - India & Selected States BTAD Districts NHFS-4 (National India Sikkim Manipur Assam Chirang Kokrajhar Health & (headquarters Family of Bodoland; Survey-Round next to 4 2015–2016) Chirang) All Indicators are for Rural Areas

71.8

72.4

979

1048

Baksa (in Bodoland; one of the Bhutan entry gates)

67.9

65.5

890

979

Udalguri (fourth district of Bodoland; mixed communities)

71.7

70.2

874

950

Bongaigaon (next to Chirang, not in Bodoland)

70.2

66.9

868

961

Goalpara (next to Chirang, not in Bodoland)

Neighbouri ng Districts Outside BTAD

Table 3.1 NFHS-4 data comparing Chirang with other districts in Assam across select development indicesv

80.5

80

764

1005

Jorhat (in Upper Assam, supposed to be better governed)

72

69.7

948

1029

Dibrugarh (Upper Assam, lot of tea garden workers - a disfranchised group)

Upper Assam Districts

74.2

73.1

905

1015

Dhemaji (in Upper Assam, regularly affected by floods)

(continued)

67.5

59.1

911

991

Karbi Anglong (in middle Assam, part of autonomous council)

76 3 Researching Fragility in the Indo-Bhutan Borderlands

99.6

96.8

Households 83.2 with electricity (%)

89.3

36.7

Households with an improved drinking water source (%)

Households using improved sanitation facility (%)

94.2

98.4

76.1

Children under age 5 years whose birth was registered (%)

51.3

38

90.1

59.7

45

83

75

94

29.9

69

70.3

95.1

37.5

75.5

72.5

95.4

Data Source - India & Selected States BTAD Districts NHFS-4 (National India Sikkim Manipur Assam Chirang Kokrajhar Health & (headquarters Family of Bodoland; Survey-Round next to 4 2015–2016) Chirang) All Indicators are for Rural Areas

Table 3.1 (continued)

54.3

82.3

81.7

97.4

Baksa (in Bodoland; one of the Bhutan entry gates)

53.6

81.2

83.9

95.1

Udalguri (fourth district of Bodoland; mixed communities)

40.7

72.6

87.3

94.2

Bongaigaon (next to Chirang, not in Bodoland)

41.9

85.9

66

94.8

Goalpara (next to Chirang, not in Bodoland)

Neighbouri ng Districts Outside BTAD

61.6

85.6

84.2

98.2

Jorhat (in Upper Assam, supposed to be better governed)

57.2

98.5

70.5

85.1

Dibrugarh (Upper Assam, lot of tea garden workers - a disfranchised group)

Upper Assam Districts

41.5

91.1

62

97.1

Dhemaji (in Upper Assam, regularly affected by floods)

(continued)

40.4

51.7

79.4

84.4

Karbi Anglong (in middle Assam, part of autonomous council)

3.2 A Snapshot of Chirang with a Focus on Health 77

36.1

3

51.4

Women with 27.3 10 years + of Schooling (%)

Women age 9.2 15–19 years who were already mothers or pregnant at the time of the survey (%)

Use of Modern Contraceptive Methods (%)

51.7

29.2

Households 29 with any usual member covered by a health scheme or health insurance (%)

22.7

8.2

38.4

3.7

52

14

23

10

61.9

19.6

19.6

6

56.5

13.3

19.6

6.9

Data Source - India & Selected States BTAD Districts NHFS-4 (National India Sikkim Manipur Assam Chirang Kokrajhar Health & (headquarters Family of Bodoland; Survey-Round next to 4 2015–2016) Chirang) All Indicators are for Rural Areas

Table 3.1 (continued)

58.5

11.3

27.8

3.7

Baksa (in Bodoland; one of the Bhutan entry gates)

63

10.6

20.3

2.6

Udalguri (fourth district of Bodoland; mixed communities)

57.4

23.9

20

8,3

Bongaigaon (next to Chirang, not in Bodoland)

41.1

30.5

18.1

12.6

Goalpara (next to Chirang, not in Bodoland)

Neighbouri ng Districts Outside BTAD

51.4

10.3

34.3

12

Jorhat (in Upper Assam, supposed to be better governed)

51.8

10.5

21.9

7.3

Dibrugarh (Upper Assam, lot of tea garden workers - a disfranchised group)

Upper Assam Districts

54.2

14.3

35.1

10

Dhemaji (in Upper Assam, regularly affected by floods)

(continued)

52.6

17

13.3

6

Karbi Anglong (in middle Assam, part of autonomous council)

78 3 Researching Fragility in the Indo-Bhutan Borderlands

74.2

40.2

94.4

85.2

83.7

Mothers who 44.8 had at least 4 antenatal check-ups (%)

16.7

Women 75.1 giving birth in hospitals (%)

54.4

Mothers who had full ante natal care (%)

Women Giving Birth in Government Hospitals (%)

Children age 61.3 12–23 months Fully Immunized (%)

61.7

40.9

60.5

27.8

62

44

60

68

17

45

40.1

51.1

59.9

11.7

41.4

40.5

60.4

65.4

15.8

37.2

Data Source - India & Selected States BTAD Districts NHFS-4 (National India Sikkim Manipur Assam Chirang Kokrajhar Health & (headquarters Family of Bodoland; Survey-Round next to 4 2015–2016) Chirang) All Indicators are for Rural Areas

Table 3.1 (continued)

59.3

77.3

87.6

21.5

49.7

Baksa (in Bodoland; one of the Bhutan entry gates)

55.9

65.6

70.6

13.7

36

Udalguri (fourth district of Bodoland; mixed communities)

39.7

58.1

65.9

12.6

24.5

Bongaigaon (next to Chirang, not in Bodoland)

40.6

66.1

69.1

15.4

39.4

Goalpara (next to Chirang, not in Bodoland)

Neighbouri ng Districts Outside BTAD

61.5

84

96.5

48

72.3

Jorhat (in Upper Assam, supposed to be better governed)

68.5

65.5

87.5

37.2

67

Dibrugarh (Upper Assam, lot of tea garden workers - a disfranchised group)

Upper Assam Districts

49.1

74.6

74.6

21.5

47.3

Dhemaji (in Upper Assam, regularly affected by floods)

(continued)

23.5

44.2

47.2

10.4

37.2

Karbi Anglong (in middle Assam, part of autonomous council)

3.2 A Snapshot of Chirang with a Focus on Health 79

5.8

35.1

BMI of 26.7 Women below normal (%)

Women (15–49 years) who are Anemic (%)

54.2

32.9

41.2

Children under 5 years who are stunted (%)

26.4

9

31.4

46

27

38

49.3

21.9

39.4

51.6

22.3

31.9

Data Source - India & Selected States BTAD Districts NHFS-4 (National India Sikkim Manipur Assam Chirang Kokrajhar Health & (headquarters Family of Bodoland; Survey-Round next to 4 2015–2016) Chirang) All Indicators are for Rural Areas

Table 3.1 (continued)

53

17.5

32.8

Baksa (in Bodoland; one of the Bhutan entry gates)

56.3

20.6

39

Udalguri (fourth district of Bodoland; mixed communities)

49.2

20.2

41

Bongaigaon (next to Chirang, not in Bodoland)

50.9

24.7

45.7

Goalpara (next to Chirang, not in Bodoland)

Neighbouri ng Districts Outside BTAD

42.8

29.9

26.5

Jorhat (in Upper Assam, supposed to be better governed)

55.6

33.2

34.8

Dibrugarh (Upper Assam, lot of tea garden workers - a disfranchised group)

Upper Assam Districts

39.6

17.4

36.1

Dhemaji (in Upper Assam, regularly affected by floods)

37.8

18.2

28.4

Karbi Anglong (in middle Assam, part of autonomous council)

80 3 Researching Fragility in the Indo-Bhutan Borderlands

3.2 A Snapshot of Chirang with a Focus on Health

81

illness treatment camp in Koroipur near the Indo-Bhutan border is of those suffering from epilepsy. For years, cerebral malaria was rampant in these areas and due to lack of timely and quality healthcare services, many patients from these areas could have developed epilepsy and mental illnesses.vii Even within Bodoland, the other districts fare marginally better than Chirang in most indices. One of the possible explanations was that Chirang District was itself carved out of far-flung and neglected border areas of then undivided Bongaigaon and Kokrajhar. In the next section, we specifically look at the concept of localized fragility as a possible determinant to these macro-level health outcomes. However, our concept of fragility goes beyond the political but also includes environmental factors. We root this idea of fragility in the manner by which individuals (and families) who were displaced by the conflict interpret the restricted or ‘Reserve Forest’ areas near the international boundary, not only as a survival strategy in the present but also visualize these restricted areas as a living space in the future.

3.3 The Research Setting: Forest Governance, Governance of Fragility, Fragility of Governance? 3.3.1 Understanding Villages in the Forest In order to understand the borderlands along both sides of the international boundary of India and Bhutan, it is to also interpret them as forming a contiguous and distinct ecological sub-system. The sub-montane forests, across all four of the BTAD districts, connects further westwards with the Nepal Terai through North Bengal and extend eastwards into Arunachal. A significant portion of the forests in BTC also fall under a recent bilateral environmental regime called Transboundary Manas Conservation Area (TRAMCA). TRAMCA which spans 6,500 square kilometres consists of the Indian Manas Tiger Reserve (which falls in the BTAD) and Bhutan’s Royal Manas National Park.viii Of the roughly 8,970 square kilometres of the current BTAD,ix approximately 3539.95 square kilometres (or roughly 41 percent) are covered in forests mostly along the international boundary with Bhutan.x A description of the terrain is given by the Forest Department of the BTC: The entire northern belt of the forest is situated in Sub-Himalayan alluvial tract of a typical formation known as “Bhabar tract” characterized by low water table and deep boulder deposits with an underlying layer of gravelly sand with varying degree of thickness of overlying sandy looms with humus varying from almost nil to 30cms. The forest available in BTC ranges from Semi-Deciduous Forests in the west with Sal as the dominant tree species to the broad leafed Wet Evergreen Forests including Khoir Sissoo and Riparian Fringing Forests (riverine) showing typical Riparian plant succession especially in Jamduar, Kanamakra and Manas. The Forest Areas under Reserved Forest (RF), Proposed Reserved Forests, Un-classed State Forest (USF) and Protected Area (PA) in BTC are as follows: 1) RF: 2,59, 128.40 Ha. (Hectares); 2) P.R.F:27, 407.75 Ha.; U.S.F.: 421.70 Ha.; P.A. 67,037.00 Ha.xi

82

3 Researching Fragility in the Indo-Bhutan Borderlands

Table 3.2 Reserve forests in Chirang Districtxii Name of division

Headquarters

Forest ranges

Reserve forests

Forest cover in hectares

Chirang Forest Division

Kajalgaon

Runikhata

Manas Part-I

18,569

Amteka

Manas Part-II

29,068

Kuklung

Bengtol

6092

Ranisundari

48.6

Katribari

34

Rakhalthakur

101.6

Sissobari

509.2

Digdari

65.1

Kuklung

1469

Teklai

112.11

The overall management of the protection and management of these extensive forest areas falls under the Conservator of Forests, Western Assam Circle, who is also the Council Head of the BTC Department of Forest. The District of Chirang also includes the Chirang Forest Division which encompasses the following reserve forests (Table 3.2). The above information is especially important as the existing systems of forest governance are deeply interlinked to the narratives of conflict that are discussed in the course of the book. As one moves closer to the international border with Bhutan and towards the northern forest belt, the contradictions between fixed notions of state power and the informality of actual practice start becoming visible. A significant pattern that is highlighted in the book is the extensive movement of those who experienced conflict and sought to move deeper into the areas designated as Reserve Forests and Protected Areas. Anwesha Datta’s recent ethnographic work on the process of ‘encroachment’ in the Saralpara Reserve Forest in Kokrajhar provides a useful conceptual framework where she develops the notion of grey legality. According to this work, grey legality is ‘comprised of a complex web of relations, recognitions, and concessions that transcends formal property rights within a system of unauthorized land grabbing leading to insecure tenure and access to forest resources’.xiii Furthermore, in contrast to the existing literature on rural informality and ‘illegal’ occupation of designated forest conservation areas that views ‘encroachment’ as an act of resistance, Anwesha’s work finds that ‘encroachment’ in forest areas was an outcome of ‘everyday forms of mediations and negotiations’.xiv Thus, in the course of the book, we try and combine three interrelated notions of fragility. The first refers to the fragility in the political environment that by virtue of perceived inequities in the setup of political institutions can lend itself to repeated cycles of violence. A second, which refers to weak state capacity due to unavailable resources or resources that have been diverted due to patronage. And third, at an individual level where people are embedded in the above-mentioned web of grey

3.3 The Research Setting: Forest Governance …

83

legality and whose daily survival is dependent on navigating these boundaries set between what is defined as legal and illegal. However, another layer of analysis is added by including health and well-being as a key measure of fragility which has been generally excluded in the literature on Bodoland. At the individual level, the search for health, in the absence of functional health institutions, further contributes to worsening conditions at the individual level. We also add another dimension by looking at how survival in a fragile context also involves livelihood and healthseeking behaviour that transverses the border. The document from the BTC encapsulates the problems in categorization. Interestingly, it shows that the process of people settling inside the forest was not new. As indicated in the document: Most of the Territorial Forest Divisions especially in the western part of BTC areas are having a number of recognized forest villages. Many of these were set up/established during the British period while many of course after independence also. Besides above, there are a number of villages inside R.F. Lands. The process of recognition of these villages remained incomplete manly due to promulgation of Indian Forest (conservation) Act, 1980. Such villages are neither treated as fully recognized villages nor purely encroachment villages. So, decision by the appropriate Authorities/Government(s) is yet to be taken.xv

Providing an official view of the ‘encroachment’ problem we also get some idea on how the conflict led to the weakening of the Forest Department, which fed into the enhancement of informality. They also became the initial casualties, and the study area records the killing of two forest personnel early on that served as a deterrence for personnel to continue work.xvi This was combined with destruction of Forest Department Offices such as in Dingborda.xvii This weakening is also attested to by the document cited earlier: Forest is essential for maintenance of life supporting systems on earth; to protect forest which is the most precious gift of nature to mankind from being destroyed due to non-forestry uses, the Central Government enacted the Forest (Conservation) Act, 1980. Earlier, prior to 1980, large chunk of forestland had been cleared and allotted to the landless people of the local community. Now, with the enactment of the Act, diversion of forestland for human settlement is not permissible. Villagers, are however, continuing to clear the forestland and occupy it with the mistaken hope that they will get allotments of the occupied land in the future. People also took advantage of the poor law and order situation that prevailed during the last decade to occupy the forestland. It is estimated that at present more than 30% of the forestland in BTC is under the vicious grip of encroachers. Forest Department is ill-equipped to tackle the huge problems of the forests in the BTC. During the turbulent period in the last decade, 80% of the infrastructure like buildings, roads, bridges, and culverts in the forest areas was destroyed. Due to lack of accommodation, field staff of the department have been forced to stay away from the forest areas. Further, due to lack of transport and necessary fund, it is not possible to effectively mobilize the forest staff and forces required to support field staff for the protection of forest. In the absence of forest staff and taking advantage of disturbed situation prevailing in the area, the miscreants got opportunities to freely indulge in illegal felling of trees.xviii

The community while echoing the above has a slightly different perspective on the above process. According to CB, a respondent from the Nepali community:

84

3 Researching Fragility in the Indo-Bhutan Borderlands In the 1970s when, there were very few number of families in the area and mainly comprised of only two communities Nepalese and Adivasi’s. There were no Bodos around they were mostly settled in the outskirts. Dingborda (presently 100% Bodos) had few Bodo families, in Milon there was one Bodo family and Saritah comprised of Nepalese and one single Bengali family. The forest department was very strict during the 1970s and the years following that. During those day people were restricted from entering the forest. If anyone was caught going into the forest with an axe or a knife, it was considered a threat and the forest department took strict action against such persons. But once the ABSU Andolan started (in the late 1980’s), there was a rapid increase in population of the area and the same forest where local people were not allowed in, was opened for settlement (note: not by the Forest Department) and we saw large scale migration to the forest lands. In the 1970s, one could easily spot sight of tigers and deer’s and bears in the vicinity. Today the forest cover is fallen beyond limits and we can spot such animals only in our dreams. Earlier, there was very less population, hence less illnesses. Increase in population because of new migration gave unprecedented increase of illnesses. After the ABSU Andolan, from the year 1996 there has been increase in number of illnesses for the next ten years. I had the highest number of patients in my pharmacy since the Bodo and Adivasi conflict till the year 2007.xix

Given the above setting, the list of Recognized Forest Villages under Chirang Forest Division is provided. While a few more would have emerged in the interim since the publication of the document, it provides a useful template of understanding the research area. The book describes the entire spectrum of human settlements in the conflict areas. Many respondents actually moved across all the categories: Recognized Forest Villages, Recognized Forest Villages and Revenue Villages that were destroyed in conflict (some rebuilt some abandoned), and Unrecognized Forest Villages and Unrecognized Forest Villages that were burnt down in violence, IDP camps or ‘relief’ camps that did not close down and have become unrecognized forest villages and temporary IDP camps (Table 3.3). Table 3.3 Forest villages in the northern belt of Chirang District close to the international boundary (0–20 kms)xx

Serial number

Name of recognized Forest Village (FV)

Area allotted (hectares)

1

Hatisar F.Vxxi

200

2

Deosri F.V

333.33

3

Simlaguri F.V

216.40

4

Santipur F.V

507.70

5

Bordangi F.V

175.20

6

Nizlaguri F.V

311.20

7

Molandubi F.V

311.20

8

Birinchiguri F.V

167.40

9

Pattabari F.V

159.30

10

Malivita F.V

86.13

11

Ranghijhora F.V

127.46

12

Khagrabari F.V

337.60

13

Salbari F.V

151.40

3.3 The Research Setting: Forest Governance …

85

3.3.2 Case Studies of Governance: The VCDCs of Milon and Koroipur Is conflict the result of poor governance or is poor governance the result of conflict? It is a very difficult question to answer and even seemingly pointless for those struggling with the day-to-day reality of living in such areas. The reality is that essential services that the state is supposed to provide to its citizens are compromised, there is low accountability to citizens and the government seems incapable of managing core social programmes and functions. In this light, the areas under study suffer from a triple jeopardy of governance. Apart from bearing witness to two and a half decades of conflict, it is in a border area suffering from the neglect that most border areas suffer. Thirdly, most of the communities are viewed as ‘illegal occupiers’ of forest land, and hence their entitlements as full citizens seem to be suspect. The field notes of a researcher about Sonapur, the Unrecognized Forest Village established by members of the Bodo community displaced in 2014, highlight the loss of entitlements of the conflict-affected families: While in Amguri too (their original village from where they got displaced in the 2014 conflict) the villagers never got much in terms of government service, schemes and programmes. But the villagers were in the process of making their ration cards and they told me that the headman in Amguri had asked for a treat from them and each family collected Rupees 20 to buy alcohol. They were assured that all the families would be getting their ration cards but even today, only one person in the present village of Sonapur has a ration card. No one else has a ration card.xxii

If the state of the physical infrastructure of government building (from where governance takes place) is an indication of the state of governance in the area, then the office of the Village Council Development Committee (VCDC), akin to a Panchayat in non-scheduled areas in Milon, speaks volumes. The formation of the BTC led to the dissolution of the Panchayats as the local governance institution. They now have a separate structure in place. VCDCs are now the equivalent of a Panchayat in the BTAD areas but they are nominated and not elected. Women’s reservation and other rules governing panchayats do not apply to VCDCs (see Chapter 2). The VCDC ‘Office’ in Milon functions out of the veranda of what was earlier the ‘Forest Office’. This run-down building is multi-functional, earlier it was the school, distribution point of relief materials during conflicts, Anganwadi centre (early childhood centre) and an immunization point among several other functions. An interview with a VCDC member in the ‘Office’ is revealing about the state of local governance in the area: Milon VCDC has 1,236 households under it, with a population of 6,800. As VCDC members, we are expected to do all the work of the government – like implementing all the schemes, selecting the beneficiaries, carry out the National Rural Employment Guarantee Act (NREGA) work, issue certificates to people etc etc. but we have to do it with no support. For example, there is no salary for any of the VCDC members, not even money for fuel for vehicles or even stationery like paper and pen! There is so much of paper work to be done. They keep asking for reports and for data which we have to send. Nowadays everything is computerised and so all the data has-to- be really up to date. We do not even have a computer. The VCDC Chairman’s brother has a personal laptop and he helps us put

86

3 Researching Fragility in the Indo-Bhutan Borderlands in all the data. The Chairman pays him a little bit for it. The PD-DRDA (Project DirectorDistrict Rural Development Agency) pays me Rupees 4,500 a month for my work as VCDC Secretary and that too we get only once in six months or so. I manage because my elder brother is a farmer and he supports the family. For all this work, we need at least 2-3 full time salaried persons and one accountant cum data entry person who knows computer. We should get salaries of Rupees 15,000 for there is a lot of work to do. I hear in Bengal; they get Rupees 12,000 for the kind of work that I do here in the VCDC. We do not get income even from selling VCDC certificates here (because very few people require it). The Chairman got 1,000 pieces printed at his own cost. We charge Rupees 20 for the certificate with only Chairman signature and Rupees 30 if it needs to be countersigned by the Block Development Officer as we need fuel and other expenses if we need to go all the way to Sidli Block office to get it signed. If at least certificates would have been sold, we would have been happy as at least some money for our tea would have come from this.xxiii

Overall, it is observed that the level of development in the villages under Milon VCDC is worse off than villages under Koroipur VCDC. There are roads and other infrastructures such as schools and health centres in Koroipur. Then, there are also more government schemes implemented there than under Milon VCDC. A Bodo VCDC member from Koroipur had this explanation to give (Fig. 3.1): There are forest revenue villages and then forest encroached villages. Under the Forest Rights Act, families living as encroachers are not entitled to any services. If today some services reach them (Milon VCDC), it is purely on the ground of humanity (and not an entitlement). Most of the villages under Milon are encroached villages. Earlier, no development works could be done in these areas and today, it is the money of BTC and DRDA that is being spent for development in these areas. There are technical difficulties in the implementation of schemes and services in an encroach area.xxiv

Fig. 3.1 Photo Showing the Milon VCDC Office in the Veranda

3.3 The Research Setting: Forest Governance …

87

From Field Notes of BL Dated 2nd December 2016 JL and I were interviewing HG (the pharmacist in Milon when from the corner of my eye, I saw three little boys of around 5–6 years playing in the VCDC veranda. They first swept the floor, then carried tables and chairs from inside a room and arranged it neatly outside in the veranda where the VCDC members sit and conduct their duties. After “playing” for some time, they came and stood near us waiting expectantly. HG gave them five rupees to buy sweets and they left. Only then did I realise that these little children were in-charge of cleaning the VCDC office and the way they were doing it so neatly, tells me they do it every day!”. This argument is repeated by most government officials when questioned about the lack of health, education services and the poor implementation of different development schemes in the Milon Villages. But how much of basis does this oft repeated argument hold to deny citizens their basic rights and entitlements to government welfare measures? RH who now works as a mobilizer in an NGO questions: The government does not give us facilities since we are forest encroachers and illegal in their eyes. Then, how come they have no problem in taking our votes during elections? How come we get recognized as citizens only then and not otherwise?xxv

Without clear policies and guidelines regarding status of forest dwellers, some of the most vulnerable populations in dire need will remain without essential services that is supposed to be provided by the government.

3.4 A Brief Description of the Unrecognized Forest Villages (FVs) from Which Data Was Collected The study areas included villages such Milon, Fulbari, Bogori, Sonapur, Lalbiti and Salbari. Given their precarious situation and the sensitivity of the data, names are coded and changed according to a methodology developed in the course of writing the book. These villages are under Sidli block of Chirang District. There were several sites for data collection with most of them being under the jurisdiction of Koroipur and Milon VCDCs. Koroipur is a good reference point from the perspective of the border. It is a hub for the people living in this area. All the Wingers and autos coming from the Bhutan Gate and going up to Bongaigaon park here. It is also a hub for institutions like the Government High School where high school children from all the nearby villages study and the All Bodo Students Union (ABSU), and important services like Police Station, State Bank of India Customer Service Point and medical institutions. People from Dadgiri (which is just adjacent to border of Bhutan) and the surrounding areas come for treatment here as there are several pharmacies (Chapter 6) and a state dispensary as well. Koroipur is also one of the biggest markets in this entire area. The

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market is open daily but the big weekly market is open on Saturday. On Saturday, this market is vibrant with people, vehicles, buyers and sellers as people from all the villages including some distant villages come here. From vegetables, fruits, clothes, shoes, meat, spices, utensils, crafts and medicines, vendors peddle their wares in the weekly market. A range of medicine sellers also peddle their wares—ranging from the ones announcing illnesses and their cures on loud speakers and attracting customers with colourful banners to ones selling herbal medicines quietly in a corner to those selling modern allopathic pills in the hot sun, and on the floor side by side fruit and vegetable vendors (Figs. 3.2, 3.3).

Fig. 3.2 The road that goes via Milon area up to the International Border with Bhutan

Fig. 3.3 Photo taken from Milon showing the Bhutan mountains across the border

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3.4.1 Milon RC (Relief Camp) Milon RC is one of the relief camps that hosted a huge number of Internally Displaced Persons (IDPs) during the 1996 and 1998 conflict between Bodos and Adivasis. The people who were living in the Milon Relief Camps were Adivasis who fled from various villages right near the Bhutan border and also next to the Milon area. They fled to Milon since it had a paramilitary force posted there and the people felt they would be safe there. Called Milon RC (Relief Camp), most of the 5,000 odd original camp inmates moved away in 2006 (after 10 years in the camp) when they got some Rupees 10,000 as ‘resettlement’ money. These families have now settled in forests from where they were displaced or in fresh areas. Today, Milon RC with 46 families living in mud huts looks more like a settled Adivasi village than a relief camp. None of these 46 households have access to toilets, bathrooms, wells and hand pumps. Their source of water is the Nijula River flowing nearby. Children attend the primary school located in Milon and the nearest health centre is Koroipur State Dispensary, just three kilometers away.

3.4.2 Bogori Village In the year 2005–06, rations were stopped and the IDPs were asked to leave the Milon RC. Many of the families could not go back to their original place of displacement due to lack of security and so they moved to a village next to the Milon RC, i.e. Bogori. There are 127 households with a population of 627 persons in Bogori. There is a lower primary school inside the village where children from the Milon Relief Camp village also come. In Bogori, there are 10 households with wells and 13 households with hand pumps. The nearest health centre for them is the Koroipur State Dispensary which is four kilometres away.

3.4.3 Fulbari Village Many of the displaced Adivasis living in Milon RC went back to Fulbari where they were originally from while some others cleared the forest for land. Located eight kilometres from Milon market, there are 160 households with 698 members. Located deep inside the forest, there are only mud paths that lead to Fulbari Village. The distance from Fulbari to Koroipur State Dispensary is 12 kms and for small illnesses, patients are taken to the nearest pharmacy at to another village, some four to five kilometres away. There are no schools, markets or even electricity in Fulbari and people either walk or cycle to Milon for purchases and other work. Water is a crisis here and the entire 160 households share three wells and a couple of hand pumps for drinking water. There is a learning centre for primary school children run

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Fig. 3.4 Photo of a house in Fulbari Village in the forest next to the Bhutan border

Fig. 3.5 Photo of children gathered in front of a school run by the ant, the NGO conducting this study

by the ant in the village. For schooling beyond Class Five, children must travel a long distance to Milon or Koroipur and hence there are many dropouts in the village (Figs. 3.4, 3.5).

3.4.4 Sonapur Village This is a Bodo village 11 kms from Koroipur. It is a forest area where the IDPs from the 2014 conflict between the Bodos and Adivasis were relocated after leaving the relief camp. It is in the middle of the forest and there are no schools, markets or health centres nearby. There is also no electricity in the village because it is in

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the forest area. Many of the displaced families depend on cutting trees for selling as firewood for their living. To go to Sonapur, one has to take an auto halfway and then people will have to go walking from there to reach their village.

3.4.5 Salbari Village Salbari a Bodo village with 77 households. The first settlement in the area date back to 1984, 12 years before the first Adivasi-Bodo conflict of 1996. SMB and his family along with five other families were among the first settlers in the village. They migrated in search of land and opportunities to make ends meet. The families of the village are located on either side of the village road which runs north and south extending a distance of nearly three kilometres. Towards the South there is the village called GLR, towards the northern side are the Bhutan Hills and the western sides are thick forest. The houses near the forest are locally called Salbari Forest Village No. 2. Salbari No. 1 serves as the boundary towards the southeast. The land of the village is demarcated into 55 blocks of land belonging to 55 families from the village. Each family in the village occupies more than 15 bighas of land.xxvi Other families in the village are supposed to be the sons who have moved out of the parent’s home after marriage (Fig. 3.6).

Fig. 3.6 Photo showing villagers in Salbari performing a community ritual

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3.4.6 Lalbiti Village Lalbiti is across the river Bhur. It was only in the year 2000 the people started building their homes in the village. The families that are settled here were the displaced populations from the 1996–98 Adivasis and Bodo conflict. These families were informed by the government authorities that compensation would come in cash only if they vacate the market areas. They were thus forced to settle in lands that were actually prone to soil erosion. After moving out from the relief camps, they were given the compensation amounting to Rupees 10,000 and forced to purchase tin for their roofs from that money. There are 45 families in the village and many of them have to occupy forest lands for irrigation. The nearest market and state dispensary are Asrabari.

3.5 Methodological Development for Studying Fragility in the Indo-Bhutan Borderland Researching a context which is just emerging out of conflict is extremely challenging. It is even further compounded when individuals are living in environments that could change rapidly. At the time of the study, the humanitarian emergency situation created in 2014 had not yet ended. While several humanitarian organizations had exited, the major armed organizations not on ceasefire, were very much active. If there is any drastic change in the situation from then and now, it is the obvious reduction in militarization of the research context. Insurgency and counterinsurgency were woven into the fabric of everyday life. In areas such as these, developing a standardized one-size-fits-all research method is not effective, given that there is necessity to cross-verify and triangulate the information being collected. Official statistics on health determinants in the forest villages are difficult to collate given that there are no PHCs in the zones occupied by ‘unrecognized’ forest villages and that many residents access informal medical practitioners. Yet, without empirical evidence it would be difficult to make concrete policy recommendations. Narrative research thus became a critical tool to understand the problems from the perspective of participants. Martin Doevenpseck (2011) in studying the Congolese–Rwandan boundary discusses a template of researching the lifeworlds of people living in border areas through narrative approaches which he calls Border Talk. According to him, Border talk ‘is always linked to real physical and material consequences, and the combined approach of static and mobile methods, as a hybrid between interview and participant observation’.xxvii This helped ‘to counterbalance the restrictions of classical interview situations and pure observation’.xxviii In this case, a multi-layered strategy relying primarily on qualitative methods helped the research team understand the actual experiences, stories, perspectives and events that happened with the population that was being studied. It gave the

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researchers opportunities to go deep into life histories not just of individuals but also of institutions. Based on an understanding of the context, the research team also developed their own pathways and research strategies.

3.5.1 Identification and Selection of Villages Initially, the villages selected were within the ant’s intervention villages. These were sites affected by the 1996, 1998 and 2014 conflicts between the Adivasis and the Bodo communities. Since rapport had been built with these villages, it was felt that this would give a good starting point for the study. In an area of ethnic polarization, it is important to study the perspectives of all the affected communities. One criterion was the continuum of informality discussed above. The research sites thus included displaced populations of various ethnicities who were living deep inside the forest and displaced population settled near the main road that leads into Bhutan. The study team also included those newly affected by the recent conflict of 2014 (that had just occurred a year before the process of the study had started) as well as those who had experienced the past conflicts of 1996 and 1998. It turned out that most of those affected in 2014 had also been impacted by the earlier rounds of ethnic conflicts. For some of them, this was the third round of displacement and disruption. Once the team started the interviews, the informants shared stories of their families, friends and neighbours in other relief camps. The researchers also learnt about villages where people re-resettled after the conflict. With this information, the team started looking for further information and understanding the differences between these villages. Villages and respondents chosen were thus through a snowballing method done with help from the informants.xxix Finally, the villages covered in the study extended beyond the jurisdiction of Milon VCDC to also cover areas around Koroipur, Salbari and Asrabari where populations have resettled after the conflict. For example, the village of Salbari was later chosen to understand how Bodo families who have fled and returned back to their original villages have fared compared to their fellow villagers who did not return to their original village from the relief camps.

3.5.2 Research Ethics The Institutional Ethical Committee (IEC) considered the ethical concerns of the research and the methodology and formulated a set of ethical protocols to be followed. Each member of the research team had to individually complete and pass a NIHweb-based training on ‘Protecting Human Research Participants’ before the ethical committee gave its clearance. The research tools developed were also examined by the committee and only then team could go ahead with data collection. Qualitative methods of data collection—such as in-depth individual interviews, group interviews and observational methods—were used to obtain the data. The interviews—where

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possible—were tape recorded and transcribed. Where it was not possible to record, detailed notes were kept. Timelines, case studies and life histories were constructed and developed throughout the process of data collection. Detailed date-wise field notes were kept of the small talks, informant interviews observations and photographs by the researchers. Given the sensitivity of the area all names and places were changed and continuously recoded to protect the identity of the respondents.

3.5.3 Methodology and Tools Used in the Study This study used qualitative methods and designs. These methods allowed the respondents and informants to explain their experiences on conflict and health in their own terms. Initially, the researchers started with participatory methods, working with Self-Help Groups (SHGs) and holding village group meetings. Different participatory methods such as disease listing, ranking, mapping of health facilities and illness timelines were used with the people to open up and warm up for interviews before going in depth into specific health issues. While the participatory methods initially did help in understanding the overall health status in the villages and in allowing the researchers to introduce the objectives of the study to the community, it was soon found to be limiting. After a few group interviews and health mapping exercises in the village, the research team found that the information was getting repetitive and that they had hit saturation very early. It was a similar experience with the semistructured research tools formulated for individual interviews. It was found the tools limited deeper explorations into the subject and upon reviewing it with the research advisor, it was decided to keep it aside for a while and first focus on collecting deep narratives of people’s lives and their lived experiences of conflict. This helped in a more in-depth understanding of the context of conflict on health and well-being of people affected by conflict.

3.5.3.1

In-Depth Interviews

In-depth interviews were used with conflict-displaced individuals of different communities to construct their life histories/thick biographies and understand in depth their experiences with conflict and its effect on their health and well-being. Indepth interviews were also used to interview key informants such as health personnel from the various phases of the conflict timeline, community leaders and those who had directly experienced the dislocation caused by the onset of conflict. Some of these thick life histories and biographies were used to later construct vulnerability maps, treatment pathways and timelines that appear at different times in the book.

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Group Interviews

Group interviews were conducted with women’s group regarding women’s health and experiences during conflict. Participatory methods such as drawing of timelines, facilities mapping, disease ranking and mobility maps were used during the group interviews to get the data and verify the information. Group interviews were helpful for respondents who were talking of events which happened a long time ago, like the 1996 conflict-displaced respondents. Memories of individuals became more vivid while talking in a group and also helped verify the accuracy of the information recalled.

3.5.3.3

Small Talks

A number of small talks (not formal interviews) with various individuals in the study area like shopkeepers, village elders, patients, carers and staff in the hospitals, among several others helped to give a deep understanding of the context and in validating some of the information gathered from other methods such as observations and interviews. Detailed time-stamped notes for these small talks were kept by the researchers and used during the analysis.

3.5.3.4

Observations

Observations and field notes were also used extensively in this entire research process especially in understanding the status of the people, the health-seeking behaviour and the healthcare service providers in the area. For example, the researchers spent hours in the shops and homes of the ‘pharmacists’ and faith healers observing the types of patients, the illnesses and the people they treated. Field notes of the observations were written daily by the researchers and these were filed. Then, it was from observations of the dismal housing conditions, illnesses, unorganized village structure, wife-beating, alcoholism and poor life conditions of one of the long-displaced Bodo villages, i.e. Paolipur that led the team to visit their original village before the first displacement took place, i.e. Salbari and include it as part of the study. Observing and comparing the living conditions of the displaced Bodos with those who returned to their village after displacement led to a deeper understanding of how the effects of conflict-induced displacement prolongs even 20 years after the actual incident of violence.

3.5.3.5

Map Construction from Life Histories

This was a tool the research team developed specifically for this study. Oral histories were used to construct various maps and timelines like the conflict timeline, history of the health system, vulnerability maps and illness pathway maps. Some of these maps were drawn while the data was being collected and helped point out the gaps in data

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which the research team then filled up. Then, sharing the health system history map with some of the relevant respondents helped validate the information and sharpen it further. Using diagrams and maps helped the research team present complex phenomenon in a concise manner. The historical context of conflict in the larger socio-economic changes has been analysed through available secondary literature and this too was put in terms of a timeline for easier and clearer understanding.

3.5.3.6

Photographs and Visuals

Photographs were taken during fieldwork to highlight the data and information collected through the other means such as interviews. Some of the photographs used were from the archives of the ant that was present at the time of the 2014 Bodo– Adivasi conflict in the area. The maps and photographs helped in corroborating the data from the interviews and along with observations helped in triangulation and presenting the data in a more complete manner.

3.6 Data Collection: Experiences Most of the villages covered in the study fell under the ant’s intervention area where the NGO has been working for almost a decade and is known to the people. Building on the rapport and goodwill already present, the researchers were given an easier access to interviewees on the very sensitive topic of ethnic conflict, pain and loss. The researchers could reach out and interview a range of respondents—community members, community and village leaders, teachers, health workers, members of local governance bodies and youth leaders. the ant’s reputation of many years helped open doors and most respondents contacted for the study were keen meeting the researchers. Even former combatants were willing to share their stories in threehour-long interviews, and doctors who served in Koroipur were willing to meet and share their stories without hesitation. The team of researchers was housed in especially rented quarters in the Milon Nepali Village which belonged to a lower primary school teacher. This proximity to the villages of the study ensured that data collection was flexible and the researchers were able to reach out to different levels of respondents with many opportunities for observation and immersion in the study sites. The interview place and time were scheduled according to the convenience of the communities and the availability of the informants and respondents. Most of the interviews were at the houses of informants/respondents. Some of the meetings with community leaders and Community-Based Organisation (CBOs) were held at their respective offices. The process of data collection was very open, flexible and iterative. The research team after two to three interviews would sit together to review data and plan the next line of questioning. Monthly meetings were held regularly with the research advisor and a bigger review meeting once in 3 months helped review the progress of the study and make changes if any were required. Each review

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meeting allowed the researchers to go back to the data, find the gaps and explore more possibilities of exploration.

3.6.1 Some Data Collection Sites One of the places where the researchers were provided a lot of information was the Milon Bazaar. As JL’s field notes of 1/11/2016 describes: SM is a widow who runs a small shop in Milon Bazaar selling packaged snacks, toffees and sweets. She also stocks and sells a bit of petrol and diesel brought from across the Bhutan border. Her shop is also popular for a couple of fast food items like instant noodles, fried eggs and tea. One always finds local people sitting in small benches outside her shop, chatting and having some snacks or a cup of tea. Hence, SM thus is well-informed about the local politics and the happenings in the local area (Fig. 3.7).

Since the tea shop owners were always curious about the young new staff of the ant residing in Milon, they would question the researchers on their projects. As the researchers explained why they were there, people would start sharing bits and pieces of information about various incidents, their opinions, their own personal experiences, stories of their past and how things are now. Some would share their personal problems, while others, who feel responsibility towards the community, would share how difficult and challenging Milon is and what the future ahead seems for the people. Sitting and observing in ‘pharmacies’ [informal allopathic practitioners] in different locations was also advantageous for the researchers. This is where all the local practitioners would share their stories of what kind of patients come to their shop for medicines, who is a regular customer and what kind of illness they treat. As MJM’s notes of 9 November 2016 reads: ‘I had visited the pharmacy of S and R and in DKNRA. My plan was to talk to R regarding the types of illnesses

Fig. 3.7 Photo of a tea shop in Milon–one of the sites for data collection

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in the area. He has been providing health service in the area since the past 11 years. As I was waiting for him, his wife walked into the pharmacy and told me that her husband would not be coming in today. Though I thought of moving away I decided to spend a little more time observing. In a few minutes’ people started coming to the pharmacy with different illnesses and the whole evening I spent just observing them.’ It was found that while the ‘pharmacists’ were quite comfortable with the some of the field researchers, they became guarded and very uncomfortable when one of the senior researchers, Dr. MS, a medical doctor, went to talk to them. They knew him to be a medical doctor and would not open up.

3.6.2 Challenges of Fieldwork Milon where most of the fieldwork was located is not an easy terrain, especially during the rains when most of the mud paths become wet and slippery. Being in the Bhutan foothills, the area receives a lot of rain. During the peak monsoon, fieldwork had to be halted for almost a monh because researchers could not travel to the villages. Most people are out in their field during the planting and harvesting seasons and cannot be reached. Then, most of the displaced populations have no land and are thus dependent on the Bhutan side for daily wage labour. The men who go for work to Bhutan leave early morning and return late evening. Meeting some of them was very difficult. Then, another specific and unexpected fieldwork challenge was the high level of alcohol consumption in the conflict-displaced villages. Interviewing people in such villages was difficult as people (when they were not at work and free to talk) would be inebriated. Among the Bodos, only men were found in such state. However, among the Adivasis alcohol consumption in one of the villages in the study was very high among both men and women. Sometimes the responses given were doubtful. To overcome this, the team changed the timings of the interviews to early morning but to their surprise many of the respondents were still found intoxicated in the mornings too. (As JL states: It was a challenge for the field team to keep their own heads steady in some villages where the alcohol fumes of locally brewed alcohol hung heavy in the air!) (Fig. 3.8). Yet another challenge for the researchers was to manage expectations from people as the researchers were seen to be from ‘the ant’ or ‘NGO’. Being in a conflict area where people have received relief materials from NGOs in the past (including from the ant), asking a few questions for the research, led some people into thinking they might receive something. Researchers faced questions from some individuals such as ‘what will we get?’ and ‘what are you giving us now?’ which made it difficult for the researchers to explain their project to people. On the other hand, the researchers also had to face rejections for interviews from people for personal reasons, which were never explained. There were also people who refused to speak to ‘NGOs’ (the proxy for researchers) because they never received anything from them in past.

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Fig. 3.8 (Clockwise) Photos Showing Challenges the Challenges of the Terrain for Data Collection

3.6.3 Walking the Fine Line Between Researcher and Activist At times, the research team found themselves treading a thin line between being researchers and being development workers. It was difficult to remain an objective researcher witnessing people’s struggles and hardships without intervening. There were times during the fieldwork where they were called to act upon certain situations. In one case, one of the researchers during an overnight stay found that a woman was having labour pains and she could not be taken to the state dispensary the next day morning because her family did not have money to pay for the ambulance. The researcher gave money she was carrying, for the ambulance, else the woman would have been in danger of a complicated birth. In another case, in one of the displaced villages, researchers found that children who used to go to school before the conflict had no more school to attend. The researchers had to write to the Executive Director of the ant regarding the situation of the children and eventually the organization started schooling facilities there.

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3.6.4 Researcher as an Insider and Positionality As a researcher, there were also dilemmas about their own positionality. There was a time when one of the researchers did a few interviews with traditional healers. Though never personally believing in such things, the researcher had to struggle not to express his own views openly. While he tried his best to position himself as an unbiased researcher called to interview, collect data and write up the data his feelings always contradicted what he was listening to. Gradually, over time he realized the importance of registering all perspectives and not to allow his opinion to shape the process of data collection. Then, being researchers from the same community had its own set of issues. While being an insider helped in the data collection as one was familiar with the language and could probe deeper issues, it had its flip side. While researching ethnic conflicts, it is not easy remaining totally unbiased about the ‘enemy’ community. Listening to story after story of loss inflicted by the other on ‘one’s own people’ and of their struggle for survival after such losses, did affect the researchers from that community. There were times when one could feel the emotions of anger and awkwardness between researchers belonging to different ethnicities. It helped for the entire research team to sit and acknowledge the negative feelings and discuss the differences. This also helped normalize the situation and created openness among the research team members.

3.7 Documentation, Filing and Data Analysis The in-depth interviews which were recorded in the voice recorders were transcribed. The first initial transcriptions were stored in their original format and filed accordingly. The transcribed data were later edited and filed based on the name of a village, given a code number and file name. Transcribing and editing of data were an ongoing process in the field. If there were data gaps which were identified, the team would revert back to the concerned informants/respondents for further clarification. For small talks and observations, the researchers kept detailed field notes. Most of the field notes give a description of what is happening around on the day of fieldwork and what was observed. The field notes from observations, small talks and interviews were integrated together for analysis. Mapping out the concepts and creating diagrams helped identify data gaps and clarified the teams’ own understanding of the phenomenon. Analysis was an ongoing process along with data collection. The team held periodic debriefing and review sessions where a highly iterative process was followed to study the data, examine the gaps and using a combination of instruments such as field notes, memos, short life histories, various forms of pictorial representations such as photographs and conceptual maps. At different phases of the study, the team sat together to sift through notes, memos and pictorial representations keeping in view the research question and generated conceptual representations for each of

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Fig. 3.9 (Left) and (right) Photos showing regular review meetings of the research team to review the data, identify gaps and plan out the next steps in the study

these questions These were subjected further to rounds of reflection and refinement (Fig. 3.9).

3.8 Limitations of the Study It is extremely important to acknowledge the limitations of the study. The subject being so wide, complex and multi-faceted involving many communities and the time for data collection being limited, the researchers had to resist the temptation, to keep going deeper and deeper into every facet. For example, though the group wanted to, it was decided not to go beyond the level of State Dispensary Level (PHC) in the in-depth interviews and case studies. Secondly, language was a limitation for the researchers especially for the Adivasi (Santhali) section. Though the researchers tried very hard, they could not hire a suitable trained and skilled Adivasi researcher to carry out the qualitative interviews. There were no qualified persons within the community in Milon and all the others interviewed were from outside the area. They were hesitant to come and stay in such a conflict-prone and ‘dangerous’ area. It was only after 2 months once the fieldwork started before a Santhali male from a neighbouring district (2 h away) agreed to stay with the team and facilitate basic translation from Santhali to English. It was felt that if a qualified female Santhali researcher would have joined, it could have led to deeper interviews with the Adivasi women.

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3.9 Conclusion This study being a part of a larger initiative to understand health inequities in India, looked at health inequities among tribal communities who have undergone conflict. The qualitative methodology was well suited for the subject since it helped study the participants’ in their ‘own terms’. It helped ‘unpack’ the many issues related to the collapse of the health system through the conflict timeline as well as deeply understand the impact of conflict on people’s health and well-being. Different qualitative and ethnographic methods of in-depth individual interviews, key-informant interviews, group interviews, observation, small talks and conceptual maps were used to collect data. Most of the in-depth interviews were recorded and transcribed, and detailed field notes were kept of the observations, small talks and key-informant interviews. Analysis was an ongoing process along with data collection, using a combination of instruments such as field notes, memos, various forms of pictorial representations including photographs, maps and diagrams which were updated through an iterative process facilitated by periodic sessions of debriefing and brainstorming by the team. One of the biggest advantages of the study was that the villages covered in the study fell under the ant’s field intervention area where the NGO has been working for 8 years and is known to the people. Building on the rapport and good will already present, the researchers were able to access interviewees on the sensitive topic of conflict. While being identified with the ant helped build rapport with the respondents, the research team had to deal with the challenges of managing material and other expectations from NGOs in general (especially as the December 2014 conflict had just occurred and from the ant in particular). Then, being development practitioners, the researchers also had to tread a thin line between research and activism. At times, it was not possible to separate the two roles. The tough terrain and heavy monsoon in the peak of data collection were other challenges for fieldwork. An account from Jennifer Liang’s Field Notes on Ecological Fragility provides a description of the challenges in conducting research in the context discussed in the chapter. Having provided the background information to the conflict, the next few chapters exclusively focus on the key findings, many of which were unexpected. In the next chapter, the vulnerabilities of health providers will be examined, following which the book records experiences of the 1996 and 1998 conflagrations. It is one of the few records of the brutal conditions inside the ‘relief camps’ following the 1996 and 1998 conflicts, which have long since been forgotten (but whose echoes are still evident for those who were directly affected).

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Appendix 1: A Case Study of Ecological Fragility After Conflict and Displacement [Case Developed from Jennifer Liang’s Field Notes from Fulbari Village]xxx Introduction We are seeing a big impact that conflict and displacement has had on the ecology of the Indo-Bhutan borderlands. What we see in our observations is only symptomatic of a process occurring throughout the ecologically sensitive belt. Yet again, for those displaced after the conflict the choices are difficult. To what extent can you balance out short-term survival goals with long-term environmental impacts? This is important to understand because it has started telling on the health and quality of life of people in the area—not just of the displaced populations but on other communities as well and on all forms of life there. Reaching an Unrecognized Forest Village It was raining incessantly the past few days in Milon. For two days now, everyone’s mobile batteries have been drained off. The electricity came for an hour yesterday afternoon while we were having the cluster meeting in our base camp but the voltage had fluctuated so much that we could not charge any of our phones or laptops. Also, even if one could charge the phone, it would not be of much use—except may be to listen to music or use it as torchlight in the dark evenings and save on candles— because it is a very Milon phenomenon that when electricity goes off, there is also no mobile signal! The only battery set with inverter in the Milon market which helps people charge their mobiles for a cost was also spoilt. Hence, it was quite interesting to find people in the market place—those with still some battery on their mobiles left—staring at their blank mobile screens every now and then as if hoping for a miracle for it to come alive. When the rains abated slightly, one hand on the handle bar and the other holding the umbrella, I started cycling towards Fulbari. I planned to spend the next few days there doing fieldwork. RH, the field mobilizer of the ant, met me at the Milon market. He was my translator for the interviews I wanted to do with the Adivasis, the community to which he also belonged. Incidentally, RH has roots in this village of Fulbari from where his family was displaced 20 years ago in the 1996 Bodo–Adivasi conflict. But with most of his family either dead or scattered elsewhere, he has never gone back to re-settle there and choose to settle right next to erstwhile Milon Relief Camp. A couple of miles from the Indo-Bhutan border, it takes around 45 min to cycle the distance of eight kilometres from Milon Bazaar to Fulbari. The village is known as a FE (Forest Encroached) village and is not officially recognized by the government. One has to pass two patches of forests to reach the village. There are only mud paths which lead to the village and it is difficult to even travel by motorcycle in the rains. Most villagers either walk or cycle and there is only one person in the village of 145 households who has recently bought a motorcycle. Divided into two parts, the bigger

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part in the south where we planned to stay has 110 households while the Northern part, half an hour cycling away, has 35 households. While on our way a person from the village in Milon had warned us to look out for elephants as they had been spotted that morning in a village we had to pass through. These elephants traverse the forests on either side of the international boundary. I could not help wondering how (in this soft and muddy road), one would cycle and get away if attacked by elephants. The piles of fresh elephant dung on the road, the damaged plants made by their stampeding and the signs of huge elephant footprints did not do much to assuage my trepidation. People in Milon market had already expressed their vocal disbelief and fear when they learnt we were planning to go and spend the next few nights in Fulbari. If something were to happen to us, it would vindicate them and look foolish on our part. I also could not help reflecting as we cycled on as to what a thin line there is between bravery and bravado. If you survive then you are called brave but just in case something untoward was to happen, then the same people will wag their fingers at our stupid bravado! Luckily the elephants seemed to have had their fill of the pineapples and returned back to the jungles and we reached Fulbari wet, but otherwise quite well. Over the next few days, we met and chatted with women in the courtyards of their homes and in the water points when they went to bathe their children, wash their clothes and fetch water for cooking. We caught up with the men in the few hours when they were home from their labouring across the border in Bhutan and when they were not too drunk to talk to us. We followed children back to their homes and came to know of their lives. And an evening elephant raid gave me a rare insight into the fragile and tension fraught balance between survival of human beings and the ecology. Clearing the Reserve Forest We stayed in the house of SH, who is one of the five headmens of the village and he looks after his cluster of 15 households in Fulbari. At 79 years of age, his father-inlaw is the oldest in the village and one of the first settlers of Fulbari Village in the early 1980s. They were from the Bengtol area (some 30 kms from here) and their family had a lot of land and also cattle. But some illness struck their village and both his siblings died and after some while, he lost his parents too. He had left school in Class Three and has not studied after that. Some years after his parent’s deaths, like many others in his village, DM also lost his entire land to river erosion. ‘The government gave us rations for a month and then we were left to look after ourselves’ he said. His Bengali Muslim neighbours who had also lost their land asked him to go along with them to Dhaligaon an area near Bongaigaon Town but he refused as he had 35 cows and 15 buffaloes and where would he keep them in the town. He moved to Parbhu and stayed there for two years. But that place was already crowded and ‘there was no land for paddy cultivation’. So, he went searching here and there and then landed up in Fulbari.

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The area was a thick jungle and they had to spend many years clearing the land. Around 10 families—most of them related to each other—came together and they started settling in the forest. He recalls: Even the Bodos in villages around Fulbari i.e. also came at around the same time and settled there in forest land. Once we cleared a bit of land and built our houses and started living there, we started growing maize, mustard, demchi (a kind of millet) as we could not grow paddy till we had made ‘dongs’ (irrigation canal to divert river water).

In 1996, after more than 10 years since they came to Fulbari, there were some 46 families living there. They had built the canals and were ready to plant paddy for the first time when the conflict broke out with the Bodos and they had to flee, ‘we fled with nothing, just with our lives and went to live in Milon (relief camp)’. After 11 years in the camps, he returned with his family to Fulbari. Danger of Wild Elephants: Ecological Conflict in a Transboundary Forest When RH and I reached the headman’s house at around 11 a.m., we could feel some tension. Two adult elephants had come the previous night and eaten away one big patch of maize owned by the family just across the stream from their house. They had kept vigil after dinner and hearing the elephants at around 10 p.m., they had gone and chased them away. But when they did not return even after 2 h, the family went to bed. The men were sleeping in a semi-open shed and with the rains pelting down the tin roof and drowning out all noise, they did not hear the elephants return. This morning when they woke up, they have found that the entire patch of maize crop, which had just ripened and almost ready for harvesting, all gone. SH had planted hybrid maize seeds this time and each plant had sprouted two maize cobs which were all big and full of ears of corn. We visited the patch and estimated around 300 plants had been destroyed by the elephants that night and even if they sold each at a minimum of Rupees 5 each, they would have lost corn worth Rupees 3,000 in one night. Already the elephants in previous visits had uprooted and eaten a lot of the simla aloo or yam behind the house. Hence, the family was tense as there was only one more patch of corn just in front of the house which needed a weeks’ time to be ready for harvesting. The whole day was spent in pregnant suspense if the elephants would again come in the night. As we waited for dinner to get ready, I sat with SH and RH in the tin shed talking about the conflict of 1996 and their return from the Milon camp to Fulbari. We had to really shout as there was huge storm raging and we could hardly hear ourselves in the rain. With sprays of water getting us wet, yet we talked. And time and again, we would all shine our torches in the dark towards the maize patch and keep a look out for the elephants. But we could hardly see our own hands through the sheets of pouring water. As soon as the rains let up a bit, we heard loud thumping sounds. RH told me that it was the elephant hitting its trunk on the ground! SH ran towards the maize patch and all the other family members also ran excitedly—some with torches and some without. I remained with the youngest boys in the shed watching in fear and awe. The two elephants—probably of the previous night—had come yet again and

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were eating away at the fresh patch of maize even as we spoke. Making loud noises and shining their torches, they managed to get the elephants away from the patch. But only for them to lumber to the back of the house towards the fields of simla aloo (yam)! Even I joined in the excitement of elephant chasing this time as we ran towards the back of the house. The elephants disappeared into the nearby jungle in the commotion. We could hear them snort from time to time but not see them in the dark. Sometime after our dinner, they crossed over back to their own side of the jungle and did not return again that night! But till we slept (and perhaps even long after that), I could spot SH going to and from the maize patch in the front of the house to the yam fields at the back, shining his torch, trying to spot and chase away elephants. Early morning, he was up at 5 a.m. and by the time we woke up, he had already gone fishing in the dong (water canal) and brought back around half a kilogram of small finger-sized fish for lunch. The family was sad and upset this morning—yet more losses and a waste of hard labour. They survive because they are able to supply a bit of milk from the cattle they own. Also, in a tiny front room, they run the only shop in the entire village, selling essentials like rice, lentils, salt and cooking oil and also some toffees and packaged snacks for children. Though it is not easy running a shop in an impoverished village such as theirs—as people keep asking for credit and being known to them, it is difficult to refuse—they keep on as else for the smallest of things in an emergency too, people will need to go all the way to Milon. SH’s household is one of the more ‘prosperous’ in the area. He is also different as he does not drink, unlike many of his fellow villagers. Like SH, his neighbour RDS also does not drink or smoke. Describing himself as a hard-working man, he says he works 6 days a week—either he goes to across the border to Bhutan and does daily wage labour or cuts trees and sells it as firewood in the market. Both he and one of his sons go to Bhutan for daily wage labour and each one earns anything from Rupees 250–400 a day depending on the type of work. They leave early morning for the border and once there, all Indians offering their labour stand in a big waiting shed in the bus stop. People who need labour come and pick and choose and negotiate their price. Some Bhutanese ‘maalik’ (owners) treat them well and even give them a cup of tea or some food at times. But some are not as nice and keep harassing and scolding for every small thing. But they have no choice. They have to do labour or else they cannot meet the expenses of the family. They had lost everything—cattle, grains, trees—in the 1996 conflict when they just managed to flee and save their lives. They again lost a lot of their grains in the 2014 conflict and are still trying to recover from that loss (Fig. 3.10). Then, elephants eat up the maize, paddy, potatoes or whatever they grow. He feels that if the conflicts and also the elephants did not disturb the people of their village, they would have enough food and not need to sell firewood or do labour in Bhutan. He blames their ‘beggared’ status largely on these two factors. RDS is very concerned as he cannot understand why he is unable to save despite earning quite a decent amount and having no particular ‘vices’ (like drinking or gambling) to spend on. The cash he and his son earn from cross the border in Bhutan is very helpful in running the household expenses but they are unable to save or build up any assets. In

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Fig. 3.10 Tree Stumps after forests are cleared for farming

fact, he does not own a single head of cattle and has to hire bullocks from others to plough his fields. They also have only one hut in which the six of them—including a married son, his wife and their child—also live. Treatment or elephants? GH, an Adivasi Pharmacist (more on the unlicensed Pharmacists is in Chapter 6), says: I am called to visit patients (in their homes) any time, even at night. Few weeks ago, I was asked to go to Fulbari for an emergency at 10.30 p.m. I refused to go because of danger of attack by elephants but they pleaded and forced me to go. I was really scared and tensed as it was so silent and scary in the jungle. We were lucky we did not cross the path of any elephants that night. Now whatever happens, I have sworn I will never ever do this again. It is too risky.xxxi

Wither the Forest And it is not just the elephants. Much else is pushing an already fragile ecology to almost breaking point. With no clear rehabilitation policy of where to settle people who have lost their homes in conflict, coupled with weak forest governance, more and more families are bound to settle here after clearing forests. Access to drinking water is a serious issue in the village. Currently, there are two water points in the area on which the 145 households depend on for drinking water. The first one is the diesel pump set with overhead tanks left behind on request of the villagers by the government paramilitary forces when they left the village after guarding the relief camp returnees for a few months in 2015. Each family used to pay for the running costs of diesel and got an allocated amount of water. But the pump is now spoilt and they are unable to get it repaired locally. Villagers, largely women, now have to fetch water from the only well that is outside the village near the river. Around 45 min walk away, this well is a huge boon to people and it has been repaired and enhanced with a concrete platform by AFX, a humanitarian organization as part

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of their post-conflict relief work in 2015. This structure has been highly appreciated by the village people as earlier dirty water which used to collect around the well would seep in and contaminate the water. For other purposes, the villagers of Fulbari wash, bathe and also water their cattle in a small stream which flows through the village. Coming from across the border in Bhutan which is visible in the photo, toxic waste from a brewery there is often seen mixed with the water. In the dry months, when the flow of water is less, the concentration of chemicals increases and this becomes really harmful. Cattle who drink the water then fall sick and also people have reported all kinds of skin allergies and ailments and one death the previous year was attributed to the family drinking this water. Though the community with support from the ant working in the area petitioned the governments of both India and Bhutan to do something about the dirty water, not much has been done. People continue falling sick as they are dependent on the water from across the border. Every afternoon right from 2 p.m. onwards, we see hundreds of cycle loads of firewood from freshly cut trees being taken out of the forest and sold in the markets. Each cycle load sells for Rupees 300–400 in the market. While many are conflictaffected families selling firewood for a living, some woodcutters come from as far as Bengtol and Asrabari (15–20 kms away). With the forest cover disappearing, the rivers that flow from Bhutan have also gone wild. Soil erosion is threatening the very existence of the entire Milon area. All communities—Nepalis, Rajbongshis, Adivasis, Bodos—lost large tracts of land to soil erosion last year. A few days ago I was taken to see this destruction and was really alarmed when SH, one of the Adivasi leaders, told me that he alone lost 20 bighas (8–9 acres) of agricultural land last year. The Nepalis who keep cattle in gumtis (large cattle farms in the middle of the river with hundreds of heads of cattle) have had to shift all of it out. The entire Rajbongshi Village nearby is also threatened— four houses were washed away in the floods and erosion this year. Milon somehow feels like an ecological time bomb waiting to burst (Figs. 3.11, 3.12). Fig. 3.11 Trees cut for selling as firewood—cycle-load of firewood every evening is a common sight in the Indo-Bhutan border areas

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Fig. 3.12 River erosion washes away big chunks of land

Notes i ii

iii iv

v vi

vii

See Chapter 7 for a historical reference to the Duars and the era of colonial rule in Assam. For historical background on Chirang, see Directorate of Census Operations Assam. 2011. District Census Handbook Chirang: Village and Town Directory. p. 14. https://www.censusindia.gov.in/2011census/dchb/DCHB_A/18/ 1821_PART_A_DCHB_CHIRANG.pdf. Accessed 1 December 2019. For further details, see Office of Deputy Commissioner, Chirang District, BTAD (Assam). https://chirang.gov.in/. Accessed 1 December 2019. Joshi, M. 2015. Comprehensive peace agreement implementation and reduction in neonatal, infant and under-five mortality rates in post-armed conflict states, 1989–2012. p. 7. BMC International Health and Human Rights 15 (27). https://doi.org/10.1186/s12914-015-0066-7. National Family & Health Survey—NFHS Round 4 2015–2016 https://rch iips.org/NFHS/factsheet_NFHS-4.shtml the ant (the action northeast trust) is a non-government, non-profit development organization based and working in Chirang District since the year 2000. It works to empower marginalized and vulnerable groups for their development. Over the course of two decades, the ant has worked on issues of women’s empowerment, community health, sustainable livelihoods, mental illness treatment, child and youth development including improving quality of government schools, post-conflict peace building, etc. See Chapter 6 for a discussion on the diagnosis of mental health in Chirang.

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Center for Natural Resources and Environmental Policy, University of Montana. 2020. Transboundary Manas Conservation Area (TraMCA) Bhutan & India. p. 2. https://naturalresourcespolicy.org/docs/Hands% 20Across%20Borders/TBC%20Profiles/TBC%20Profile_Transboun dary%20Manas%20Conservation%20Area_Bhutan%20India_Wangdi. pdf. Accessed 6 February 2020. Forest Department, Bodoland Territorial Council. 2008. Profile on Forest and Wildlife of Bodoland Territorial Council. Kokrajhar: Forest Department, Bodoland Territorial Council (BTC). p. 1. Ibid., p. 10. Ibid. Ibid., p. 13. Dutta, Anwesha. 2018. Rural informalities and forest squatters in the reserved forests of Assam, India. Critical Asian Studies 50(3): 353–374. p. 362. https://doi.org/10.1080/14672715.2018.1479646. Ibid., 354. Ibid., p. 72. Interview with Respondent CDV. Interviewed by MJM. Date of Interview. 19 December 2016. GSLMRI Village, Chirang, BTAD (Assam). Interview with Respondent NN. Interviewed by MJM. Date of Interview. 12 December 2016. Milon Village, Chirang, BTAD (Assam). Forest Department, Bodoland Territorial Council. 2008. Profile on Forest and Wildlife of Bodoland Territorial Council. Kokrajhar: Forest Department, Bodoland Territorial Council (BTC). p. 80. Interview with Respondent CB. Interviewed by researcher [undisclosed]. Date of Interview. 20 December 2016. Forest Department, Bodoland Territorial Council. 2008. Profile on Forest and Wildlife of Bodoland Territorial Council. Kokrajhar: Forest Department, Bodoland Territorial Council (BTC). p. 78. Hatisar which is a derivative of Hathi-Seher or Elephant Town due to the large number of elephants (Hathi). It is directly adjacent to the Gelephu Bhutan Border Gate. Hatisar was also once the earlier name applied to parts of Gelephu the major town on the other side of the gate. The weekly border market or Haat on the Indian side which also caters to Bhutanese customers at Dadgiri is adjacent to Hatisar. It was also the site of notorious massacre in 2002 when 22 people were executed by unknown assailants (see Chap. 9). Field notes of MJM. 21 September 2016. Interview of Respondent SNRBS. Interviewed by LB and JL. Date of Interview. 2 December 2016. Milon VCDC Office, Chirang, BTAD (Assam). Interview of Respondent CPS. Interviewed by MJM in Sonapur. Date of Interview. 19 December 2016. Field notes of JL. 5 July 2016. Bighas is a measurement of land in Assam with a bigha being around 14,400 square feet, i.e. 120 X 120 feet of land or 3.02 bighas of land making up for an acre, i.e. 43,560 sq feet.

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Doevenspeck, Martin. 2011. Constructing the border from below: Narratives from the Congolese–Rwandan state boundary. Political Geography 30: 11– 14. p.3. https://doi.org/10.1016/j.polgeo.2011.03.003. Ibid. Biernacki, P., and D. Waldorf. 1981. Snowball Sampling: Problems and Techniques of Chain Referral Sampling. Sociological Methods & Research 10(2): 141–163. https://doi.org/10.1177/004912418101000205. Extracts from Jennifer Liang’s field notes. 3 July 2016–5 July 2016. Interview of Respondent GH. Interviewed by JL. Date of Interview. 2 December 2016.

Chapter 4

Armed Violence and the Breakdown of the Health System: Vulnerabilities of Health Personnel in the Conflict-Affected Borderland

Abstract The literature on health and conflict often highlights that health systems are devastated in conflicts as health professionals flee, infrastructure is destroyed and the supply of essential supplies is halted. But what happens when the conflicts are long-drawn or when they are repetitive? Or when the conflicts are not intensive but cause fragility as they persevere over time affecting individuals, households and institutions? What happens to health governance and health systems in such an atmosphere of political fragility? The chapter seeks to address these questions by examining the key state-run health institutions that are immediately adjacent to the study area. It traces out the history of a state-run public health centre closest to the border. The chapter outlines the process by which political unrest, armed movements and ethnic conflict interacted to impact health delivery systems and health personnel. The fleeing of health personnel and the subsequent absence of doctors due to the threat of violence lead to major consequences which are discussed in detail in the next two chapters: first, the high incidence of preventable deaths arising out of spread of diseases in the major ‘relief camps’ for the displaced populations; second, the emergence of informal healthcare provision as the primary choice for the conflictaffected communities. In addition, the inadequate provision of quality healthcare continued after the conflict. Political fragility in the area (which was a combination of conflict and the shifting power distribution between the state government and the local Bodoland Territorial Council) also impacted essential welfare services. It translated into poor implementation of government welfare schemes critical to the health and well-being of vulnerable populations like those related to food, guarantees of employment, supplementary nutrition of young children, school mid-day meals, housing and provision of safe drinking water and sanitation. Without these protective measures, those who have already suffered severe loss due to the conflict were left even more vulnerable to ill-health and ill-being. In the aftermath of violent conflicts, families and individuals in the Indo–Bhutan borderlands are thus left unassisted, with diminishing prospects of recovering over the long-term. Keywords Health System · Koroipur State Dispensary · ABSU Andolan · Conflict · Vulnerability · Medical Personnel · Health in Conflict · Life-History of Health Institution

© Springer Nature Singapore Pte Ltd. 2021 S. Sinha and J. Liang, Health Inequities in Conflict-affected Areas, https://doi.org/10.1007/978-981-16-0578-9_4

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4.1 Introduction One of the characteristic features of modern-day conflict is the increasing number of non-combatants being caught in the violence as well as the attacks on civilian targets. As stated by a study on attacks on health workers in Manipur: There is reporting across the world of health facilities and their staff being attacked in conflict zones, clinics being bombed or demolished, healthcare workers being abducted or murdered, threats and intimidation against fulfilling medical duties which jeopardize lives of healthworkers, disrupt services and affect access to medical care. Despite being part of the setting of armed conflict for decades such violence against healthcare providers and facilities is grossly overlooked, compounded by limited reporting, lack of impact-analysis and absence of mechanisms to prevent them. Events which even do receive some attention mainly involve international humanitarian workers featuring prominently in major news sources and have becoming subject to a landmark study. In contrast, less focus is directed towards security conditions that threaten the average working day of local healthcare workers, especially in a conflict that is not recognized internationally.i

The invisibility of the impacts on local health practitioners also arises out of methodological choices available to researchers. These methodological problems are especially identified by the Healthcare in Danger (HCiD) project of the International Committee of the Red Cross (ICRC). According to the HCiD project: …. disruptions to health care caused by violence are less visible and more difficult to measure than overt attacks against health-care personnel and facilities. But they are just as deadly for all the wounded and sick who never manage to reach the help they require.ii

These methodological implications tend to hamper the degree of importance we attribute to violence directed against health personnel and institutions. Thus, by only studying a particular set of attacks, we might misinterpret these processes as routine acts of violence within the broader set of events that constitute the conflict. However, the indirect impacts of such targeted violence against health workers and institutions as will be seen are equally serious, with ramifications for the health system and those who seek treatment going well beyond the time of the particular attack. In many cases, the perception of fear that is created, is by itself a deterrent to reconstruction and rebuilding of services, with government medical personnel unwilling to serve in areas that are considered high risk. In the next few sections, we will focus on the intersection of politics and the health system in the Indo–Bhutan borderlands. In attempting to delineate the manner in which services were obstructed, we trace the life-history of a single public health institution across the conflict-timeline. The institution was the primary source of healthcare for a significant part of the borderland in which the study was situated. A number of sources were utilized in developing the case study of the Koroipur State Dispensary (KSD).iii Thus, interviews were conducted with a range of people both within the state health system and from outside of the system. The research team also spoke to retired doctors who had served in the health system earlier and to new doctors who have joined the system afresh. The collapse of the institution had several cascading effects as will be seen in the next few chapters. While the KSD is slowly rebuilding, the pace of reconstruction

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in terms of human and material resources being directed into the institution does not seem to keep up with the emergence of a new post-conflict reality. The nature of the conflict is itself transforming. As deeper and less visible but equally potent processes (that were once masked by the armed conflict) start coming to the forefront, it is critical that the previously non-functional institutions are strengthened and made more resilient in order to cope with future disruptions.

4.2 A Micro-View of the Effect of Conflict on Health Services Five of the villages that formed the core of the initial study fall under the jurisdiction of the Koroipur State Dispensary (Koroipur SD or KSD) which is about 10–15 kms before the border gate of Bhutan. KSD is the main health institution accessed by people in the Forest Villages. Other villages fall under another government dispensary called Asrabari which is 15–18 kms from Koroipur. Both the government health centres cater to villages in a radius of 20–25 kms. The markets adjacent to the state dispensaries also have a number of ‘pharmacists’ (unqualified informal practitioners of allopathic medicines). These ‘pharmacists’ are also easily available even in village markets, much smaller than markets near the State Dispensaries. These and are the first caregivers in emergencies (Fig. 4.1). They will be studied in more depth in the next chapter, but nonetheless, despite their lack of formal training, the pharmacists have some degree of expertise and knowledge of the context, which provided useful insights for the study. Referrals from here are usually to Bongaigaon Town or to Kokrajhar Town which has the Government ‘Civil Hospital’ with 200-bedded facilities, apart from a number of private hospitals. Koroipur SD to Bongaigaon is more than 40 kms (about 2 h by road) and to Kokrajhar is even further away, about 60 kms. Though there is a District Hospital known as the Civil Hospital (200 bedded) in Chirang, it does not function as well as the Kokrajhar Civil Hospital and hence, patients are largely referred there. From there, the next referral is to the State Capital of Guwahati. This is 180 kms from Bongaigaon and 230 kms from Kokrajhar. Apart from the government hospitals, there are many private hospitals in Bongaigaon as well as in Kokrajhar (Fig. 4.2).

4.3 Socio-Political Changes and the Health System of Assam Until the Assam ‘Agitation’ In the 1960s and early 1970s, the health system of Assam was gradually evolving. The three medical colleges, the district hospitals and associated nursing schools were the major healthcare resources of the state.iv With a few doctors recruited from outside to fill this gap, the disconnect between demand and supply of trained doctors

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Fig. 4.1 Map of the Location of Major Health Centres in the Study Area

remained substantial. Earlier, this gap had been filled with two other recognized types of formal medical practitioners in Assam, i.e. Ayurvedic doctors and the Licensed Medical Practitioners (LMPs).v In fact, in the 1970s, most of the recognized allopathic practitioners were LMP doctors but gradually, their numbers came down as the three medical colleges stopped training of such doctors with nothing much to close the demand–supply gap.

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Fig. 4.2 Koroipur State Dispensary: The Site for a Micro-institutional history

The peak of the Assam Agitation (1983) coincided with India seeking to put the National Health Policy in place.vi The policy attempted to integrate all the services of the health system and focus on a decentralized system with a participatory approach. This included involvement of civil society organizations and the private sector. Assam seems to have lost out on these developments that were occurring in the rest of India. With bridges burnt, roads blocked the breakdown in law and order had an effect on healthcare services; although, health facilities were not specifically targeted. However, despite this, the health system managed to recruit doctors apart from increasing other healthcare personnel in the system. The nursing and other paramedical services training institutions were also working to develop the paramedical workforce. The medicine dispensers appointed in the hospitals, erstwhile called compounders, were increasingly being replaced by trained pharmacists, after being awarded with diplomas from a pharmacy institute. While a bit shaken, the public health system in Assam did not collapse during the Assam Agitation. In fact, it seemed to have recovered sufficiently to provide people with decent health services even in far-flung remote areas, such as in some of the health centres in the Indo–Bhutan border areas, even till the start of the Bodoland Movement in the late 1980s. But with globalization, liberalization and privatization in the 1990s becoming the dominant economic paradigm, health spending in India fell sharply bringing down the quality of healthcare. For the state of Assam, the situation was more serious. With violent militancy ravaging the state, the public health governance weakened further and, in many places, health centres collapsed completely and health indicators fell sharply. Even today, Assam has one of the highest occurrences of maternal deaths in the country.

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4.4 Between the Assam Agitation and the Bodoland Movement Being a part of undivided Assam, the public health system in the Bodoland areas was functional and comparable to most other parts of Assam till the 1980s. There were even specialist doctors in rural Public Health Centres (PHCs) such as Bhetagaon and Sidli which are now in Chirang District. Many of the senior doctors said they joined the medical services hoping to serve their fellow people, ignoring other career prospects which were easily available at that time. Dr. GN was one of the first few doctors of the Bodo community who graduated from a prestigious medical college in Assam. He joined the government health system hoping to serve his people years before the armed movement began. Of his initial days, he recalls: As a young doctor graduated from the prestigious Assam Medical College, I was quite enthusiastic in spreading the awareness and overall improvement of the community health. At that time there were specialist doctors in the nearby government hospital and all of them had strong connections and rapport with the community. There were number of communities living in absolute harmony and there was hardly any conflict related to their ethnicity. Only a few doctors were there in whole of the district. I remember when I used to to ride horses to go to the remotest villages which fell under my area. Medicines were supplied and we catered to the health needs of the community. Vaccination drives were slowly started though there were few takers for them. Most of the villagers were illiterate and preferred the treatment by the local ojhas, faith healers and priests. At that time, there were even specialist doctors in the nearby government hospital and all of them had strong connections and rapport with the community.vii

Though about to retire, Dr. KLB was still serving as a senior doctor and administrator in one of the Community Health Centres when he was interviewed in 2016. He was posted in the remote health centres near the Indo–Bhutan border in the 1980s: Only a few allopathic doctors were serving in the whole area which is covered by district of Chirang when I started working in early 1990s. Doctors then started to leave, either getting transferred out (from here) or quitting their job. The safety and security issue was there, and most of them left due to a sense of fear though doctors were hardly targeted. Even hospital related violence was less here compared to the other parts of the state, except one or two sporadic incidences. There was one incidence where a pediatrician from Kokrajhar was killed. I served in Asrabari and Koroipur area during the time of conflict. These areas were malaria endemic and the malaria workers regularly got both Plasmodium Vivax (PV) and Plasmodium falciparum (PF) positive slides. There were deaths, despite the effort by the government. I had been to the forest villages, as at that time the doctors went for home visits (a practice, which is almost extinct now a days). I was surprised to see the health and hygiene condition of the forest dwellers, all Adivasis, who were considered as the illegal encroachers by the administration. There were approximately 17,000 -18,000 of them at that time, though there were no any official record. I went to all those areas on foot, due to the road conditions and no provision for other means of travel. Ambulances like 108 services were also not there and the families used to carry the patient, when required. At that time, most of the deliveries were home deliveries and often the doctor used to go to the home of the woman in labour. Conducting home-birth was a routine phenomenon then for any doctor serving in rural areas. There was no ambulance, labour room and equipment in the hospital. It was difficult but we did our best with our knowledge, skill and the clinical acumen. I remember how I once resuscitated one newborn who was considered as dead by the parents

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and others. The boy has finished his studies now and is working. The law and order situation is much better now but doctors are still not joining.viii

Though younger than both the doctors above, Dr. SB is also a qualified allopathic doctor belonging to the Bodo community who worked in different government PHCs for many years and even served in KSD, the health centre in the study area for 4 years prior to the 1996 ethnic conflict. He says: When I joined the government as a doctor, there were about 11 Dispensaries and one PHC in our Block which used to come under Kokrajhar district. All the PHCs were fully staffed with one MBBS Doctor, two nurses, one pharmacist and one Grade IV staff. The only thing we lacked were vehicles. Before the conflict, the health system was working quite well. The pay was comfortable, and once a month there was a review meeting for all the doctors of the Block. It was very strict and all the MBBS doctors were expected to attend. There was regular provision of medicines to the hospitals and a truck used to come to AKT (a village next to the Bhutan border) once a month with supplies.ix

He mentions the challenges as well and says: Medicine was always in short supply. Where a thousand tablets were required, only five hundred were provided. This could have been due to inability to procure medicines as much as mismanagement. Because of this shortage we had to “ration” the medicines by not prescribing the full course to the patients. In this way, by planning ahead, we could make their stock last a full month. In some ways, we are the culprits in creating drug resistance in people.x

Recalling the services of Dr. SB, a respondent KB, a Nepali male in his late 40 s says: Koroipur SD was functioning very well during Dr. SB’s time. Deliveries were conducted in the hospital but our people at that time were not educated or very conscious about these things. So, they preferred giving birth at home. Only the educated and more conscious people took to the hospital (for delivery). Even before Dr.SB, while I was still in the lower primary school the MBBS doctor came to the villages and gave the service. I have heard my elders say that the services were very good and even minor surgeries were done. All this ended with the fourth doctor. The andolan (movement) started and then services started to decline, though one cannot blame the disruption of services entirely on the movement. When the movement was being led by the students union, the state dispensary and the schools somehow continued. Once the movement went out of their hands (to the hands of the militants), things went from bad to worse.xi

CPS is a community elder of the Bodo community in his late-50 s and also a Chairperson of a Village Council Development Committee (VCDC). He recalls that before the andolan, the Koroipur State Dispensary provided what he calls ‘outstanding’ service to the people. He was even able to name all the qualified MBBS doctors who were ever posted in the KSD in the almost 50 years since its establishment in 1971. The Koroipur State Dispensary was safe enough for the doctors to live in the compound in the designated accommodation with their families. He recalls: In the 1980’s, before the days of the conflict, I was a boy in my middle school, I clearly remember there being a doctor and some nurses in the Koroipur hospital. I even used to see nurses in uniform moving around my village. (These) doctors and nurses did awareness on alcoholism, family planning like use of contraceptives and operation (sterilization).xii

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The respondent NB (a former member of the student’s union) and now a school teacher in the local government school provides an overall assessment of public health services in the late 80’s. While the system was not necessarily comparable to those in developed countries, it was nevertheless functional: Prior to 1987, there was a proper functioning government health service centre, educational institution and forest department office etc. Years before 1987, KSD had an MBBS doctor, ANM and GNM. The doctor lived in the hospital premises.TT injection was regular so also the polio. Men on bicycle moved around the village and sprayed DDT in the dong (irrigation channel constructed by the community). Emergency treatment facilities were readily available. Villagers largely visited the state dispensary for common illness like cold, cough, fever etc. A constituent body known as society looked after the public distribution system. Families received regular supply of rice, kerosene oil and sugar. Anganwadi centres performed outstanding services during those days. But other health promoting schemes under PHE (Public Health and Engineering Department) like constructing toilets, water supply etc. did not exist. Mid-day-meal scheme was only introduced to the schools around 2007. The common illness of the time was malaria, diarrhoea and dysentery but the major issue was malaria. At that time, patients received good malaria treatment from the KSD. The pharmacist of that time (who passed away recently) was very good in treating malaria and before the Andolan (referring to the Bodo movement for political rights) period, that pharmacist addressed the malaria problem of the area. To address the problem of malaria, the health personnel even visited villages and carried out blood tests. DDT spray was done regularly. Families were even provided with the powder that was left over after the spraying. Prior to the 1987 andolan, the student’s union maintained close relations with the staff of the health centre. Some members from the student body visited the dispensary frequently. The medicine supplies were adequate to address the demand of the area. The health personnel continued visiting the village even after the ABSU andolan started. Apart from availing the government health care facilities, families also simultaneously practiced home remedies. Villagers identified herbal plants and leaves to cure simple ailments and abdomen pains.xiii

It is critical to note that the malaria surveillance was functional at that time. Interviewees stated that the health department did a commendable job as DDT spraying was regular. CPS, the VCDC Chairperson even remembers there being a malaria centre in Belpur (a highly sensitive area during the conflict both before and after 2014) which was set up sometime in the 1950s or 1960s, or probably ‘even before he was born’.xiv A subsequent chapter (on the challenges for the health system in the major Bhutanese district shows that the situation on the Indian side also obstructed malaria control activities across the border. There is further no trace of the centre in question.

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4.5 Onset of the Movement for a Separate State of Bodoland or ‘Andolan’ and Militant Violence and Its Aftermath 4.5.1 Damage to Health Infrastructure The situation in the interim period was changed fundamentally, as the movement for the separate state of Bodoland was launched in 1987. In recalling the situation, NB states: …health activities and services began to decline during the andolan. Some years after the andolan, doctors along with treatment facilities and other activities were all gone. Neither in the hospital nor in the villages were health services provided anymore.xv

NB describes how the early days of the andolan (which started in 1987) saw massive destruction in government owned infrastructure. This was because anger was directed at all symbols that signified the authority of the state (i.e. provincial government) and the perceived failure of the Assam Accord to take into account the interests of the tribal communities. Many schools under Koroipur area were demolished or burnt down. Koroipur High School was burnt and also a neighbouring primary school was burnt while another was demolished. Electric wires were pulled down. Roads and bridges were bombarded. Forest offices were burnt down in several places. In GH itself, the forest office was totally burnt down to ashes. The period saw total boycott and destruction of government infrastructure and halted functioning market systems, hospitals and health centres. It was a ‘mass movement’ and all Bodos – both men and women – took part. Some non-Bodo government officials were attacked during that period and these attacks had very negative consequences. Non-tribal government officials used this ‘feeling of insecurity’ as an excuse to get transfers out of Bodo areas. Koroipur hospital did not have doctors for a period of 7-8 years after the andolan.xvi

What happens to government health systems and services when violent conflict starts? One major problem was damage in health institutions as well as support infrastructure leading to problems of health access. An elderly Nepali woman, DB, describes the situation then and now: I had one son who died of malaria at the age of twenty. Overnight he developed high fever, was shivering and was taken to Koroipur hospital in a handcart by my husband and some fellow villagers. The hospital did not have a doctor, and the compounder said they did not have the right medication. They were advised to take him to another health facility in Kokrajhar District. There was no vehicle, so the two men attached a handcart to their cycle and started taking him there. My husband said he will pick up some clothes and food from home and join them. But even before he could leave home, news came that our son had passed away. He had barely survived two hours. What to do ? It was my fate, now I consider the other youth as my children. Nowadays there are cars, ambulances, bikes and many other modes of transport. It is now much easier to take someone to hospital. During the conflict, sometimes people in medical emergencies would be transported in police vehicles, but many others died due to the difficulties of transport. The journey in itself was difficult. There would be incidences of violence along the way. Besides, the only good dispensary in the area was in Kashikotra (about 44 kms away), but the bridge to Kashikotra had been blown up. It was

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difficult to go to Sidli (about 40 kms) as well. The bridge there was broken and vehicles could not cross. It took three to four months to construct a wooden bridge, and many people opposed the building of it (fearing security forces would then keep coming to the area). A police complaint had to be filed and the police had to come and stand guard over the bridge so it could be completed.xvii

4.5.2 Security Threats Faced by Doctors and Other Health Professionals Most of the health personnel interviewed in the study had direct personal experience of conflict and they candidly shared their experiences with us. Dr. SB was posted at that time as the Medical Officer in Charge in a far-flung state dispensary. He says: When the ABSU andolan started, two government hospitals close by were burnt and broken. This was done by the people themselves as they did not want the buildings to be used by the security forces as shelter. One paediatrician in Kokrajhar was killed after extortion demands were not fulfilled. Even though no other doctor had been threatened or attacked in any way, a lot of fear prevailed and the Assamese doctors all fled. Even though the Bodo doctors stayed back and gave service, that was not sufficient because most of the doctors at that time were Assamese. After the violence started, electricity was cut-off (since the poles were destroyed) and I used to conduct deliveries with torchlight. There was no system for sterilization of syringes, except a stove on which water could be boiled. There was also no supply of bandages, or even anaesthesia. I remember (treating) one case during the Bodo-Muslim conflict in 1993, a man had been injured with a spade on his head. It was a deep gash and required stitches and (due to the lack of supplies), I sutured him without any anaesthesia.xviii

In the years of militancy and conflict, it was not just the non-Bodo health personnel who felt threatened but Bodo doctors themselves did not seem to have had it any easier. From their interviews and long narrative accounts, it seems that the pressure was on local Bodo doctors was just as great, if not more, by belonging to the community. Dr. A was already serving as a senior doctor in the health system in the days of the armed conflict. He says: I could have done any advanced study in medicine and worked in any medical college. But I opted to use my knowledge in the areas where it is needed most, for which I had to repent at the end. I was in YDLA in the early 1990s. Some student leaders took me to some place in the jungle to treat some of them who were injured by “Teer (an arrow with poison at the tip). They also asked me to teach them the technique to surgically debride the wounds. I had no option but to obey them, though it was not possible to train them in surgical techniques. I had been called to their place a number of times. Later on, I realized that they belong to one armed organization. I discussed the whole episode with OC (Officer-in-Charge) at the local police station who advised me to give this in writing and assured (me) that I will get full security protection from the administration and police. I followed his advice in good faith but immediately afterwards was treated by my department and administration very badly. There were a number of enquiries instituted upon me. Promotions were withheld. I was given punishment transfers to hill districts far away. Finally, I was suspended from service. There were frequent harassments from police and military. The OCs assurance and his due expectation from the administration was in vain and I was extremely humiliated and frustrated. Then, one night, some of the militants from that armed organization came and

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attempted to murder me. I had a severe head injury. I had been punished for divulging about them to the police. Later on, I came to know that one of the staff informed them about me. I was from the same place and from the same community for whom those people were fighting for. Maybe I had been targeted for my occupation and the inherent vulnerabilities associated with it. As a doctor I discharged my duty and as a responsible citizen I did whatever I could. But in return I suffered and nobody stood by me. How can you expect doctor from other places to serve here? This is how the health system broke down here.xix

Despite the assumption of neutrality attributed to medical practice, medical practitioners did face situations of personal loss of immediate family and threats to their families from both sets of combatants. As seen below, in one case it was attributed to an unknown force, which included former cadres of an armed organization. In the second instance the attack on the same family was at the time when two major armed organizations were engaged in a brutal internecine struggle. In fact, at one the point the respondent was asked to leave and had to relocate to another state for three months. This sense of pressure on local Bodo doctors was also echoed by Dr. C who recounts: Once I left KSD, I went to another hospital. Before that in KSD, a colleague of mine was simply told to leave the hospital by the militants as they were going to break down the hospital. Not a single brick was left. This was during the separate state andolan. That’s why I also came out from there. In the new place, one of our nurses were called and threatened she will be shot. Dr. RN was picked up. RN’s in-laws were picked up and beaten. Dr. B was also picked up too. Even in those days (of the disturbance) all of us were picked up at gunpoint and we had to go with them and treat them. I too was taken. When I applied for a passport about two years later, during police verification they showed a prescription of mine recovered from a guy (militant) and asked me what this was. I told them as so many (patients) visit the hospital, how could I know if he is a militant or not. The police then asked if they came with guns. I said yes, at times they came with guns. They then asked me why I did not inform them. I replied How could I inform as you? You won’t be giving me 24-hour protection. Moreover, your tenure here is for three years only. What after that? I will be here for my whole life and these guys never forget. At least you guys question me, but those guys don’t even question, they just shoot. My brother in law got picked up by unknown forces and killed. Then my brother was shot out of suspicion of being with VXYZV (a militant group). Actually, he was back from his college and was just relaxing at home. He was shot at by a rival militant group. At that time, if you even talk with one group, the other group comes for you. The highway was the dividing line between the RSTY and VXYZV side.xx

In another instance, a pharmacist working in a health centre from outside the study area, but also in the District of Chirang spoke to a researcher. He also pointed out that the biggest deterrent for the doctors to join was fear about their safety. He says: During the ABSU andolan and the subsequent years, doctors from the KSD were called to give treatment in the villages, to places including the forest where activists were seeking refuge. If the doctor denied going for the treatment, the people would turn against the doctor. In years following the andolan, and especially when VXYZV and RSTY emerged, doctors felt insecure to make village visits. The doctors could never predict the places they would be called for treating patients. One of our doctors who served well for many years here was threatened by the militants for not paying their monetary demand. At one time, only the two of us were running the hospital and serving the area, sometimes even beyond our capacities as a doctor and pharmacist. We had to give them the ‘demand money’ as we have been threatened that they might lift our children or other family members. We were not afraid of

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them, but worried about our families. One day, they went to my child’s school, took him aside and made him to talk to me from their phone. This scared me a lot and there was practically no one to stand beside me. The authority and police are useless to us during such crisis. In fact, they harassed us when we give treatment to the militants but we are just doing our duty. I had to hand over all my savings to the militants but that was not all, I was also almost beaten to death. I had serious injuries all over the body, including the neck. All this gave me tremendous mental shock and I had to take treatment from a psychiatrist in Guwahati. I am from this small town itself yet I was tortured. The doctor serving here is from outside and so naturally, he left.xxi

A description from LP, a Nepali respondent who was witness to an incident in 1999 provides some idea of the overall environment: After the1998 conflict, people had just started settling down, when there was a small incident in 1999. The security forces commander was killed and one Adivasi man was attacked by militants. This led to a revenge attack from the Adivasi side. They attacked with bows and arrows and killed many people. I saw with my own eyes one man who was fleeing being cut down from behind. He ran a few more steps before falling down and dying. I saw how the blood spewed out. It became very unsafe for the Bodo doctor and compounder in the dispensary. We tried to protect them. We locked some of them inside the toilet, and like this we kept them safe. We were very frightened. It was that kind of danger.xxii

The threat on health personnel and the breakdown of governance collapsed to the extent that they could not even respond in emergencies. In the 1996 Bodo–Adivasi conflict, for instance, respondents recalled that no medicines reached the relief camp for nearly six months following the violence. Doctors mentioned that due to fear of the militants, doctors and other health personnel were hesitant to visit the relief camps. The period after the 1996 and 1998 conflict records the highest number of deaths from illnesses like diarrhoea and dysentery. DM, now in his late 70s is one of the oldest surviving Adivasis who lived through in the relief camp for 11 years from 1996 to 2007. He recalls those days saying: So many people died. Children, men, women. Four-five dead bodies were buried every single day but unlike now where we know (how) to do things, no records were kept at that time.xxiii

He estimates at least 1,500 people would have died during that period though no actual records were kept. But not all died of dysentery, some died of having no food (Fig. 4.3).

4.6 The Post-Conflict Phase and the Health System The interim period between the onset of the Andolan and the establishment and consolidation of the BTC witnessed a number of civil society led healthcare providers entering in for emergency response work in the relief camps and health facilities which became defunct. Of these the biggest was HFA Foundation (Note: Name is coded) who provided high standards of quality care in the area for about 5 years. This experience is discussed in a separate chapter. Though the National Rural Health Mission (NRHM) had already been launched in Assam by the Government of India

Fig. 4.3 Historical Timeline of the Koroipur State Dispensary (KSD)

4.6 The Post-Conflict Phase and the Health System 125

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before the major medical relief agency HFA Foundation left the area in 2007.xxiv Yet, the programme still remained unpopular for a long time. With influx of funds, there was perceptible improvement in the collapsed health infrastructure but the human resource crisis persisted and to a large extent; even today, there is no regular qualified doctor working in the KSD. Most of the rural hospitals in the research area are manned by ayurvedic doctors who have been trained in the traditional Indian system of herbal medicines but are forced to prescribe allopathic drugs in the government hospitals. To augment the huge gap in trained personnel in rural areas, the government of Assam also places fresh graduate doctors who have to do a mandatory year-long rural posting to apply for further studies. People refer to them as ‘one-year doctor’ and even KSD has one such doctor placed. But apart from a lack of experience, most of these young medics travel from the towns and do not stay in the areas which are close to their workplace. They are available for a few hours some days of the week. There is also a lack of mentorship and guidance. As Dr. SB stated: We learn medical science and straightway into practice when we work in areas like this. There is no mentor, none to guide or support you. I remember how I got scared to drain even an abscess.xxv

In 2004, to deal with the huge shortage of doctors, Assam even experimented with placing a cadre of Rural Health Practitioners (RHPs) in the health centres. Though the concept has worked very well in other countries and might have helped bridge the gap here too. However, the hurried decision and implementation, combined with strong opposition of the medical fraternity caused the matter to go to the court and the RHP system failed in Assam.xxvi Through the interviews, we find that two prominent and related factors impeding the recovery of the public health system in the conflict-affected areas. Table 4.1 provides some indication of the kind of health institutions are available for those living in the area. We highlight a few reasons, why the existing state-based system, serves as a deterrent to improving healthcare, despite the devastation we have described until now.

4.7 Current Problems of Government Health Centres: A Community Perspective Whether it is the Adivasis, Bodos or Nepalis, the government health centres are not popular among the people and suffer from poor utilization in their current state. This is clear from various interviews. Except for Lalbiti Village which is close to the Asrabari State Dispensary, all the villages access the Koroipur State Dispensary. The distance from the nearest government health centre is an average of seven kilometres with some being right next to the hospital. Both Fulbari and Sonapur (the most affected villages in the recent 2014 conflict and hence by far the most vulnerable) are as far as 12 kms away. We have already seen that even where there is access, the

Village

Lalbiti

Salbari

Sonapur

Milon Relief Camp

Bogori

Fulbari

Lalai

Sl. No

1

2

3

4

5

6

7

Nepali

Adivasi

Adivasi

Adivasi

Bodo

Bodo

Bodo

Community

Koroipur State Dispensary

Asrabari State Dispensary

Nearest Government Health Centre

4 km

12 km

4 km

3.5 km

14 km

10 km

1 km

Distance to nearest Govt. Health Centre

Table 4.1 The Matrix of health facilities available in the villages studied ASHA Worker available or not

Ayurvedic doctor stays on campus but remains in his room most of the time; 2 nurses are posted but do not stay; deliveries are conducted against payment ranging from Rupees 500–800; patients complain most medicines have to be bought from outside with the prescription given in the health centre

Available

Available

Available

Available

Not Available

Available

MBBS doctor visits but Available does not stay; some health personnel stay on campus

Do Health Personnel stay at Health Centre?

2

1 (Located in nearest village, i.e. HPLI)

1

0

0

11–12 (approximately) In Asrabari Bazaar

Number of Pharmacies in the village

4.7 Current Problems of Government Health Centres … 127

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quality of services in the Government State Dispensaries is highly inadequate and hence for those who need it. For those located inside the forest the problem of access is severe. By virtue of the grey legality seen in chapter three, problem where these hamlets are seen as encroachments, lifeline services that are supposed to be free, don’t remain so (as these hamlets are not supposed to exist) in the first place. People are forced to incur expenses as the field observation note from Fulbari indicate: Most women in Fulbari have home births. The available institutional delivery services have remained inaccessible and unattractive to the villagers. The 108 [Ambulance Service] drivers find it hard to get into the village because it is located deep inside the forest. During the monsoon, the soil on the roads are loosely held due to constant downpour and the vehicle can get stuck. The delivery cases during the nights have mostly been attended by older, experienced women from the village. The expenditures incurred when a family avails institutional delivery is beyond the reach of many in the village. The ambulance service has to be paid the fuel cost, the doctor and nurses attending the delivery demand not less than Rupees 1,500 though institutional deliveries in government health centers are supposed to be free. The Rupees 1,400 which the mother and child receives as a result of institutional delivery has remained unattractive because they end up spending more than the amount received.xxvii

Dr. SMNH, in his note dated 30 December 2016 on the health status of people after conducting multiple assessments and interviews in the Adivasi village of Fulbari, writes: RH was applying an antiseptic paste on his bleeding finger when we arrived in his single roomed dilapidated hut. He had a cut injury just a few minutes back which was bleeding profusely. They believe that this herb has strong antiseptic, antibiotic and coagulating properties. This is one of the thousands of herbs they use customarily for their ailments. The plant is named as Patgajar in Santhali. The people of this area rely heavily on the medicinal properties of the rich flora and fauna of the jungle. The presence of the public healthcare system in their lives is known by the occasional rounds of immunization where they are called to Milon. No other interventions from the government sector has been noticeable here since they have been here. RH has in fact lost two of his wives in the last two decades in malaria. The first wife died in the relief camp in 1996. He says it was a regular affair and there are hardly any households which has not lost any member during their stay in the relief camp. His second wife died last year around this time (November 2015) when a number of families were suffering from a malaria outbreak. She had the classical malaria symptoms of chill and rigor along with sweating. Later, her whole body swelled up (Ascites?). She was taken to the local pharmacy in Milon who told him that disease had ‘migrated to the brain.’ Though he tried treating her, she died. RH knows that modern medicines are better, but being costly, people like him cannot afford them. So, it is better to rely on the traditional medicines rather than to have no medicines at all. The local pharmacists (quacks??) have treatment for all ailments but they are costly at times. Doctors are almost never available in the nearby hospital in odd hours. There are no other options but to rely on their traditional knowledge about health and disease.

Currently, not just the Adivasis but those of the Bodo community also do not prefer government health facilities as is explained by Dr. SB: Nowadays, the Bodos do not visit government doctors very much. This could either be due to affluence, since they can all afford private doctors now, or due to a lack of confidence in the government health system. Each CHC (Community Health Centre) should have at least 7-10 doctors, including specialists, but where are the doctors? Doctors are unwilling to come to BTAD. Even though there is no violence here right now, and there is electricity, there are

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roads and there are even mobile phones for communication, yet there is an idea of this being a violent place that scares outsiders from coming here. Moreover, there is no social life, and very poor educational facilities for their children.xxviii

4.8 Paucity of Qualified Health Personnel in the Conflict Areas With young doctors graduating from medical colleges unwilling to join government services, there is already a shortage of doctors in the public health system of Assam. Add to that a negative perception associated with areas which have experienced conflicts in the past, and the shortage becomes a crisis. In his note on the status of the health system in Bodoland, researcher Dr. SMNH interviewed a senior doctor working in neighbouring Kokrajhar Civil Hospital. The doctor had doubts whether the gap in health personnel can ever be filled. In 2016, out of the 786 posts of doctors advertised, there were much fewer applicants than the available posts and even fewer joining in Districts like Kokrajhar and Chirang districts. He felt that no permanent but only short-term contractual doctors would join their posts in such areas. Negative perceptions (which may not even be based on facts) regarding the dangerous area of Bodoland (with an omnipresent threat to life) seems to be a big factor deterring health personnel from joining here. An interview with a fresh, non-Bodo MBBS doctor working in another state dispensary and his colleague, the official government appointed pharmacist (also a non-Bodo from two districts away) throws light on this fear and apprehension, and how these can be overcome. JL’s field notes of 14th September 2016 records the interview with this doctor and his colleague. Dr. SS is a new MBBS doctor - a Bengali Hindu from the nearby district (some 40 kms away) who after completing his medicine from Dibrugarh Medical College has been posted to a PHC for the past three months or so. When he heard about his posting in Bodoland, he was ‘terrified’ and tried very hard to change his posting from this area. He tried to exert all kinds of influence and pressure but could not get his posting changed. He didn’t know what to do and was ready to quit the government job than join in Bodoland where he felt he was going ‘to be killed.’ Then, a friend of his father gave him the name and phone number of one Bodo person in the area where the PHC was located. He felt much more confident and came to see the place. Then, he joined. It has been three months. Dr. DSS say he has had a most pleasant experience and is enjoying being part of this PHC. He has not had any problem till now and now feels that he was being scared unnecessarily. In his own words, ‘But then one hears so many stories about this place’. Of course, he still does only day duty leaving the night duty to another fellow Bengali; a pharmacist from another district as he says that with one doctor, it is impossible to serve for 24 hours in the PHC. He emphasised the point that like him, most non-Bodo doctors and their families are petrified on hearing of Bodoland and hence do not to come here to join duty. He got a chance to change his perception but others will not even join and so live with and also spread the fear to others.

This interview points out that the threat perception of the doctor is first and foremost, a perception. Like most perceptions, it can be corrected. It took a single contact with one local Bodo person to give confidence to a non-Bodo doctor to overcome his apprehension and join the hospital. Hence, though the deep sense of fear among

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non-Bodos from outside the area is real, but it can also be countered. Weak governance in a conflict area and weak law and order encourages people to take the law into their own hands. Health personnel also fear aggression and violence becoming standard responses to any incident or interpersonal conflict. This is highlighted in an interview with a non-Bodo government pharmacist appointed to the same PHC. JL’s field notes of 14th September 2016 say: UJR, the pharmacist at the XYZ State Dispensary says that as soon as night falls, he starts getting ‘fever’ out of fear as there is no problem during the day as people are well behaved. But as soon as the evening dawns, people start drinking and with that, the level of aggression increases. He claims that he has got threatened and almost beaten up a couple of times. Even as we were speaking he was also busy getting his applications and documents ready to get posted out of this area. Earlier, he was posted in another state dispensary within the same district and insisted that ‘it was much, much better.’ I was rather surprised as the previous area was an exclusive Bodo area which was much more remote than his current posting (next to the busy main road with a diversity of communities). His main reason for finding the earlier area ‘safer’ and easier to be in, was that the students union of the Bodo community was close by to keep ‘an eye on things’ and for trouble shooting any problems that emerge. He also said that the Hospital Management Committee was very active and interested. In his view, the students union and the hospital management committee in the previous location helped take care of issues of ‘daadagiri’ (bullying) but here he felt unsafe as the local people take no interest in the management of the hospital and the staff are left to fend on their own.

The interviews with non-Bodo health personnel serving in remote health centres point out to the crucial role played by local community organizations and local people in dispelling fear and instilling confidence to stay on to serve.

4.9 Role of the State, Localized Fragility and the Promotion of Well-Being of Communities in Conflict Areas In the earlier sections of this chapter, we see that the role of the state in providing healthcare services was greatly diminished due to collapse of the health system during the conflict. This role was filled in by informal healthcare providers and NGOs. But health is not just about medical services when people are ill but also a range of essential services that the state is supposed to provide for the welfare and well-being of its citizens. While violence is only part of the conflict, the protracted instability impacts negatively on government initiatives that directly or indirectly contribute to health and well-being and are therefore health promoting schemes.

4.9.1 Status of Health Promoting Schemes There are many welfare services for the poor in India but the most important healthrelated services include subsidized food rations for the poor and guaranteeing work which leads to food security. The Mahatma Gandhi National Rural Employment

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Guarantee Act (MGNREGA), for instance, guarantees 100 days of work to every family.xxix Then, there are childhood nutrition and education schemes and also compulsory Mid-Day meals for children in primary schools.xxx Apart from that, the Public Health and Engineering Department (PHED) of the government (currently under the BTC) is supposed to provide water and sanitation facilities to the people. Yet the duality of Recognized and Unrecognized Forest Villages precludes the extension of many of these facilities (see Chap. 8). Table 4.2 shows the status of government facilities in the villages studied on the Indo–Bhutan border of Chirang District. These villages are indicative only and provide for brief assessments of the status of government schemes in the area.

4.9.1.1

Food and Work—The Public Distribution System and Employment Guarantee Scheme

In India, the Public Distribution System (PDS) which gives subsidized food grains to poor families (under the rubric of the Food Security Act) and the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) guaranteeing 100 days of work to rural every household) are two important schemes that try to ensure food security for the poor. Where these schemes are well implemented, the nutrition security net of the poor is significantly strengthened. Important for poor families in any situation, these schemes become crucial after conflict (and even natural disasters), when families have suffered multiple losses and are extremely vulnerable to illness due to the losses suffered. Both these schemes in the area of study—the PDS and MGNREGA—were underperforming. Most of the respondents do not have Below Poverty Line (BPL) ration cards which entitles them to highly subsidized rations and in some circumstances free food grains. For example, of the 59 households in Lalbiti (a village with Bodo IDPs), only six of the households have BPL ration cards. Only one of the nine families in Sonapur has ration cards and of the 160 Adivasi households in Fulbari only 24–25 families have these documents. The PDS system is already very weak and irregular and without ration cards, the poor families cannot avail of food subsidy even in this system. Compared to the food scheme which though irregular and subject to leakages still exists, the work guarantee scheme of MGNREGA (locally referred to as ‘job card’ work) which guarantees 100 days of work is even worse. Though most of the households in the villages studied said they have the ‘job card’ and hence is eligible for getting work under this scheme, there is no work. Adivasi women of Bogori village in a group discussion reiterated that there is no proper job card work for the past 2 years. Most of the work under this scheme is for constructing village roads but those who need work do not get it. And the few that get work, it is only for a few days in a year. And then, even if they work, they do not get the money or get it after many months. They complained that some people in their village who worked six months ago have still not got paid. BM is a young male Adivasi member of the Milon local governance committee called the VCDC (Village Council Development

77

9

46

127

160

Bodo

Adivasi

Nepali

Milon Relief Camp

Bogori Village Adivasi

Adivasi

Sonapur Village

Fulbari Village

Lalai Village

185

59

No. of Households

Salbari Village Bodo

Community

Lalbiti Village Bodo

Village

No Info

25

No Info

No Info

0

No Info

6

No

No

Defunct

Defunct

No

Defunct

No

Below Poverty ICDS/ Line Ration Anganwadi Card working?

Yes

No

Yes

Yes

No

No

Yes

Government Primary School Available?

Table 4.2 Status of critical health promoting services of the government in villages studied

Regular

No

Regular

Regular

No

No

Irregular

School Mid-day Meal Available?

No

No

No

No

No

No

No

Piped Water Supply

185

0

0

0

2

0

3

No. of Latrines in the Village

185

85

127

46

0

77

40

MGNREGA Job Card Holders

132 4 Armed Violence and the Breakdown …

4.9 Role of the State, Localized Fragility and the Promotion …

133

Committee). He blames the people for their unwillingness to work under this scheme, saying: People here are not willing to do job card work. For example, in a road we built, only 15 people turned up to work. No one trusts that they will get paid as they have earlier experienced that money due to the laborers was not paid even after two or three months. Now systems are much better, and their wages are deposited into their accounts within 15 days of completing the work but it was very, very difficult earlier. Also, laborers need the money immediately after working and keep enquiring if their money is deposited. Another problem is that the bank is so far away from here. It is in Kokrajhar and Bongaigaon (40-50 kilometers away) and it will cost them Rupees 200 for one trip just to withdraw their wages.xxxi

The poor performance of these two critical government programmes for ensuring food security has further increased the vulnerability of the poorest families affected by conflicts in the study area.

4.9.1.2

Supplementary Nutrition Programme for Children

While the health of the entire household is adversely affected by food insecurity following a conflict, vulnerable populations with special needs such as young children, pregnant women, lactating mothers and adolescent girls are even more severely impacted. In all the villages studied, irrespective of the communities, the government’s flagship Integrated Child Development Scheme (ICDS) which provides for early childhood health, supplementary nutrition and education (also popularly known as Anganwadi centres) do not function in the area. Under this scheme, pregnant and lactating mothers and adolescent girls are also given supplementary rations, but no functioning ICDS centres means none of this is also given. According to HR a field mobilizer for an NGO working in the area: In 2008, with the help of our NGO, a team from Delhi, including the Child Rights Commissioner visited the Milon area and our people complained to her. After this, a few more ICDS centers were opened. It ran for two years but again stopped in 2010 and has remained defunct since then. The Anganwadi worker and the helper are never to be seen in the centers. The distribution of cereals and other supplements have stopped. Children have stopped coming for the 7-9 am classes because there is no teacher present in the centre. I have filed two RTI (Right to Information) applications and found that sanctions and supplies were given regularly for all the centers. But this does not reach the ICDS centers because it is misappropriated in between.xxxii

Figure 4.4 shows how illness and possible deaths of vulnerable populations with special needs are linked to poor nutrition. From the figure, we see that not one of the seven villages in the study had a functioning ICDS centre which shows the complete collapse of the programme in the area. Failure of a supplementary nutrition programme in a conflict area is failure to prevent malnutrition of the neediest population. A well-functioning supplementary nutrition programme might keep these vulnerable people from weakening, falling sick and dying. Similarly, the availability of government primary schools after conflict also mean that children would get a

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4 Armed Violence and the Breakdown …

Integrated Child Development Programme (ICDS) not working

No supplementary nutriƟon for children of 0-6 years age and for pregnant women, lactaƟng mothers and adolescent girls

Malnourishment of vulnerable populaƟons

Illnesses, IllHealth & possible deaths

Fig. 4.4 Effect of Non-Functional Supplementary Nutrition Scheme (ICDS) on Children in the Study Area

cooked, hot mid-day meal every day. This again would go a long way to help children from poor families maintain their nutrition and remain healthy. In our study area, we find only two of the schools attended by the children of three villages, i.e. Milon Relief Camp, Bogori and Lalai (a predominantly a Nepali village) have regular mid-day meals whereas young children from four villages do not get any mid-day meals. According to KB: Before 1987 there were no other communities here. So, almost all the families benefitted from the Public Distribution System. There is an anganwadi (as the ICDS programme is called) centre in Milon today and another four more in surrounding villages. But except for Milon, all the centers are defunct. One cannot even find the building of the anganwadi. If they really have beneficiaries, no one knows. The staff are drawing salaries without discharging any duties. I can say for sure that wherever I go, I find the above anganwadi centers are defunct. Milon anganwadi centre started in the year 1970 or 1975 while the other four centers started after the 1996 conflict. The Milon anganwadi center face challenges for the reason that it is attached to the Lower Primary school and many children from different villages are enrolled in this centre (where as rations for the ICDS centers are allocated village wise). I was recently transferred to Koroipur LP School. I came to know that there is an anganwadi center there only today as I have not seen any functioning of it. Other services like water and sanitation, it can be said that nothing was there. People used to go for open defecation (during the interview from where the field researchers were sitting, the respondent points out to the building which was incomplete and said ‘look this is our PHED department! the construction has stopped for the past two years). The water in Milon is not fit for drinking directly. Had they started (the department) we would have got clean water. What the people came to know from the contractor was that 90 percent of the work has been done but they have not received the payment for even 10 percent of the work. ‘But, (pointing to the building) does this look like 90 percent of work?’. Money for the mid-day meal is released, but when it comes to implementation, there is a lot of corruption. The regular meal comprises of rice, dal, one – two pieces of potato. They do not follow the menu given under the Mid-Day-Meal Scheme. The only time when children are given a good meal is after the half yearly examination and annual exams. This is the only time they get meat. It is not up to the mark.xxxiii

4.9.1.3

Water and Sanitation Facilities

Quality drinking water and sanitary latrines keep people healthy by preventing waterborne diseases. But in all of the villages studied (as seen in Table 2), there is no government supplied water (see Chap. 9). Villagers depend on their own water sources like

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135

hand-pumps, public wells or small streams and rivulets. Humanitarian organizations have helped provide some wells and hand-pumps in affected villages following the 2014 conflict. According to SH, an Adivasi man who is also the headman of one of the clusters in Fulbari: When our family first came to settle in this village, the nearest drinking water facility was in Milon, 12 kilometers away. Like the other men from the village, I too would fetch the water only two times in the entire day. People then mostly used earthen pots which would often break but I was lucky to have a stainless steel one. It was easier in Summer because we could collect water from the stream. When the stream water dried up in the dry season of Winter, we would go right up till Milon bridge, wandering everywhere looking for water.xxxiv

The first well in the village of around 100 feet depth was dug in the year 2005 after they returned from the relief camp. All the villagers got together to dig it after their neighbouring villages stopped them from drawing water, fearing their wells would also dry up in Winter. As that was too far and after the conflict, they were scared to go far from the house after dark, they then dug a second well on this side of the village too. Then, when the army left (they had set up camp to guard the returned villagers after the 2014 conflict), they petitioned the army to leave behind the diesel engine and water pump for them. Each household contributes money for buying the diesel to run the pump but now this is also out of order and they are unable to repair it. Later, an NGO gave them another hand-pump in the Northern side of the village after the 2014 conflict but that is also spoilt and the village of over 160 households depends on one single well for drinking water. All the villages practice open defecation, i.e. except for Lalai where all households say they have some toilet facilities (though some of them could be temporary pit latrines and may be not sanitary latrines). It is interesting that there are only the Nepalis have toilets in their home whereas the others do not. The Nepali village has not been displaced before and that could be a possible reason why they are relatively well-off and can afford building sanitary latrines. The headman of Fulbari village says he does not remember any officials ever visiting their village to address the problem.

4.10 A Case Study of an NRHM Programme Manager: The Possibilities of Transformation LN has been a District Programme Manager with what was then called the NRHM (National Rural Health Mission) when he joined in 2007 as a young graduate. He was earlier the programme manager in one of the largest districts in Assam where he served for 5 years before being transferred to one of the four districts in Bodoland. When he was interviewed in June 2017, LN had already served for 2 years in his new district. As stated by LN: Coming to a BTAD District was a huge challenge. My earlier district (where I worked) was a very old district. All doctors and five specialists were always there in full force. Though

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4 Armed Violence and the Breakdown …

the health system was not functioning well, (at least) all the systems were in place, like there were doctors posted, the buildings were there, the personnel were there. The district also had good roads and good quarters for the health personnel. One only had to get it all functional and improve the management which was very poor. But when I came here, it was like starting from scratch. The health centres in BTAD had collapsed and we heard from senior doctor who worked here that for years most of the quarters for doctors and other health staff were filled with security personnel. So, how and where were the medical staff to stay? Even a few nurses staying in the hospital premises felt unsafe and so, they also stopped staying. So, with no doctors or nurses, why should someone visit the health centre? Then, fear is created by the health service providers themselves who paint a very scary picture of the place. In some sub-centres in very remote areas in my district, they discourage new staff to be posted there telling them, ‘don’t come, don’t come here’. But now I have managed to get doctors to begin staying there.xxxv

LN has been able to turn things around in his new district within the BTAD. When he joined two years ago, there were 42 vacancies for doctors in the district, but now 25 vacancies have been filled up and they are working to fill up the remaining posts. Earlier, there were just five General Nurse Midwives (GNMs) and eight doctors but now they have 20 GNMs and 28 doctors in the hospitals. Of these, only seven of the doctors are Bodos and the rest are non-Bodos. He says that many of them are now staying with their families in the quarters provided, and they seem happy. One of the important lessons he has inculcated is that he has provided them additional opportunities to practice and improve their skills. They are especially free to interface with other health institutions and encourages them to become consultants. However, he has set a few strict norms: it is compulsory for them to be present for full duty hours from 8.30 a.m. to 2 p.m. and they have to be available during emergencies. For the time outside duty hours there is minimal interference. In order to ensure proper attendance LN has introduced new methods and technologies by which attendance and time spent on duty are recorded across all the health centres. Thus staff cannot just leave but have to be somewhere in the building and campus. In order to enhance a sense of ownership over their work, he took into cognizance the problems faced by individual staff. He thus helps health personnel by ensuring to the best of his abilities that their children get admission into the best English Medium Missionary school in the area. LN is clear that only when there are doctors, the patients will come. He told the political representative (Executive Council Member) of the district that all the doctor quarters are now full and more doctors want to stay, but they need to build new quarters for them. Land has been identified and they will be building more quarters. With change in political power in the centre, the NRHM programme was undergoing a transition between 2014 and 2015. He used that time to focus on improving the Civil Hospital in the District headquarters. Earlier, there were just 50 O.P.D patients a day but now there are over 200 O.P.D patients a day. They got the X-Ray machine to work and in mid-2017, theirs was the only district hospital in the four BTAD districts with an operational CT-scan. He also advocated for post-mortem facilities and which have recently been authorized. Caesareans and eye surgeries are also done in the hospital. He is now trying to get a surgeon and a paediatrician posted there and with the hope that the hospital will be able to offer full-fledged

4.10 A Case Study of an NRHM Programme Manager …

137

services, including surgery and child-related illnesses. LN is upbeat that the blood bank will open in 3 months. In Chirang for instance, there is no blood bank in the government health system. To show how things have improved, LN cites the example of a recent food poisoning case in which 300 people from a village took ill after a community feast. They were all rushed to the Civil Hospital and they could be treated only because they had staff posted and staying there. They could also mobilize many other local community organizations to help and managed the situation. This would not have been possible earlier. He feels vindicated that five MBBS qualified doctors who joined as 2-year NRHM contractual doctors later cleared the public services exams and joined as full-time permanent doctors in the health system. They have all asked for posting to his district and he does not want to leave saying that the people here are ‘nice, simple, easy to deal with and not easily agitated.’ This feeling, LN says is echoed by a senior supervisor in his district who is a non-Bodo from another district, but who feels safe enough to not wanting to leave BTAD. LN feels that the turning point came when the top administrators of the district, the Deputy Commissioner, the Superintendent of Police all started staying in the District Headquarters. They were accessible and he even started getting them to visit the health centres regularly. This gave confidence but also conveyed seriousness of the administration in getting things back on track. He feels that two things are critical to make things work—Monitoring and also Motivation. He is very persistent when it comes to following-up and monitoring his requests with the higher authorities. He keeps pestering them till they post the right personnel, release the funds and approve the plans. ‘If we do not follow-up and monitor again and again, things will not move’. Of motivation, LN says: I take a flexible and not a rigid approach. Our job is to facilitate the health personnel to stay back and so we have used the hospital funds for bettering the quarters. We post spouses together and one-year compulsory rural postings, we post two women doctors together and not one. The role of community-based organisations like the students’ unions are also very important. If they work to create a welcoming atmosphere, motivate the health personnel to work, support them and help look after them, then they will stay. After all, if there are no quality health personnel, how will we serve people?xxxvi

4.11 Conclusion There was a functional public health system in place in Assam in the 1970s and 1980s. The Assam Agitation of 1980–1985 was comparatively short-lived and while it was serious enough to disrupt the governance of various systems including the healthcare system, but it did not derail it. The evidence of this is in the fact that before the Bodo Movement of the late 1980s and early 1990s, there was a working health system in place. There were qualified MBBS doctors and a full team of support staff present in the health centres and people of every community used the services at the health centres. Though there were challenges like shortage of medicines and lack

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of vehicles, the health system was functional, even reaching out with community programmes right down to the villages. Clearly with conflict, the health system in Bodoland did show a sharp decline. As the movement became violent, public infrastructure, including health centres, schools, electricity, roads and bridges were destroyed to keep the security forces at bay. When militancy followed soon after, non-tribal doctors fled leaving only a few Bodo doctors to manage the health centres. The Bodo doctors who stayed back also faced high levels of insecurity—sandwiched as they were between the militants and the counterinsurgency forces. Unlike international humanitarian workers, who enter into conflict zones from outside and do not belong to the ethnic groups, local medical workers who are very much part of the society, face very distinct challenges. This was also the period of economic liberalization of the India in the 1990s when government spending on the social sector including health decreased substantially affecting health services across the country. In Bodoland, the rise of violent militancy interspersed with waves of ethnic conflicts during that same decade further sounded the death knell of health. It collapsed so badly that the health centres could not even respond to emergencies and epidemics following ethnic conflicts. This created the space for a range of medical providers, from informal practitioners to civil society organizations. These actors have remained in some form or the other in the area. As will be seen in the next chapter, which specifically examines the manner by which these new stakeholders emerged or re-emerged (as is the case of traditional healers), a major challenge is to coordinate across these pluralistic and often competing systems. Physical infrastructure such as buildings and equipment along with some lower level health personnel improved greatly in the health centres after the NRHM came in. But regardless of improvement in infrastructure, the health centres in the conflictaffected areas never got qualified doctors to provide quality services. One important lesson is that even if the grassroots health institutions lack resources, committed human resources (both in terms of numbers and normative or psychological commitment) for heath provision can offset many of the obstacles. The negative perceptions about lawlessness and lack of security have sustained long after the conflict and discouraged health personnel from other parts of Assam from serving here in the BTAD. Some health centres function but with inexperienced part-time doctors (fresh MBBS doctors forced to serve a 1-year rural posting to qualify for post-graduate studies) or semi-qualified (the 3-year trained Rural Health Practitioners) or even wrongly qualified (like Ayurvedic doctors forced to practice allopathic medicine). This has caused people to lose faith on the government health system and is an unpopular choice for treatment. An assessment of the flagship programmes that also contribute to health and hygiene promotion also provides a daunting picture. In the case of India, central and state welfare schemes provide an important safety net for families in rural areas. The existing mechanisms also attempt at some degree of universal coverage, and especially in conflict-affected regions, these schemes provide an important set of instruments to ensure that the benefits of development reach all sections of society. Thus a more expansive definition of healthcare is needed, simply beyond the provision of treatment. Health promoting schemes (including education) also become

4.11 Conclusion

139

central to ensuring that individuals can overcome the severe disruptions that they have experienced. An unresponsive public health system is a catastrophe for families completely impoverished by conflict as we will see in the next chapter. We see the unfathomable impacts on the families and individuals, who lived through a long cycle of conflict and displacement, between 1996 and 1998. Relying solely on the memories recorded and voices of the community members, we try and reconstruct, however, partially, the humanitarian situation inside the camps and the violence outside. We also show that these impacts continued into the modern day. In their original form, these memories were recorded, transcribed, and documented and filed. Yet, in the course of the book, once the authors reopened the archived ‘data’ what seemed to be hundreds and hundreds of pages of just transcripts, suddenly revealed connections and a logic started to emerge. Narratives that were seemingly independent (given that they were collected from distinct ethnic groups) actually had many subterranean and less visible connections. Based on suggestions by those who knew of the endeavour, the transcripts started getting reorganized through the entire cycle: the witnessing of the attacks, the experience of fleeing (a burden which fell heavily on children), the overwhelming of the capacity of camps to sustain life, the lack of food, the spread of disease, experiences of incarceration, violence outside, inside and within. We emerge with a conclusion that shows how identity works in profound ways, the mechanics of which is best known by the communities themselves, and it is privileging their actual lived experiences that existing theories on conflict resolution and peace can be improved. On the one hand, the chapter has presented a brief glimpse of how KSD collapsed. The inability of doctors to continue their work due to threats had its ripple effects in the manner in the health situation in the relief camps deteriorated with several preventable deaths. In the events surrounding the relief camps there are conflagrations arising out of seemingly ordinary reasons. We also see bridges being built in unexpected ways. For those who lived in the ‘relief camps’ the death, destruction and suffering witnessed was unimaginable, and left an indelible mark on the small corner of the borderland where the work is based. Yet historical struggles of immense proportions were played out in these sites, some of which are recorded in the next chapter. Notes i

ii iii iv

Sinha, S., David, S., M. Gerdin., and N, Roy. 2013. Vulnerabilities of Local Healthcare Providers in Complex Emergencies: Findings from the Manipur Micro-Level Insurgency Database 2008–2009. PLoS Currents 5. https://doi. org/10.1371/currents.dis.397bcdc6602b84f9677fe49ee283def7. International Committee of the Red Cross (ICRC). 2011. Healthcare in Danger: Making the Case. Geneva. p. 7. Names have been changed to protect identity of respondents. Dutta, Indranee., and Shailly Bawari. 2007. Health and Healthcare in Assam-A Status Report. Mumbai: Centre for Enquiry into Health and Allied Themes (CHEAT). https://cehat.org/go/uploads/Hhr/assamreport1. pdf. Accessed 1 June 2019.

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v

Licensed Medical Practitioners or LMPs were the allopathic practitioners of Assam state from the British era. LMP diplomas were awarded in undivided Assam by Assam Medical College, Dibrugarh. There was a state branch of Licentiate Medical Practitioners in Assam. Some of these practitioners continued to practice till the 1990s. See Assam Medical College 2020. https://www.assammedicalcollege.in/web/. Accessed 1 June 2019. Dutta and Shailly (2007) for details on Ayurvedic practice. Dutta, Indranee., and Shailly Bawari. 2007. Health and Healthcare in Assam-A Status Report. Mumbai: Centre for Enquiry into Health and Allied Themes (CHEAT). p. 19. https://cehat.org/go/uploads/Hhr/assamreport1. pdf. Accessed 1 June 2019. p. 19. Interview with Respondent Dr. GN. Interviewed by Dr. SMNH. Date of Interview. 10 December 2016. Baghmara Village, Chirang, BTAD (Assam). Interview with Respondent Dr. KLB. Interviewed by Dr. SMNH. Date of Interview. 21 December 2016. JLB health centre, Kokrajhar, BTAD (Assam). Interview with Respondent Dr. SB. Interviewed by JL and TRPTI. Date of Interview. 1 July 2016. Baghmara Village, Chirang District, BTAD (Assam). Ibid. Interview with Respondent KB. Interviewed by [Undisclosed]. Date of Interview. 14 December 2016., Location near Milon village, Chirang District, BTAD (Assam). Interview with Respondent CPS. Interviewed by MJM. Date of Interview. 19 December 2016. SGM Village, Chirang BTAD (Assam). Interview with Respondent NB. Interviewed by MJM. Date of Interview. 12 Dec 2016. Near Milon Village, Chirang District, BTAD (Assam). Interview with Respondent CPS. Interviewed by MJM. Date of Interview. 19 December 2016. SGM Village, Chirang BTAD (Assam). Interview with Respondent NB. Interviewed by MJM. Date of Interview. 12 Dec 2016. Near Milon Village, Chirang District, BTAD (Assam). Ibid. Interview with Respondent DB. Interviewed by TRPTI. Date of Interview 15 June 2016. Milon Village, Chirang, BTAD (Assam). Interview with Respondent Dr. SB. Interviewed by JL and TRPTI. Date of Interview. 1 July 2016. Baghmara Village, Chirang, BTAD (Assam). Interview with Respondent Dr. A. Interviewed by [Undisclosed]. Date of Interview. Unspecified. Location not specified. Chirang District, BTAD (Assam). Interview with Respondent Dr. C. Interviewed by [Undisclosed]. Date of Interview. 31 December 2016. Location not specified, Chirang District, BTAD (Assam). Interview with Respondent and Interview Date Unspecified. Interviewed by [Undisclosed]. Chirang District, BTAD (Assam). Interview with Respondent LP. Interviewed by TRPTI. Date of Interview. 29 August 2016. Milon, Village, Chirang District, BTAD (Assam).

vi

vii viii

ix x xi

xii xiii xiv xv xvi xvii xviii xix

xx

xxi xxii

4.11 Conclusion

xxiii xxiv

xxv xxvi

xxvii xxviii xxix xxx

xxxi xxxii xxxiii

xxxiv xxxv xxxvi

141

Interview with Respondent DM. Interviewed by JL. Date of Interview. 4 July 2016. Fulbari Village, Chirang, BTAD (Assam). See Dutta, Indranee., and Shailly Bawari. 2007. Health and Healthcare in Assam-A Status Report. Mumbai: Centre for Enquiry into Health and Allied Themes (CHEAT). https://cehat.org/go/uploads/Hhr/assamreport1. pdf. Accessed 1 June 2019. Interview with Respondent Dr. SB. Interviewed by JL. Date of Interview. 31 December 2016. Baghmara Village, Chirang District, BTAD (Assam). See Borah, Amarjyoti. 2015. Assam’s rural health practitioners face uncertain future. https://www.downtoearth.org.in/news/assams-rural-health-pra ctitioners-face-uncertain-future-48728#:~:text=Owing%20to%20the%20s hortage%20of,rural%20health%20care%20and%20medicine. Accessed 12 July 2019. Also see World Health Organization (WHO). 2020. Cuba’s primary health care revolution: 30 years on. https://www.who.int/bulletin/ volumes/86/5/08-030508/en/. Accessed 13 July 2019. Field Note of LIAJ and MJM. Date of Interview of Respondent BM and family. 10 November 2016. Interview with Respondent Dr. SB. Interviewed by JL and TRPTI. Date of Interview. 1 July 2016. Baghmara Village, Chirang, BTAD (Assam). See Ministry of Rural Development, Government of India. 2020. https:// nrega.nic.in/netnrega/home.aspx. Accessed 7 July 209. For a comprehensive overview of the schemes see Dr. Samrat Sinha, Dr. Upasana Mahanta, “Disjuncture in Law, Policy and Practice: The Situation of Child Welfare in India’s Conflict Affected Regions” Asian Pacific Law and Policy Journal, Volume 17 (1), 206: 1–71. Interview of Respondent SBS. Interviewed by LB and JL. Date of Interview. 2 December 2016. Milon Village, Chirang, BTAD (Assam). Interview with Respondent HR. Interviewed by TPRTI. Date of Interview. 12 June 2016. Near Milon village, Chirang District, BTAD (Assam). Interview with Respondent KB. Interviewed by [Undisclosed]. Date of Interview. 14 December 2016., Location near Milon village, Chirang District, BTAD (Assam). Interview with Respondent SH. Interviewed by LB and MJM. Date of Interview. 11 Dec 2016. Fulbari Village, Chirang, BTAD (Assam). Interview with Respondent LN. Interviewed by JL. Date of Interview. 4 June 2017. Baghmara Village. Chirang District, BTAD (Assam). Ibid.

Chapter 5

Surviving Conflict in a Fragmented Borderland: Community Voices on Violence, Dislocation and Ill-Being in the Border Villages of Chirang

Abstract The previous chapters until now have established linkages between armed violence and the collapse of healthcare provision. The previous chapter attempts at providing a degree of institutional analysis, albeit at the micro-level, incorporating various sources of data including narratives. In this chapter on the other hand, we seek to record and analyse the direct experience of disruptions caused by repeated cycles of violence on the communities living in the border areas. Pushed even deeper into the forests, towards the international border with Bhutan, the displaced communities found themselves surviving at the margins of the state. Militarization, insecurity and daily violence were woven into the fabric of everyday life. Using diagrams and conceptual maps drawn from thick life-histories, we try to understand how conflictaffected families interpreted the reality of violence and coped with their losses in changed circumstances. Their losses are multiple, multi-layered and intricately linked into a complex web which tend to push the families beyond their coping capacities towards ill-health and ill-being. What would ordinarily have been manageable survival and health challenges then turn into catastrophes. Even amongst the vulnerable, a case is made for particularly vulnerable groups that need our special attention. Women, children, the disabled and the elderly are disproportionately affected through the various stages of a conflict—during fleeing, living in the relief camps and even resettlement in a new place. The struggle for survival brutalizes the bodies and minds of these groups leaving them with reduced resilience and higher risk of ill-health. Keywords Displacement · Conflict Induced Displacement · Relief Camp · Mortality · Communicable and Non-Communicable Diseases · Food Insecurity · Domestic Violence · Impacts on Children · Stress of Survival; Health Inequities · Health Vulnerability · Conflict Survival

5.1 Introduction The deep history of conflicts in Bodoland is profoundly imprinted in people’s memories. While researchers play a mediating role in providing an interpretation of key events or processes underlying a conflict, it is also crucial that the narratives of those who personally experienced violence and dislocation are recorded. This is especially © Springer Nature Singapore Pte Ltd. 2021 S. Sinha and J. Liang, Health Inequities in Conflict-affected Areas, https://doi.org/10.1007/978-981-16-0578-9_5

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true when we see that writings on the political history of violence on Bodoland tend to privilege institutional politics. Alternatively, despite the existence of evidencebased work on the conflict, the utilization of macro-level theoretical formulations by research does not capture the complex reality of the situation, nor the level of variation in violence itself. In this chapter, we seek to reverse our methodological standpoint, by presenting the voices from the affected communities to highlight some of the more nuanced aspects of the conflict. We record and present these narratives, to show the longterm struggles of the communities in the borderland, by tracing out in some cases, their experiences across multiple cycles of conflict. The chapter, therefore, maps out the challenges faced at the household level, where the reach of the state and the humanitarian organizations who responded to the conflict(s), seemed distant. Interpretations of politics at the institutional level are very different from how the communities construct the experience of conflict. In many cases, the existing research assumes that the ethnic differences were fixed and there was a long history of enmity. The narratives on the other hand show that in some instances pre-existing linkages were actually quite strong and that several communities did receive some form of early warning that tempered the impact of the violence. Another aspect that is thrown up by the narratives is that in a situation of seeming disorder, violence and anarchy, people’s survival strategies rely a lot on community traditions and other forms of decision-making at the individual level, rather than purely on state-policy or the programmatic outcomes set by civil society organizations. It must be also clarified that when we write about the 1996 and 1998 conflicts, these occurred more than twenty years ago, yet the intensity of the experiences, led the members of the community to recall the incidents with a great deal of clarity. It is also important to note that the experience of the populations, who were displaced, in the repeated cycles of violence in Bodoland, especially in 1993, 1996 and 1998, was rarely recorded. Milon till 2003 was a part of undivided Kokrajhar District and fell under KokrajharSubdivision. Fleeing into the deep forests (as this area was then thickly forested then) and living in relief camps, that emerged organically, with barely any contact with the state-authorities (who came sporadically for relief work) meant that statistical and qualitative data from that time is difficult to come by. Even humanitarian organziations and externally situated peacebuilding organziations, who operated in the BTAD at various times, despite having rich records on the socio-economic conditions of their areas of intervention, do not necessarily disseminate this information publicly or generate community histories. It is our contention that in order to understand the scale of rebuilding in the BTAD, the issue of post-conflict recovery actually involves an understating of multiple legacies, from the onset of militant violence to multiple humanitarian crises. While the 2012 and 2014 conflicts in BTAD led to more extensive documentation, due to improvements in information gathering and dissemination, there is an absence of community narratives on the earlier conflicts. In the next sections, we try and understand the process of conflict, displacement, rehabilitation and resettlement utilizing accounts from the narratives that were archived in the course of the original study mentioned previously. In a classic

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disaster management cycle, post the disaster event, there is the emergency phase of response followed by rehabilitation and recovery. The interviews recorded experiences across several phases of conflict show the non-linearity of the experience of dislocations rarely fits into such silos and frameworks (on which crucial decisions on providing relief and rehabilitation are made). These were experiences of largely forcibly displaced populations of Adivasis and Bodos, some of whom had experienced three rounds of forced displacement in a span of two decades from 1996 to 2014. We also include narratives from the Nepali community, who overnight became a host community, with the settlement of IDPs in the area from 1996 onwards (an estimated 17,0000–18,000 persons came to the Milon area). Their lives have been punctuated by major conflict events and they have suffered many cycles of loss and suffering. This complicates existing theories as the effects of these multiple events seem to be layered and not linear, i.e. having pre-defined start and endpoints. Even if we take one episode of violent disruption in the lives of affected families, we see that the effects and hence the needs of emergency response and restoration are very different at every stage of the disaster. To map out some preliminary patterns, the chapter uses diagrams and conceptual maps drawn from thick life-histories to try and understand how conflict-affected families interpreted the reality of conflict and coped with their losses as well as changed circumstances. We then conclude with some inferences and recommendations based on the narratives. The accounts have further been placed thematically and sometimes chronologically to enable interpretation. What links a few of the narratives of the early years of conflict, is they trace out, individual accounts of persons, both Bodo and Adivasi, who in some manner were connected to the same set of events and locations, but might (or might not) have known each other. In addition, a key connector is their lives converging in and around Milon Relief Camp.

5.2 Micro-Narratives of Violence and Survival of the Earlier Conflicts Between Bodos and Adivasis (1996–1998) 5.2.1 The First Big Disruption: Witnessing Violence and Fleeing Shibu and his wife Maina are an elderly Santhali couple. They still live in Milon Relief Camp (which was created after 1996). In the course of their life together, they had many children and lost three. Some of their children have grown up and have families of their own now. Their lives and those of many respondents across ethnic lines lives show how multiple forced migrations bring about vulnerabilities which get complicated by complex relationships between the communities and also by law and order and forest governance. First, in the voice of Shibu:

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I grew up and used to look after cows in Raipur where I also got married and we had two sons but one of them died. I owned five bighas of land which was unregistered. When I got around to registering the land, by mistake I included some part of my neighbour’s lands. The next day when the neighbours (who were from another community) came to know of this, they were very angry and came to my house and threatened me. I was scared by their threats and leaving my land to my elder brother, I fled. I had heard that land was being distributed in the forest area of Dholpur and so we went and settled there. In the beginning we got two-bighas of land but after some time we cleared the jungle and made it to about 10 bighas (3.5 acres). The land we had was near the riverside and within 20 years, the river eroded the land and we lost our land. Another son and a daughter also died while we were living in Dholpur. With our land gone, we moved to Sengelsing forest which was close to Bhutan. During our stay in Sengelsing forest, our two sons got married and we needed more land. So, he joined others to clear the forest land in another place and after clearing it, he moved with his family there. We also did the same and went to a nearby forest area and cleared some land and then shifted there.i

Circumstances suddenly changed in 1996. When the 1996 conflict broke out the members of the family fled to relief camps—his son’s family went to Milon Relief Camp and some stayed on since then till now while others fled to Asrabari relief camp. In Shibu’s story, we see an example of members of a community being alive because they were warned ahead by the other supposedly ‘enemy’ community: The paddy was ripening and I had gone to the jungle to collect jungle potatoes. At that time, one of the Bodo men told me not come to their place anymore because there are people who are going to harm us. I returned to our village and told the others what I heard. But they did not believe me and instead got angry with me. But soon, we had to flee. We had four sacks of rice and before fleeing which we hid in the jungle. Along with the others, our family also ran through the forest. I was suffering from ‘andhua’ i.e. night blindness and could not see anything in the dark. I carried my youngest daughter on my shoulder when going through the forest. Three other children and my wife were walking ahead of me. I got lost on the way because my daughter and myself were behind the others. My daughter was instructing the way to go because I could not see. I could hear my family members calling out to us but they could not hear when I called them back. Later, my eldest son came back to search for us and carried his sister. Eventually we reached the Asrabari Relief camp. We were there for two years and then shifted to Milon camp. We have not returned to our village since then.ii

Another account is by Sanjib and Nili. The couple who belong to the Bodo community had witnessed first-hand, the violence of 1996 and 1998. The narrative given by Sanjib provides important information on the immediate circumstances of the outbreak of violence. It also testifies to the close relationship between members of the Bodo and the Adivasi communities, in some areas. Sanjib witnesses the exodus of Adivasis in the initial days of Milon Relief Camp but is then displaced with his family within a short span of time. We also get some idea of the complex and many times close relationships between the Bodo and Adivasi (Santhali) communities prior to a conflict which impinges on the decision-making process when conflicts break out between them. Sanjib describes the circumstances of the 1996 and 1998 Bodo–Adivasi conflict below: I came to Milon in 1994 just after the Bodo-Bengali Muslim conflict after losing our land to erosion. When we moved from there, we carried six bullock carts of paddy so that the family could eat till the next harvest season. I bought four bighas of land from an old Santhali man

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and another seven bighas from someone else for paddy cultivation. The old Santhali man from whom I purchased the land was left with no more land and so I asked him to keep living on the land. He worked in my fields and we had such a close relationship that the old man used to call my wife his daughter and address me as his son-in-law. I also used to go to Bhutan for daily wage labour. One day while returning from Bhutan after work, I heard that a ‘Southal Daourou’ (Santhal attack) had started. On reaching home, I first went to check on my Santhal neighbours and was surprised to find their houses empty. They had all fled even before informing our family. We passed that night in complete fear wondering if we would also be attacked. Early morning while I was near the river, I suddenly saw huge numbers of Santhals fleeing towards Milon Bazaar. The women carried children and bundles on their backs and the men were pushing bicycles loaded with their things. They were trying to climb the high river bank to reach the security forces camp at Milon which they believed was the safest place for them. They were struggling and so, I helped them push their bicycles over the top of the river bank and none of them said a single word. I asked them why they were fleeing? Finally, one familiar face told me that the VXYZV militants had burnt their houses and they were forced to flee. After all this, I came back home feeling very insecure. I was sure that it was also time for us to prepare to leave the village. I started to first take our paddy to the house of a Nepali neighbour for safety and also started loading some of our household things onto the bullock-cart. In the middle of all this, the old Santhali man came who was living with us told me that we should also run away as their (Santhal) youth have decided to fight back and it would not be possible for the Bodos to stay any longer in the village. After some time, some known Adivasi militants came to me and asked me to flee. They used to regularly come and drink in our house and we had good relations with them; and, so they warned me that their people were preparing to attack the Bodos and if we did not leave immediately, we would be in danger. Since lunch was ready, we decided to first eat. We had just finished eating, when a large number of Santhali men carrying bows, arrows, knives and spears came and encircled our house. We fled. I got the servant to avoid the road and lead the bullock-cart through the maize fields. I started to push the loaded bicycle. We met a widow crying trying to carry a big wooden box filled with the dokhonas (traditional dress worn by Bodo women) for her son’s bride-to-be. I broke open the lock and bundled all the dokhonas together and loaded it on my bicycle. The Santhals kept shouting at us to leave the place immediately. I replied to them, ‘just (give us) few more minutes, we are leaving, do whatever you want after we leave’. I sent away my wife and children along with the others through the river Aie to reach a camp. My wife tied one son on her back and the other infant on her chest and made the eldest daughter walk. It was dangerous but I stayed back because of the cows which I had left to graze in my Nepali neighbour’s field. After few days, I joined my family in the KTJR Relief Camp. It was so difficult. We had no money and there was no work. I would catch some fish and sell it. We spent six months in this relief camp where my son fell severely ill. Luckily the Mission Hospital doctor there somehow saved my son. The administration brought us Bodos back to Milon, where another relief camp was set up. And when the situation improved, we returned to our houses. I had asked one Nepali family to look after our paddy when we fled six months ago. But I got back only one sack of paddy. The rest was gone. In 1998, conflict broke out again with the Santhalis. It was very dangerous and we were stuck. Young men belonging to the Adivasis blocked the road and checked every single vehicle to find and possibly kill our people. None of us had money and I only had three rupees in my pocket. I bought paper for one rupee and taking someone’s help, wrote a letter asking the Asrabari Police station and also the Students Union to help us. A minibus driver helped carry the letter to them and we were saved. Escorted by the army, the Student Union boys arrived in Milon and our villagers were taken in vehicles to KRR Relief Camp. Again, I sent my family ahead while I stayed back to try and protect our village with some other men. But that afternoon I was caught by the security forces. I was carrying a torch light and wearing a red t-shirt. They suspected me

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to be a militant causing trouble in the area. They brought me in a jeep along with another friend of mine who was also arrested. Inside the jeep we also discovered a dead body lying in a pool of blood. We recognized the dead body as pagla (lunatic) from KYGL village. That night I was kept in the security forces camp and the next day I was taken to the police station and then sent to Kokrajhar jail.iii

Sanjib’s wife Nili recounts developments after receiving the news of the arrest of her husband: My son (the one who recently got married) was crying a lot that particular day. He would not stop crying so I tied him on my back and kept cleaning the snails which we planned to cook for dinner. I was not aware that my husband was caught by the army. I think the boy must have missed his father and was crying. When my father in-law learnt of the arrest of his son, he asked me to sell the bulls in order to get him out of the jail. Even in their earlier village, during the Bodo and the Bengali-Muslim conflicts, another son of his was caught by the police and taken to jail. He could get him out of the jail by selling pigs. He convinced me that I had to sell the bulls. I sold two big oxen for Rupees 2,200 and Rupees 3,000 to get my husband out of the jail. I did not get the full amount, for the one which was agreed for Rupees 3,000, I got only 2,000. To go and see my husband in the jail, I also sold 3 dokhonas (traditional clothes worn by Bodo women). Those days were terrible and along with my children, I lived with my in-laws. The people in that area had newly started a market in the village. I deliberately never used the road that passed through the market. When I went near the market with the children, I walked through the fields so that my children did not see there is a market as I did not have any money to buy anything for my children to eat. My husband used to make fishing nets and there were some pieces of net in the house. I sold them for Rupees 20 and sometimes Rupees 30. The Bodos who used to go and catch fish used to come and buy them from the house since they could not access the Koroipur market came and purchased the net from me in the house. Mr. N, a government employee in Milon helped get my husband out of the jail. I borrowed money from Mr. N too as I did not have enough for the bail. During the second conflict (1998), he also helped hide many of our people in their office. All the people employed in that office were good to us. While we were hiding in their office, the Santalis would come and enquire if they had seen Bodos. They would deny they had anything to do us. But later on, they found out and Mr. N also had to flee for his life. One hot day, something seemed to have frightened my baby daughter and she would not stop crying. She kept getting worse, but we had no money and the roads were also not safe to take her to a doctor. So, my mother-in-law took her to an ojha (medicine man) and he advised the child to be given some herb called ‘jaku muli’ which stops children from crying. I had to carry the child on my back the many trips I made to get my husband released. To keep the child calm, I would carry that herb, mix it with river water and feed the child. I must have over-fed the child this medicine because she became ‘dumb’ and could never talk after that. After my husband’s release, we came to live in the KKR Relief Camp with the other villagers from our place. From here we moved to our current village where we bought a small piece of land with the Rupees 10,000 we got as compensation. We do not have any relatives. In this new village, we lived together with the people around as our own people. Now I feel anyone in this village is my brother, my sister, my mother and father. We have been living as a family since the days in the relief camp.iv

RS of Bogori village is an Adivasi woman who was 6 years old at the time of conflict in 1996. They are landless and they manage with money earned by her husband through daily wage labour across the border of Bhutan. Her husband comes home once a week. She recollects being saved by a Bodo after the attack:

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We had very less land in our village. So, we left and came to the new place called PWA. It was just a year before 1996. I was around six years old. Being in a new place, we did not have enough food. We only had two cows. So, my father worked in a house of a Bodo as a servant. In 1996, when the conflict started, the Bodo house owner helped us to flee from the village. While running from the village, we were surrounded by some young men. But the Bodo house owner stopped them from attacking us and we managed to flee without any difficulties. Otherwise the youth might have killed us on the spot. The rest of the villagers ran away earlier. We did not know. We were around seven families who got left behind. But no one was killed in the village. We could bring nothing from home.v

If the narrative shows that linkages with the ‘other’ community were strong, we find the case of a Bodo woman who was living in a multi-ethnic village, but fled due to a mixture of rumours and panic. It also provides an example of opportunistic behaviour from a smaller tribal community who are considered co-ethnics and associated with the Bodos. TD fled in the 1996 and 1998 violence, lived in a number of relief camps before settling down in Lalbiti village: The violence in our village was not intense, so we could flee with our cattle and other essential items. We were the only Bodo family in that part of the village. Our neighbours were from the Adivasi and DSWRT communities. They (the DSWRT neighbours) painted a very scary picture of us getting attacked in the night and warned us to move out from the house. So, we fled. we fled the conflict to a village where there was a relief camp. We carried whatever we could by loading it in the cycle. We buried some under the soil. The other remaining items/property was all lost. I suspect the DSWRT of stealing all the property because they did not flee their homes. We had purchased some costly wood to make bed from it, even that wood was stolen. They even pulled down our house after looting it. The Adivasis were not present in the village they had already fled the village the remaining were only DSWRT so we suspect the them to have destroyed our house. My husband had returned to the house to collect the vegetables from the garden but he discovered that even they were all stolen; he finally collected some few pieces of yam and returned. We lived in the relief camp for two years. There was not much problem while there was regular supply of relief materials like oil, soap, biscuit, pressed rice, dal, rice (initially boiled rice followed by polished rice). With the compensation money (Rupees 10,000) we purchased some land in a village. The land belonged to a Santali person but there was rumours saying that the Santalis would come back to their land where we were now living. When the conflict of 1998 broke out following the incident in Koroipur market, we again fled to AJHR relief camp.vi Another category of narratives also challenges accepted notions of immutable ethnic differences. This account is of a person who first helps Adivasis who are fleeing and then participates in the burning of houses, but then saves an elderly Oraon couple and hides them for 3 months. MSBR is an elderly Bodo man who is now more than 75 years old. It was a routine day in Salbari village when the unrest started. When the conflict broke both the Santhals and the Bodos fled together to the hide in the forest: We were not aware of what was going on. Seeing the houses burning we just knew that there was a conflict. After some time when we realised that the VXYZV militants were burning the houses of the Adivasis. We helped the Adivasis to flee towards Fulbari through the forest.vii

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After this incident at some point of time, MSBR accompanied a large group of Bodos attacking the Fulbari village. According to him around 45 houses in Fulbari were burnt down. He did not find any people in their houses all of them had already fled to the camp of the security forces camp located at Milon. That was the first time he actually went to Fulbari. Though he did not actively participate in burning down the houses, he saw what had happened in Fulbari. He also saw that many Adivasi families near his village flee their homes without any possessions. Despite the conflict, for 3 months he managed to hide an elderly Adivasi (from the Oraon tribe) and his wife in his house. As the old Oraon was very close to his family and considered him as his son, he said he was morally obliged to do that favour.viii When the conflict subsided, he dropped the man and his wife till the Bhur River, from where they went to Milon Relief Camp. Another account is by TWLN of Asrabari village. He is a Bodo male and was a child when his village is attacked by Santhalis but is then saved by an elderly Santhali. He then calls on one of the major militant groups to help: I was in studying in Class Six when the violence started. It was nearly the half- yearly exams. I saw many Santhals with few belongings on their backs passing through our village road. These groups had been chased from some of the nearby villages. Some from the fleeing group were familiar faces. We had our paddy fields in DKNRA village and often the Santhals tilled our fields. Some fleeing Santhals who knew us well stopped by our house and in deep agony told us “thir marileou nuhumai” [even your arrows cannot pierce us]. The Santhals were fleeing to Milon as there was a police station there and they felt they would be safe. Our father was elsewhere when the attack in Milon started. My brother, his wife and his two children and myself were in the house. It was in the evening when a huge group of armed Santhals came to our house and asked us to come out of the house. They had knives in their hands raised high enough as when they lowered it down would cut anything. The spears were long enough to be just reaching us from a distance. We were hiding in fear. My brother and I were lost what to do, there was no telephone at that time whom do we call. An old Santhali man in the group was shouting at the top of his voice, ‘please let them go! please let them go!’. Our Nepali neighbours were mere spectators, witnessing the entire scene from their houses, they remained silent, not able to voice out in favour of us, they had to consider their own security. The Santhali old man then asked us to come out of the house promising that no harm would be done to us. We timidly got out from the room. My brother and his wife carried the children wrapped around their arms and we slowly moved through the angry and violent group of Santhalis. We started to run as fast as we could till we realized that we were at a safe distance from the angry crowd. We fled to another village which was mainly inhabited by the Bodos and Koch Rajbongshis and left the children and the mother with some reliable families. I along with some group of Bodo youths returned back in the silence of the dark night to check the house but found that the angry crowd were breaking the house. I went with one friend in search of the VXYZV militants to come to our help. After searching for the whole day, we met two of them and we informed them about the incident. After having heard my story one of them asked us to leave the place. No sooner after we reached back, a large group of VXYZV cadres arrived in our village. They were asking the youth from the village to accompany them to attack the state forces camp. They had come with a plan to attack the police camp by midnight. All their plans were shattered, when the state forces discovered them lying in ambush near their camp.ix

Another Bodo male respondent witnessed violence first-hand in both the 1996 and 1998 conflict and was displaced twice as a result of attacks on his village. Yet in order to make ends meet, he eventually sells his land to a Santhali:

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We were displaced from our home as a result of the 1996 and 1998 conflicts. When the 1996 conflict struck our village, most of the villagers were out of the village as it was the market day. It was then the Santhalis came and raided our village. The attackers were driven out by the VXYZV militants. I accompanied the militants who had rushed to the village in order to drive away the attackers. They fled when the militants fired some bullets in the air. I discovered that more than 20 houses from the two adjoining villages were all set ablaze. An old man and his wife (both of them around 60-70 years) were burnt to death as the houses was burnt down. Another old lady was found dead with cut marks lying on the ground. So much of cattle were destroyed during the attack. After some time, the security forces arrived at our village. Seeing them the militants moved out of the village. I began to untie the cows and oxen from the fields and collected them together to be taken to the other side of the river Bhur. Few days later the Bodos from the nearby villages came to our village with straw and bamboos and built houses for our villagers. Though some families had migrated across the river Bhur most of the families remained back in the village. Security forces came to guard our village. We continued living in the village until the 1998 conflict when two villages near each other were burnt down for the second time. This time, the Santhalis crossed the Bhur river and burnt all the Bodo houses, sparing the houses of the other community also living there. The attackers could easily identify the Bodo houses as they used to work in their houses. The conflict period seemed extra difficult for the people of our village, we did not receive any relief aid until a fortnight. We were left to manage on our own until our names were registered in the relief camps. The students union took care of our food and stay initially. They distributed clothes which they had collected from the Bodo villages in different places. Though we went back to cultivate our fields in our previous village, we felt insecure as the Santhalis were growing in number. We found many new Santhali faces, they must have come from those villages which were burnt elsewhere. We finally sold our lands to the Santhalis at a throw away prices and moved to this present village. I was beginning to prosper in the previous village the fields were fertile and fit for any type of crop but I lost my entire property as a result of the conflict. After losing the fertile agricultural fields, I am reduced to a daily wage labourer. The conflict has made me start my life and build the family from scratch twice. I have not been able to adequately support the education of the children and hence they have not been able to progress.x

For women from both the communities, the experience of fleeing was traumatic and forced them to make difficult choices. Across ethnic communities, conflict seems to have a disproportionate effect on women. Through the different phases of conflict—from fleeing their homes in the wake of violence to living in the relief camps, to settling in a new place to rebuilding their lives the conflict puts a huge burden on women’s bodies and minds. Munni is Adivasi woman who is 40 years old. She was displaced in 1996 conflict and did not go back to her original village. She now lives close to the erstwhile Milon Relief Camp. Her narrative, highlights, that at the peak of the violence and on the verge of being killed, a number of people seeking refuge in a school were spared, because they identified themselves not as a Santhali but as an Oraon (a sub-tribe). In 1996, it was primarily a conflict between Bodos and Santhalis and this small difference became a matter of life and death. A woman from the Bodo community also helped her during the attack: I am from Salbari… its far from here. At the time of the attack, we were surrounded.…. with all kinds of weapons, khukris and swords and what not. All were shouting “joi, joi, joi” … both my father-in-law and mother-in-law were drunk that time. My daughter was just an infant and my mother-in-law had taken her along with her searching for more liquor from a

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Bodo village. I ran to search for them and bring them back. One of the Bodo women gave the old lady half a bottle. She tucked it into her blouse and was told to quickly flee. We had hardly reached our house when the attackers found us. I didn’t know what to do. My brains were not working. Here both the old man and woman drunk and a brother-in-law who was suffering from a mental disorder. My husband had left that same morning to go out for work and so, he was not around. What to do? What not to do? Who to take? Who to leave behind? I told the brother-in-law, ‘leave the mother and take the father’ and so he carried the old man on his back. I took the child and we started fleeing and came to the camp. We left the old lady behind as she was totally drunk and could not even stand by then. My child kept crying for the old lady as she was very close to her. I was also worried and wanted to go back for her but there was no way. But she survived. She went to a nearby Bodo household for water and they gave her. We had so many cattle – two sheds of cattle and they asked her, ‘Are these your cows?’. She denied, ‘No, no. These are not ours. You take them’. She had to say that or else they might have killed her. Like that, we also had a very fat pig and many hens and goats. We lost them all. Anyway, she was in the jungle for two-three weeks. There were others too who could not run immediately. A relative of ours gave birth that day of the conflict. She was in labour and it was so difficult to run. They fled from the house and there were some bushes to hide behind and she gave birth there. It was really dangerous. Anyway, many of them hid in the jungle and slowly, very slowly made their way to a school where many of our people had gathered. The Bodos wanted to burn the school down but they begged for their lives saying that ‘we are Oraon Adivasis and not Santhals, don’t kill us’. They were then spared and slowly came and joined us in the Milon camp.xi

MBW and AM are a Bodo couple Bodo now in their 40 s living in Lalbiti Village. They were displaced in both the 1996 and 1998 conflicts. They experienced both floods and conflicts and suffered again when their young daughter died. MBW recalls: After the conflict of 1998 we did not return to Salbari. Though the villagers from there persuaded us to return, the hard experiences of the two conflicts did not allow us. We had seen fighting with bows and arrows, knives and spears. We had heard of bloodshed in another village, of the slaughtering of a child and an old woman. Our neighbours were mostly the Santalis and a few Rabha families. The conflict of 1996 divided the Santalis and the Bodos. While they (Santalis) fled to the relief camp in Milon we fled in the opposite direction to KTJR relief camp. Though we returned to Salbari in 1996, we always suspected that they would one day they would return to attack and reclaim the village. In 1998 they constantly tried to enter our village backed by the militants and some forces.xii

AM talks of the hardships faced after they got back from relief camp the first time in 1996: On returning to Salbari from the relief camp, our elder daughter fell sick. She just closed her mouth and could not speak a word. We tried to reach her to the hospital in Bongaigaon (which was a few hours away) but she died on the way. During those days the roads were very bad and there were only few vehicles on the road. It was even very unusual for a dog or a cat to walk the roads during those days. The girl died in the arms of the father on the way to the hospital. Then, we were hit by floods in 1997. The flood water rose high enough to make us abandon the house and look for a place where the water had not yet reached. Our house was destroyed. Later when the flood water subsided we discovered that a water spring had formed inside the house. I was pregnant and was about to deliver another baby. The flood water had washed away some our kamplai (a type of stool, usually not very high) and three baskets of grains (paddy). A relative from the village who visited to check the dykes had discovered that the dykes were broken and the Nijla river water was flushing through the small canal that passed through the back our house. Having seen the dykes broken and my condition, he had warned us to shift to some other place. I was reluctant to move from the

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house thinking if had to die I better die sitting inside the house on the bwisang (a bed prepared from tying together of bamboos and some woods, it is normally higher than a usual bed). I was also scared of elephants at night if we moved to some other place. In the evening when the flood water was increasing my husband took me and the daughter to some house which was not affected by the flood water. That house was built on some high raised ground and the flood water had not reached there. I had brewed some) Jou (traditional wine for festivals which is prepared from rice) and hung the pot in the veranda to save it from the flood water. With this Jou we invited people from the village to come and help us fix a house which was abandoned by an Adivasi family. The abandoned house was not affected by the flood water; it was still standing even though it was damaged in the 1996 conflict. The villagers cut some fresh and green thuri (a long grass used for fencing the walls or the roof when it is dried) and fixed the house and we could live there. The very night the house was fixed, I delivered the third child (girl) and we continued living in the house for a day or two. But the conflict again broke out and we fled to KTJR relief camp. The umbilical cord of the new born baby had not yet fallen by then, I carried her on my back tied with a gamcha (handwoven towel) and walked all the way to KTJR along with the other villagers.xiii

Another Bodo family experiences a personal loss, just at the time of moving to the camps in 1996: My sister was seriously ill when we had to flee. We could not take her to the hospital because all the roads were blocked and we had very little money with us. In the fighting we fled to a nearby village to spend the night and that particular night we entered the house of a Christian. My sister passed away that very night. We had to wait and see her die as there was no option of hospital and medicine. The owner of the house was compassionate enough and allowed the body to be kept in their house. Early next morning, we went back to our house and buried her behind the house but when the night fell, we had to flee again and could not spend time in her grave. None in the family could accept that our sister was dead. Even the other sister, while living in the relief camps had gone so ill that we all thought that she would not survive. She had dysentery initially and later could not hold what she ate. One day we found a buffalo which had drowned in the river. I carried back home some meat and smoked and dried it. I made my sister eat the meat with all the meals. This is how she sustained till my father could save enough money to take her to the hospital.xiv

5.2.2 To the ‘Relief Camps’: Visible Safety, Invisible Violence For those fleeing the sudden explosion of violence, the ‘Relief Camp’ became the only source of refuge. The historical experience of the communities until then had not prepared the people for the series of dislocations to the new spaces called ‘relief camps’ and the horrors that being internally displaced brought upon them. It is the extreme brutalization inside the ‘relief camps’ that became part and parcel of the memories of the respondents. Many camps in 1996 and 1998 (as well as in all the conflicts mentioned earlier) emerged through a combination of processes. In some cases, people fleeing their villages and hamlets would congregate in an area that would offer some form of protection (largely outposts of security forces). The state government established some of the camps in school buildings but mostly, it came up informally. People would flee and cluster in areas where there were larger concentrations of members of their community. In some cases, people would escape into the jungle. In other cases, it was more organized, especially, as we see post

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1987, the All Bodo Students Union (ABSU) playing an important role in setting up camps and relief distribution. Similarly, the Adivasi ceasefire groups and other student unions also play a role in relief and rehabilitation in later years. Once established, camps recognized by the government would then receive standardized rations in accordance with the established government norms (such as in the Assam Relief Manual). What is important to remember, is that in 1996 and 1998 the Milon area was covered by dense jungle and with some level of area-domination being achieved by the militant groups. Many of the IDP camps were well beyond the reach of the state. The whole idea of living in ‘relief camps’ was an alien concept to those who were displaced. There was visible violence, due to attacks by militants or sometimes by the security forces who were sent to guard them. The invisible violence was the consequences of living in overcrowded conditions compounded by the failure of relief and rehabilitation efforts. The long-term effects on health and well-being were equally serious and extremely difficult to measure. This includes psychological well-being of the men, women, children, the elderly and the disabled. The actual numbers who died due to communicable and non-communicable diseases in the 1996 and 1998 conflicts inside the camps are not even known. The fact that doctors could not reach them due to insecurity and the collapse of the health system (documented earlier), fundamentally changed health seeking behaviour (as we will see in the next chapter). The determinants of health and well-being thus deteriorated due to conditions that were created precisely in the areas that were deemed safe. In the next set of narratives, we examine various facets of the humanitarian situation inside the camps. For those moving into the camps, we see a situation of restricted movement outside the camps due to risks of violence by militant activity or the newly introduced security forces, sporadic supply of food, poor sanitation, no schooling, no access to healthcare and most of all a situation of protracted dislocation (caused by the uncertainty of rehabilitation). For women conflict-survivors, they do not just suffer physically but also mentally, socially, sexually and economically. These gender burdens are interrelated and they cause immense suffering for women at multiple levels. Without the required and sustained external support and intervention, the coping capacities of these women are severely tested leaving them vulnerable and smallest life challenges push off the edge of well-being and health. Figure 5.1 shows the population shifts and upheavals caused by displacement following 1996, 1998 and 2014 conflicts in the Milon area. Some of those displaced travelled long distances and after moving from camp to camp, choose to settle down in a particular relief camp and later, moved to other camps or to villages far away from their original site of displacement. Though some did return to their original village, many of the displaced families have not been able to return as their lands have now been occupied by the so-called ‘enemy’ community and they fear reprisal. DM, an Adivasi man, currently in Fulbari village is now about 90 years old. He was already 60 years old when he went to live in Milon Relief Camp in 1996. He was also displaced in 2014. He remembers it being nothing like he was ever used to:

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Fig. 5.1 Displacement map of the study area

All of us are village people and we had never lived so packed together with no space. We could not breathe. We could not eat because of the smell. Where would so many people go? Day time you can go and shit in the open but what about children in the night? Same place we live, cook, shit. The smell was so terrible that with rains, the dirt would get mixed with the water and that is when people would fall sick and die. So many people died. Children, men, women…. Four to five dead bodies were buried every single day but unlike now where we know (how) to do things, no records were kept at that time. At least 1,500 people would have died. But not all died of dysentery. Some people died of having no food.xv

Another Adivasi respondent MB who is a farmer in Fulbari says: We had thirty cows, a few goats, a pig and sixteen bighas of land for cultivation. We left everything behind. We left all and ran to save our lives and stayed in Milon Camp. When we came first time to Milon Relief Camp we suffered a lot because we (had) never faced such problems (earlier). It was a new experience for us, of poverty. After ten years, we were to get Rupees 10,000 from the government, but received only 8,700. With the help of this money, we bought a piglet. It was our first livestock after the conflict. We could not go back to their own land and so shifted here.xvi

Bodo families too found themselves in absolutely crowded conditions. A male respondent who now lives and works in Lalbiti says: In the 1996 conflict, the Bodos had to flee out of the Milon area in just one or two nights. Most of us went to the HJRK relief camp. I was not home that day but had gone a few kilometres away to repair some machines. After the machine was repaired, I started for home but as I was nearing, I was informed that all our people from Milon have moved out to the relief

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camp in the Higher Secondary School campus. I looked for my wife all over the school, but she was nowhere to be found. I searched for my wife all night and also the following day. I asked my friend to accompany me to Milon. When I reached Milon, I saw my wife and few families still in the house. All of them were living together for fear of being attacked. It was very near the Santali’s relief camp. How could we stay any further in the place which was so dangerous and had such few Bodos? We left and I took the bulls through a village and brought it to the camp. We registered ourselves in the HJRK relief camp and started staying there. After some days the government asked to go back to Milon, but we could not use the roads. All the roads were being checked (by the opposite community) and for us, it was unsafe to travel. Though we men tried to go back, it was tough. The supply of food to those areas was very limited. We ended up spending a year in the relief camp. In the relief camps, the rice we got as relief rations from the government was of poor quality and our people were not used to eating it and many got stomach problems. There were no toilets in the relief camps and people had to defecate in the open by the roadside. The local people of HJRK village started complaining about us because the entire area was stinking and they could use the roads any more. Then, the school where we were housed could not be kept closed for so many days. So, through the order of the Deputy Commissioner, a new relief camp was set up for us near Milon. We were transported back to the new camp in trucks. One of the trucks broke down and ran off the road but luckily, there were no casualties. We again lived in the new relief camp for another year. We were informed that we could leave the relief camps only after we received the compensation amount. After receiving the compensation amount of Rupees 10,000 we moved back to our homes. The relief camp of the Bodos near Milon was thus dissolved. A few months after we moved back to our village, the second conflict of 1998 again broke out.xvii

The condition for women and children were especially serious. Even in the most ordinary of circumstances, those with special need of care and protection—children, young girls, pregnant women, elderly populations, persons with disabilities are known to be vulnerable. ES was a 12-year old Adivasi cowherd working in the house of a Bodo family when the conflict of 1996 broke out and he went to live in Milon Relief Camp. His account gives us a deep insight of conflict as experienced by a child: Many people from all over Milon came and started staying in the camp. There was no food and water to drink. It was so crowded. Five-six families were living under one tent. Many people died in the camp, may be because of gas and the bad smell. There was no space even for sleeping. We were like dead bodies lying on the ground without any cloth. People started dying, worse than animals. Every day, 10 to 12 people died in the camp. The cemetery South of Sopon’s house became full. Diarrhoea could have affected people because we could not go far for our needs. Like animals, people used to urinate and defecate here and there. There was no water for washing. All around the camp, there was bir (big jungle). It was very dangerous (for us) to enter the jungle because they were coming till here. We lived like this for two years in the camp. In 1998 we were attacked again.xviii

With erratic supply of rations, food security was a huge problem. Watching their children hungry in the camps is described as one of the most difficult experiences for women. A respondent Sunita who is now a resident of Fulbari village says: The relief camp was very dirty. There was very bad smell. Because of the smell, the children used to get fever and fall sick. We could not take to the doctor because we do not have money. In the camp there used to be sickness every day. They used to take out dead bodies of both

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children and elders. While we were in the relief camp, we used to get only a handful of rice. We would eat food using ‘Kochu’ (yam) leaf as plates since we did not have utensils. We would eat rice with ‘kathal’ i.e. jackfruit seed. The people did not expect that the conflict would reached our village because it was happening only in the forest areas.xix

As HJ, an elderly Adivasi woman of 60 years living in Bogori village describes the situation of fleeing and conditions in the camp brought about by hunger (her husband was at one point arrested on suspicion of being a militant): I brought all the four children with me. They were small. It was so difficult for me to flee along with my children. My husband remained in the village to defend (it) against the attackers. They were firing and burning down the houses to chase us. Out of fear, we brought nothing with us. I was having on my body, only a longi (a cloth wrapped around the waist) and somehow managed to carry a chadar (shawl). I tied up one of my sons on my back, carried one on my shoulder, the other two I caught with both hands and tried to run to save our lives. People from a neighbouring house helped me to carry my children. Compared to the attackers, there were very few men in our village to fight back, so they too ran from the village. My husband and the fellow villagers were chased with continuous firing till the river here in Milon. The other villagers (who were in the camp by then) went with the police and brought my husband and his friends also to the camp. It was getting dark and we saw fire everywhere. In the camp, I had a very tough time to manage food for my children. We got rations only after two days in the camp. We got very little rice. It was not enough for us. Out of hunger the children used to cry till they were tired and would then fall asleep. They became so weak that they could not stand. We started collecting wild yam, kapu and kulu (wild potatoes) for food. We boiled them and ate. We would get just four to five kilograms of rice for a month. We were given salt, dal (lentils) and mustard oil. It was not enough for us. My husband, our four children, my in-laws and myself, all together we were 12 of us in the family. People from another village, because they were not chased, could at least carry some of their things with them. Since we left many things at home, I was so worried. I was about to die out of hunger. I needed support of someone to get up. I had a small child. And the elder sons used to cry and tell me to go ask for some rice from our relatives who had come from another village. It pained me so much. The love for the children forced me to go and ask for some rice. Our relatives used to give me as much as they could. I used to beg and cook Dak Mandi (thin rice gruel).xx

NH is an Adivasi woman who was displaced in the 1996 Bodo–Adivasi clashes. Her older daughter died and her husband was killed by militants. She lived for 10 years in the relief camp and then settled in a nearby village. She was again displaced in the 2014 violence. in 1996, after her daughter’s death and her husband’s killing, she still had her baby daughter to look after. Her in-laws were living separately in the camp and could not help her. She had a really difficult time in the relief camp for 2 years (her detailed life story is also discussed in Chapter 7). She describes the situation: My daughter and I often went hungry as going for work in the houses of the nearby Nepalis – even if there was work - was difficult because my daughter was so small. But luckily we did not suffer from any major illnesses in these two years. To get by, I brewed alcohol with the little rice received as relief rations in the camp and sold the alcohol to get more money to buy rice so that we could eat regularly. Our health while in relief camp was very poor – can give it only one out of ten points as we were very weak. But even now, we are not in good health. It is only half of what it should be. Women are unhealthy because (there is) fighting in the household, illnesses, problems getting food, pain during our periods, difficulties in child

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birth, also every two-three years, women keep getting pregnant and having babies. (We feel) unhealthy as we are not getting enough food. The head spins, we feel weakness. Nowadays we are unable to work as much as we used to do earlier (before the conflict).xxi

Trade-offs between food and dignity had to be made. In the words of SL: There was no hair oil or soap from the government. We used to take bath without soap. Some people in the camp used to sell their rice to buy soap and hair oil.xxii

The complex political environment, can be gauged by the fact that even a protest for regular rations by women, could take on a completely different colour. A respondent SL from Bogori village recounts: After 1997, the camp people decided to protest when the (relief) rations were stopped and they were eating only damru and jatge (jungle roots and vegetable). Women were told to bring along the wild roots and vegetables to show that these were the things they were eating. During that time, some of the people who were drunk blocked the police vehicle and snatched the gun from the police. The Officer in charge ordered by blowing a loud whistle and the police fired on those people. Two persons died. The police arrested two other people. One person was injured during the firing. He was supposed to be taken by the police to the hospital but they took him to the jail. He was a militant. Only one rifle was snatched by the relief camp people from the police. The police threatened that if we do not return the rifle, they will continue arresting the camp people. So, the camp people returned the rifle to the police.xxiii

For women, camp life especially would destroy many notions of privacy and dignity. For example, in very crowded relief camps, where would women dry their menstrual cloth? Adivasi women of Bogori village who had lived for over 10 years in relief camps said: (since there was no place to dry it in the camp), we used to tie the freshly washed and dripping wet menstrual cloth to our bodies. The heat of our bodies would dry it.xxiv

5.3 Violence and Incarceration: Some Narratives from the Outside The years between 1996 and 1998 were a formative time for the armed organizations. The major divisions between the armed organizations had emerged post-1993 and by 1996 and violence levels at the Indo–Bhutan border (which was a quiet border between the 1950s and 1980s) increased. Counterinsurgency operations which were conducted across Assam (and other surrounding states) were extended to Milon and its surrounding areas, thus enhancing the levels of violence. Just as the rise of militant activity and inter-ethnic violence was overwhelming for the communities at the local level, so was the level of militarization. A vicious logic was set up. The relief camps sprung up as a result of Adivasis or Bodos fleeing both real and perceived threat to their lives. In order to guard these camps, security posts of the various state and central forces, were established near the relief camp. These posts in turn become targets of militants who saw the same forces as impeding control of their zones

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of influence. The suspicion between the two communities was heightened with the militants suspecting those living in the camp to ally with the security forces, thus further inducing armed attacks. This logic was especially accentuated in Milon with the formation of the Adivasi militant groups within the relief camps themselves. We thus see a mix of motivations behind acts of violence. Milon relief camp and the area around the river, bridge and paddy fields also became a battleground. Conversely, for those living within the camps, relationships with the state armed forces guarding the camp were cordial, but there were instances of acts of torture and incarceration, especially when militant groups emerged within the camps (see A Commander’s Story). What is important is that, community level linkages that could have proved to temper the violence, kept getting eroded. We will never be able to determine the exact cause of violent acts by the militant organizations on all sides (was it an attack on the camp or the security post or targeting of the population?). Given the proximity of the camps to the forest, routine activities such as the search for livelihoods like woodcutting and activities related to food gathering could have escalated into killings given that militants hideouts were in the same area. If the overall outcome of the breakdown of health systems was increased mortality among the displaced and non-displaced population, life inside and outside the camps for all communities contributed to a psychological breakdown. For men, the challenges were distinct, of which navigating the insecure environment outside the camp was a daily necessity. This meant living with risk every day. An account from an Adivasi respondent shows how a boy had a narrow escape: In the camp there was scarcity of food and to earn they (the men) had to go for daily wage labour but most times they would not get any work. Sometimes they would go to catch fish and cut firewood. If they went for work far away, the militants would shoot at them. If they went deep inside the jungle, they were scared they would be found and killed. Even if they went fishing, they were scared the militants would kill them. Once a boy and some elder people went for fishing. When the militants came to the site, the elders managed to run away. Even the boy started running and the managed to hide inside the bushes. The militants were chasing them and since they could not find them, climbed the tree so that they could get a better vantage point. The boy who was hiding inside the bush got scared and suddenly he just came out and started running. They shot him and he was injured on one of his fingers but he escaped.xxv

In portraying violence outside the camp by militants, we also find ambiguity in the causes of localized violence. DSK is an Adivasi originally from a place called TAKM but now living in Bogori village. He had lived there for nearly 12 years and says there were Adivasis, Rajbongshis, Bengali-Muslims and Bodos who used to live together. He shifted to the area in 1992 in search of land. He and his wife fled to Milon Relief Camp in 1996 when he was 33 years old then. They collected their clothes and utensils while fleeing to the camp. Before fleeing his house in 1996, he handed over 20 cows and seven goats to a Nepali farmer in Milon. In making the sale he signed a fake written document stating that he had sold the cattle to the Nepali farmer for Rupees 12,000. He made this sale deed because (possibly the VXYZV) militants sometimes used to snatch away the cattle from the Nepalis, thinking it was stolen by the Nepalis from the Adivasis. As he recalls:

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Many of us lost cattle during the conflict. Often there were cheap offers made of around Rupees 500 for the cattle, thinking if we would all be shifted somewhere else, we would not be able to carry the cattle along. After three days in the camp, men formed into groups and returned to their respective villages to bring back some of their utensils. Once, men from the camp went to a village to bring the cattle that was left behind. On reaching the village, they were fired on by the militants. The men also used their bows and arrows to shoot back at the militants. When they realised that their arrows could not reach the militants, they retreated back to the (relief) camp. While the militants were firing, the security forces in the camp also fired back at them and forced them to retreat to a nearby village. We met many people from our village in the camp. The families from our village set up their tents in three rows. There were 26 families in the first line, 35 families in the second and 19 in the third. After two years of living in the relief camp, the men from our village went to clean up the overgrown bushes in our village hoping to return. But many were not interested to return there because they thought that it would not be possible for them to live there. After we had spent five years in the Relief Camp, some of the Rajbongshi community came and occupied the land. Once, while in the camp, we took our cattle to the Aie river but some Bodos took these away. People from the camp grew angry when they lost their cattle. When they continued losing their cattle, the Adivasis invaded a Bodo village and in the ensuing conflict killed some Bodos. The Bodos also fought and quarrelled among themselves because a group of them felt that because of a small number of people who committed the crime, the whole community was bound to suffer the aggression of the Adivasis. 23 of our men from the camp were arrested on suspicion of killing them.xxvi

Another respondent, a young boy, comes across a group of VXYZV militants seeking to attack Milon and witnessed a failed attack: At that moment I had gone towards the river to see if my cow was still grazing or was it missing. As I was about to get down through the steep river bank, I suddenly saw some persons lying down on the ground. These men were dressed like the army, for a moment I kept staring at them. One of them had pointed the gun towards me but I heard another lying beside him whisper that I was one of them. He had tied his knife on his waist with the muffler. One of them called me to come down and join them. When I went down another person called me and informed that their leader wanted to meet me. I went some distance and found their leader lying down in the paddy field. Then, there were sounds of gunfire. The leader asked me if I knew how many security personnel there were in the camp. I told them that there were two army trucks which had just passed by the road but most of the force had gone out for duty in Asrabari and Milon. The leader then calculated that then there should be less forces inside the camp. Another of their members argued that there should actually be more security forces. I felt that they did not come there to attack the security forces camp but had actually followed the BSRY community whom they had chased from different villages. The leader insisted that I remain with them but I told him that I had actually come to take my cow to some safe place. They warned me that they would not be responsible if the forces arrested me. By this time the forces had already arrived close to the river bank, and started to open fire at me from a distance. They must have thought me to be VXYZV. I fell flat to the ground, the bullets just passed above my back. I thought I would die. I started crawling from the spot and when I reached a canal I started running as fast as I could till I reached my village.xxvii

As shown above, the cycle of violence and counter violence was occurring frequently and must be seen as a continuum rather than episodic or unidirectional. An instance of a deadly attack on Milon by VXYZV was a recurrent theme narrated by many respondents and dependent on which community is narrating it, different details get highlighted. As HSMAI describes:

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When we were in the relief camp in good number, the people were not that worried or scared because we were together. Once day, it was around four in the morning that we were fired on from the east and the west. Luckily no one was hurt. They fired for one hour. Expecting a lot of casualties, empty trucks were sent from an army camp from some distance away to take the dead bodies. But they were so surprised to see that there were no dead bodies. The leaders of the camp checked tent to tent but there were no bodies. Only a dog and rat were killed. Most of the bullets fell in the river.xxviii

Recalling the attack in 1998, SL of Bogori village says: At that time there was a change in the paramilitary forces guarding the camp. After the new force came in 1998 there was an attack by the VXYZV militants to kill all the camp people. They also brought in a light machine gun. The security forces advised our people to do duty all around the camp. We built a trench near the camp to hide from the militants. Another trench was constructed to enable a counterattack. The firing came from the east side of the camp. The person who was firing the Light Machine Gun was shot with an arrow and killed by our people hiding in the trench. Immediately when this person was killed, the rest of the militants came and took away his body. They left behind the bullets and medicines they were carrying. Another attack was in the month of May and that attack happened at 4 o’clock in the morning. I was told the bullets looked like a swarm of glow worms. I was not on duty at that time because the police had arrested me by then. There was a case on me about going and burning houses and killing people in a village where both Bodos and Santhals lived. I was one of 15 arrested. In the jail, the former headman of the village who was a Santhali was beaten the most. The police suspected that he was the one who brought the people to burn down the houses of the Bodos. The headman after being beaten was given medicines and injection in the jail. We stayed for 3 months in the Kokrajhar jail.xxix

Motives were difficult to determine for the armed militants. While camps like Milon became a target because of the concentration of another community but with the formation of armed groups inside the camp, a new dimension to the violence emerged. It is difficult to say with any certainty if the motives were offensive or defensive. A respondent comes across a group of armed men of VXYZV about to attack Milon in 1998 gives an alternative explanation to possibly the same attack described earlier. By 1998, central forces were withdrawn and a police post was opened at Milon. DNBR of community X says: There were no more central forces in Milon and what remained was only a police battalion. VXYZV (militants belonging to community X) grew concerned with the enemy constantly attempting to enter and raid their villages. On many instances, the men of our community who used to guard the village on the banks of the river could avert the attackers from Y and force them to retreat back to their relief camps. But the relief camp of the Y community in Milon was very close to the security forces and often, they them in their raids to the X villages. Many innocent people were arrested and sent to jail on suspicion and the lives of women was made miserable during the 1998 period. Having witnessed this constant humiliation and atrocities, VXYZV came forward to give a strong message. The militants gathered in three different locations, north and south of the state forces camp and one in the south west. They were stationed at a far distance from the camp. The groups from all the directions fired bullets and I saw them use AK-47 rifles. The gunshots were done from a distance so that it did not hit anyone. They purposely saved the people in the relief camp as the objective of the attack was neither to destroy the state forces camp nor the relief camp. Rather from my understanding, it was a signal for the state forces to understand the struggle endured by X community due to the oppression from the security forces and the Y militants. I think it was

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not easy even for our militants to attack such a huge camp, which would have already been prepared from the previous experiences.xxx

The presence of security forces again provides a mixed picture. At times, as seen above, there was a protectionist role, at other times there were escalations. TRG, an Adivasi respondent and the father of MS (see next section), who himself gets incarcerated at one point, says this about the above challenges. It also shows the narrow margin between life and death on an ordinary day: It was very difficult for men while staying in the relief camp because they had to earn money so that we could buy food. We had to go for fishing to supplement the food for feeding the family. After fishing we used to store the fish near the river but there were people who used to steal the fish which belongs to others. The men also had to be on duty near the river the whole night for protecting the camp. Once there was an incident that occurred in the ALN River. There was a father and son duo who were on duty to guard the camp near the river. Once it was night, the security forces were also on duty. The forces saw these two - father and son near the river and thought they were militants. Before shooting at them, they burned a firecracker (flare) and then shot the man dead. The son managed to escape by running away.xxxi

On talking about the same force, which protected against the militant attack, they would also sometimes resort to coercion especially after the formation of militant groups inside the camps. There was, however, in-fighting among the major Adivasi militant groups as well, HL recounts: Some of them (the security forces) who came to the camp were good while some were very bad. They used to arrest a person and take him to a mango or jackfruit tree. They make the person to climb on the tree and would break the nest of the ants and the person would be bitten badly. In the camp when the DEFG (an armed group of Adivasi youth) was formed, the security forces and these boys were against each other. The security forces used to look hunt for the DEFG cadres in the camp. My brother was one such cadre but had a compassionate heart. They arrested and tied him in the bullock cart and he was beaten to death. Though the DEFG was formed for the betterment of the Santhal community in the camp, they went the wrong way and misguided the people. Then, another group QRYT was formed but there was conflict between them. DEFG complained to the police that QRTY were creating militants in the camp and because of that accusation, I was also arrested. I went to jail thrice. While DEFG did not educate the children, QRTY did and even today, they are still educating the children, but now, only to become members of their group.xxxii

Joining an armed organization came with inherent risks for the family members. Field notes outline the case of an elderly respondent (BR), who was displaced in 1998 but now settled in the area. Her younger son had joined a militant faction (now dissolved) before 2014: Last year (in 2015), the security forces arrested BR’s older son who lived next to their house and sent him to jail. It was her younger son who was in the anti-ceasefire faction of VXYZV, having joined the organization when the family went through hard times. Since the conflict of 2014, she never saw or heard from her younger son but the security forces took the older boy that night when they did not find the brother. BR and her husband could no longer work in their fields and was dependent on the older boy to plough the fields. Since that year, the family could not do any cultivation as he was arrested during the paddy transplantation season. BR sold the pair of bulls and mortgaged a portion of the land to get the son out of

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jail. She spent Rupees 80,000 in the process. This year she has given the remaining land for Adi cultivation. She runs a betelnut shop in the bazaar near her village. Her small shop makes her just enough money to feed them for the day. Though BR is not feeling well, she has to go to run her shop as her husband has lost eyesight in one of his eyes. She is the sole bread earner for the family.xxxiii

Incarceration was a risk not just for families of armed militants but for others as well and the exact causes for arrest were at times difficult to understand. The experience of an Adivasi respondent TGR gives an insight into the memories of being imprisoned during the relief camp years: In the year 1997, I was on the way back to the relief camp after selling thatch along with two other Santhal men when we were arrested by the police. When we got inside the police jeep, one of the men escaped by jumping from the jeep (note: another account of the arrest says that the person who escaped possibly had some training and could have been a militant). When I was inside the jeep initially, I thought that my friend and me would be released when we reached the police station. I was kept there the whole day and night. My name and address was registered at the police station. The next day I was taken to Kokrajhar jail. On being taken to Kokrajhar, I had no more hope of being released. When I was arrested, I felt angry because I did not do anything wrong but I knew that I could not do anything about it. While in the jail, I worried about my family - my children were so small and they are in the relief camp. How will they survive without me? Would my wife search for a new husband? I had seen there were many women in the relief camp whose husbands were arrested and they would marry another man. When inside the jail, my in-laws came to visit me but they could not meet me because some money was required to be given at the police station. I remember that when I was going for a court hearing, I was tied along with the others in a group. It was very difficult even to walk. There were two policemen behind and two in front. I had lost all hope in the jail because no one would be there to help me. As my brothers were uneducated, they would never manage to get me out of the jail. Fortunately, the Relief Camp Committee leaders took up the case to get us released from the jail and I was after three months and seven days of arrest. Immediately after my release from jail, I went to work as a daily wage labourer in Gelenphu, Bhutan.xxxiv

5.4 Displacement and Its Effects of Conflict on Health and Well-Being of Vulnerable Populations 5.4.1 Impact on Women Following displacement and long stays in relief camps after a conflict, their bodies heavily malnourished and minds in severe stress, women who receive almost no care or external support, find it difficult to ensure child survival and have frequent and multiple child deaths. The extreme and harsh living conditions in relief camps ravage women’s bodies and compromise not just their health but also the health of their children. During a group discussion with slightly older Adivasi women in 3 No. Milon Village, the research team counted that seven of the 10 women who gave birth said they have lost children. In their ten years in the ‘relief camps’ and after that, these 10 women had given birth to a total of 41 children, of which only 27 survived and 14 children died.

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This is in addition to multiple miscarriages women have suffered, which was difficult to count up. This was in sharp contrast in another group discussion with a group of younger Adivasi women in Fulbari Village. These were younger mothers in their twenties and thirties; and, though they had recently experienced the 2014 conflict, they had lived in the relief camp for only 6 months till they returned back to their village. And even though these women live in the middle of the forest and almost all of them said they had given birth at home and not in hospitals, still children have survived. Among the 15 younger Adivasi women, four said they had ever lost children. But it is not just the physical burden of loss that women suffer but also the mental burden. The older group of Adivasi women we interviewed had lived in the Milon relief camp for 10 years before moving out. In the discussion, women link their bodies being weak and unhealthy to many things—prominent among them being mental stress resulting from the tensions after the conflict. Food insecurity, fights in the house, wife-beating and alcoholism are some of the main stressors they specifically mention: What tensions do men face? As long they have food to eat and can sleep with their wives – what tension will they have? But a woman has to manage everything – manage the money, manage household needs and food. When children are hungry, they will go to the mother and ask for food, not to the father. We worry that there is no money in the house and worry where to get the money from. We worry when the men are in the house, we worry when they are outside.xxxv

The same group of Adivasi women blames two major stressors of women, i.e. alcoholism and wife-beating on the Bodo–Adivasi ethnic conflict of 1996 and their subsequent displacement to the relief camp. Increase in alcoholism amongst men after conflict and the resultant stress and tension faced by women has a negative impact on their physical and mental health. They say: In our earlier village before the gondogol (conflict), out of 10 families, one or two had drinking problem. (They were) those who were poor and struggled and did hazira (daily wage labour). But the rest of us had land, work to do and also money and did not drink like this. We were busy. All this ‘bottle problem’ started when we came to the relief camp. The men had nothing to do and started showing more bahaduri (recklessness). They would exchange the rice we used to get as relief rations for alcohol and also finished the cash we got as compensation. What we drink now is also different, it is a water type. Earlier, we made wine with rice in our own house. We used to drink one or two cups for festivals and some occasions. There was no fighting like we now have. Almost no fighting. There was no need to drink as we had enough food, we had land, money, proper house to stay (so no need to drink). But now, they start drinking and don’t stop till they are totally drunk. Men do not have so many illnesses (as women). Women fall sick much more. We are weak on top of weak. We have so much work. Heavy things that are difficult to lift, yet we have to carry. We have to work all the time. Then why our bodies won’t be weak? On top of that, we have fights in the house. Then, there is worry all the time and we keep thinking of these things – we have no land, no cattle, no proper house, no money, nothing we have. How to feed my children? How to manage? So many worries. And then illnesses on top of that. And no proper food. When we (women) have worry and keep thinking a lot, our bodies dry up.xxxvi

These long-term impacts can be seen in the programmatic work of the ant. As part of its work on empowering women, the ant is implementing a Domestic Violence

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Table 5.1 Cases of Domestic Violence Processed by Case Workers under the Avahaan Project of the ant (March 2020) Name of Cluster

No. of Caseworkers

No. of DV Cases reported & handled

Average DV Cases Handled by a caseworker

Rowmari

2

21

10.5

GNR and PNRB

2

83

41.5

Koilamoila

1

10

10

Patabari

1

17

17

Milon

1

64

64

Ulubari

3

78

26

(DV) reduction programme in over 100 villages in Chirang. All these villages are divided into smaller clusters with one caseworker looking after a group of 10–12 villages in a cluster. As Table 5.1 shows the number of cases handled by a single case worker in the cluster of villages in and around Milon is double and at time five times higher than that of most of the colleagues working in other clusters (except for the GMR and PNRB cluster which is made up largely of Bengali-Muslim families who were all displaced by conflict in 2012). Also, the team working in Milon report that the severity of beating and hence, the number of grievous injurious are much higher in the Milon cluster. The Adivasi women’s group interviewed in Milon had said that out of 10 men, nine of them drink and of these, only two or three don’t have kazia (fights) in the house, i.e. six out of nine men have fights and beat their wives. But they also say that the cases of fights have reduced slightly after the ant’s intervention and women’s groups have been formed. These groups intervene and stop the violence happening in the homes and also counsel the families. In Fig. 5.2, we see how various dimensions in a woman’s life, the physical, mental, social, economic and sexual, can get compromised following conflict. The different dimensions are inter-connected and go to create ill-health and ill-being for women and their families. But yet, it is women’s resilience that they are able to carry on despite such immense challenges which threaten their health and well-being. To help women decrease their vulnerability and remain healthy and well, policy measures are needed beyond relief to develop resilience along the various dimensions.

5.4.2 Impacts on Children—The Youngest Victims of Conflict Children are the youngest victims of conflict and every aspect of their right is compromised. In the ethnic and militant conflicts in the areas of Chirang (and other BTAD districts) we have seen that children, irrespective of the ethnic community they belong to, have suffered loss of their rights and entitlements. When forcibly displaced from their homes in conflicts, their very right to survive is challenged as they suffer hunger

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Fig. 5.2 Mapping Increased Vulnerabilities of Women Following Conflict

and fall sick from malnutrition, and when they are sick, there is no quality healthcare to ensure they survive. When houses are burnt in the violence or when they are forced to flee with their families for safety, they lose their shelter. Many children suffer loss of education as they cannot access their schools after they are displaced. In crowded relief camps, they lose their right to play and cannot get over the trauma of witnessing extreme violence. Thus, fundamental rights of children, including that to develop, get snatched away. When they lose their homes and their families are pauperized, children are at best neglected and worst, exploited. Once they lose their schooling and the families also struggle for food, many parents send the young children out to work, opening them to risk of abuse, exploitation and even trafficking. This is especially true of adolescent girls (see case of NH in Chapter 7). Boys are in danger of being conscripted as child soldiers by the militia or being picked up as suspects by the police and armed forces. With adults focussed on survival, the voices of children are silenced and children lose their right to any say or participate in decisions that affect their development, like whether to continue their studies or not. The high levels of child mortality arising out of diseases such as malaria stands out when we trace health seeking behaviour in the next chapter. The chain of vulnerability immediately begins with the act of fleeing. MS witnesses two Bengali-Muslim

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children, who fled with their parents along with the Santhali neighbours, get separated from them: To come to Milon, people of Sengelsing forest had to cross the Aie river. While crossing the river, many children and belongings of the people got washed away. One Muslim family were also fleeing. The husband and wife got separated from their children and the two Muslim children also ran with the Santhals. They were crossing the river with the older girl holding her younger sister and some clothes. While crossing the river, the younger girl was carried away by the force of the water. So, the elder girl had to cross the river by herself and she accompanied the Santhals to the Milon relief camp. When she reached the camp, the camp people asked where she was from. She could not say anything and just kept crying. Seeing this, one Santhali family took the girl to their family. They adopted her and today she is grown up and speaks Santhali and calls the family heads as father and mother. She also once went outside for work where her original parents found her and asked her with whom she was staying. She told them that she is adopted into one Santhal family. Her original parents once came to take her away but the girl refused to go, also her Santhali ‘father’ refused to send her away. Presently the girl is outside the state for work.xxxvii

The experience of ES (who was a cowherd for a Bodo couple before the 1996 conflict) captures many of the suffering and vulnerabilities of children: Even before I came to the camp, I was not interested in studies. But here, I pestered my father to enrol me into the camp ‘school’ held in the veranda of a building. The-time table was prepared by the relief camp leaders for the school and for distributing rations. The same place was used for distributing rations and also for running the classes for children and so, it was always crowded with people and we could hardly study. But I got interested after I got a taste of reading and writing. I had no clothes to wear and yet would attend classes dressed only in a gamocha (loin cloth worn around the waist). I somehow managed to complete primary school and started middle school in Koroipur but dropped out as the family could not afford it. In the camp, the number in my family increased and my younger brother and three sisters were born there. Among them, one died. I was the second in the family and food was our biggest problem. We did not see such aakal (drought) of needs as we saw here. There was shortage of food, water, clothes, shelter. We would cry out of hunger. One day it kept raining and our whole family were taking shelter under one umbrella. We were hungry. My mother was so pained that she went around begging for a bit of rice. I don’t know where she managed to get 250 grams of rice, but with that, she cooked dak mandi (watery rice gruel) for us. No one could help us as all families and my relatives were in the same situation. Security was also a major problem. There was constant threat of attacks from militants belonging to the other community. Young men had to ‘protect’ the camp in the nights and out of these came our own outfits. Out of hunger they used to do some illegal acts, but boys like us of 15 to 18 years would get picked up from the camps and put into jail. I was also picked up and taken to the Kokrajhar jail. Once caught, they (the police) used to kick and beat us anywhere they wished. Sometimes the paramilitary police posted to guard the camp were ‘greedy for women’ and so we had to be very careful about allowing the young women and girls outside the camp.xxxviii

The collapse of education became one of the major constraints that faced children. Tracing out the education pathway of the respondent MS we see impacts across the lifespan from 1996 through 2014. Born in the relief camp, she spent a significant part of her early childhood in the camp, before the family finally settled in the village called Bogori. She was again displaced in the 2014 conflict. In the course of her childhood she witnessed her father being arrested by the police and her mother started working in a Nepalese household for daily wage after her father was arrested.

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Her mother took her where she worked and kept her near her to sleep or play while she worked. Her two sisters were left at home. Sometimes her mother left her at home with her sisters. At home her sisters looked after her: It was tough time for us during that time. When my father was released after nearly a year in jail and returned home, he had long beard and hair. We got scared upon seeing him. When he saw us, he cried, we children had no proper clothes to wear. My father began working as a daily wage labourer. We then left the camp and settled in our current village. One of my sisters studied till class VIII and the other studied up to VII. After dropping from studies, they went to work as domestic servants. One of the sisters stayed for two years and the other stayed for three years. My elder sister married at first and then my middle sister. Myself I remain at home and I am still studying. Now I have my father, mother and two younger brothers. My younger brothers were born after my father returned from the jail. When I was small, my friends used to tell me that their parents are going to take them to hostel for studies. So, I also told my parents to take me to hostel. But I was also worried how my parents would manage to pay my fees. I told my parents to buy me a small trunk box to keep my clothes, when the time came for admission my parents took me to the hostel in Basugaon. I used to cry every day remembering my parents. During my initial stay in the hostel my mother used to visit me. When she visited, I used to cry and she too used to cry as I was taken to the hostel when I was small. While in hostel my friend’s parents sometimes visited and I used to be happy thinking that my parents would visit too. They could never visit nor did they send me anything. I was told that her parents fine and busy, so they could not come to see me. I cried for one year every day, but eventually I adjusted to the hostel. I managed to study and left the hostel out in 2012. When I came home, my parents could not admit me in the high school that year due to low income in the family. So I had to stay at home and help my parents. I took admission again in Koroipur, in 2013 in class nine. In 2014 I was in class 10 when the conflict started it was very difficult to study at home and I had to write my exam the very next year in the month of February.xxxix

From Fig. 5.3 and also extrapolating from other recollections, many critical vulnerabilities were faced by the children in the course of the protracted humanitarian crises. While peace would imply the receding of violence, the increasing developmental deficits continue over the long term. As seen in the diagram, children became extremely vulnerable to ill-health and ill-being when their rights are not protected during and after a conflict. Another cross-cutting issue there is a surge of underage marriages post a conflict. After losing their education and having nothing to do in the relief camp, young boys and girls get married early. Parents of girls have also confessed that they feel safer when their daughters are married. They then have someone to protect them as parents who themselves are struggling for survival cannot guarantee safety of their girls in the very crowded camps and with the allmale security forces around. Also, with relief and compensation given to separate ‘households’, there is a pressure to get this for even underage sons by getting them married early. Education does have the potential of enabling children to overcome the barriers of conflict, yet, a major structural problem is that the forest regulations do not allow for the construction of any permanent structures in the reserved forest areas. This also means that no school buildings nor community health centres can be built. While people living in encroached forest villages are not eligible for proofs of residence, which is an essential requirement for several entitlements, there are no state-led

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Fig. 5.3 Mapping Impacts on the Rights of Children in Conflict-Affected Areas in the Research Site

mechanisms, which would allow for formerly displaced children, to avail formal education in their areas of residence.

5.5 Rehabilitation and Resettlement In contrast to the camp situation discussed above (which became a protracted situation spanning a decade), there was a degree of variation in quality of relief provided and the experiences of the Bodo community living in the camps. This could be because they are better organised with timely emergency support coming in from strong community based institutions. This pattern was even observed in the 2014 Bodo– Adivasi conflict. Relief camps of the Bodo community were less crowded and more organized, just as it happened in 1996 through 1998. Hence, it was relatively more hygienic and therefore, probabilities of child survival and safety were higher but only in the camp. Once the displaced families left the camp and settled elsewhere, the situation changed fundamentally. Children became highly susceptible to illnesses

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and deaths (See Next Chapter) or at risk of abuse and exploitation (See Chapter on Cross-Border Impacts of Conflict on Bhutan). In the case of the Bodo community in 1996, the organizational capacity of institutions such as the student union to organize relief was an important variable. The Bodo families were supported with food, their relief camps were much better organized and with more educated people in the community, records were better maintained. A Bodo VCDC member stated: When the conflict broke out, the student’s union mobilised resources like food and clothes from the Bodo villages which were not affected. They also fed the people in the relief camp and this continued till the ration supplies from the government started coming in. Then, the student’s union also negotiated with the government, right up to the Deputy Commissioner (DC) level, for security and protection of Bodos. Unlike the Bodo relief camps, the Adivasi relief camps were very disorganised then.xl

Given that the conflagrations occurred pre-2003, at a time when the activities of the armed organizations near the border were at their peak, the nature of rehabilitation for the communities followed a pattern that combined official state government rehabilitation grants (cash-centric) with informal resettlement in the ecologically sensitive forest areas. This movement that was cross-cutting across both Adivasis and Bodos was partially arbitrated by armed actors rather than the forest department. This process was documented by earlier research studies into a cohesive theory of entrapment (See Chapter Two). Yet, the community voices until now unpacks and disaggregates this cohesiveness. This movement into the forest was also part of an older tradition and it is the channelization of these earlier traditional practices to modern political aims that contributed significantly to their legitimacy and mass support (as protectors of the community). The minimizing of this legitimacy function or framing it only as a strategic rationality in the previous works removes in essence the deeper role played by these armed organizations at a societal level (which also defined their ability to negotiate ceasefires and peace settlements). Prior to enactment of the forest protection legislation mentioned in earlier chapters, both Bodos and Adivasis had substantive land-holdings. These would be acquired through traditional forms of forest clearance and patterns of settlement that were well known and commonly accepted. As a respondent BN states: The dream of finding fresh and fertile forest lands is an ancient practice of the Bodos- this practice is denoted as Kola Kristi in the Bodo dialect.xli

With population growth in a particular village, families would at some point collectively arrive at a decision that their ancestral land was now inadequate. A cluster of families would then move, after identifying a prospective place to relocate. A reasonable sale or distribution of existing plots would be done. They would then migrate and establish a new village, mainly in forested areas, till the carrying capacity of the land (and natural resources) would be exhausted. At this point there would be another migration. This process was reducing as a result of the new forest governance mechanisms, but gets catalyzed under conditions of conflict. As AM (the Bodo woman who had fled with a new born infant) describes: We lived in a relief camp for two years. There was not much problem while there was regular supply of relief materials like oil, soap, biscuit, flattened rice, dal, rice etc. With the

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compensation money of Rupees 10,000 we purchased some land in another village. The land earlier belonged to a Sanhtali person and there were rumours that they would come back to their land. When the conflict of 1998 broke out, we fled to another relief camp. Two persons then purchased the land. From this relief camp we were shifted to the DRGAU relief camp. After living there for few years, we moved to this present village along with the others.xlii

Informal occupation of land of those who were displaced did occur, and the closure of relief camps brought out the older inter-community interdependencies to the fore although in a newer reversible form. Thus, many who left the camp, most likely would have found themselves working on land formerly owned by members of their own community. Yet, the necessity to accept the situation can be gauged by JH’s story from Bogori village. An Adivasi, he lived in the relief camp for many years after 1996: When we returned back to our village in the year 2005, we had nothing. Everything was destroyed. We used to go to the Bodo villages for daily wages. Though the mind was not prepared to go and work in their villages, we went, because there was no other choice. They also welcomed us to work in their villages. For them also, there was no other choice. We used to think, we have to work to get something to eat. We never got frightened to go to their villages. They could easily kill us, but they did nothing to us and also said nothing. If they wished to kill us, they could, but they never did. Sometimes, some women would feel sick by looking at the weapons in some of their houses. We worked for a year in the Bodo villages. After a year, we bought bulls and cultivated maize and then slowly we became self-dependent.xliii

While some stayed on the camps and continue to live there, others left for the forest areas once they received the rehabilitation package (cash) from the state. For members of the Adivasi community, the core problem driving them into ‘encroachment’ were the problems of dual jurisdiction of the State Government and BTC. This disjuncture is described by the respondent CA: Rehabilitation is a big problem. Our people have gone to forest areas and settled down as there is no place for them. Notice has already been given and there is supposed to be eviction sometime in February. There will be conflict if this happens. Where will our people go? The BTC says that they cannot rehabilitate us as they do not have the relief and rehabilitation portfolio and the Assam state government has no land to settle us as the BTC holds the control over land. (We) don’t know what will happen to us.xliv

5.6 Impact of the Conflict on the Host Community in the Indo–Bhutan Borderland For the Nepali community living in Milon, the 1996 and 1998 conflicts, as well the intermittent militant violence, brought about many changes. Changes in health seeking behaviour were one significant dimension. As the focus is on Milon, we mainly look at the Nepali community, but in certain cases, we do have co-ethnics becoming hosts as well. For instance, SN the Bodo hamlet mentioned earlier (of former relief camp inmates) was settled in an area bordering the land of another Bodo village (with the new boundaries) leading to internal conflict. They also have

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disputes over water sharing between two Bodo villages (one, a newly formed postconflict village and the other, an older village settled from before). The older village had built a traditional canal (Dong) with exclusive rights of water usage. With the new settlement upstream, the older village now became a downstream community, losing control over the water. BSNR of Salbari states: Our village started to do wet rice cultivation some 10 years back when we managed to dig canals to channelize the water from river Bhur to the village cultivation lands. But we always faced conflict with the people of the area since they started to divert the river water to their village. When we first came to settle in the village, we dropped applications to the ‘dam committee’ in Gamarbil to allow us to take some portion of the water to our village for irrigation. But, our request was always turned down. Till date the villagers have dropped more than 700 applications to the dam committee requesting them to allow us to use the river water. The people from Gamarbil area never even tried to negotiate with our villagers and so, we have to steal the water. There are some five hundred farmers in the dam committee of Gamarbil area. Often, they (people from Gamarbil) block our canals but we again make space for the river water to flow through but in recent years, they have reduced blocking the canals of our village.xlv

Given that we are mainly presenting qualitative data in the chapter, it would be difficult to come to a definitive conclusion on whether the situation worsened or improved for the host community.xlvi Yet, we can provide a range of perspectives that can possibly lead to a more specific quantitative measure. Many of the Nepali respondents we interviewed seemed to believe their economic development suffered because of the sudden influx of displaced populations into the area. Some also spoke about the general situation of militancy and conflict and how it victimized them. In the absence of an adequate state response, the Nepali community of Milon who were considered its original residents (note: Milon was and still is notified as a Forest Village) became inevitable and at times unwilling hosts for the conflict displaced Adivasi families. Again, categorization is never absolute as there is a range from altruism to opportunistic behaviour to outright opposition. One set of views is that sharing the personal supplies with the Adivasis did not affect the Nepali community badly. They only helped out in the beginning, when the crisis descended suddenly. CR a 45-year old Nepali man says: We (Nepalis) helped the Adivasis a lot when they came here. From my own house we gave them rice to eat. I would go and check on them at night in the school building, where they were staying, to see if they had eaten or not. I did not like it if the children were crying, so I did all I could. We gave them not only rice, but also wood to burn and cook the rice on. After the initial move to the relief camp, they started working in the fields and stabilized their situation, so the Nepali community did not have to help out any more. But it did however cause other difficulties – with the relief camp located between our village and fields, we found it difficult to go to our fields to work. Many of the Adivasis sought work in the fields of the Nepalis, but they too found it difficult to leave the camp and go out into the fields. Thora sa bhi bahar jayega to maar dega (if they even stepped out a little bit, they would get killed. For about six years, the fields lay uncultivated. We then grew maize, mustard, vegetables, etc. in their kitchen gardens and courtyards and at times, it was so difficult that they themselves had to buy rice to eat.xlvii

KPH, an elderly Nepali man, says:

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I was the Headman of the Nepali Basti in Milon at the time of the 1996-98 conflict. The situation was such that whenever the police saw any young men, irrespective of their community, they would round them up and place them under arrest in order to prevent them from engaging in violence. When the family members went to have the boys released, the police would demand a statement from the Village Headman regarding their character. So I had to keep rushing to the police station at all hours of day and night to testify that so-and-so was a good boy, he had never seen him cause any trouble, etc. I went to help both Bodo and Adivasi youths in this manner. However, it came to a point when the Bodos started thinking that I was supporting the Adivasis, and the Adivasis believed that I was with the Bodos. This caused me a lot of problems. Ultimately, I went and confided in the Superintendent of Police (SP) that I was unable to cope with this situation. The SP advised me to go and visit relatives in another state or go on vacation till the situation calmed down. So I went away to visit relatives in West Bengal for three months; and, when I came back, the situation had calmed down. On my return, I was asked to help the Adivasis in the relief camp in obtaining ration. Most of them were unable to read or write. They were unable to write applications for release of ration. They were also not aware of the procedure of getting rice released, or whom to contact. So, they approached me and I helped them in obtaining their rations for well over three years.xlviii

Another elderly lady, BT, provides a perspective on inter-community relations between Nepalis and Adivasis: For the past few years Durga Pooja and Kali Pooja have been huge events in Milon. There is music and dancing, fireworks, a goat sacrifice, and much enjoyment. During the conflict years the celebrations had been subdued to the point of being non-existent. Till 2008-09 everyone was very upset. Every once in a while, there were reports of violence that would cause panic among the Adivasis. This would affect Nepali festivities too. If everyone’s mind is not at peace, then how can it be? Nepalis and Adivasis celebrate their festivals together. In fact, traditionally, it was the Adivasis who played the drums at Nepali events. So, if the Adivasis were not celebrating, it was difficult for us Nepalis to do so.xlix

LP is a male community mobilizer belonging to the Nepali community. He explains: The situation of the Adivasis had an effect on the Nepali community as well. The government was unable to supply anything at short notice, so the Nepalis gave them food and clothes. Sometimes there were night-time thefts as well – fruit and tamul (betel nut) would be stolen. But what to do? These people had nowhere to go, they could not go back to their work, they could not go elsewhere to look for food because they feared being attacked. The Nepali Basti was the only option close at hand, so they all went there. The Nepalis could not object. If an entire village comes to the relief camp, then it will affect the neighbouring village as well. The arrival of the Adivasi community caused some problems for the Nepalis. I used to attend the Milon Primary School at that time, and during the day there were cars passing by on the main road next to the school. I saw with his own eyes people beating up some members of the other community people who had been passing by in a car. I also saw people bringing in guns at night. Yet, we (the Nepali community) continued to help them. We gave them employment because we were in a position to do so. Many Adivasi people were destitute and the Nepalis would provide for them as well.l

An elderly Nepali lady, while empathizing with the situation of the Adivasi settlers into their areas, also points out the negative impacts: Our village is the poorest in Chirang. Those (Adivasis) who shifted into Milon (relief camp) would go from house to house asking for food, and would steal if they weren’t given any.

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They took fruits from trees, goat kids. It was difficult to even say something to them. When AKJ district was made, the fights between the communities started. Had they (the Adivasis) lived in their own villages, they would have been able to eat from their fields, or at least have the fruit from trees in their villages. But since they were being attacked, they left behind everything, including their clothes, and fled. When they came to Milon, there was a burden on our resources. Even now, within their community, they are not very well-off. Only ten or fifteen families have money.li

In the words of the respondent CBC who is also regarded as a community leader, the situation completely changed for the worse: The Bodo-Adivasi violence affected our community the most. These people’s violence happened and kept repeating. But we are the original settlers in this place and we have suffered. When they came and stayed in the relief camps, we could not grow our income anymore. Whatever is grown in the fields, these people would take away. We could not sell our own betel nut; it was all stolen by the new settlers. I had gone to college and when I returned in 1997, I found a relief camp near my village. Huge influx of people into Milon cost us to lose our livestock and produce from our fields to the relief camp people. We could not harvest our makai (maize), they would take it away. Betel nut they would take away. Could not keep good goats for income or even cows…. We could not keep anything outside; they would take it away. But we could not say anything to them because they are in the relief (camp). We also had to guard our cattle during the night against them. I had to discontinue my college education and return home to guard the cattle because my father was alone in the house as my eldest brother had already moved out after he married.lii

Another added pressure on the community was the militant presence. The major militant group (coded as VXYZV) was present, and one can infer the risks borne by individuals, if they were seen as being too pro-Adivasi or helping the community both directly or indirectly. He also says that the militants used to put tremendous pressure on the community for donations. He added that if they did not pay up, people were killed. Though nobody was killed in Milon, such extortions were common and he himself ended up paying over Rupees 15,000 in these years.liii One interesting perspective was put by LP, in the discussions, was that the fear of being killed or wounded in cross-fire was greater than the risk of being seen as siding with the Adivasi community. LP was just a boy in the 1996 and 1998 conflicts and witnessing the fighting first-hand would have been traumatic: Life during the conflict years was one of constant fear. Even a firecracker during a festival would scare people – they would think it was a gunshot or a bomb attack. There was an incident when the Milon market caught fire at night. My family and me gathered up all their belonging and got ready to leave (thinking we were attacked). Even the slightest thing would scare us those days. People feared going out of the house. Once when a friend and I had gone to graze our cattle by the Aie river, we saw the Bodos and Adivasis attacking each other - one side there was ‘teer dhanush’ (bow and arrows) and on the other one side, ‘goli’ (bullets). We could not even run away because we would have been in danger. So, we watched through the entire episode.liv

Given the above, and with the official dissolving of the militant organizations in 2020, we see viewpoints that if still collectively felt across the border belt has potential risks for the future. It also shows the intractability of the problems we discussed. Armed violence is symptomatic, it is built on deeper structures, and sometimes new

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conflict forces can emerge, which can develop over a longer time horizon. As seen in the comment below: Prior to the conflict, relations between Nepalis, Bodos and Adivasis were very good. We went to the same markets, worked together on dams, celebrated Dussehra together, went to each other’s festivals, weddings, parties, etc. Now, once again, relationships are like that. But during the conflict, the Adivasis and Bodos fell completely foul of each other. Dono ko milane wala hum Gorkha log hi tha (the Gorkhas were the ones who brought both of them together). The Gorkhas would counsel both communities to not be violent, live together peacefully, conduct ‘Shanti Committees’, hold meetings with the SP (Superintendent of Police), DC (District Commissioner), etc. But the worst insult for us Nepalis who are the original settlers of the area is when a person now living in Milon displaced by the conflict of 1996 (and came here) much later has the power to issue us VCDC certificate certifying that we belong and live in this area!lv

5.7 Conclusion: The Political Determinants Indirect Mortality in Conflict and the Emergence of Informal Healthcare Provision in Violence Affected Areas In the chapter we try providing a perspective of violence and its psychological manifestations which shaped a deteriorating humanitarian situation in one of the earliest and least documented sets of humanitarian crises. Many remote hamlets scattered throughout the Indo–Bhutan border areas (like Milon which was then just a remote Forest Village), became a site where these historical and violent struggles of rights, identity and territory were enacted; thus entailing massive human suffering and loss. With a collapsed health system, as a consequence of violence against medical professionals and institutions, the condition in the relief camps deteriorated further, leading to unmeasured mortality and morbidity rates. All this in a highly polarized political environment, where barriers to health access were occurring as a result of the political and military strategies of all the armed actors. We also see the beginnings of a fundamental shift in health seeking behaviour, where informal (or what has been called Emergent Healthcare Provision) becoming the primary source of healthcare provision as opposed to the state. We argue that the roots of this transformation lie in the complex identity transformations that occurred. A severe outbreak of cholera in the camps marks an important transition, in the findings of the study, and testifies to this transition. We thus encounter the unlicensed ‘Pharmacist.’ Chunu Tudu describes the situation: In the camp there was this one sickness. In Santhali, we call it ‘howlat ruwa’ which affected every family in the camp around 1997-98. The affected persons would vomit, pass stool, their nerves would stretch and then they would die. During that sickness if no saline (drip) was given, death was certain. Then, there was diarrhoea and from almost every family, one or two persons used to die. There was no facility for medicines. Later on, news reached the people on top that the relief camp people were suffering from diarrhoea and cholera. Only after that, medicines were brought the camp. But the medicines did not work and it did not help people recover. But there was this young man who helped the most in giving saline to the people in the camp. The quantity of saline given was dependent on the paying

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capacity. I cannot say how much I paid but I did have a loss (of money). I recovered from the sicknesses through saline. Many people in the camp recovered. Those who did not get saline, died. This person is still here and has built a pharmacy near the current VCDC office. Once, the edible oil given by the government was bad and many people fell ill after having that. It came in tin containers and was spoilt.lvi

A second set of important stakeholders in treatment provision, who we discuss, is the traditional healers or ojhas. In the response to communicable and noncommunicable diseases in the post-conflict situation, as well as in response to psychiatric problems, these old (new) actors also take centre-stage. We encounter them in passing in a field-based case study by the researcher MJM on an occurrence of Tuberculosis (TB) in a village in the study area: The village of 45 houses records a total of six diagnosed tuberculosis patients. While two have been cured after medication, the others have continued to suffer even after their second round of medication. There were no records of tuberculosis in these six persons prior to the conflict of 1996 and they claim never to have heard of such illnesses while they lived in their previous villages. The family migrated from Karbi-Anglong District to a place called Sorolpara (which a Reserved Forest area in Kokrajhar just adjacent the international boundary). They lost one daughter and two sons, according to them, due to inability to access Ojhas (traditional healers). During the 1998 conflict, the family moved to another relief camp after which they resettled in their current location. In order to sustain the family, they would cut firewood from the forest and sell in the market. The forest was far from their house and they would spend the entire day away from the house. Only in the evening , they would return with some food to feed the children. Once the father of the house was beaten by the VXYZV militants (reason not yet known) so severely that he could not go out to work for many days. According to his wife and other villagers, the injuries were severe and largely contributed him getting TB. The other villagers’ suspects that he contracted the disease because he took bath late at night and said he coughed since then. He was first diagnosed with tuberculosis in Kokrajhar Civil Hospital. From there he was referred to a TB-centre for medication. After his first round of medication when he went for check-up, he was still diagnosed with the same illness, the reports read that his condition was even worse than before. Even the second round of medication could not help him recover from his illness. Presently the man has migrated to Bangalore for work. He helps the family from there by sending money. He recently informed his wife that he was badly suffering from TB and was spitting blood in large quantities, also adding he would not be able to come home for the festival as he was too weak to travel or go for work or even book his tickets.lvii

One can understand the gravity and seriousness of the diseases in the camps, as it managed to affect the host Nepali community, who were economically sound, healthier and definitely nothing as vulnerable as the displaced camp inmates. The situation is described by SP and provides insights on the third mechanism of informal healthcare, i.e. international humanitarian NGOs: People would have three or four days of ‘blood dysentery’ and then die. 16 – 17 Nepalis died within one week. In the relief camp (of the Adivasis), many more died. Eight of them in a single family used to die. There was no medical support at that time. The international NGO came only much later. There was only one pharmacist who used to bring medicine from Sidli. There have been no incidents of blood dysentery apart from that time. When the NGO came, they made hand-pumps in all houses, distributed phenyl and also the relief camp shifted.lviii

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RS recalls, Nepalis accessing Bhutan for treatment, the dynamics of which will be the subject of the chapter on Cross-Border Health Seeking Behaviour (See Chapter Seven): In the relief camp, about 30-35 people would get fever in a day. Infection travelled fast and many of the Nepalis fell ill too. However, we (the Nepali community) were more prosperous, so we could go and get treated in a good hospital, which saved our lives. Earlier, we would go to Bhutan for treatment at a Bhutanese government hospital.lix

Regardless of the variation in rehabilitation outcomes, as will be shown in the next chapter on Informal Healthcare and Treatment Seeking Behaviour, a deeper granular analysis over time reveals that beyond the immediate emergency response and rehabilitation phase, health outcomes between both conflict-affected communities are similar. Once out from the emergency situation and especially when the relief camps closed down, Bodos as much as Adivasis are also left to recover on their own and remain at high risk of ill-health. In fact, as the findings of the next chapter will show that by the time of the conflict and humanitarian crisis of 2014, the dysfunctional health system (which had begun to deteriorate in the late 1980s) equally affected all the communities and was a major contributory factor in declining health and well-being across generations. Notes i

ii iii iv v vi vii viii ix x xi xii xiii

Interview with Respondents, Shibu and Maina. Interviewed by SDS. Date of Interview. 29 August 2016. Milon Relief Camp, Chirang, BTAD (Assam). Ibid. Interview with Respondent SNB and MILI. Interviewed by [Undisclosed]. Date of Interview. 12 July 2016. Lalbiti Village, Chirang, BTAD (Assam). Ibid. Interview with Respondent RS. Interviewed by LB and BD. Date of Interview. 11 August 2016. Bogori Village, Chirang, BTAD (Assam). Interview with Respondent TN. Interviewed by MJM. Date of Interview. 11 July 2016. Lalbiti, Chirang, BTAD, Assam. Interview with Respondent MSBR. Interviewed by MJM. Date of Interview. 4 November 2016. Salbari Village, Chirang, BTAD (Assam). Ibid. Interview with Respondent TWLN. Interviewed by MJM. Date of Interview. 3 July 2016. Asrabari, Chirang, BTAD (Assam). Interview with Respondent RSNM. Interviewed by [Undisclosed]. Interview Date. 9 July 2016. [Location unspecified], Chirang, BTAD (Assam). In a group discussion with Adivasi women respondents. 1 June 2017. Bogori Village, Chirang, BTAD (Assam). Interview with Respondents MBW and AM. Interviewed by MJM. Date of Interview. 7 July 2016. Lalbiti Village, Chirang (BTAD), Assam. Ibid.

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xvii xviii xix xx xxi xxii xxiii

xxiv xxv

xxvi xxvii xxviii xxix xxx xxxi

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Interview with Respondent RENS. Interviewed by MJM. Date of Interview. 10 June 2016. Lalbiti Village, Chirang (BTAD), Assam. Interview with Respondent DM. Interviewed by JL. Date of Interview. 4 July 2016. Fulbari Village, Chirang, BTAD (Assam). Interview with Respondent MB. Interviewed by DN, SDS, LB. Date of Interviews. 14 September 2016 and 20 September 2016. RBKI Village, Chirang, BTAD (Assam). Interview with Respondent RENS. Interviewed by MJM. Date of Interview. 10 June 2016. Lalbiti Village, Chirang (BTAD), Assam. Interview with Respondent ES. 12 August 2016. Bogori Village, Chirang, BTAD (Assam). Interview with Respondent. Interviewed by LB and translated by SH. Date of Interview 26 June 2016. Fulbari Village, Chirang, BTAD (Assam). Interview with Respondent HJ. Interviewed by DN and LB. Date of Interview. 10 August 2016. Bogori Village, Chirang, BTAD (Assam). Interview with Respondent NH. Interviewed by SDS and LB. Date of Interview 30 November 2016. Fulbari Village, Chirang, BTAD (Assam). Interview with Respondent SL. Interviewed by DN and SDS. Date of Interview 1 Dec 2016. Bogori Village, Chirang, BTAD (Assam). Interview with Respondent SL. Interviewed by LB and SDS (as translator). Date of Interview. 8 December 2016. Bogori Village, Chirang, BTAD (Assam). In a group discussion with Adivasi women respondents. 1 June 2017. Milon 3 No. Village, Chirang, BTAD (Assam). Interview with Respondent TGD and HT. Interviewed by LB and SDS [Translator]. Date of Interview. 29 August 2018. Milon RC, Chirang, BTAD (Assam). Interview with Respondent DSK. Interviewed by [Undisclosed]. Date of Interview. 21 December 2016. Bogori Village, Chirang, BTAD (Assam). Interview with Respondent DRSW. Interviewed by [Undisclosed]. Date of Interview 12 July 2016. Location [Unspecified]. Interview with respondent HSMAI. Interviewed by DN and LB. Date of Interview. 10 August 2016. Fulbari Village, Chirang, BTAD (Assam). Interview with Respondent SL. Interviewed by [Undisclosed]. Date of Interview. 31 August 2018. Bogori Village, Chirang, BTAD (Assam). Interview with Respondent DNBR. Interviewed by [Undisclosed]. Date of Interview 12 July 2016. Location [Unspecified]. Interview with Respondent TRG. Interviewed by LB with SDS [Translator]. Date of Interview. 28 November 2016. [Location Unspecified], Chirang, BTAD (Assam). Interview with Respondent HL. Interviewed by [Undisclosed]. Date of Interview. 1 December 2016. [Location Unspecified], Chirang BTAD (Assam). Interview with Respondent BR. Interview by [Undisclosed]. Date of Interview Nov 2016. [Location Unspecified] Chirang, BTAD (Assam).

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xxxiv

xxxv xxxvi xxxvii xxxviii xxxix xl xli xlii xliii xliv xlv xlvi

xlvii xlviii xlix l li lii

liii liv

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Interview with Respondent TGR. Date of Interview. Interviewed by LB and SDS. Date of Interview 28 November 2016. Bogori Village, Chirang, BTAD (Assam). In a group discussion with Adivasi women respondents. 1 June 2017. Milon 3 No. Village, Chirang, BTAD (Assam). Ibid. Interview with Respondent MS. Interviewed by DN and LB. Date of Interview. 3 September 2016. Bogori Village, Chirang, BTAD (Assam). Interview with Respondent ES. Interviewed by DN and LB. Date of Interview. 12 August 2016. Bogori Village, Chirang, BTAD(Assam). Interview with Respondent MS. Interviewed by DN and LB. Date of Interview September 2016. Bogori Village, Chirang, BTAD (Assam). Interview with Respondent CVD. Interviewed by MJM. Date of Interview. 19 February 2016. SNG Village, Chirang, BTAD (Assam). Interview with Respondent BN. Interview by MJM. Date of Interview. 12 December 2016. Milon Village, Chirang, BTAD (Assam). Interview with Respondents MBW and AM. Interviewed by MJM. Date of Interview. 7 July 2016. Lalbiti Village, Chirang (BTAD), Assam. Interview with Respondent JH. Interviewed by DN and LB. 10 August 2016. Bogori Village, Chirang, BTAD(Assam). Confidential Interview with Respondent [See Chapter Two]. Interview with Respondent BSNR. Interviewed by MJM. Date of Interview. 4 November 2016. For impact on host communities specific to Internally Displaced Persons (IDPs) see Norwegian Refugee Council. 2020. Living Conditions of displaced persons and host communities in urban Goma DRC. https:// www.nrc.no/globalassets/pdf/reports/living-conditions-of-displaced-per sons-and-host-communities-in-urban-goma-drc.pdf. Accessed 1 February 2020. Interview with Respondent CR. Interviewed by TRPTI. Date of Interview. 13 June 2016. Milon Village (RFV), Chirang, BTAD (Assam). Interview with Respondent KPH. Interviewed by TRPTI. Date of Interview. 14 June 2016. Milon Village, Chirang, BTAD (Assam). Interview with Respondent BT. Interviewed by TRPTI. Date of Interview. 15 June 2016. Milon Village, Chirang BTAD (Assam). Interview with Respondent LP. Interviewed by TRPTI. Date of Interview. 13 June 2016. Milon Village, Chirang, BTAD (Assam). Interview with Respondent CMN. Interviewed by TRPTI. Date of Interview. 14 June 2016. Milon Village Market, Chirang, BTAD (Assam). Interview with Respondent CBC. Interviewed by [Undisclosed]. Date of Interview. 14 June 2016. [Location not Specified], Chirang, BTAD (Assam). Ibid. Interview with Respondent LP. Interviewed by TRPTI. Date of Interview. 13 June 2016. Milon Village, Chirang, BTAD (Assam).

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Interview with Respondent SLD. Interview conducted by LB and MJM. Date of Interview. 14 June 2016. Milon Village, Chirang, BTAD (Assam). Interview with Respondent Chunu Tudu. Interviewed by DN and SDS [Translator]. Date of Interview 31 August 2016. Bogori Village, Chirang, BTAD (Assam). Field Observation by Researcher [Name of Researcher and Location Undisclosed]. Date of Interview. 14 September 2016. Interview with Respondent CBC. Interviewed by [Undisclosed]. Date of Interview. 14 June 2016. [Location not Specified], Chirang, BTAD (Assam). Interview with Respondent RS. Interviewed by TRPTI. Date of Interview. 13 June 2016. Milon Village, Chirang BTAD (Assam).

Chapter 6

Deep Vulnerabilities and Coping After Conflict: Ill-Health, Treatment Seeking Behaviour and Informal Medical Practices in the Borderland

Abstract In the previous chapters, we see the manner in which prolonged unrest and militant violence (in conjunction with weak governance) contributed to the breakdown in the health system. In addition to the victims of direct (and often targeted) violence we see massive burdens of morbidity and mortality due to protracted displacement. The first phase of displacement was in the relief camps, the second was once people left the camps and starting settling in the Reserve Forests (RFs) and other areas. Given this outcome, what are the key sources of healthcare in the border villages in Chirang (many of which are informal settlements) and what are the treatment options available to those recovering from the conflict? Just as families living in the forest areas traverse between formality and informality, in terms of accessing entitlements, we see a similar process in health seeking behaviour. For the border communities of Chirang, the district headquarters and the adjacent town with a large number of health facilities is considered to be unaffordable. Conversely, the nearest public health centre (whose history we traced out previously) is not functional. In this situation, we find the emergence of a variety of health actors filling this intermediate space. Mapping out the treatment seeking pathways of families in the post-conflict period shows that the search for treatment is not necessarily based on needs. Rather they prioritize access and affordability. With the state health system unable to respond to these highly vulnerable families, they depend on informal and semi-formal sources of treatment such as faith healers, herbalists and unqualified unlicensed practitioners of allopathic medicines. These have become the foremost frontline treatment options of the poorest in the border villages of Chirang. NGOs have attempted providing relief and medical care during and after the repeated cycles of conflict. But these short-term measures are unsustainable and at times, can be even more harmful if it erodes the coping capacities of conflict-affected populations. Keywords Treatment Seeking Behaviour · Medical Pluralism · Informal Medical Practice · Traditional Healers · Community Mental Health · Informal Pharmacies · Medical Relief NGOs

© Springer Nature Singapore Pte Ltd. 2021 S. Sinha and J. Liang, Health Inequities in Conflict-affected Areas, https://doi.org/10.1007/978-981-16-0578-9_6

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6.1 Introduction The previous chapter traced out the manner in which the formal state-run health institutions gradually collapsed as a consequence of the conflict. In the absence of a functioning state-based system, the search for healthcare, led to the (re)emergence and reliance on practices, which fall outside the domain of clinical medicine. Alternatively, we also see the role of civil society organizations, who despite providing high quality services, were not able to establish a long-term presence. Methodologically, it is very difficult to provide a direct causal linkage between conflict factors and these forms of healthcare provision. Further they have not necessarily replaced the ‘formal’ public health system. What we are interested in is the questions they raise, in terms of who constitutes a healthcare provider? While the state-based systems receded as a result of conflict, it is the nature of the alternatives, which is the core concern of the chapter. In a study by Peter Hill and M.E. Michael et.al. (2014) titled The ‘empty void’ is a crowded space: health service provision at the margins of fragile and conflict-affected states, we find an attempt to explore ‘the ways in which healthcare provision is configured by multiple actors beyond the reach of a state absent, unwilling or unable to provide public services’.i The work examines sixcountry case studies: Afghanistan, Central African Republic, Democratic Republic of the Congo, Haiti, Palestine, and Somalia. They contest the “distortion” produced by ‘the assumption that beyond the reach of state sponsored services is a “void”, waiting to be filled’.ii Instead they find ‘multiple, diverse substitutes have emerged where public services have been absent’.iii There is a need to identity the ‘local diversity that emerges in these spaces beyond state governance’.iv This can especially be done by a sector-wide analysis, ‘assembled from the bottom up, by studying as many distinct local situations as possible’.v The book, using the above approach corroborates several aspects of the work, especially their findings on cross-border healthcare; and some additional insights are provided in this chapter into the mechanisms of the process of emergent healthcare though the interviews of these informal and semi-formal actors in the study area. One slight deviation of our work is from their definition of Emergent Networks of Health Provision. According to them, the ‘opportunistic growth of private actors to occupy the space left by the receding or absent state produces complex emergent linkages for health services both locally and internationally’.vi There is no doubt about medical care in the conflict-affected areas being primarily privatized, some of the key providers especially traditional healers, faith healers, exorcists among several others, also enjoy a degree of legitimacy. This legitimacy marks a level of continuity from the past and is slightly modified in the contemporary circumstances. This legitimacy is dependent on a combination of two interacting factors: the first, is a continuity from the past; the second, is a belief in their ability to actually deliver (i.e. their reliability). Samrat Chaudhuri and Nitin Verma (2002) in their study on perceptions of medicine among the labour population residing in tea gardens in North Bengal state: ‘continuation of traditional beliefs and their mutation into new forms also points

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to continuities across time (colonial/post- colonial), and space (migration)’.vii The resilience of these belief systems despite the hegemonic position of modern medicine, implies an operating logic beyond assumptions of pure rationality in determining people’s attitude to health (including the health providers). In explicating on the latter mechanism, of reliability, Philppe Descola (1993) in The Spears of Twilight: Life and Death in the Amazon Jungle describes the work of Achuar shamans (ushwin) in the chapter ‘Craftsmen of The Imaginary:’ Having been dragged by a close family member to some famous ushwin whose abode they could reach with great difficulty, they would return home a few days later with a lively step and a blooming look, delivered from a torment that probably never did have an organic origin. Because they calm the fears of those who consult them and deliver them from their terrible sense of alienation in the face of pain and the unknown, shamans even manage to produce a temporary improvement in the lives of people who are truly ill. Any subsequent deterioration in their condition is regarded not so much as sign of failure on the part of the shaman, but rather as the indication of a new spell being cast upon them, one that is totally unconnected with the first.viii

In other words, there is a complex linkage between the choices available to the communities and the decisions to utilize a specific pathway of treatment. We find individuals who also choose practices which have some cultural resonance. Causes attributed to disease, such as ‘bad omens’ or ‘spirits’ may be more legible to the individuals concerned rather than purely scientific explanations. In terms of the study, we do not necessarily enter into the debate, between “traditional” and “modern” medicine, but rather argue, that from a policy perspective, it is important to incorporate the best practices across all domains. By virtue of their continuity, traditional and informal systems cannot be dismissed outright. In the case of India, traditional systems of healing were especially damaged by the legacy of colonial medicine whereby western clinical models, were prioritized over traditional forms of treatment as a result of ideological moorings in science and rationality. It is important to recognize some cultural practices. In many cases, these practices could be seen as collective coping mechanisms. We find traces of festivals in Bodo society, which were disease specific, such as Morong-puja. This ritual sought to placate the ‘cholera demon’. The ritual involved the placement of various food items on a raft and set afloat on a river. The account by Endle (1910) states: ‘It may be taken for granted that, whenever these rafts are found on streams in the Kachari country, cholera or other malignant disease is or has been doing its deadly work among the people’.ix Another festival identified was Mahu Hanai or the ‘driving away of mosquitos’.x According to the author: ‘This is a form of merry-making mainly by the young people of a village in the latter part of November or early in December, to celebrate the departure of the mosquito plague for the cold season’.xi In order to provide a more holistic analysis of the impacts of conflict on health, the chapter delves into the types of treatment options that were either available or emerged in the course of the years of political unrest. It is also important to note, that the relationship underlying these informal systems themselves are not necessarily one of pure complementarity. Rather they occupy a continuum between competition and cooperation, with their relative positions continuously shifting. The chapter starts

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by narrating in-depth life histories of two couples one Adivasi and the other Bodo. The treatment seeking behaviour for both couples is derived across two episodes of conflicts, i.e. 1996 through 2014 and mapped out in detail. Following this, the chapter provides some insights into the workings of three types of health providers who became key to health provision, i.e. traditional healers (Ojhas or Kobiraj), unlicensed informal Pharmacists and Non-Governmental Organizations. All names in the following cases have been changed to protect identities and locations.

6.2 Mapping Treatment Seeking Behaviour of Conflict-Affected Communities With the public health system so weakened and collapsed, how do highly vulnerable conflict survivors, left with depleted resources, cope with illness and disease? What treatments do people resort to? Is it poverty or cultural barriers or callous neglect by poor families that determine the kind of treatment sought or not sought by conflict survivors? How does treatment of the physical symptoms of the illness heal problems caused by hunger, deprivation and suffering? The first treatment pathway we try to map out is of Sarna, the daughter of the Adivasi couple Binod and Lakhi whose story we will read. Figure 6.1 shows how poverty after a conflict, negatively affects health outcomes of a displaced household. The family’s choice of treatment is dictated by resources or rather, the lack of it. They use the government health system and

Fig. 6.1 Vulnerability Vortex of an Adivasi Household Following Conflict

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take her to hospital but it is not very helpful. They also sought recourse to the Ojha for negating effects of the evil eye and possibly herbal medicines. Using multiple strategies, the family struggles to save her. The second case history is that of a Bodo couple, Mohan and Rupsi, whose lives follow a similar pathway in the aftermath of conflict, the impacts of which continue to constrain their future.

6.2.1 The Story of Binod and Lakhi—An Adivasi Couple in Milon Relief Campxii Binod Tudu met Lakhi and started living with her when their families fled to the Milon Relief Camp along with the rest of their community members in the 1996 conflict. Their first child, a son was born in 2001 after living together for four years in Milon Relief Camp. But he was not immunized as there was no system then. When the child was one and a half years old, a wound on his foot started festering. They took the child to an ‘Ojha guru’ (a traditional healer). Their son was under the treatment of the Ojha guru for three weeks and his wounds seemed to have healed. But after a few days, the child’s stomach started swelling up. They again took him to the Ojha guru. Another two weeks of treatment followed but he did not get better. They then decided to take him to Koroipur ‘Hospital’ for treatment. In the hospital, the doctor checked the child and gave them some medicines. But the child’s abdomen had bulged up and he started to vomit. While returning from the hospital in the public bus, the boy died. Lakhi covered her child with her clothes and after reaching the camp, they buried the child. They had two daughters after the death of their son. The second daughter died after surviving only for one day. There was no medical support system then for mother or child, no check-ups were done nor were tetanus injections given. When they finally left the relief camp after 10 years, only one of the three children born there survived. Leaving Milon Camp and Settling in Fulbari Their process of resettlement was fraught with problems: After living for 10 years in the camp we got eight thousand rupees from the government when we were supposed to receive ten thousand. With this money, we bought a piglet. It was our first livestock after the conflict. We could not go back to our own land because members of the other community had occupied it. We then came to Fulbari Village and settled here.

They occupied around 12 bighas (four acres) of forest land. After a year, they sold the pig which they bought from the compensation money. They wanted to buy cows but the money was not enough. Lakhi’s father added some amount of money and they bought two female calves. After a few years the numbers of the cattle increased and they had 12 cattle heads. Unfortunately, three of the cows died. They blame it on the water in the stream from which the cows drink. Binod says: ‘this stream comes from Bhutan where they dispose all the wastes and chemicals into it and makes it poisonous’. As they were left with only one girl child, he married the younger sister

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of his wife. They had three children together, but she then eloped with another man and left for Kerala, leaving Binod and his wife with the other three children too. Of the initial years since they returned from the relief camp, Binod says: …. slowly our lives were improving. We cultivated rice, mustard, yam and sesame. We had sufficient paddy, cattle and goats but then fighting broke out and we had to run to the Milon Relief Camp again in the month of December 2014.

This time, they left behind more than 50 maund, i.e. 2,000 kg of paddy and fled but they managed to take the cattle. After a few days they came back to take the utensils from their house and they found that the house and paddy were burnt. After six months in the camp, they returned to the village. Lakhi says: Now we are struggling for food and for other things like buying clothes and medicines. We could not cultivate paddy last year in 2015 because it was late for cultivation. We took time to clean the field because they were wildly overgrown. We manage to run our home by going for daily wage labor work to Gelephu (Bhutan) and selling firewood.

This time round, Binod received a compensation of Rupees 47,000 out of Rupees 50, 000. He used this money for buying clothes, rice and also repaid debts taken while they were living in the camp. In addition, they had to spend on their own ‘marriage’ ceremony since they had not been married officially since they could afford the marriage feast all these years. Another Death Sarna was their only child who had survived the relief camp in the first round of the 1996 conflict. She was around 15 years when she had gotten married a year before the 2014 conflict to a boy from a nearby village and was living there with her husband and in-laws. They too were displaced to the camp during the 2014 conflict but because the son-in-law quarreled with his parents, he did not go back to his parental home. The couple followed Binod and his family to Fulbari when they came back from the camp in May 2015. Sarna was two months pregnant when she came to Fulbari. She did not have any medical check-ups. Slowly, her body began to swell up and she also had fever and cough and ‘started getting weaker day by day’. The mother thought she was weak because it was her first pregnancy but when she had been suffering for over a month from fever and cough and was unable to eat, the Accredited Social Health Activist (ASHA) worker told them to take her to the Koroipur State Dispensary, ten kilometers away. The son-in-law pushed the cycle for four kilometers to the main road and then from there they caught the shared auto to Koroipur. Her mother accompanied them too. They did the check-up and she was also tested positive with malaria. But they did not get any medicines for malaria but got vitamins only. They thought of shifting her from their village to her uncle’s house in a village near the highway. Firstly, they believed someone was cursing the family and this was the cause of illness. But they calculated that from the highway, they would be able to take her to Bongaigaon for treatment as it will be nearer. Though she was getting worse by the day, it was some time before they could shift her to the uncle’s house.

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There they wanted to take her to a private hospital but they realized they did not have enough money. They sent word to Sarna’s in-laws asking for help but they did not respond. She was already in her sixth month of pregnancy by then and her body started swelling up more. Accompanied by a relative, they took her to a Kobiraj or Ojha guru (traditional healer). He started treating her but she was not recovering. The Ojha Guru advised immediate hospitalization. But they had no money. They had sold their two bullocks and by then, had already spent over for Rupees 13,000 for her treatment. It was a month later when Sarna got serious that they finally called the 108-Emergency Ambulance Service to shift her to the hospital. When the ambulance reached the uncle’s house, she was already dead: ‘The ambulance doctor checked her and said she was dead’. They had no money to bring her dead body to Milon. They sold another young bull for Rupees 6,000 to hire a vehicle. They paid Rupees 2,500 for the vehicle and buried her in her husband’s land. The rest of the money they used for the last rites and the various rituals. They had spent over Rs. 20,000 to try and save her but could not: Later, we thought we could have saved her if we had taken her to big hospitals. But by that time, all our money had been spent and we could not take her to any private hospital. If there is any sudden outbreak of illnesses again in the family, we now have only the cattle which we can sell for the emergency.

In Fig. 6.1, when we map the life-history of this Adivasi couple Binod and Lakhi into a diagram, we see that when cycles of conflict punctuate their lives regularly, it becomes like a vortex. In Fig. 6.1, it becomes clear how loss and suffering leave conflict displaced families with lowered resilience and at higher risk to ill-health and ill-being. Coupled with inadequacy of support systems such as abysmal government healthcare (as seen in the previous chapters), poor support from society, restricted help and aid from humanitarian aid organizations, ordinary life challenges coverts into disasters for conflict survivors. They are sucked into a vortex of vulnerability which results in tragic outcomes. In Fig. 6.2, we now map out the health seeking journey of this same Adivasi couple for their pregnant daughter when they return from the relief camp in 2015. Figure 6.2 shows how poverty after a conflict negatively affects health outcomes of a displaced household. The family’s choice of treatment is dictated by resources or rather, the lack of it. They use the government health system and take the daughter to the government hospital but it fails them. They try all treatments within their means, from trying government health centres to using local healing traditions like the ‘ojha’ or traditional healer for negating effects of the ‘evil eye’ to and also using traditional medicines and possibly herbal medicines. The tragic circumstances were largely avoidable and there are so many points in their journey when they could have been helped but are not. Another case history, this time of a Bodo couple, suggest risk factors of ill-health post displacement are cross-cutting across ethnicities. Though this couple was affected by earlier bouts of ethnic conflicts, in this case, we look at the aftermath of their most recent disruption, i.e. the 2014 conflict.

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Fig. 6.2 Treatment Seeking Pathway of an Adivasi Family Post the 2014 Conflict

6.2.2 The Story of Mohan and Rupsi: A Bodo Couplexiii For both Mohan and Rupsi, it was their second marriage. Rupsi had three children from her first marriage. Mohan had none from his rather brief first marriage. They had been married for five years and had added two more sons to the family when in 2014, violence broke out suddenly between their Bodo community and the Adivasis. Life had never been easy for both of them even in their earlier days. Mohan was an orphan who spent his entire childhood working as a cowherd in people’s homes and had no relatives. After growing up, he kept migrating from place to place working as a labourer for many years till he settled down in a little village called Amguri. He hoped to get a bit of land and settle down but till then, he used to go to Bhutan which was nearly ten kilometres away for daily wage labour, earning Rupees 1,500 and 1,750 rupees a week. After his wife died of illness within a few months of their marriage, he was on his own again. Some years later, Mohan married Rupsi—a single

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mother with three children—and brought her and her children to live with him in Amguri village. Rupsi was from a village right next to the India–Bhutan Border Gate. Her family was poor and for as long as she can remember, she had been a housemaid living away from her family in the homes of better-off villagers. The little money she earned helped her parents while food and shelter were provided by her employer. She met a young man living in a nearby relief camp, they married and he brought her to live in the camp. It was after the first round of the 1996 Bodo–Adivasi conflict and many relief camps had been set up for those who were fleeing attacks and burning of their villages (with the Bodos and Adivasis being housed separately). Rupsi has some faint memories, especially of the floods in the relief camp, where she came to live in after her marriage: …it (the flood waters) was more than 3 feet high and we were unable to prepare our meals for two days and remained hungry till the flood water subsided. But we lost all the relief ration supplies in the flood waters.

She also remembers people receiving tin roofs and compensation money of Rupees 10,000 after the conflict of 1996. Rupsi gave birth to her first daughter in the tent in the relief camp and then after some months, they shifted out of the camp. Ironically, they settled in lands of communities who had been displaced in an earlier outbreak of violence. It was a very tough life and there was no work and there were no wells or hand pumps in that village and they drank water straight from the river. When their second daughter was born, seeing their struggle, Rupsi’s brother and relatives invited the couple to settle in Rupsi’s original village. Her brothers allocated a small plot of land to them but two years later, while she was pregnant with her third child, her husband left her suddenly as ‘he could not adjust with his in-laws’. Rupsi’s son was born a few months after her husband left, leaving her to bring up her two daughters and a new-born son. Her parents and brothers (themselves struggling to survive) could do little to help her out. By selling vegetables from her small plot, rearing silk worms, weaving some small items to sell and doing farm labour whenever it was available, she struggled to keep going. Marriage and Move to Amguri Village When Mohan approached and asked for her hand in marriage and agreed to take her and her three children in, Rupsi agreed to the proposal though her family opposed it. Mohan was rumoured to get into fights with people. Rupsi married Mohan against the wishes of her parents and went to live in another village. They worked hard and earned enough through daily wage labour. As she said ‘we did not face any difficulty with food and were lucky that we did not suffer from any major illnesses’. Rupsi gave birth to two sons just a year apart from each other. One of the villagers described the boys: ’no one in the village has ever had such healthy children as them’. Rupsi’s eldest daughter was sent away to work as a maidservant in a rich man’s house. The second girl helped her mother in raising her step-brothers, along with attending a nearby school.

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They owned two-and-a half bighas of land (a little less than an acre) in which they cultivated tapioca. They also gave a small portion of the land as ‘aadi’ (sharecropping) for cultivating black sesame to another farmer in return for half the produce. Though the land was not suited for paddy and even other vegetables, they had other options and opportunities for livelihoods. They grew vegetables around their house and Rupsi remembers: I used to sell lots of vegetables like pumpkin, water gourd and maitha (rosellea) leaves. We had enough and I also shared the produce from the garden with the neighbours and they often complimented us on the fine produce from our kitchen garden.

During harvesting season, the couple would go and harvest other’s fields and earn extra income. Being near the main road to Bhutan, Mohan could also earn an extra income through daily wage labour across the border, as and when it was needed. 2014—To the Relief Camp Again The conflict of 2014 between the Bodos and the Adivasis completely disrupted the family. They fled along with the other villagers to a neighbouring Bodo village called Oxiguri after a sudden attack by a group of Adivasis: It was 8.30 in the morning and I was working in the field as it was harvest time. The older boy ran toward me shouting ‘saoutal daourou’ (i.e. the Santhals are attacking). But I was surprised at why the Santhals would be attacking us. There was a huge commotion in the village and we went outside to see. My wife who had gone fishing in the morning had just returned and was boiling some simla aaloo (tapioca) for breakfast. I told her about the attack but she said it will not happen so fast and asked me to go and get news from some young student leaders who had come to the village. I had hardly gone some distance when the commotion started and I was lucky to even reach back the house. Even before we could pack a few belongings, we had to flee. The attackers had already reached and started to burn the houses. They started from the last house near the Koroipur side. They were trying to cut our connection with the other Bodo villages. “We did not even have the time to get a gamsa (woven cloth towel) from the house to tie the children on our backs and so my wife carried the younger child and I carried the older one in my arms and we fled from the village. The attackers robbed the houses, burnt and demolished all the houses of Amguri. All our livestock from the village went missing and misfortune came to the family since the day we fled from the conflict.

As the couple was making their way through the paddy field, they were stopped by an Adivasi man armed with a bow and arrow: He was prepared and pretended to shoot me but was lucky that he did not. Soon he started to hit me with the bow on my head, legs and shoulders trying to stop us from fleeing. All my legs and the other parts of my body were swollen because of the beating. Luckily the attacks did not hit the child. All the Bodo men from the village had already fled, else we could have tackled this man. We managed to escape from him and felt safe once we reached a Bodo village called Oxiguri. Right till sunset, the people from both the communities were chasing each other near the Nijla River. It was only after some of our leaders came along with the army that the situation was controlled.

They had fled nearly five kilometres from their village which has remained abandoned ever since. A relief camp was set up for in the primary school in Oxiguri

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and the family started living there. Rupsi remembers the first days in the camp in December: The nights were very cold in the relief camp. We did not have any blankets and we spent the first two nights without warm clothes. On the day we fled, we did not have food the whole day.

The family lived in the relief camp for more than six months. Fearful for their lives if they went back to Amguri village, some leaders of the Bodo community pointed out barren land on the edge of the forest for this group to settle in and the families moved there: We didn’t go there immediately. We thought we would occupy some community land in Oxiguri village for a few months and earn some money to buy a bit of land of our own.

They stayed on for another month but finally came to Fulbari. They were pressed by the constant invitation from their villagers and also increasingly unsure of being able to earn enough to buy land of their own. Life in the New Village Though Mohan liked the new village, the main problem was lack of work and income opportunities. Losing documents of identity proof while they fled their homes added on to their problems: Many of our villagers have migrated to different places for work but even over there, they face discrimination by the employers who often suspect them to be militants as they have no identity proof or other papers.

In this new place he was allocated around nine bighas (three acres) of land, but being jungle land, first it has to be cleaned and readied for cultivation using a tractor. Mohan has no money for that. So, though he gets only half the produce, he had to give it away for share-cropping. Even building a small shelter was a problem: ……as the village is cut-off from other villages and not part of them (so no one comes to help). There are no work opportunities here. The Koroipur market is at a distance of more than 11 kms from this place. No four wheelers can come to this village and the only way for us to survive was to cut firewood and sell it in Koroipur market.

Along with selling firewood, they also try to catch fish, dry it and sell it in the market. During the agricultural season, they hope some daily wage labour will help ease the burden. Before the conflict, Mohan used to drink once a week with friends when he got his payment from Bhutan for his labour. Afterwards he started drinking every single day and the couple often end up fighting. Illnesses and Deaths They had been staying for a few months in their new place and it was the harvest season, i.e. between November and December of 2015. Rupsi used to take the boys, who were now three and two years old, along with her to the harvest fields where she worked for someone. Though Mohan asked her not to go out for work because of the young children, she wanted to earn a little extra and help ease the financial situation.

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Even in their previous village, they had worked together in the harvest field and got paddy as payment. Here as she worked, the boys used to play around their mother: Often they had to sleep in the open under the hot sun when they were tired or sleepy, else they would go and play in the nearby stream for long hours with the other children. Leaving the children at home was even more risky and dangerous.

Soon, the children fell sick. Mohan said: Earlier my children recovered from illness with the medicines I got from the state dispensary in Koroipur. Even while living in the relief camp, my son recovered quickly from the illness with medicines from the pharmacist in the nearby market.

This time too, the couple got medicines from the pharmacists and waited for the boys to recover but the younger one did not improve. Since he was not improving from ‘tablets’ they bought from the pharmacy, the couple took him to an Ojha a traditional healer in a nearby village, two kilometres away. The Ojha, an old lady had a good reputation for her practice and she diagnosed the child with jaundice. She boiled some leaves with which she bathed the child: On our way back home, my son started talking and by the time we got home, he was already recovering and improving. Though he refused to drink his mother’s milk, he ate a little rice when we forced him. Thinking he was better I went to cut yam stems to feed the pigs.

While he was away, a man from his village came running and informed him that his son had just died. Rupsi said ‘it was a Thursday on the day he died and I remember he was also born on a Thursday two-and-a-half years ago’. The elder son had recovered from his illness when the younger boy was seriously ill. But hardly had they buried the brother, that the older one started to fall ill again. This time it was even more serious. Mohan borrowed Rupees 2,000 which after six months would cumulatively become a sum of Rupees 3,000 (given the interest rate of informal lending). With this loan he took the older boy to the hospital. Paying Rupees 900 as fare, he hired a vehicle to take the boy to the Baptist Mission hospital some 20 kms away. But the doctor was out and so the person-in-charge asked him to take his son to the government hospital in Bengtol another five kilometres away. Finding the boy in a serious condition, the doctor in the government hospital asked him to rush the child to the Catholic Mission Hospital in Bongaigaon town, another 25 kms away. Mohan recalled ‘When the doctors there in Bongaigaon heard that child had been in this condition for the past four days, they did not even bother checking him up’. By then, he realized he only had only Rupees 1,100 rupees in his pocket and he could not afford to take his son to another hospital. He knew that he would not be able to borrow any more money as getting the earlier loan had been a struggle: We are new settlers to the area and money lenders do not trust we can pay their money back and so do not lend to us. But we begged and begged and they gave us only after we told them we were ready to sell the tin roof of our house, our two pigs and even mortgage our land to treat our sons.

Now seeing his son’s condition and not having money, Mohan was at a loss what to do:

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His skin had become so pale. His eyes were nearly closed and lips were drying up and he was breathing with great difficulty, whispering so softly that I had to lower down my ears near to his lips to hear what he was saying.

The final option left for them was to visit the Ojha (traditional healer) on their way back home. The Ojha treated his son for two days but the boy kept asking to be taken back home. They suspected the child to have typhoid fever and so they took him to another Ojha who they learnt specialized in typhoid cases. The ojha applied a paste of herbal medicines on the child. While they were returning home the elder boy breathed his last in his father’s arms: ’We buried him next to his brother with the hope they can reunite’. In search of answers to the death of his sons, Mohan feels that he had asked his wife not to cut the hair of the eldest boy, but she did not listen, as she felt the long hair was irritating the boy. Mohan, Rupsi and the villagers concluded “this and other things might have displeased the Gods.” The couple sold the two pigs they owned to perform the last rites, ceremonies and also cleansing rituals. At the time of the interview Rupsi was again pregnant and then in her eighth month. Sending the Girls Away Before she re-married, Rupsi had sent her eldest daughter away to work as a maidservant. The little money she got from there was helpful and it was one less mouth to feed. But the second daughter Sonima was a huge help in the house. After the birth of her step brothers, she helped Rupsi look after them while her mother went out for work. She also attended middle school in Koroipur, something she loved to do. But after the conflict, there was no way for her to go to school. The family was in no state to send her to school now 11 kms away and she had to stop schooling. Sonima was thirteen years old by then. An NGO which was helping the displaced families promised they would help get her admitted into a government residential bridge school where school drop-out girls like her could get free studies, food and stay. But Rupsi is worried as she has tried but has not been able to come up with the money required to buy some clothes and essentials needed to send her daughter there: I would be the sole person responsible for taking care of the expenses of my daughter. Yesterday I had gone to a nearby village to borrow some money for her expenses but I failed to get any. I am now carrying another child and I foresee the problems that I would have to face if my daughter goes to this school. Right now, I am in no position to take added responsibilities because I have only a few days before I give birth to another child.

Sonima pleaded with her mother. She said she wanted to study and not be a maid servant but there was no choice. Weeping and heart-broken, Sonima and her friend were taken away by a Mahajan (rich owner) to work in his house. Apart from some small housework, Sonima’s main responsibility was to be a companion to the master’s young daughter and to drop and pick her up from school. She would be paid Rupees 1,300 a month for this. Her friend, two years older at 15 years (with previous experience of being a housemaid) would be preparing meals for the Mahajan’s brother living close by. She would be paid Rupees 1,500 a month. Rupsi consoled her daughter by promising she would get to meet her friend often. She got an advance payment of Rupees 1,500 from the Mahajan.

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This money was of immense help 10 days later when the time came for Rupsi’s delivery. They had planned for a home birth as they had no money to go to the government hospital. Before the conflict, both her sons had been born in the government hospital but this time, they just did not have the money to spend. But the labour went on for many hours and finally, unsure and coaxed on by others, they called the government 108 ambulance which thankfully came; and, they moved Rupsi to the government dispensary. After some hours, Rupsi gave birth to a girl. The ambulance which was supposed to be free, charged Rupees 300 one way and the hospital nurses and doctors took a lump sum amount of Rupees 1,000 in complete contravention of established government norms. They were thankful for the money got from the daughter’s Mahajan some days ago. The Situation in 2019 As of 2019 the situation had deteriorated further. Mohan’s drinking increased and in a drunken brawl, he beat someone up badly. He has fled the village and had not come back for a year. Rupsi is now alone once again and struggling to earn a living and keep her family together. Since her parents and brothers were opposed to her marrying Mohan, she cannot go back to them for help. Her eldest daughter, 19 years old, is married. The second one who is now 17 years and has been a housemaid for over five years. The son works as a cowherd for a better-off family and lives at home with his mother and youngest sister who is now five years old. Like in the case of the Adivasi couple, here too we present a diagrammatic representation of the vulnerabilities of Mohan and Rupsi’s family post their displacement. In Fig. 6.3, we see that forced displacement due conflict creates a new ecology of vulnerability that really tests the coping capacities of the affected families and at many times, far exceeds it. It negatively impacts their bodies, the choices they can or cannot make and their health and well. For example, before the conflict, Mohan and Rupsi’s two sons were born in the government hospital which meant they had the money and agency to practice what they perceived as safer childbirth practices. It was after the conflict that their two young sons died because they were malnourished and when they fell sick, the parents could no longer afford timely treatment. The layers of effects get further complicated as a negative consequence for one family member actually becomes a positive result for another. For example, after the conflict, Rupsi sends her young daughter away to work as a maidservant even though it increases the chance of the child getting abused or exploited. But with advance money that is paid for the daughter’s services, the mother has a safe childbirth. These effects are by no means simple but inter-twined in complex and multi-dimensional ways. These also defy simplistic solutions. Policy frameworks and peacebuilding approaches cannot be shallow, quick, one-directional or predictable with guaranteed outcomes. In this and also in the case of the Adivasi couple, the intersection of poverty, powerlessness, environment degradation, mental stress and poor governance pushes such families literally over the edge of their endurance and coping. The fact that the families who have undergone severe conflict related losses are completely out- of -their depth in coping with a crisis like this is quite clear. Though there are so many layers of vulnerabilities, there is not much that they can do about it when it

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Fig. 6.3 Mapping the Post-Conflict Vulnerability of a Displaced Bodo Family

is a struggle for to them to even keep their children alive. In the following Fig. 6.4, we map out the illness cycle and the treatment pathways that the family sought for their two young sons.

Fig. 6.4 Mapping the Pathway of Treatment Sought by a Bodo Conflict Displaced Family

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From both the treatment seeking pathways of members of the Adivasi and also Bodo family, we see that in situations of conflict and fragility, negative life events are so acute that recovery from it—without effective external support—becomes very difficult. With no support from either government or non-government agencies after a conflict, minor illnesses end up as health catastrophes. Even in this case of the two young children, the choice for treatment is largely dependent on the money available and what is affordable—it is a mix of modern medicine, traditional healing and herbal medicine. The poor seem to try everything within their capacity and reach for treatment. It is ironic that the government health facility does not even seem to be an option for the poorest. It has no role to play in saving the lives of Mohan-Rupsi’s two young children. Even in Sarna’s case, though she was taken there, the required treatment was not given and it did not help her.

6.3 Continuity and Change: Informal Health Practitioners in the Indo–Bhutan Borderlands When the public health system is unable to respond to health needs of people in conflict areas, dependence on informal healthcare providers is extremely high. Informal health practitioners, both allopathic and non-allopathic, such as traditional healers, pharmacist and NGOs take over the role of healthcare providers in an area where there is lack of government healthcare. The informal healthcare providers have established an understanding and built a relationship with people. Moreover, they are they accessible and available when required. There were three main categories of healers who served and continue to serve conflict survivors in the area. Figure 6.5 shows that for the vulnerable communities in the study area qualified doctors are not a treatment option—private doctors are not accessible and affordable and the government health system is unresponsive and ineffective. Hence, people use a very well-developed system of informal healers—whether traditional healers or the unlicensed pharmacists. While they do manage to treat minor illnesses and even save lives, it sometimes delays the provision of formal treatment. And as we seen in the treatment seeking pathways of Sarna and the two young children, at times it can lead to tragic health outcomes. To see just how important informal healers are to the people in the Indo–Bhutan borderlands, we need to delve more deeply into the work of traditional healers and the untrained ‘pharmacists’ and understand their relationship with their clients.

6.3.1 Traditional and Faith-Based Healers Catherine Abbo (2011) studied the role of traditional healers in providing care for mental health patients in two districts of Eastern Uganda. She outlines an expansive

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Fig. 6.5 Various Treatment Options Used by the Conflict-Affected in the Indo–Bhutan Borderlands

definition traditional healing and medicine. According to her this form of medicine ‘is the sum total of knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve, or treat physical and mental illnesses’.xiv In the case of the border villages of Chirang, traditional healers are known locally as Ojha, Ojha Guru or Kobiraj. They are practitioners who have been curing people either by offering pujas (ritual worship), sacrifices or herbal medicines. Giving jungle roots, herbs and jadibuti (herbal medicines) is a very common form of traditional healing for any kind of illness. Traditional healers are present across all ethnicities (Adivasi, Bodo and

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Nepali), with their own distinct approaches. People approach the traditional healers for a range of illnesses such as malaria, jaundice, diarrhoea, abdomen pain, dysentery, typhoid, broken limbs, snake-bite, menstrual problems, evil eye removal, black magic and problems in the family. These are among a variety of ailments referred to them. Various traditional healers have different methods of diagnosing illnesses, preparing and giving medicines. Not every illness is treated by offering pujas or giving herbal medicines. NN, a Bodo traditional healer says that he treats fevers by collecting herbs and making a medicinal paste of it. The paste is put on the forehead to bring down the temperature. To get rid of evil spirit, he checks the symptoms and based on his diagnosis, he performs the evil eye cleansing ritual called jahrinai. He specializes in the jhar for twisted ankles and broken limbs (and related orthopaedic problems). He also provides cures for those persons possessed by evil spirits. It is important to note, there are multiple routes to become a traditional healer, a formal one through training, or through visions. Once inducted, though they have to secure their reputation, keep themselves up-to-date on cures/rituals and build networks (just like other professional associations): I have been practising for the past two years. I did not learn from any books or practice under any Jana Guru (see TML’s story below) prior to this. Everything came to me through my dreams. The gods tell me what has to be done and which plants to be included in the medicines. I am in the learning process now. The other Jana Gurus unlike me studied through books or practise under senior jana gurus. He does not know all the mantras written in the book. Whenever I to the altar it spontaneously come to me. I do not need to memorise the mantras (incantations).xv

Beyond traditional herbal treatments are many who are into faith-based healing. LN, a young 25-year old Bodo faith-healer claims he has patients who come to him for serious cases and illnesses as well as those having problems with the Gods. He is in fact trying to set up a new practice but uses a different approach from the one above. I visit different Deosigiris (see below) with the hope of learning more healings or medicines from them. The other Deosigiri in turn also visits me hoping for the same. Another reason why Deosigiri visit each other is in order to get himself or herself recovered from illnesses. A Deosigiri cannot treat oneself. The serious patients that come to me are the ones that are bed ridden and on whom doctors and ojha’s medicines have not worked. When a person contracts multiple illness, it is very difficult to get them healed.xvi

In Fig. 6.4 the rate list advertising the services of LN in a border village provides us a good idea about the range of illness covered. It has been set up for just over a year. An amulet is seen to be as essential as gastric medication and the cost of protecting the family from the evil eye is wedged between the rates of gastric medicine and leg massage medicine. The board has been translated from the Bodo language (which is written in Devnagri script). LN also takes on the role of a counsellor for domestic problems and prescribes rituals for the same (Figs. 6.6, and 6.7). Beyond, the individual traditional healers (who are equivalent of consultant practitioners), there is also a referral system (especially among the Bodo healers) which is partially captured in a field note:

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Fig. 6.6 Photo showing the rate list of the services of a traditonal healer in Milonxvii

Fig. 6.7 Photo of a traditional healer in the middle his practicexviii

The Deuri is a person who is like a priest - a witness to the Gods in villages during thanksgiving and family purification rituals. But a major role is played by the Deosigiri (a seer or someone with supernatural powers to see visions of the past or future). Their major focus is on ensuring the maintenance of the balance relationship between the family deities and the family. For prolonged illnesses, a family visits a Deosigiri whose role is to find out which family gods are please or displeased. Some who practice a religion called buli bathou also make it a point to visit Deosigiris regularly so to get protection and prevent any kind of illnesses or diseases. Since the Deosigiri communicates with the Gods, so in order to please

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the gods they meet the Deosigiri. The Jana Guru is the one who performs the rituals as directed by the Deosigiri. Another individual is the Deodini. This position is exclusively occupied by a woman and she is the mediator between the specific god worshipped by the family during the ritual. She is a person who dances on the knives during a ritual called the kherai. While performing the Kherai, a Jana Guru recites the mantras in order to make the gods come down and speak to (and through) the Deodini (Fig. 6.8).xix

Traditional healers are not just men but a number of healers in the area of study are also women, especially those faith healers who perform rituals to exorcize the evil eye or evil spirit from a person’s body. TML is one such female Bodo Deosigiri. In fact, she is considered at the apex of the referral system among the traditional healers and other healers also aspire to go to her for training. She says that families come to her after they have spent a lot of money in vain on ojhas, doctors and medicines. However, it not necessarily in opposition to the allopathic system. She explains that when the family gods and goddesses are displeased with the family, they cannot be cured with medicines, either modern or herbal. She then directs the family to do the required rituals and offerings to appease the Gods and once that is done, the patients are advised to visit the doctors as now the medicines will work. The following field observation note provides a brief outline of TML’s work as a healer: Individuals or families who have spent money on ojhas, doctors, medicines and still not recovering go to TML. If the family gods and goddesses are displeased with the family, the sufferings and illnesses cannot be cured with the doctor’s medications or the ojhas herbal medicines they are bound to come to her. For TML, all the medicines she uses for her treatment has been shown by the gods in the form of dreams. Her main task is directing the family to do the required rituals and offerings. Those are mainly done through bali or

Fig. 6.8 Kerai Puja with a Deodini performing her duties as the mediator

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sacrifice. If the family gods are displeased, they perform the rituals which will send away the illness. If they find that they are possessed by the evil spirits, they are advised the person to offer a black hen to the gods. After performing the rituals, they are told to visit the doctors again. Sudden loose motions, stomach ache and loss of appetite are said to be caused by gods not worshipped by them. A person having stomach ache means a particular kind of evil spirit called ‘kubir’ has to be chased. In case of leg pain the evil spirits known as ‘chokro.’ A person having pain on the hips the evil spirit name ‘sikari’ has to be exorcised. In case a person is suffering from ailments in the chest, they have to offer a black hen to a spirit known as ‘Runsundri.’ A person who suddenly has rages or mood swings can also be controlled by offering a black hen. All these occur suddenly so they do not have to visit doctors; the people can recover through offering pujas and giving offerings. The people believe that the family gods are the guardian angels for them. If they are displeased and don’t protect them, that is the time that the gods whom they don’t worship have the chance to attack them.xx

Among the Adivasi community, Ojhas play a significant role, although with a few differences. One major difference is that as shown in Chapter Four, referral into the formal allopathic system is delayed much more, especially inside the Unrecognized Forest Villages (FV), created after 1996. These life sketches provide insights into the range of ailments that they treat, which are quite distinct from those mentioned in Fig. 6.5. NBB is a seventy-year old Adivasi healer. He is originally from a village in the neighbouring Kokrajhar District. He lives with his wife and has a daughter and two sons. His eldest son is married and is in Kokrajhar while his second son is in Delhi for higher studies. He also does a part-time job as a mason and is also a farmer. He has been in Fulbari since 1993. As he says: When the conflict broke out in 1996, we lived in Milon Relief Camp. I used the compensation money to buy some land in Milon. I am a mason by profession and earn Rupees 350 per day. I also practice traditional healing. I started this practice back in my previous village when I was twenty years old. Both my parents were also traditional healers. I learned this from my parents. I have been able to cure many. People come to me if doctor’s medicines fail. I give herbal medicines and also offers puja (prayer rituals) for healing my patients. Some of the illnesses that I have been able to cure are: Tuberculosis, Pneumonia, Typhoid, Jaundice, Malaria, Abdominal pain, swollen body, various pains, menstruation problems, diarrhoea, wounds, paralysis, various aches and pains. During the 1996 relief camp, I cured many people suffering from diarrhoea and wounds. In the camp, my first patient was a woman who suffered from diarrhoea. When the woman recovered, the others realized that my treatment was good. Thereafter many started to come to me for the same. Many people from the camp in those days who could not avail proper treatment, died from diarrhoea. Then, I could not treat all the suffering persons because I could not make a collection of the herbal plants and roots as the it was impossible to go to the forest because of the conflict. Once a woman from Milon was suffering from malaria and she was taken to the hospital for treatment. She was given medicines from different places but did not recover. Her family brought her to me. On seeing her, I found her to be really serious. I went to the market to buy some of the essentials and also collected some herbs. When everything was ready, I gave the herbal medicines to her. She took the medicines and was cured in the course of one month. I also treat children who are unable to walk even after attaining five years. Once, such a child was brought to me. After seeing him, I gave herbal medicines both for massaging and drinking. The child is now able to walk. I also treat paralyzed patients with medicines and massage.xxi

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Another Adivasi healer HC, provides an insight on the interface of formal and informal practice. HC started practising as an ojha when he was unmarried and his parents were still alive. He has been practising for twenty years. He also treats patients from other districts too. His father used to practise before him and he learnt from his father and many gurus (teachers). Originally from another area, he came to Milon relief camp after the 1996 conflict. He was married before the conflict and had one child before coming to the relief camp: I also used to treat patients in the relief camp. In the relief camp mostly, I treated for swollen body and also for the family problems like attacks on people through black magic. People come to me for family problems like being affected by black magic and not recovering after taking medicines. I also treat bad dreams. I offer puja with fruits and flowers for this type of problems. After offering the puja I throw away the flowers and the fruits which were used during the puja in the river. People also come to me for chest pain, body pain and if a person is very weak. For this type of illness, there are different medicines. I buy herbs from the market and collect them from the jungle and grind them. For body weakness, it is called ‘dhatu durbol’. And for jaundice it is called ‘hamus.’ For malaria it is called ‘bilki’. People also come to me for typhoid and pneumonia. I treat tuberculosis patients but people who come to me are ones who have faith in me. It depends on the patients’ faith. Those who do not have faith in me do not come. If a person is suffering from any sickness; and, does not go to the doctor, then how would the doctor know what sickness is a person suffering from. For doctor they do blood test to find a person sickness. I meditate and diagnose the sickness of a person. When any patients come to me for the first time I meditate and see if I can heal the person or not. Only if I am confident of treating the patient, then I treat. If not, I tell them that I cannot treat them. For diagnosis and also for the medicines, I am able to see in the meditation, what is required for the illness. I also use the dreams and sometimes see treatment that is needed in the water after offering puja. I practice the Ram Shiv religion (a subsect of Hinduism present in the Milon area).xxii

In terms of the organizational hierarchy, and also the link with the formal system of medicine, HC says: I never refer my patients to other ojhas or doctors. We have an association of ojhas among the Ram Shiv religion. There is one main mandir (temple) in Milon for the people of Koroipur and other villages (all sites effected by 1996, 1998 and 2014 conflict). For this temple, there is one ojha guru or a pandit and same for other temples as well. The ojha gurus are spread everywhere but the ojhas of the Ram Shiv religion have different levels of powers among them which has been given to them by their gurus. Because of the distribution of this power, we are grouped into different classes. I am in the third position of the Ojhas. There are certain rituals which only the Guru can perform. If a person is dead, then after fifteen days the ritual has to be done. In the ritual they dig one chulha (earthen cooking stove) and burn fire in the chulha and blow it for the peace of the person spirit. If any person is getting married, then he will have to do brahma puja. This brahma puja will be done by the ojha. In all these cases, if the ojha guru does not have time for this; then only does he refer other ojhas to perform these rituals. Until and unless the ojha guru orders, other ojhas cannot perform the rituals or treat any other patient. Then, in this religion there are restrictions on eating certain types of meat. Food practices are different for ojhas of different sects. For treatment, mostly the Adivasis come to me. Christians also come to me when they are not recovering with the medicines or prayers. I practise ahimsa and treat anybody. To continue the practice, I teach this to my children twice a day. In the previous year, mostly malaria and jaundice patient came to me. I could not cure one girl patient because he was affected by black magic. The black magic was too strong. The girl

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Fig. 6.9 Ongoing Diagnosis with a Divination Implement by an Adivasi Healerxxiv

who had come to me twice earlier came a third time after her delivery; her placenta was not removed. There was infection inside her body. I told her to give me money to buy medicines but she could not give any money. So, I could do nothing and could not treat her. In the end the girl died. She was newly married. For sicknesses in my own family, I treat them first and if they are not recovering, then they visit the doctor. My youngest daughter who five has a has wound in her cheek for the last three years. For her treatment I sold eight bulls and have spent about Rupees 300,000 for her treatment as far as Bongaigaon, Kokrajhar, Alipur Duar and Cooch Behar (the latter two places are in North Bengal) but she is still not recovering (Figs. 6.9).xxiii

While for Bodo and Adivasi healers, the system displays some degree of hierarchy and is thriving, there is a slight difference as can be seen from the narrative of DBH, a Nepali traditional healer: I learned this practice from my father. I also learned some aspects of it from an ojha Guru. My guru passed away many years ago. I started practicing since my youth. I can cure only few illnesses. I do not go to my patient’s house for healing. My patients come looking for me. Mostly my own community people come to me; mainly for family problems like getting rid of an evil eye. I diagnose the illness of my patients from rice after performing puja. Adivasis also come to me for treatment. Medicines which I learned from my guru are not easily found. I collect medicine from the jungle. These days I get exhausted collecting all the things needed for preparing the herbal medicines. I am presently willing to give up the practice. I do not take any money from my patients. People mostly treat me to tea for receiving the treatment.xxv

With the increasing acceptance of modern medicine, the children of traditional healers, are gradually moving away from the earlier practice. As the son of a Bodo traditional healer states: It is not true when the doctor or medicines or ojhas herbal medicines cannot cure a person’s illness, visiting a Deosigiri or performing rituals through a jana will cure it. I do not believe in faith healing because for my own epilepsy, I approached a Deosigiri and performed all the rituals many times over but still I did not get cured. Now I take medicines from a mental health programme, have lesser number of attacks and am recovering.xxvi

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6.3.2 Impacts of Conflict on Traditional System and Emergence of Unlicensed ‘Pharmacists’ For traditional healers of this area, the lines between physical and spiritual is porous. For example, a broken ankle is treated both with medicines and also cleansing rituals. It is a mix of medication, counselling, prayer, religion and fear of the unknown. Pointing to the continuity in traditional practice, interviews with conflict-affected families and also traditional healers tell us that prior to the conflict in 1996, most of the people living in the Indo–Bhutan border villages were highly dependent on traditional healers and in herbal home remedies. In fact, some households living very deep in the forest areas got introduced to allopathic medicines only when they were displaced to the relief camp, like for the treatment of malaria. An Adivasi respondent HSH says: During those days, people were not aware or have never heard of the word ‘malaria.’ When people had shivering and high temperature, they went to the ojha for treatment. In Santali language, the word rabang ruea denotes a type of fever that reaches its peak in the morning and evening hours. This was a cure we Adivasis practiced at home. We would burn the nests of a yellow coloured insect found in the maze plants and this rabang ruea would disappear with the burning smoke. The whole villagers practiced this as home remedy for recovery from rabang ruea. When we came to live in Milon Relief Camp in 1996, we learnt that rabang ruea was known by a different name. Doctors coming to the Relief Camp called it ‘malaria’. Over the years rabang ruea/ malaria cases has been consistently increasing. It was rampant during our stay in the relief camp. The traditional practiced method of healing from rabang ruea has decreased over the years. Today the villagers visit pharmacies or hospitals for medication.xxvii

The headman of this same Adivasi village called Fulbari narrated an incident to show how the depth of attachment towards traditional healing among the Adivasi communities was even known to non-Adivasis and qualified doctors. While he was in the relief camp, his niece fell very ill. With much hesitancy, they took her to the hospital in Kokrajhar. A woman doctor first gave them medicines. Understanding their fear of allopathic medicines, she told them that on their return from the hospital, apart from consuming medicines, they must also perform a puja (prayer ritual) and the girl would recover fully. Seeing their poor state, she even gave them a 100 rupees for the puja.xxviii The impact of conflict on the traditional medical system is not well known. However, in course of the conflict, many traditional healers also moved into the relief camps as was seen above. The traditional healing practices seemed to have suffered as healers could not go to the jungles to collect the herbs for fear of attacks by the opposite camp. Moreover, people who had lost everything had no money to perform rituals. When those who were displaced to the camps left after several years, they went back to some of their traditional healing practices but this was now mixed with a belief in modern allopathy. The years in the relief camp also depleted people’s stock of herbal home remedies. People’s knowledge shrank with years of disuse while they lived in the crowded relief camps with no access to the herbs and ingredients.

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Also, people started getting used to quick acting allopathic medicines. This is when the role of the village pharmacy starts gaining centre-stage as the first line of treatment. Another significant factor, that possibly accelerated the rise of the pharmacy, was the changing positionality of the Ojhas, with the onset of the movement. Whereas our previous chapter, brought out attacks on government health personnel, a study documented how the traditional healthcare system was also impacted by the conflict. Some of the respondents in the study believed that the impact was even more severe on the traditional systems. As stated in a study: …...during the movement, militants had killed so many Ojhas (traditional healers) in the name of removing the witchcraft and sorcery practices from the society. Because prior to the movement, sorcery was very common, so whenever a person could not be cured from illness for a long period of time, it was believed that the Daina (witch) had imputed the illness through his evil magical power. In such case to diagnose and get cured, (the) concerned family would invite Ojha and the Ojha would perform Kherai Puja where the Ojha through ‘Doudini’ who goes into a trance state invites all the god and goddesses and Doudini reveal the cause of illnesses. In most of the cases the Doudini diagnoses the illness as the super natural causation or the illness has occurred due to sorcery of Daina and they would mention the name of the witch from the village and once the Daina is identified, village council would punish the Daina through social boycott, letting him/her eat his own excreta, so that his magical power will no longer be useful. But during the movement, the identified so-called Dainas were not spared because the sophisticated weapons was already available in the hands of young people. In such a process, many a times innocent and knowledgeable Ojhas were also killed (the Ojhas were mistaken as Dainas).xxix

In some cases, apart from mistaken identity, personal vendettas against Ojhas also led to their denouncement as being sorcerers and witches: The age-old traditional source of treatment got affected badly and people were at the cross road in dealing with their health problems, on the one side they could not go to the urban areas to visit doctor due to the fear of police and on the other hand traditional healthcare providers were disappearing. At this juncture, new health providers –untrained medical practitioners emerged, and traditional healthcare providers had to pave its way to the untrained health care providers.xxx

The above coincides with the narratives from Milon, which was then a far-flung area of Kokrajhar. In the narratives, we see the rise of Noren ‘Doctor’, an informal practitioner who is appreciated by the health personnel of Koroipur and also the communities in the 1990s for his work in the relief camps. Both Adivasis and Bodos recall his work.xxxi The researchers who participated in the study were able to locate him in a remote Forest Village close to the Indo–Bhutan border twenty years after he first started practicing in Milon. The field notes of the interview provide the context: “Noren Doctor” as he is better known is calm and speaks softly. He runs a clinic from his house. He is a barefoot pharmacist who trained himself by working under some local pharmacist for seven years before he started his own practice in 1999. From field visits to making home visits to patients in villages, he also seemed to have helped many mothers deliver their babies during the conflict period when hospitals remained inaccessible to people. Many families could save their spouse and children only because of Noren’s medicines. In fact, the present headman of the village had tried out many traditional healers when his wife suffered from jaundice during the conflict period but everything failed. His wife recovered only when he managed to get a bottle of syrup from Noren.xxxii

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Noren Doctor provides an insight into the medical practices of those days, in the late 1990s, especially the cultural interpretations of diseases like Malaria: Malaria was yet to be diagnosed before 199-95. Malaria was more commonly known as Bhaluk Jhor prior to these years. The symptoms of Bhaluk Jhor were mainly shivering, high temperature and bitter taste in the mouth. The then available medicines in the form of tablets were Prenaqueenen, Nevaquinnen. In addition to either of these tablets’ patients were also given Sibajal tablets suspecting of typhoid. For cure from Bhaluk Jhor, people approached ojhas/traditional healers. As the name of the illnesses signifies Bhaluk means Bear and Jhor means sickness medicines comprised of bear fur. There was huge influx of spectators to see bear performing dance whenever there was bear dace being performed. More than watching the dance performed by the bear people were more interested in getting the fur of the bear which could help them recover in case of Bhaluk Jhor. Very few people visited the pharmacy or hospitals. They were more attached to traditional healing methods. Some notable traditional healers of the times were Thukra, Harold and Tarini (all three are now dead). When Bhaluk Jhor was finally diagnosed as malaria around the year 1994 I had not yet been trained to use the microscope. It was only when the malaria test kit came up in 2007 that I started using the kit to detect malaria. Prior to this the symptoms were the only indicators for malaria treatment. The symptoms of Bhaluk Jhor were very identical to what people now call as malaria.xxxiii

While on the one hand Noren Doctor provided services to the Bodo community and is remembered long after the conflict, Chunu Tudu, a Santhali, set up his practice right next to Milon Relief Camp. His role became crucial when access to camps around Milon became difficult due to the violence outside Chunu was only a 16year-old teenager when he started practicing in the wake of the 1996 conflict and his services are recalled by several people in the area: After finishing my matriculation (Grade 10 exam), I began an apprenticeship with a pharmacist in Koroipur. When the conflict broke out in 1996 and Adivasis moved into the relief camp, they were scared to go out for medical treatment. They were also falling seriously ill with diarrhoea but received very little health care. At that time many of my relatives urged me to come to the relief camp and provide medicines. So, along with my family, we shifted into the relief camp. I bought my first stock of medicines with my own money, and thereafter reinvested all the income generated from selling medicines in the relief camp to buy more supplies. I had to go very far to buy medicines. When the need to administer saline drips arose, I remembered what I had observed at the Koroipur pharmacy and started performing that task as well.xxxiv (Note: As seen in the conclusion of Chapter Five, Chunu developed a practice where he was giving saline to the people in the camp and the quantity of saline given was largely dependent on the paying capacity of the patient).

6.3.3 ‘Pharmacies’ in Village Markets As conflict receded and the health system did not rebuild to respond to the medical needs of people, informal practitioners or pharmacists become the major source of healthcare provision. Locally called Pharmacy (pronounced as Pharr-maa-cee) these self-taught and unlicensed practitioners of allopathic medicine have slowly become the frontline treatment choice of families in the border villages (for a contrast see Chapter Seven on Bhutan’s Health System in Sarpang just ten kilometres away).

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Most of the pharmacists have learnt from observation and apprenticing with other pharmacists and they give medicines for most illnesses, apart from administering saline, injections and conducting malaria tests. Gradually as we see, people have sought out cures through increasing usage of modern medicine but due to the poorly functioning government health centres and non-availability of medicines, there is a high dependence of people on these pharmacists. Some of the pharmacists who were the sole healthcare providers during the periods of conflict and having won the trust and confidence of the people, enjoy great influence in the community even as they continue practising till date. Pharmacists are also popular with the community and the patients like them as they are flexible and ‘adjust’ the dosage of medicines based on the money available with the patient. This however runs the grave danger of creating drug resistance. An interview with a Pharmacist in Gopur village provides the following insight into health seeking behaviour of the communities: The most common illness in the area is malaria, typhoid, itches (skin allergies) and gastric. Recently, a Santhal having cancer came to my pharmacy. Jaundice is also another frequent illness of the area. Malaria as a disease comes from the North with the flowing river water. Those villages nearest to the forest seem to have a greater number of malaria cases. Malaria is highest during the rainy season (cultivation period). When the river water starts flowing, the mosquitoes seem to come along. By the month of May when the rains come malaria cases also begins. The number of malaria cases consistently rises since then till the month of October. When November starts, the number declines with three to five cases in a week. This occurrence of malaria is a yearly phenomenon. The months of November till February record the highest rise in people coming for painkiller to my pharmacy. In the absence of malaria and typhoid, body pains and gastric remains the predominant illness. Malaria, typhoid, skin allergies simultaneously affect the people of the area. Cough and cold comes almost the same time with malaria. The first rainfall I no good as a person getting soaked in such rain will have fever, cough and cold. Diarrhoea and dysentery are now reducing. The first step in treating malaria is to see the type of malaria whether PF or PV by doing the blood test in the malaria test kit. The second step is checking the temperature and giving tablets to calm down the temperature. The third phase is injection when the temperature comes down. Even in typhoid case the process involves the same. For malaria there are three injections. There has been change in malaria injections/medicines over the years, presently we use the Pelsitar injection. In case of serious patients, we refer the cases to hospitals in Bongaigaon. We usually avoid the risk in treating serious patients and consider ourselves to be providing just the basic services by treating illnesses while in its initial stages. The people usually delay in coming for check-up. When a person first falls ill, he/she is first given some tablets. The family keeps waiting for better results at least for 2 days. When the person does not improve then they are brought to the pharmacy. The Santhals tend to wait for the last minute before they approach the pharmacy. Often when a person is found to be shivering and having high temperature the person is treated with malaria and typhoid injections even without blood tests. People try to avoid the expense of conducting the tests. In case a person is suffering from two types of malaria and typhoid, the number of injections reaches 9 in total. In such cases if malaria is found to be severe, then first the malaria injection is given and after an hour, the typhoid injection is given. Many people do not complete the malaria treatment course. When they feel better with just one injection, the person stops the course. On many occasions people cannot complete because they do not have the money for the injections. When a person feels weak, saline (drip) is given. The two groups which always remain more vulnerable to illnesses are the children and old aged people.xxxv

As mentioned earlier, it is not necessary that within the realm of informal practice, relations between the providers in necessarily purely competitive. As field notes of

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SDS, a member of the research team states, even pharmacists fall back on traditional healers, and there does exist a rudimentary referral service: SC (a traditional healer) says once the child of the pharmacist near the VCDC office was bitten by a snake and the pharmacist brought his child to SC. On seeing the child’s wound, he immediately started chanting the mantra (incantation) to remove the poison from the child’s body and also blew at the wound. Slowly the child recovered when the poison was being removed by the mantra and the pain too was over. Another time, a child of an Adivasi family from nearby was bitten by a spider. The child’s parents took the child to the pharmacy and asked for medicines for spider-bite, but he did not have any. He suggested that they should take their child to SC and they eventually found him and he treated the child through the required incantation (Figs. 6.10).xxxvi

RM and SM are two pharmacists who share a pharmacy in a local market. An afternoon spent observing the two pharmacists at work proved very educational. SM has been treating patients in the area the past 11 years and easily rattles off names of the most common illnesses they treat, like malaria, typhoid, itches (skin allergies) and gastric disorders. A particular afternoon was spent observing them. In the course of the day they treated 18 patients. Five patients, three men and two women, came for painkiller tablets. Then, an Adivasi man from Fulbari came to buy medicines for his wife

Fig. 6.10 Photo of a ‘pharmacy’ found in small and big markets in the Indo–Bhutan Borderlands

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suffering from severe pain because she had delivered a baby at home that morning. RM gave him two tablets worth Rupees 10 for the pain. Then, another two persons were suffering from fever and one person from continuous headache. They treated three cases of malaria and two skin infections—of a woman and a child. Then, a newly married woman consulted privately and took some medicines. A mother of a 17-year-old girl came for medicines for her daughter who is unable to get up from the bed because of illness. The earlier medicine she was given did not work and so this time, the mother was given medicines for typhoid. It was busy afternoon and there were a lot of blood tests done of various patients. It is quite telling that a single unqualified practitioner selling allopathic medicines in a village market area sees many more patients than the government state dispensary. The unreliability of state-based care and excessive costs of private medical care in the cities, incentivizes individuals to seek out alternatives, with the demand being fulfilled by these informal practitioners. An Adivasi woman from Bogori village in Milon says: We hesitate going to the Koroipur hospital because it is too expensive, and besides the doctor just writes the name of medicines on a slip and sends us to the pharmacy. So, we might as well go to the pharmacy straightaway, why go to the hospital? Moreover, we have to pay both in our local pharmacies and (in) the government hospital. But in the local pharmacies, we can get credit. Then, the pharmacists are also well behaved and nice to us and available to us all the time, unlike in hospitals when the staff have fixed duty hours and not available otherwise.xxxvii

6.3.4 The Entry of NGOs into Healthcare Provision Among Conflict-Affected Populations: The Role of an International Medical Mission (the HFA Foundation)xxxviii The public health system already weakened by unrest and militancy could not respond to the humanitarian crisis when the conflicts broke out in 1996 and 1998. This gap was filled by various non-government actors. Some major humanitarian aid agencies conducted relief work and the Church–led organizations first provided medical services in some areas immediately following the conflict. Largely people in Milon and its surrounding areas were left to survive on their own. One of the most significant contribution to health services in the border areas was made by an international NGO who arrived in the erstwhile pre-2003 districts to serve the people directly affected by conflict. Their role was highly recognized and remembered by the people till today for the service they provided during the emergency period especially in tackling malaria. People remember them as ‘the NGO who was there after the 1996 conflict.’ Recalling those days, one of the pharmacists say: There was huge rise in the number of malaria cases by 1996 i.e. the conflict period. Government health centres and the few pharmacies of the area were just inadequate to address this rising problem. I suspect malaria spread such abnormally because people gathered in huge numbers in the relief camp. When they (the NGO) came to tackle malaria, it could control

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its increase to a large extent but one could see huge numbers of malaria cases even after five years of their intervention.xxxix

Apart from medical services, the organization also looked at Maternal and Child Health, Water and Sanitation. HR who is a community mobilizer and lived through the camps in 1996 and 1998 states: In the initial years after the conflict, people from the relief camp could not go for institutional delivery. Maternal and child deaths was rampant because they could not afford the charges in the hospital and the roads were not safe for them to travel. Their regular diet of the mother comprising of rice, dal, and jungle potatoes served as protein for the mother and the new born child. The communities from the relief camp were ignorant about maternal and child care on the first place nor was any such facilities/ services available to them even before the conflict. It was only after when ‘the NGO’ came in addressing the health crisis situation that pregnant mothers first started to receive attention. Apart from enquiring malaria, dysentery, diarrhoea and other allied illnesses from tents to tents they also began to nurse the pregnant mothers living in the relief camp. They also constantly checked the drinking water consumed by the people living in the camp. They tested the well water for germs and other water borne diseases. Medicines were put in the well waters to kill the germs. They also installed hand pumps and dug well water in order control water borne diseases. Prior to this the camp people were dependent on the river to collect their drinking water. They checked the drinking water consumed by the people living in the camp. They tested the well water for germs and other water borne diseases and helped disinfect the wells. They also installed hand pumps and dug well water in order control water borne diseases. Prior to this the camp people were dependent on the river to collect their drinking water.xl

Members of the research team interviewed Dr. RH in Delhi. He was part of the medical mission and was part of the programmatic activities in the Koroipur area. His account provides some insight into the interim period between the collapse of health services in the aftermath of the Andolan (the movement) and subsequent militant activity. Dr. RH stated that the organization began its work in Assam in the early 2000s but shifted to the immediate study area a number of years after the 1996 conflict.xli These areas were selected in keeping with the organization’s mission statement of helping those who lack healthcare due to conflict. He came to the undivided Kokrajhar first in 2003. The government dispensary (KSD) was lying abandoned and the organization took over the building. Most local health centres were not functioning since health workers were afraid. The organization did recruit two local nurses. Thereafter, they expanded into the Milon relief camps since the malaria situation was very severe there. Initially the condition of the relief camps was not very good, due to lack of water, and since people customarily did not use toilets, the sanitation problem was very severe. However, when people started settling down for the long-term with their compensation money, the situation started improving. By 2009 the rehabilitation process was complete. Though the situation had been tensed till 2001. The BLTF coming over-ground and joining mainstream politics and Adivasi groups entering into a ceasefire, the situation stabilized in the area of work. By 2006–2007 government health workers started returning. He remarked that it had seemed to him throughout his stay in the area the common people were not concerned solely with the conflict but the struggle for livelihoods and the necessities of survival were more important. Further, it was mentioned the team

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was always made to feel welcome by the community. They never felt any opposition, neither from the local population, nor from the militant groups, nor from the security forces. He feels this may be because of their policy of providing treatment to one and all, without discrimination or bias: Throughout our stay in the project areas, the common people were not concerned with fighting but more caught up with the struggle to survive. In the waiting rooms of the clinics, members of all communities would sit together, wait together, discuss each other’s symptoms, enquire about each other’s children’s well-being. Since the patients were seated on first-come firstserved basis, there was no grouping together of a particular community, nor any preference or bias. Even militants, police and security forces personnel sat together with the common people while waiting for a check-up.xlii

One enabling factor behind the people’s faith in the organization was their professional conduct in terms of punctuality and the high quality of various institutional processes. The organization’s office was located in a town and all the staff had taken up living quarters there. They would leave between 7:00 and 7:30 in the morning and start the clinics at 8:30 a.m. The last registration was done at 3:45 p.m. and the clinic closed at 4:30 p.m. Clinics were started in the dispensary buildings and the RSTI clinic was in the LP school building. There was no infrastructure whatsoever in the dispensaries when the Programme Team opened their clinics. They had to bring in everything from outside from beds to laboratory equipment. The organization also recruited ten Community Health Workers (CHW) from the local population and trained them as per their existing knowledge levels and skill-sets. For example, those who could read and write were given registration work. The organization also treated patients free of cost. However, they only ran an Out Patient Department (OPD) clinic, with a labour room. For surgeries, Caesarean-sections and serious cases patients were transferred to a private hospital in Bongaigaon town and costs were subsidized. When the Kokrajhar District Hospital became functional they transferred the patients there. The organization also established malaria laboratories where they trained people on how to check samples for malaria. Yet, there are challenges for relief-based organizations. Unlike the state health system, which even notionally has to cover the entire population, coverage here was dependent on a multitude of factors and left to organizational calculations (including funding). In the end they can only work with a limited and very small subset or people. Though necessary to save lives, through narratives we do arrive at a problem of humanitarian exit. In evaluating their response, Noren Doctor says: Even though they could reach distant village doing awareness programmes there were still many villages which were left behind. The clinic based in Asrabari and Koroipur remained inaccessible to many families due to the following factors: belief in traditional healers and lack of faith in modern medicines; lack of proper roads; and, money was another prime factor. Though the treatment was for free there were families who could not spare a day off to come to the clinic because they had to go for work.xliii

At the same time, there were attendant risks, but having a transparent set of policies, did mitigate some of the issues (See Appendix: Life as a Community Health Worker for the International Medical Mission: Some Insights). As the case study

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shows, in terms of their conduct the medical personnel did make a courageous attempt in highly disturbed situation. Yet, as in all conflict areas, humanitarian response by civil society does throw up important questions on sustainability after exit. It raises questions on whether communities are actually consulted in terms of the alternatives that would be provided. In their exit, the organization did hope that NRHM would take over their programmes, but it could not see through the transition in a complete manner. Alternatively, were efforts made to reach out to the Traditional Healers and Pharmacies or consult them about the context, peoples’ belief systems and disease patterns? Also, was five years enough to bring about sustained change? It is important that humanitarian organizations leave some sustainable alternatives in their wake rather than plan for exits which are sudden. This does not necessarily have to be in terms of resources, it can also be training, capacity building and building community owned systems that would outlast the emerge. It is one of the problems of neutrality (See Chapter Eight), but having connections and deeper roots in the community, would have allowed for a more nuanced exit; an exit that would have catered to the fragile situation that emerged post-rehabilitation. Also, the introduction of high quality healthcare and new resources (and ways of working) into an area where there were practically no healthcare services did have problems. Undoubtedly the organization played an important role in saving lives and filling critical gaps in government health services, left broken by the conflict; it also, has its critics within the community, which shows that community perceptions are important. BNB is a Bodo teacher in his late 40 s from the area who was witness to the years of unrest and conflict. Appreciating the organization for their role, he says: Their major focus was on malaria and many lives could be saved from malaria because of the organization, but their medicines were very strong and of high dosage. When they left after their project ended in the year 2007 our own malaria medicines did little good to help malaria recover.xliv

This feeling is also echoed by some of the Nepali leaders in the area: I heard that the organization is from America. They used very high dose of medicines on our people but still, it helped address the health crisis of the period.xlv

Another Nepali respondent who is a community leader though appreciative of the malaria services during the emergency, echoed a perception, that reflects the need for longer term interventions (and better planned exits): Their tablets and injections caused mental disorders here. Before that there were no cases of mental people. Now they have to run mental health camps. They gave bad medicines, of high voltage. To get cured, we ate what we got. What did we villagers know? We had to survive. Some people are very poor. They did not have the diet to support such medicine.xlvi

The organization served in the area for five years from, leaving when some of amount of peace and stability had returned. It was also just when the nascent NRHM programme was being launched and even an MOU was signed with the State in the hope of government ownership over the services they started. But it was a long shot in the dark. The government health services never replaced the high quality of care and services that had been established.

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In the aftermath of the 2012 conflict, which is described in a subsequent chapter, the organization revisited Chirang but they found the health system to have greatly improved due to the efforts of the government through the NRHM, and the efforts of NGOs. However, Dr. RH found it strange there were at least five government doctors allocated to each relief camp, some of whom were even brought in from West Bengal, but nobody checked whether people had access to existing health infrastructure or not. In 2012, therefore, the organization provided only non-medical services. The distributed three sets of emergency kits to the affected population which contained non-food items. One was the Shelter Kit containing tarpaulin, rope, and other tent material. The second was a kitchen kit with basic utensils, and the third was a Hygiene Kit with toothbrushes, sanitary napkins and other necessities. One key lesson that Dr. RH insists on is relief should be provided by meeting needs from the perspective of the beneficiary, rather than that of the provider.

6.4 Conclusion: Building Bridges in Formal and Informal Through Mental Health and Emergency Services In Bodoland, the rise of violent militancy interspersed with waves of ethnic conflicts during that same decade hastened the decline of the public health system. It collapsed so badly that the health centres could not even respond to emergencies and epidemics following the different waves of ethnic conflicts. Post a conflict, families who have suffered severe losses and highly vulnerable have to rely on their own resource, that have already been severely depleted, when it comes to seeking treatment for illnesses. In this chapter, mapping the treatment seeking pathways of two families, we understand that the choice of treatment for impoverished conflict-affected families is dependent on the money available and the most affordable treatment options. The strategy is a combination of modern allopathic medicine, faith healing and herbal medicines. While the poor seem to try everything within their capacity to reach for treatment, it is ironic that the closest government health facility is not even an option for them. Thus, they reach out to traditional healers and also unqualified, unlicensed Pharmacies who become the primary choice for reducing the suffering of families. In strengthening health systems in the study area, especially where resources are scarce, there is a strong argument for a more pluralistic approach, that dialogues with these ‘emergent’ health practices and practitioners. The diagnosis and provision of mental health services is one key area where traditional healers have a significant role. the ant has been running seven mental illness treatment camps in different parts of the district for over seven years now. Compared to other similar camps, the monthly treatment camp that they run in the premises of the Koroipur State Dispensary has the maximum patient-load. According to the doctor co-supervising the mental treatment outreach camps: ...there was also a spike in the number of cases of common mental disorders such as severe anxiety and depression immediately following the 2014 conflict. Some were injured victims

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of attacks also accessed the camps, but a majority of the patients were not. Even among severe mental disorders, there were (and are) a number of patients registered in the camp from the immediate vicinity of the border. But I find the maximum irregularity in attending the monthly camps as many families could not even afford the nominal costs of the services and medicines. They skipped camps or adjust the doses of medicines to make it last longer.xlvii

Ojhas and other traditional faith healers were normally the first point of contact for mental patients in the area. Families put a lot of faith in the healing powers of the rituals performed by the traditional healers. Based on that finding, a rudimentary bridging effort was made to understand their viewpoints by the project. A Traditional Healers Seminar was organized in 2015 in Chirang by the then Jan Man Swasthya Project (Community Mental Health Project). During their interaction, the project team provided an overview of the work of the project. A few clinical cases were also used to describe the mental disorders with some of very typical symptoms. The key objective of the exercise was to understand their diagnostic formulation and the additional information they take into account. The proceedings give a glimpse into an alternative worldview, where spirituality, does play a significant role in people’s lives, and even determines the choices made by them. It also shows that the boundaries between modern medicine and traditional one is quite blurry: In the mental health arena, they treated all types of mental disorders. Most of them resort to Jhar Phuk” which are cleansing rituals to drive away the evil eye, they give “tabiz” or protective amulets and they also perform sacrificial worships or puja. None of them seemed to follow any procedure inflicting physical harm or visible injury to patient. To attain and keep their power to treat - they perform pujas, Jhar Phuk, animal sacrifice, listens to god (Dhyan) and perform fasting. One of them fasted recently for 18 months, eating only fruits and uncooked food. This particular Ojha said that three Goddesses of strength or shakti i.e Kamakhya, Mahamaya and Bagheswari bestowed the divine power on her to do good for her bhaktas (followers) and patients. Some of them have the power to diagnose spiritual possession and know how to chase away the evil spirits. All of them were very clear in stating that not all mental disorders can be cured by them. Some need the doctors’ intervention, especially if this “involves the brain” and not caused by evil spirits or evil eye. The project team tried to understand the organization of their system of healing. From their description, it seemed they had systems of referral and reverse referral. Some of them specialized in some areas only. For example, there were specialists for children’s diseases, snake bite, labour complications and even epilepsy. Once the participants were comfortable with the project team, they admitted that they could not treat mirgi (fits) and asked for information and help on how to treat it. Dr. M gave an input on epilepsy and especially the various types of it and the team demonstrated the safe ways of handling a person with fits. They were very happy with the input and said that we must have more of these as it will help them a lot. Overall, they endorsed the use of medication in some of the patients and supported the possibility of doing cross-referral to and from our mental health programme. The ojhas hoped a cordial collaboration from the project team which was assured.xlviii

Given their level of access inside the unrecognized forest villages, an interface with the more formal government system needs to be developed with Traditional Healers and Pharmacies, especially in (but not limited to) the domains of emergency management and mental health. Humanitarian organizations responding to conflict (See Chapter Eight) could always find ways to incorporate informal medical practitioners into the programming, given their deep knowledge of their context (and can think in terms of look deeper at the psychosocial aspects of their work).

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In fact, a study in Burundi found that training in rudimentary diagnostics to Healers would possibly ‘prove beneficial for certain cases of cross-referral, such as acute conditions that require immediate referral from healers to biomedical facilities’.xlix Despite the civil war situation, Burundi even experimented with the establishment of a government supported Centre for Research and Promotion of Traditional Medicine (CRPMT) that was co-developed with the Burundi Association of Traditional Practitioners (ATRADIBU); this is addition to a pilot clinic that included traditional medicine and biomedical practice.l The traditional healers can make contributions in the identification, referral and monitoring of mental illnesses. Overall, the civil society sector, working in peacebuilding, conflict transformation and humanitarian response, very rarely engages with them. There is an entirely new framework for linking peacebuilding and health, if these overlaps can be mapped in the Indian context. There is evidence of programme models internationally where cross-learnings have occurred. Traditional medicine practitioners have been allowed to open formal centres in refugee camps along the Thai–Myanmar border in the 1980s.li Their efficacy was especially seen when responding to psychiatric illnesses and domestic violence with a high volume of recoveries attributed to their methods. This especially reduced the burden on psychiatrists trained on modern methods and led to a reduction in prescriptions for psychiatric drugs that were expensive for the communities. In concluding this chapter, it would be critical to state, that more research is needed on the effectiveness of emergent health networks in border areas and new models of health programming that transcend the boundaries of informal and formal medicine be developed, with a view to improve healthcare access for border communities. In the Cases appended to the chapter, we first see the challenges faced by a community health worker, for the civil society led medical mission mentioned earlier. The second case examines the role of traditional institutions in resolving a case of Domestic Violence (DV) in a Bodo village.

Appendix 1: A Case Study of Life as a Community Health Worker (CHW) for the International Medical Mission-Some Insightslii Introduction Sapna was associated with the international medical and emergency response mission since the year 2003. When they joined end of that year, a group of them—largely local youth—were trained to test malaria. By the beginning of 2004, when they started its clinic in a state Dispensary (SD) she served as the lab technician. She says: During those days, every Santhal who came to the clinic was detected with malaria. Initially the clinic restricted to just treating malaria, but later, they addressed other health crisis namely diarrhoea/dysentery, skin infections, tuberculosis, maternity and child care while other critical diseases were referred to hospitals in Bongaigaon. One important aspect of their work was addressing health issues of different communities.

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These included visiting the village and arranging cleanliness drives followed by talks on different illnesses. The Awareness Team persuaded communities to avail the free treatment from the clinic. The team was very active in performing its duties. The foreigners in the team were always a role model. Whenever they saw any dirt, they never asked other people to do the cleaning but they themselves would start cleaning which would make anyone standing around to also join in. Before joining the organization, she says: I was very shy but accompanying the awareness team to different village as an interpreter, I now can speak a lot and for long hours. In a volatile, conflict ridden area as the one the clinic was in, the local staff are not just treatment givers but they also take on the role of peace makers and negotiators, as will be seen in some of cases below. The Rush in the Clinic As Sapna recalls: One day in the year 2005, I registered exactly 500 patents, starting from 7 a.m. it went on till 4 p.m. with no break in between. I filled my stomach by drinking water and not eating anything. That day, the team had decided to record maximum number of patients coming to the clinic, hence they decided to do extra work. Patients used to come by the clinic and stand in queue as early as 4 am in the morning. Though the registration was on first-come-firstserved basis, patients coming with serious and critical illnesses always availed immediate care and attention. The staff in the registration room performed the task of tracing health history and treatment of the patient and taking the weight and temperature. Those patients with fever were instantly given paracetamol tablets.

Sapna faced problems with local people from within the catchment area when they first started using the clinic. They demanded instant registration to meet the doctor, especially the more influential and economically better-off persons in the local area. Unlike the poor who came from distant places, these would demand instant service and Sapna coming from the local area herself found it a real challenge to manage them. Apart from running the clinic, the team often visited the villages to identify different illnesses. If a patient below the age of 14 years was detected with malaria the team visited the family of the patient for medication. The team sometimes travelled to far-flung areas to identify patients and urge them to come to the clinic for treatment. Malaria Initially, the better-off families the area of the major clinic did hesitate to come for treatment. Thy preferred to visit private hospitals with better facilities in Bongaigaon or Kokrajhar, but slowly, realizing that, even after spending thousands of rupees they did not recover from malaria, they started coming to the clinic. They had better medicines to cure malaria compared to hospitals in Bongaigaon or Kokrajhar. By the beginning of 2005, the clinic recorded influx of people from different classes belonging to diverse communities. Even patients from far off places like Amteka began visiting the clinic. A young person, (from Amteka) after spending thousands of rupees treating his malaria from private hospitals in Bongaigaon had still not recovered. He had heard of good malaria treatment by some NGO and came to the clinic. He went back with some medicines. After nearly a month he returned to the clinic to offer money for the treatment. He was cured from malaria and his happiness

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knew no bounds. He kept insisting that Sapna who was in the registration office accept payment. He left the clinic only when the team refused payment but accepted some packets of biscuits instead. Once, a seven-year old Nepali girl was taken to the clinic by her mother as she was ill since many days. The mother had previously bought tablets from pharmacies to help the child recover. The tests result showed that the child was suffering from cerebral malaria (cerebral malaria was still rare those days). The mother left with the child immediately after giving her blood for testing. The doctors asked Sapna to inform the family that the child was in a critical condition and was in need of immediate attention. Accordingly, she asked the mother to bring the girl to the clinic early morning the following day. The next day doctors after giving some injections referred her to a private hospital in Bongaigaon. Unfortunately, she passed away on the way even before the ambulance could reach the referred hospital. The family started accusing the organization and a few members of the student union stopped Sapna on her way home to warn her that they were going to file a case against the doctor. She asked them to come by to the clinic for any clarification regarding the death of the child but ultimately, no one came to the clinic to take up the case. Tuberculosis Treating TB patients posed important challenges during follow-up: Once we went for a tuberculosis patient follow-up in No. 3 Milon (an Adivasi village). As we entered the village and neared the patient’s house, we saw him running away from his house after he must have seen our jeep. When we reached his house, the wife told us that her husband was out to some relative’s house in another village. We pretended to leave the village but went back to the house on foot after parking our jeep some distance from the village. We found the patient in his house. The man was in a critical stage and if he skipped his medication, it would cost him his life. But he was scared with the dosage of the drugs as his system was so weak that after taking medicines in the clinic, he had to lie down for an hour or so before he could start back his journey home. Secondly, the family had no money to even afford the transportation to the clinic. A doctor from the team paid the old man for taking his medicines and his transportation.

Maternity and Child Care In the later years, the team addressed issues of maternal and child care. Any pregnant woman from the village was identified and recorded with the number of months of pregnancy. In due course of time, she would receive the essential attention and care extending till after birth of the child. In one case, a woman from within the area of intervention had consulted the doctors at the clinic during her pregnancy. She was given an injection as per treatment protocol. That very night she started bleeding excessively and she lost the baby. Later that day the husband came to the clinic and demanded the type of injection doctors had injected his wife. The doctors and other staff had already returned after work. Those present at that time were locally based staff like Sapna and others who assisted in cleaning. He started getting abusive and with some difficulty she convinced him to come the following day for negotiations. Next day the husband came again and created commotion before the Student’s Union leaders and other local leaders were called in for mediation. During the

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meeting, the nurse in the State Dispensary (the nurse had already served in the hospital for many years) informed everyone that his wife had previously undergone 2 abortions because of excessive bleeding. The student’s union helped the man understand his wife’s underlying health conditions and convinced him to apologize for his behaviour towards the organization.

Appendix 2: Case Study of Traditional System of Justice for Victims of Domestic Violence in a Bodo Villageliii (Names Changed) It is not only in healthcare and treatment seeking where in the absence of state health services, communities manage on their own. But with poor governance, law and order, traditional communities also have their own ways of meting out justice. This is especially true in Bodo villages where there is a strong faith in the community jurisprudence system and they do not go to the external agencies like the police or courts for justice. Traditional systems provide an alternative that is not litigationcentric, does not entail high costs of police, lawyers and courts and moreover, does not stigmatize the survivor. Though the methods and rulings of these traditional ‘informal courts’ does at times go against modern notions of gender justice, equality, negotiation, use of non-violent means of meting out justice and against provisions of certain laws of the land, yet it is the most preferred means of justice seeking in the Borderland villages studied. Let us take an example of a case of Domestic Violence (DV) that was resolved in a village in which the research team was present. This is from field notes of MJM who witnessed the entire proceedings of this case.

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The Case Sumi’s mother and sisters had come all the way from their village to call out the villagers of Salbari for a meeting. Over the years of their married life Binod had constantly been abusive towards Sumi. Many a times Binod had forcefully sent her back to her parents’ home. The neighbourhood also has been the witness to the abuses. They have two sons; the elder son was around 12 years and the other was seven. They had sent away the elder son to her parents’ home for studies. Binod’s habit of consistently coming home drunk disturbed the younger son. The younger son has also been victim to the father’s abuses. The mother often has to take him to hide in the bushes behind their house. Binod continuously verbally abuses his deceased father-in-law. He verbally abuses Sumi and beats her up any time, using whatever object is available within his reach. Presently she has a scar on her back. Three days earlier Binod had used a ploughing implement to hit her. She showed the mark to the villagers as she was making her statement. She also showed fresh cut marks on her fingers, caused when Binod tried to stab her the previous night. These are just two scars which can be shown in public. Sumi has multiple marks and injuries all over her body. There were several nights, during the peak winter season when she was locked out from the house. Those nights she survived sitting near the fire. Whenever Sumi attempted to defend herself against his verbal abuse, Binod would attack her physically. Few days before the hearing, Binod had kicked her on her ears which caused her to lose much blood. Sumi has been sliently receiving all these abuses since she married Binod. The thought about his reputation always held her back in reporting the incidents. She has been surviving all the injuries taking pain killers. Though Binod claimed that abuses happen only under the influence of alcohol, Sumi proved that when he hit her, he was mostly sober. The Hearing Both men and women in equal numbers had gathered for the meeting. The villagers felt humiliated as Sumi’s family had to come over to call for the meeting. Angry men had sticks ready in their hands. After Sumi had finished making her statement Binod was called in to the centre where he received his punishment. They hit him with the same ploughing instrument that he used to hit his wife with. After some time, Binod fell to the ground. Decisions When Binod was able to stand on his own, he was taken to the Bathou shrine (a prayer place) where he lit the fire. Binod was made to ask for forgiveness from Sumi by touching her feet. Binod had to ask for forgiveness from the villagers by touching their feet (he touches the feet of those older than him; the younger ones touched his feet). This is considered the final chance for Binod. If Binod is found abusing Sumi again, the village women will have to beat him up and he will then be forced to leave his family and village. All his property would be handed over to Sumi. All the proceedings and decisions regarding the future course of action were put down

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Fig. 6.11 Perpetrator of domestic violence is made to seek forgiveness from victim by village council

in writing. The villagers present for the meeting approved the decision by putting their signature/thumb impressions (Figs. 6.11). Notes i

ii iii iv v vi

Hill, P.S., Pavignani, M E. Michael et al. 2014. The “empty void” is a crowded space: health service provision at the margins of fragile and conflict-affected states. Conflict and Health 8(20). p. 2. https://doi.org/ 10.1186/1752-1505-8-20. Ibid., p. 7. Ibid., p. 8. Ibid. Ibid. Ibid., p. 5.

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Chaudhury, Samrat., and Nitin Varma. 2002. Between Gods/Goddesses/Demons and ‘Science’: Perceptions of Health and Medicine among Plantation Labourers in Jalpaiguri District, Bengal. Social Scientist 30 (5/6):18–38. https://doi.org/10.2307/3518000. Descola, Philppe. 1996. The Spears of Twilight: Life and Death in the Amazon Jungle. Translated by. Janet Lloyd. New York: New Press. p. 349. Endle, S. 1990. The Kacharis (Bodo). Delhi: Lowprice Publications. p. 39. Originally the text was published in 1910 and reprinted in 1990. Ibid., p. 49. Ibid. The Case History has been developed from three sets of interviews. Interview with BML and AMB. Interviewed by LB and SDS. Dates of Interview. 14 September 2016; 20 September 2016 and 15 December 2016. Fulbari Village, Chirang, BTAD (Assam). This case history was constructed after multiple interviews conducted by researcher [Undisclosed] in Sonapur Village. The Dates of Interview in the location were: 27 June 2016; 11 August 2016; 13 August 2016; 18 August 2016; and, 8 December 2016. Sonapur Village, Chirang, BTAD (Assam). Abbo, Catherine. 2011. Profiles and outcome of traditional healing practices for severe mental illnesses in two districts of Eastern Uganda. Global Health Action 4(1): p. 1. https://doi.org/10.3402/gha.v4i0.7117. Interview with Respondent NN. Interviewed by MJM. Date of Interview. 18 November 2016. HGBRIK (No.1) Village, Chirang, BTAD (Assam). Interview with Respondent LN. Interviewed by MJM. Date of Interview. 19 November Dec 2016. HSBRI Village, Chirang, BTAD (Assam). Field Photo by Research Team. Field Photo by Research Team. Interview with Respondent BEM. Interviewed by MJM. Date of Interview. 17 November 2016. MSWDA Village, Chirang, BTAD (Assam). Interview with Respondent TML. Interviewed by [Undisclosed]. Date of Interview. 19 November 2016. SGNN Village, Chirang, BTAD (Assam). Interview with Respondent NBB. Interviewed by SDS. Date of Interview 14 December 2016. BNS, Milon Forest Village, Chirang, BTAD (Assam). Interview of Respondent HC. Interviewed by LB and SDS [Translator]. Date of Interview. 2 December 2016. Bogori Village, Chirang (BTAD), Assam. Ibid. Field Photo by Research Team. Interview with DBH. Interview by SDS. Date of Interview. 16 December 2016. BNS, Milon Village, Chirang, BTAD (Assam). Interview with Respondent SRBN. Interviewed by MJM. Date of Interview. 17 November 2016. SWMDS Village, Chirang (BTAD), Assam. Interview with Respondent HSH. Interviewed by LB and MJM. Date of Interview. 11 Dec 2016. Fulbari Village, Chirang, BTAD (Assam).

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xxviii xxix

xxx xxxi xxxii

xxxiii xxxiv xxxv xxxvi xxxvii xxxviii xxxix xl

xli xlii xliii xliv xlv xlvi xlvii xlviii xlix

l

Ibid. Narzary, R.K. 2005. Impact of Bodoland Movement on the Health Seeking Behavior of the Bodo Community. Unpublished Dissertation. Mumbai: Tata Institute of Social Sciences, Mumbai. Ibid. Interview with Respondent HSH. Interviewed by LB and MJM. Date of Interview. 11 Dec 2016. Fulbari Village, Chirang District, BTAD (Assam). Interview with Respondent Noren Doctor. Interviewed by MJM. Date of Interview. 4 November 2016. DRNG Forest Village (FV), Chirang, BTAD (Assam). Ibid. Interview with Respondent Chunu. Interviewed by TRPTI. Date of Interview. 13 June 2016. Milon Village, near VCDC Office. Interview with Respondent BNST. Interviewed by [Undisclosed]. Date of Interview. 8 November 2016. Gopur Village, Chirang, BTAD (Assam). Interview with Respondent SC. Interviewed by SDS. 16 Date of Interview. Milon Relief Camp, Chirang BTAD (Assam). Group Discussion with women respondents on 1 June 2017. 3 No. Milon, Chirang, BTAD (Assam). Name changed and coded name is assigned to the NGO. Interview with Respondent CTBR. Interviewed by MJM. Date of Interview. 20 December 2016. Koroipur Bazar, Chirang, BTAD (Assam). Interview with Respondent HR. Interviewed by LB and MJM. Date of Interview. 26 November 2016. Milon Village (FV), Chirang, BTAD (Assam). Interview with Respondent. 14 August June 2016 [Location and Interviewer Undisclosed]. Ibid. Interview with Noren Doctor. Interviewed by MJM. Date of Interview. 4 November 2016. DRNG Forest Village (FV), Chirang, BTAD (Assam). Interview with Respondent BNB. Interviewed by MJM. Date of Interview. 12 December 2016. Milon Village, Chirang, BTAD (Assam). Interview with Respondent BK. Interviewed by MJM. Date of Interview 14 December 2016. Milon Bazar, Chirang, BTAD (Assam). Interview with Respondent DCB. Interviewed by TRPTI. Date of Interview. 14 June 2016. Milon FV, Chirang District, BTAD (Assam). Respondent’s Note sent by email on 3 April 2020 in response to questions. the ant. 2015. Report and Proceedings of the ant’s Ojha Consultation. [Unpublished Report]. Falisse, Jean-Benoît., Serena Masino and Raymond Ngenzebuhoro. 2018. Indigenous medicine and biomedical health care in fragile settings: insights from Burundi. Health Policy and Planning 33(4): 483–493. p. 490. https:// doi.org/10.1093/heapol/czy002p.490. Ibid., p. 484.

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Hiegel, J. 1983. Collaboration with Traditional Healers: Experience in Refugees’ Mental Care. International Journal of Mental Health 12(3): 30–43. The Case Study is based on Interview with Respondent Sapna. Interviewed by MJM. Date of Interview. 13 September 2016. Lalbiti Village, Chirang (BTAD), Assam. Field notes of MJM. Based on observations at Salbari village. Date of Interview. 3 November 2016.

Chapter 7

The Transboundary Impacts of Conflict on Bhutan’s Border Districts: Insurgency, Border Malaria and Cross-Border Healthcare

Abstract The perspectives that have been brought out until now, indicate that the extensive humanitarian challenges facing the region and particularly the study area, was compounded by the gradual exit of externally based organizations and the closure of relief camps. As the wave of conflicts receded after 2015, communities that were displaced temporarily or dislocated permanently, sought to rebuild their homes and livelihoods. The story of recovery is complex and chapter unfolds through two parallel narratives. The Indo-Bhutan border, although unfenced in most locations, is still well demarcated. From the Indian side, the boundary can be deciphered visually through Border Pillars, Border Out Posts (BOPs) and Border Gates. The existing open border regime has over time resulted in complex web of socio-economic relationships across the main border gate. From the perspective of the book, the breakdown of health systems that was experienced in Milon and its surrounding villages, was in contrast, mirrored by the gradual strengthening of Bhutan’s health system in its southern districts (especially in Sarpang District and Gelephu Thromde area) that are contiguous to Kokrajhar and Chirang, respectively. Located a few kilometres from Milon, the border gate after Dadgiri marks the edge of Indian territory. Paradoxically, both sides of the border experienced intense episodes of civil strife, but had completely different outcomes in health. For Bhutan, the ingress of the armed organizations (between 1992 and 2003) onto its territory and establishment of camps by the militants (who numbered between 3,000 and 4,000) was a major foreign policy challenge. This culminated in a brief but intense armed conflict (Operation All Clear) in 2003, between the Bhutanese armed forces and the major Indian militant groups (ULFA, NDFB and KLO) based in Bhutan. The Dzongkhag of Sarpang was severely impacted as a consequence. Utilizing a cross-border perspective, which links together the community histories on both sides of the border gate, the chapter examines the problem of Conflict and Border Malaria and traces out the manner in which Bhutan’s health system transformed despite the occurrence of large-scale violence on the Indian side. It also provides some insight into the importance of the open border in rebuilding lives and livelihoods for communities living near Milon. The chapter presents key learnings from Bhutan’s experience and the possibilities emerging from local-level health cooperation.

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Keywords India–Bhutan · Bhutan · Health System · Armed Conflict · Operation All Clear · Cross-Border Malaria · Vector Borne Disease Control Program · Sarpang Dzongkhag

7.1 Introduction For those participating in the humanitarian response, especially in Chirang and Kokrajhar, the hills of Bhutan and the entry gate at Gelephu served as a unique backdrop. Bhutan always portrayed a degree of tranquility, in the midst of raging violence and devastation. The contrast between the two sovereign zones on either side of the border gate is immediate and striking. While on the one hand one witnessed a sense of order, peace, functional schools, well-regulated health institutions and reasonably thriving markets, crossing back from the gate was a study in contrast. This was especially true in the immediate aftermath of the 2014 crisis, given the scale of destruction and displacement that was visible within just a few kilometers of leaving Bhutan. This contrast in living standards is obvious to both outsiders and the residents of the area. Repeated visits and longer stays, inside Gelephu, threw up more questions and puzzles, when seen from a comparative lens. The architecture of the border gate, the entry process and differences in time zones was an objective fact; and the contrasts that occur within a few meters of crossing the gate reflects what Martin Doevenspeck (2011) calls ‘asymmetries and inequalities’.i On deeper examination, it is found that this seemingly asymmetrical development between two sides of the border is essential to a delicate set of cross-border relations that have withstood several vicissitudes and transformations. For many individuals such as businessmen, small-scale traders, vegetable sellers, Winger (shared taxi) drivers and others, crossing of the border was (and is) seen as routine; routines that have been developed over several years. They are now familiar with the Bhutanese immigration authorities, shop owners and the general population. The normalization of crossing two sovereign spaces on a near daily basis itself is exceptional; given the underlying complexity of the historical processes that allowed for the construction of these daily crossings. However, the closure of the borders by Bhutan, due to unrest or other emergencies occurring on the Indian side is detrimental to their livelihood, depending on how far they reside from the border gate. For those living further away from the border, and closer to the district centre (Kajalgaon) or the city of Bongaigaon, their options to diversify and cope with these closures is much higher. As the chapter was written, Bhutan closed all its border gates with India, as a response to the ongoing pandemic. On the other hand, as the narrative shows, for a large population residing in the immediate vicinity of the border, crossing of the border line is part of the daily struggle to survive. They are part of a large pool of individuals who are completely dependent on construction and other related work, across the border in the town of Gelephu, and they lead a highly tenuous existence. Thus we see the creation of a distinct form of interdependence. While these labour flows from India are central

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to development of the border town, the labour pool is large enough to keep wages low in Bhutan (but only marginally higher than rates in India). The alternative to this seemingly sub-optimal outcome is the falling back into a vicious cycle of poverty and debt, which is virtually impossible to exit. They are therefore the most severly impacted by disruptions and closures of the international border. Methodologically, the chapter relies on Baud and Van Schendel’s (1997) ‘CrossBorder Perspective’. According to them, there is a need to ‘properly understand unintended and unanticipated social consequences of national borders only by focusing on border regions and comparing them through time and space’.ii The ‘Cross-Border’ perspective provides methodological insights because ‘the region on both sides of a state border is taken as the unit of analysis’.iii This convergence of perspectives, whereby two distinct systems of governance (and government) can be analyzed as a holistic unit of analysis, allows for a degree of interpretative capacity to understand the formerly conflict-affected borderlands. In Table 7.1, we provide a basic analytical construct by which the number of overlapping boundaries can be derived in the immediate area of study, with each unit of analysis representing distinct set of policy spaces. Crossing the border can have impacts on both sides. If on one hand, we see individuals searching for livelihoods, on the other hand, demand from Bhutan drives the existence of border markets on the Indian side. Transboundary interdependence can also have positive cascading effects for conflict resolution. One is the unconscious or sub-conscious linking of the formerly polarized and conflict-affected communities into economic relationships that are necessary for sustaining local markets. For instance, in the now expanding weekly border market near Dadgiri that caters to customers from Bhutan, one also finds buyers and sellers from all the communities in the BTAD (Adivasi, Bodo, Bengali-Muslim, Nepali and Koch-Rajbongshi).iv From the perspective of post-conflict recovery and public health, the interdependence created by border trade and livelihoods did not necessarily translate to provision of cross-border health services. This health cooperation existed at a point in the past, and it was routine for patients to visit Bhutan and get treatment there. The onset of conflict led to some degree of border controls. The regulations that are part of the repertoire of sovereignty became a necessity for Bhutan, especially in the context of this particular border crossing. Whereas in the previous chapter, the concept of Emergent Healthcare identifies cross-border healthcare as being an outcome of fragility, and in the case of the Indo-Bhutan border area near Milon (and extendable to other formerly conflict-affected border villages in BTAD), we actually see a divergence from the above expected outcome. In fact, health-seeking behaviour in border communities partially changed due to necessary sovereign controls that were exercised by Bhutan, once its own security situation transformed as a result of militancy and political unrest in the early 1990s. The availability of livelihood options, proved to be an important coping mechanism for those living in the relief camps (and also the non-displaced villages residing close to the border town of Gelephu, Bhutan). There is a distinction between healthseeking behaviour and livelihoods. Post-1996, we also see significant transformations in the health outcomes of Sarpang District despite the barriers posed by anti-militancy

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operations inside (that culminated in Operation All Clear by the Royal Bhutan Army) and outside the border belt (on the Indian side). The process by which these goals were met, in an adjoining geography, holds important lessons, not only in optimal use of resource allocation but also the importance of normative commitments. The chapter starts with an account of a family displaced to Milon Relief Camp and highlights how political borders are intimately linked to the individual choices of individual families and households. The chapter then traces out the history of the border, both from above and below. It also highlights the problem of civil strife in Bhutan in the late 1980s and early 1990s, especially around the integration of the Nepali community. This converged in part, with the securitization of the border districts, with the inflow of the armed organizations (especially ULFA, NDFB and KLO) from across the border, into Bhutan’s southern border districts. We briefly describe the impacts on this on Bhutan’s malaria control programme and the issue of Border Malaria.

Fig. 7.1 Map of Bhutan showing Southern Districts (Dzongkhags)v

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Table 7.1 An Analytical Construct to Understand Overlapping Boundary Relations and Multiplicity of Policy Spaces Country Bhutan India

Type of International Dzongkhag Shared and Border (e.g. Interdependent A Sarpang) Borders B

Thromde (e.g. Gelephu) C

Village Village Reserve Forest Block E & Protected (Gewog) Area D F

International Boundary A

AA

AB

AC

AD

AE

AF

State Boundary (Assam) B

BA

BB

BC

BD

BE

BF

BTC Boundary (Territorial Council) C

CA

CB

CC

CD

CE

CF

District DA Boundary (e.g. Chirang) D

DB

DC

DD

DE

DF

Block Boundary E

EA

EB

EC

ED

EE

EF

Village Council Development Committee (VCDC) Boundary F

FA

FB

FC

FD

FE

FF

Village Border GA G

GB

GC

GD

GE

GF

Reserve Forest HA & Protected Area H

HB

HC

HD

HE

HF (Transboundary Forests)

7.2 Chitra’s Story: Loss, Resilience and Reconstructing Fragility Near the Indo-Bhutan Border (Note: Names of Respondent and Some Locations Have Been Coded)vi The Conflagration of 1996 and Beyond Chitra, who belongs to the Adivasi community, was born in Gosaibil, and she grew up in Rongbapur. While staying in Rongbapur, she married her first husband and moved to Komlapur (now considered a forest encroached village) in 1993. When the

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1996 conflict broke out she had two daughters. One daughter was 5 years old and the other was then an infant of 7–8 months. They shifted to Milon Relief Camp as a result of the 1996 conflict. Her eldest daughter died in the relief camp because of pneumonia. The daughter was taken to a pharmacy near the relief camp on the third day of her illness. The pharmacist gave the girl injection and some medicines. When the daughter was brought back to the camp, she started to vomit and died after that. The family spent around Rupees 5,000 in treating the daughter. Four months after the death of the daughter, her husband was killed by militants when he was out hunting. Her husband had accompanied his friends from the relief camp to the forest, and the militants who were hiding there fired on the group. As they fired, the group fled. Some from the group who managed to reach the camp early informed Chitra that her husband was left behind in the forest. That night she waited for her husband’s arrival until midnight. The next day, the men from the camp went searching for her husband till the Sarpang Road (that runs adjacent to the international boundary and a few meters inside Bhutan). They continued searching for 3 days but could not find him. The leaders from the camp and her brother-in-law also asked them to search the place where they were fired upon the other day. When they reached the place, they found Chitra’s husband lying dead on the ground as he had been shot in the head. The body was in a pitiable condition. The men took the body to Koroipur police station. A Bodo man, living nearby (possibly), recollects the day the body was found: I was already studying in Class VI during that time. A Santhali who had gone to the forest for hunting deer was shot dead by the VXYZV. It was after five days the Santalis went to collect the deceased body from the forest. I was standing at the door, looking at the Santalis carrying the body. They carried the body through the highway. Some of them passed through our courtyards.vii

With her husband now dead, Chitra was worried. She was left with her young daughter and had a difficult time in the camp for two years. She and her daughter went hungry many times and since her daughter was very young, it was really difficult going out for work in the house of a Nepali family. Luckily for them, both the mother and the daughter did not suffer from any illness in the two years. She brewed alcohol with the rice she received in the relief camp. She managed to get more money this way and was able to buy rice regularly. Once, when she was out to work in the house of a Nepali family, one of her friends informed her that people were going to work in Gelenphu, Bhutan. On hearing this, she went to Gelephu for work accompanying her friend. When she returned from Gelephu, she went to live along with the in-laws in the relief camp. While staying with the in-laws they told her that they were going to look for a man to marry her. As she was struggling to make ends meet as a single mother, she agreed to the idea. Her second husband was originally from Dhakenara Village and had siblings still living there. He used to go to Gelephu (Bhutan) for daily wage labour work and when the 1996 conflict broke out, his family came to live in the Milon Relief Camp. By then, he had already been married three times and all the three had left him. He has two children from his previous marriages.

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She does not remember exactly which year they were released from the relief camp. She received a compensation of Rupees 1,000 after the death of her first husband. She was also supposed to receive another installment of Rupees 3,000 rupees but the camp leaders cheated her. After nearly three years of staying in the relief camp, she received a sum of Rupees 6,000 rupees in connection to the death of her husband. She spent the amount in performing the ritual for her husband and daughter’s death. After release from the relief camp they shifted back to the original settlement in Rongbapur. On returning, they shifted and rebuilt the house where they are presently living. They did this because it got flooded during the rainy season. When they returned, they primarily sustained themselves through wage labour. She had three daughters and one son from her second marriage. The daughter who was an infant in 1996 (and had grown up by then) was also staying with them. The 2014 Conflict The village became a target in the 2014 conflict, with militants firing on it and subsequently parts of the village were burnt down. Their house was burnt down to ashes. The family also lost the paddy and mustard which was yet to be harvested. While running to the relief camp, they managed to take their oxen. But the oxen died when they were living in the relief camp. They received tin roof on returning to the relief camp They spent three months in the relief camp. During the 2014 conflict, the family received rice, dal and potatoes. The ration they received did not last for many days. It got over by the time next ration distribution was made. At present, they eat rice and vegetables. When they first returned from the relief camp, they ate jungle potatoes. They started eating rice after she and her husband started going out for daily wage labour to Bhutan. It was when the family was still living in the camp that her husband went back to the village to rebuild the house (even before receiving the compensation money). They do not have any livestock in their house after their cattle died. They are not prepared for treatment in case of illness. They only have one option of paying for treatment and that is by first earning through wage labour work. They feel if there was no conflict they could be rich because they were cultivating before the conflict (1996). They cultivated maze and mustard prior to the onset of conflict. They started cultivating paddy after they were released from the relief camp post-1996, channelizing the river water to the village. Prior to the conflict, they had enough rice and money to run the family. The fate of the children. After returning back to the village her two daughters Joya and Rina were ill with jaundice and fever. The daughters were taken for treatment to the Ojha Guru (medicine man) a week after they fell ill. Both did not recover from the illness. Joya, the fouryear old deteriorated day by day, with newer episodes of respiratory distress. They wanted to take her to the doctor, but it was too late by then. Considering the symptoms, the villagers added that she suffered from malaria though she had not been diagnosed by a doctor or a hospital. Joya died first, and the other daughter Rina was taken to Koroipur hospital by her husband’s nephew and his wife as the couple had to bury the body of Joya. She believes that the unhygienic conditions and their

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environment are responsible for malaria and that her daughter would not have died if she had been treated by doctors in time. The other daughter Rina’s treatment cost them Rupees 5,000. She was taken to the pharmacy for treatment and she tested positive for malaria. The family sold two of the cows for the treatment of their daughter and the entire family fled their village and went to stay with her husband’s relatives in another village. The girl recovered only after six months. During that time, Chitra and her son also suffered from diarrhea and both took medicines from the Ojha Guru. She believes that something is wrong in their house because they were all falling sick and so to ‘cleanse’ and purify their house, they did pujas for which another Rupees 1,000 was spent. She is aware that malaria is a disease, which is spread by mosquitoes. The local health authorities had spread this awareness in 2015. From time to time people from the health department took samples of blood to detect malaria. But test results were placed in some irregular Drop-in-Centers which are at times, inaccessible to the villagers. Her second daughter from the second marriage left along with her friend to work as a domestic help in Arunachal Pradesh. She went in the month of March 2016. Later in that year, the friend had come home and informed them that their daughter would be returning home the following year in the month of March. They are not sure as they have no contact with their daughter and the girl also does not send them any money. Her oldest daughter from the first marriage (who was with her since the days of 1996) went eventually with a relative to Gelephu for work. The two cousins worked together for a Nepali family there. Her husband used to collect her pay from the employer. One day the sisters shifted to another family for work. While working there, the cousin eloped with a boy from their community who was also working in Gelephu. A few days later, when the parents went to collect money from the new employer, they were told that their daughter too had run away. Chitra and her husband looked for the girl everywhere in Gelephu but could not find her. When contacted, the cousin said that their daughter was still in the new employers’ house the time when she had eloped. Chitra informed about their missing daughter to the cadres of one of the Adivasi militant groups who are currently on ceasefire and based nearby. But till date, they have no information on the whereabouts of the girl.

7.3 Beyond the Border Gates: A History from Above It is beyond the scope of the chapter to provide an in-depth political history of Bhutan. Nevertheless, without detailing some salient features, the historical context of the border areas under discussion would be lost. Within the broader historical development of Bhutan, it is especially important to attempt the relevance of its modern-day Southern Border districts that are currently coterminous with administrative boundaries of the present-day BTAD. The bilateral relationship with post-colonial India did not emerge in a vacuum. Rather, we see continuities between arrangements developed in the course of British frontier policy. This frontier policy structured external relations with the various kingdoms, principalities and tribes that were outside the

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directly administered territories (especially in the hills), and evolved dynamically with the shifting boundaries of imperial expansion. First, evidence in the literature indicates that despite, the military confrontations embodied in the two Anglo-Bhutan wars of 1772 and 1864–1865 as well as the punitive actions in the intervening years (which were especially occurring in the Duars) area, the British were reluctant to increase their footprint beyond the Southern Frontier of Bhutan. The Duars or Dooars as described by Barjpujari (1952) were ‘narrow stripes of land, varying from 10 to 20 miles, running along the Southern base of the sub-Himalayan range’.viii In 1825, subject to payment of tribute, Bhutan’s earlier control of the Duars of Assam and Bengal was recognized. In Assam the seven Duars were Bijni, Chapakhamar, Chappaguri, Buxa Ghurkola, Kaling and Buriguma. Pemberton, who led a political mission into Bhutan in 1837, describes the Duars as: The most valuable portion of the Bootan Territory; through them and from them are procured, either directly or indirectly almost every article of consumption or luxury which the inhabitants of the Hills possess. Their principal trade is with them, the priests and the higher classes of laity subsist almost exculsively upon their produce. The silk of China and the woolens of Tibet are purchased in bartar for the cotton, rice and other products of the plains.ix

The historical accounts mentioned above shed some light on the geographical space, which constituted the Southern Frontier. The history of the frontier was also intertwined, not only with attempts at British or Bhutanese state building or boundary demarcation but also with the limits set by the incidence of disease. David Bello’s work on the Qing Empire and the role of Malaria in determining the limits of expansion into Myanmar points to the nature of imperial order in the Yunnan and Myanmar borderland. As Han were vulnerable to Malaria, settlement in Yunnan was limited: The distribution of the disease compelled the dynasty to rely on hardier tribal intermediaries to control the inner frontier. Consequently, Qing space in frontier Yunnan was structured by malaria, as the disease selectively manifested itself in both people and places. Local environmental conditions compelled the dynasty to maintain native chieftainships, an often unstable system of indirect control, in the face of countervailing political and economic pressures.x

We see a similar strategy being utilized by the Bhutanese rulers, where three major categories of governance can be inferred. The first was the seat of power, in the capital Thimpu, where power was exercised through the dual system of rule (through the Dharma and Deb Rajas). The second were semi-autonomous provincial governors or Penlops. The Penlops of Paro and Trongsa were the two most powerful Penlops, given that the Bengal and Assam Duars fell within their domain, respectively.xi The third form of governance were the semi-sovereign Rajas located in the foothills and plains whose domains constituted the Duars.xii These frontier territories, which were also Malaria endemic, were under a tributary relationship with the Bhutanese rulers.xiii In the case of the Assam Duars, the Rajas also acknowledged some degree of allegiance to the earlier Ahom rulers, through some amount of revenue transfer, and became mediators of this bilateral relationship between the Hills and the Plains. In contrast to the Qing rulers in Yunnan, the arrangements between the frontier Rajas and the Bhutanese authorities (as well as Ahoms) were relatively stable. With

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the advent of colonialism, the frontier Rajas found themselves on the edges of the administrative districts set up by the British, who to some extent maintained the earlier arrangements, based on expediency. Once these tracts were gradually seen to be lucrative by colonial authorities, given the rich ecology of the region, we observe increasing instability being wrought on the earlier arrangements, with the frontier tracts ultimately subsumed under British administration. This was especially true of the Rajas of Bijni and Sidli whose estates coincided with a substantive part of the modern-day borderland across Chirang and Kokrajhar. Sanghmitra Misra (2005) traces out the interactions between the British administration of the erstwhile undivided Goalpara District and the two Rajas utilizing memorandums that highlight the system of dual sovereignty and the nature of the relationship between the Rajas and Bhutan. She explains these interactions ‘as efforts at defining and fixing previously rather fluid realms as reflecting a confrontation between indigenous and colonial notions of political space’.xiv The instability introduced in the earlier arrangements was of two kinds. The first, through the exercise of administrative power, by which land clearance for agriculture was accelerated; and the second, through the use of military force (which ultimately culminated in the annexation of both Assam and Bengal Duars). By 1825, the British had officially recognized the rights of Bhutan to collect revenue from the Duars, in exchange for tribute. The work of H. K. Barpujari shows that problems emerged, as a result of disagreements on assessments and actual collections. In addition, the Three-Tier system identified earlier was vulnerable to provincial authorities, acting autonomously. Between 1825 and 1841, British and Bhutanese relations, in the Southern Frontier, especially the Duars continued to decline, with periodic cross-border raids, kidnapping of British subjects and punitive actions.xv From the British perspective, there was a tolerance for these violent incidents and a reluctance to resort to a direct war with Bhutan, despite the tacit support provided by some Bhutanese frontier officials to these incursions. One of the reasons behind this reluctance to directly confront Bhutan was the fear of disrupting the older regional trade between Bhutan and Assam, which the British were keen on encouraging and maintaining (given the possibilities of lucrative revenues that could be accrued of this trade from North Bengal at that time). We also find initial traces of the fear of disease (especially Malaria) being a deterrent for military expansion, which also combined with geopolitical calculations. As stated by Robertson in 1833 in describing the arguments against war with Bhutan: There would also be an indirect loss sustained by the cessation of that commercial intercourse whence there is every reason to hope that great benefits may soon accrue to Assam. The Booteahs not only require the produce of the plains for their support but seem disposed to become the customers of the Assamese for various commodities which the latter can either supply by their own industry or procure from Bengal to be exchanged, among other articles for gold….Years of disturbance and foreign invasion between the mountains and the plains have interrupted the intercourse between the mountains and the plains but it has never been broken off, and will now I trust, if not checked by and political misunderstanding annually increase. But the inconvenience, both indirect and direct are insignificant in comparison with the expense to be apprehended from warlike operations, which if defensive must be confined to an unhealthy region at the foot of the hills or if active and offensive, be pursued at the

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imminent hazard of a war with China and without the slightest prospect of any compensatory result.xvi

By 1841, the expansion of British economic interests, had overturned the necessity of maintaining the arrangements in the Assam Duars. This expansion coincided with internal strife in Bhutan between the regional governors and central authorities. Between 1841 and 1865 (the onset of the Anglo-Bhutan War), the Bengal Duars were especially identified as suitable for Tea production, while the dense Sal forests were needed for the expansion of the railways.xvii The Anglo-Bhutan war fundamentally reshaped Bhutan and British relations, along the frontier. The role of disease, in determining the nature of military operations, in the context of Anglo-Bhutan relations was significant. Deliberations on the terms of peace, during the occupation of Dewathang, indicate that ecological constraints on the military were severe and deterred expansion beyond Dewathang: On the Bhutan frontier, the service was dis-liked by the army. The troops in the forts hate monotony, those in the plains as the reserve were sick and the service was inglorious.xviii

As shown in the work of MacKay (2007) of the 5,000 troops deployed in the campaign, 480 died of disease and 1300 were eventually on sick leave.xix The Treaty of Sinchula (1865), which laid down the terms for peace, in the aftermath of the war, led to the final annexation of the Bengal and Assam Duars.xx The Treaty also fixed the boundaries between Bhutan and British India, and subsequently the British withdrew from the newly demarcated Bhutanese territories. Post-1866 the reorganization of the frontier led to the partition of a highly interconnected sub-region into distinct administrative spheres, which reordered earlier socio-economic linkages. This reworking of the frontier, which was driven by elite interests, must be viewed in its totality, whereby it was written over, an earlier process of settlement that was occurring in the Southern foothills and plains, despite the deterrent effects of disease. While the Bodo, Nepali and Adivasi communities, settled in the frontier zones, it is the Nepali community, which especially found itself concentrated in the foothills of Southern Bhutan. The Bodos and Adivasi settlements which developed in the nineteenth century, on the other hand were inside the densely forested plains, which became adjacent to the new international boundary. From the perspective of Bhutan, the loss of its Southern Frontier had significant repercussions for its historical trade linkages. Recent evidence has shown that these trade linkages survived in some form or another, and that the objectives of Bhutanese diplomacy in its southern border, was to ensure that access to markets through British territory. The unequal treaty of 1865, though signed under duress, set the stage for British non-interference in the internal affairs of Bhutan. This principle was further enshrined in the Treaty of Punakha of 1910, an event which was preceded by internal consolidation and the establishment of centralized monarchy in Bhutan.xxi The settlement of the boundary with British India in the Treaty of Sinchula provided a degree of stability, in border relations especially in the area of the Kachari Duars. A description of a Bodo woman weaver, which Endle, in 1910, reflects popular attitudes held by European settlers in the area:

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Indeed, a Kachari woman working placidly and contentedly at the eri loom, singing quietly to herself in sheer happiness of heart, offers perhaps one of the most complete illustrations of the benevolent influence of the Pax Britannica to be found in the wide realm of India, especially when it is borne in mind that less than seventy ago these Kachari Duars were subjects of the Bhutan Rajas, who seem to have harried and plundered in the most cruel and lawless way.xxii

Revisiting the logic of settlement provided by Endle in Chap. 2, one can observe that the act of boundary demarcation did not necessarily percolate down to those communities that were continuously migrating into the frontier areas, prior to the fixing of the new border. The older cultural landscape had enabled a higher degree of social mobility, and in some cases was resilient enough to adapt to the changes brought upon by colonialism. For Bhutan’s Southern Frontier, especially, migration into the forest tracts by settlers from Nepal, was an important historical process, which had significant repercussions for ethnic relations in Bhutan, in the future. Modern day Sarpang which is adjacent to the districts of Kokrajhar and Chirang was one of the major catchment areas, to which this migration occurred. An account by C.J. Morris in 1935 provides some insights into conditions of the Southern Border in the 1930s and the causes of migration: It is said that until some sixty years ago the foothills about Sarbhang were peopled by Bhutanese. About I870 however the Bhutanese are believed to have begun a gradual movement farther into the hills. Until a few years before the Great War the district, which consisted for the most part of dense jungle, appears to have been practically uninhabited; but about 1910 the first of the Gurkha settlers arrived. Prior to this however many Gurkhas used to make annual visits to the district, but they never stayed more than a few months in the hot weather. They came in order to tap the rubber trees, of which there is still a large number, but for the rest of the year they remained at their homes in Nepal. This rubber tapping went on for some years, but eventually the Government of Assam commenced to plant on a large scale, after which it was no longer profitable to the Gurkha owing to lack of proper equipment and ignorance of scientific methods. The systematic settlement and commencement of agriculture by Gurkhas in this part of Bhutan appears to date from this time. There are several reasons for this immigration into Bhutan. Some men for instance told me that in I914 there was a very serious landslide in the Yangrup district of Eastern Nepal. Large numbers of people lost their entire property in this calamity, and hearing that there was good land to be obtained for the asking in Bhutan they decided to emigrate.xxiii

Another, major reason for immigration, which is not mentioned in Morris’ account, is that Nepalis were encouraged to immigrate by Bhutanese authorities (especially Ugyen Kazi) with a view for expanding agricultural output and enhancing revenues.xxiv An early description of Sarpang provides insights into the life in the Nepali settlements. An important observation, made by Morris, was that the dense forest tracts on either side of the border became even more inhospitable during monsoons, minimizing linkages of the settlements with the plains of Assam and Bengal. This allowed these communities to retain aspects of their culture and reproduce their original way of life in geographically similar conditions, without necessarily returning back to their place of origin. The name ‘Chirang’ refers to a district in Bhutan and is not to be confused with the modern Chirang district in India: A mile or so beyond the frontier is a big clearing in the forest, and here is Sarbhang, the principal and indeed the only market for the people living in the Chirang district. It consists

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of about forty thatched huts, all occupied by Nepalese. The inhabitants live here throughout the year and rice is grown in the surrounding fields. Every Sunday throughout the year a Haat, or market, is held and practically the entire adult population of the district regularly attend. They bring down oranges, potatoes, mustard, and a certain amount of rice from the hills. These they sell or exchange for salt, which is unobtainable in the hills. I also saw many stalls where cheap cotton goods, necklaces, and mirrors could be obtained, and there was a brisk sale in umbrellas. Oranges are obtainable here at one hundred for eleven annas (about one shilling), and the market rate for rice at the time of my visit was 36 lb. for one rupee (one shilling and sixpence). Most of the oranges are exported by Bengali traders who either visit or have agents in these various markets. Chirang, which gives its name to the district, is about 5000 feet above sea-level. It is only one of many villages, but the name is used to denote the whole of the settlements in this area. There are said to be about one thousand houses in Chirang, exclusively occupied by Nepalese, and beyond the Bhutanese official who accompanied me I saw none but Gurkhas in the whole area. The Bhutan Government does not in any way interfere with its Nepalese settlers, and provided they pay their taxes they are entirely free to live as they wish. It follows therefore that the system of village administration which has gradually come into being is based on that existing in Nepal, only slightly modified to suit local conditions.xxv

Recent research has shown that British imperial attitudes towards Bhutan, especially at the time of the Duars war, involved racial constructions that provided ideological justifications for the annexation of territories seen as lucrative by the varied political interests (such as Tea and Timber).xxvi Skillful diplomacy by Bhutan and the deterrent effect of disease, topography and ultimately the opening of the direct trade route into Tibet via Sikkim, allowed Bhutan to avoid the adverse impacts of direct colonial rule.xxvii As shown by McKay, the Sikkim Gazetteer of 1928 states: No one wishes to explore that tangle of jungle-clad and fever stricken hills, infested with leeches and the pipsa fly, and offering no advantages to the most enterprising pioneer. Adventure looks beyond Bhutan; science passes it by as a region not sufficiently characteristic to merit special exploration. Our policy towards the Bhutanese, therefore, is determined solely by considerations of geographical position and diplomatic expediency.xxviii

The avoidance of direct colonial rule was a significant factor in determining the trajectory taken by Bhutan’s health system in the future. Thus, Bhutan’s external relations were to be conducted under the shadow of British imperial rule, and the monarchy in Bhutan was able to gradually build a public health strategy without external interference and was free to draw on external assistance based on its own domestic imperatives. Although, Bhutan relied on foreign assistance to introduce modern medicine, these medical missions could not dictate the trajectory taken, due to the principle of non-interference that was enshrined in the terms of the treaties discussed earlier.xxix While, the structures of a modern health system did not necessarily exist then, there was still substantive Royal patronage for medical improvements. In the case of Southern Districts, communities relied on health institutions in India. For instance, patients from Bhutan would access hospitals in the Tea Plantations of North Bengal.xxx Yet, crucial decisions by the Bhutan Government, once British power receded and that Treaty relations with India were stabilized, set a completely new trajectory, for self-sufficiency and quality healthcare. This especially found expression in Bhutan’s choice of selecting a state-based public health system with marginalization of private practice. In contrast, in colonial

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Assam and Bengal, the provision of health services for the colonial authorities was a low priority and there were recurrent outbreaks of epidemics.xxxi Health coverage was minimal and there was insignificant funding for healthcare services in rural areas. This was combined with a de-recognition of practitioners of traditional medicine. Furthermore, epidemics were only acted upon, when they would possibly lead to excessive mortality in the Tea plantations. In Bengal and Assam, Tea plantations became central to the early research for cures for ‘Tropical’ Diseases (such as Malaria and Kala-Azar), but remedial measures were mainly limited to European enclaves and metropolitan centers.xxxii In the case of independent India, the trajectory of the health system reflected a continuation of the previous system of mixed healthcare provision and in the post-liberalization era, leaned towards excessive privatization.

7.4 Open Border, Bilateral Treaty Arrangements and Key Achievements in Healthcare Bhutan’s acceptance of the terms of the Treaties of Sinchula and Punakha, substantively reduced its sphere of influence, in terms of its ability to project power and exercise suzerainty over the frontier Rajas. Events in India, including the anti-colonial struggle, participation in two world wars and partition, brought about immense suffering, the effects of these upheavals did not impact on the existing arrangements between British India and Bhutan. The loss of sizeable portion of its territory forced Bhutan to define its core interests. The maintenance of these foreign policy goals echoed across the formal Treaty Arrangements with both: British India and Independent India. First, which was described earlier was the principle of non-interference in its domestic administration. Second, the maintenance of free transit arrangements for its goods and people, as the shortest route connecting the border districts passed through British India.xxxiii In contemporary times, this is also relevant for trading relations with Bhutan’s trade linkages with Bangladesh which utilize the same transit routes.xxxiv Article V of the text of the 1949 Treaty with India, stated that: There shall, as heretofore, be free trade and commerce between the territories of the Government of India and of the Government of Bhutan; and the Government of India agrees to grant the Government of Bhutan every facility for the carriage, by land and water, of its produce throughout the territory of the Government of India, including the right to use such forest roads as may be specified by mutual agreement from time to time.xxxv

Article 3 the 2007 India–Bhutan Friendship Treaty expanded the scope of the clause, by stating that: There shall, as heretofore, be free trade and commerce between the territories of the Government of Bhutan and the Government of India. Both the Governments shall provide full cooperation and assistance to each other in the matter of trade and commerce.xxxvi

External relations for Bhutan under Article II of the 1949 Treaty of Perpetual Peace or Friendship was to be ‘guided by the advice of India’,xxxvii a clause which the

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2007 India–Bhutan Friendship Treaty excludes. Rather the Treaty of 2007 re-affirms ‘respect for each other’s independence, sovereignty and territorial integrity’.xxxviii These textual interpretations have important implications for bilateral and multilateral cooperation for health, especially in Bhutan’s ability to diversify its public health strategies. These interpretations, must also be complemented with an understanding of community-level linkages. The Bhutan–India treaty arrangements are one of the few such diplomatic agreements whereby the text of the treaties closely reflects older interdependencies albeit in a modified form. As mentioned earlier flows of good and people which were seemingly routine in the past, across permeable conceptions of sovereignty, all became transboundary problems. The mutual recognition of sovereignty was an extremely graduated process and at the time of the 1949 Treaty of Perpetual Peace or Friendship, Bhutan was not a member of the United Nations (UN) or any other international body. It is only in 1962 that Bhutan entered the Colombo Plan and became a member of the United Nations in 1971.xxxix Its formal bilateral diplomatic relations with India were further upgraded in 1978 with the establishment of Embassies in both countries.xl This is not to state that the open border was not problematic. The open border regime and increasing infrastructure assistance by India (as well as economic activities) did make Bhutan vulnerable to disease outbreaks. Furthermore, response to these disease outbreaks was limited by the principles enshrined in the 1949 agreements, where India partially mediated Bhutan’s external relations. This was especially seen in the history of Smallpox Eradication. In 1966, there was an outbreak of Smallpox in Thimpu that was attributed to Indian and Nepali labourers in road building projects and was followed by subsequent outbreaks in the southern border districts in 1967, 1973 and 1974.xli All the cases originated in either Assam or West Bengal especially through prolonged contact in border markets or infrastructure projects, yet the WHO (World Health Organization) was unable to investigate the pattern of transmission these outbreaks. The work of Sanjoy Bhattacharya (2011) establishes that in responding to these outbreaks, the WHO, which was unable to access either Bhutan or the border districts of Assam, ultimately accepted epidemiological findings that were provided by India (especially through data collected by military units).xlii This acceptance occurred despite parallel sources of data existing on incidence of the disease, which was independently verified. Moreover, the committee responsible for certifying Bhutan as Smallpox free, included both India and Bhutanese health professionals, who designed ‘Operation Small Pox Zero’.xliii Bhutan occupies a precarious position, i.e. as a landlocked country with unfenced borders located between China and India. The values-centric stance of Bhutan as a promoter of non-violence and peace combines with the close foreign policy relationship forged with India. The actual success of its diplomatic strategies can especially be seen in Bhutan’s focus on social welfare spending that lead to some remarkable achievements in the healthcare sector. At the heart of these achievements lies a set of reforms enacted through the various 5-Year plans. The effects of these reforms can be gauged from a few historical statistics. In 1961, there were only two hospitals, 11 dispensaries, three doctors, two nurses and 12 compounders.xliv Since then Bhutan’s heath sector expanded exponentially. In 1972, there were 39 health facilities

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of all categories.xlv By 1991, this had expanded to 160 facilities.xlvi This focus on healthcare has made steady progress, and in contemporary times, there are 31 Hospitals including a National Level Referral Hospital (at Thimpu), 2 Regional Level Referral Hospitals (Gelephu and Mongar), 178 Basic Health Unit (BHU) Clinics and 654 Outreach Clinics (ORCs) across all 20 districts and 201 sub-districts.xlvii Most importantly, all referrals across the system, including international referrals, are funded by the government, which invests 5.7% of its budget in healthcare (with the right to free healthcare enshrined in the constitution).xlviii Furthermore, Bhutan has retained a deep commitment to Traditional Medicine, with all Dzongkhag level facilities having a Department of Traditional Medicine.xlix In terms of immunization, by 1991, 84% of all children less than 4 years old had been immunized based on the goals of Universal Child Immunization set by the WHO/UNICEF.l Other arenas that support health also saw steady progress. Between 1972 and 1991, the number of school-going children had increased from 12,000 to 70,000 and the total number of educational institutions had expanded from 100 to 316.li In 1972, whereby there was no provision for safe drinking water and sanitation, by 1991 about 2,000 rural drinking water facilities and 1800 latrines for better sanitation had been installed.lii Ironically, in the late 1980s and 1990s one of the biggest challenges facing these developmental outcomes and long-term economic reforms was neither epidemics nor natural disasters, but political consolidation by the communities residing in the once sparsely populated forest tracts (on the Indian side of the Border) and foothills (on the Bhutan side). This wave of unrest especially affected the major southern Dzongkhag of Sarpang which is contiguous to modern-day Kokrajhar and Chirang Districts. While seen as a cluster of huts in the account by Morris, Sarpang underwent a gradual modernization to become one of the critical districts for Bhutan, especially in terms of malaria elimination strategies. These strategies significantly enhanced living standards in Sarpang and the urban centre of Gelephu. This was achieved despite the confluence of two major political upheavals, which created significant disruptions in the pattern of cross-border relationships at the community level. The first was ethnic unrest between Bhutanese and the Nepali community which became a major crisis by 1990; and the second was the spillover effects of the Bodoland agitation and the multifarious insurgencies that emerged in its aftermath. Both events had a direct bearing on the securitization of a once open border. Though the former did not fundamentally challenge the India–Bhutan treaty relationship, the latter problem became one of the most serious foreign and security policy challenges confronting Bhutan, which ultimately culminated in a brief but violent armed conflict, which marked Bhutan’s first military campaign since the Duars war.

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7.5 Destabilization of the Border 7.5.1 The Citizenship Question and Civil Strife in Bhutan There is a clear consensus on Bhutan’s importance to India’s security strategy. Very few of the works connected with analyzing these developments have incorporated community-based perspectives into their analyses or alternatively provided analytical frameworks that allow assessments of sub-regional impacts of these shifts in security strategy. Bhutan’s importance to India’s security architecture was initially viewed purely through the lens of the bilateral relationship between China and India; and, China’s own claims of suzerainty over Bhutan. Bhutan’s vulnerability vis-à-vis China was especially seen in China’s occupation of Tibet, the consequent influx of Tibetan refugees. Further, in the 1962 India–China war, Bhutan became a safe haven and transit route for Indian army units in the aftermath of the hostilities.liii The primary geopolitical threat for Bhutan until then was from its Northern borders. Instead, unexpectedly future events dictated what was to be the fundamental shift in the understanding of the Southern border, with the onset of the long cycle of unrest and agitation, especially in Assam (a history that has been addressed in earlier chapters). As stated by Dorji Penjore: While its limited security forces were guarding northern borders, all was quiet on its southern front because an excellent Indo-Bhutan friendship was thought to have guaranteed it. There was not a single security post along the southern border. It turned out to be ironic that the major security threat in recent years came from its unguarded southern border.liv

The shift from a demilitarized border zone to a militarized one, implied a fundamental change in Bhutan’s security scenario, especially towards the Southern Border. Earlier, there was no administrative interference with the border population concentrated in the Southern foothills, and inter-ethnic relations were amicable. The situation gradually changed, with the initiation of political reform. The genesis of this conflict can be traced to the increasing political activism of the Nepali community, under the aegis of the Bhutan State Congress (BSC) that was formed in Patgaon (under the then Goalpara District of Assam) in 1952 and various other political formations.lv Changes in the citizenship criteria, which were first defined as a response to the issue of Tibetan refugees, led to the passage of the 1958 Citizenship Law.lvi This was altered in 1977 and 1985.lvii Further proposals connected with administrative arrangements towards the southern border districts (especially the conduct population census and development of a Green Belt) resulted in mass protests.lviii By the early 1990s, the situation transformed into one of large-scale violence and consequently an internationally recognized refugee crisis (with several thousand fleeing to Nepal and some eventually resettling in the adjacent districts in India). lix It is also important to note that this phase of protests in Bhutan also coincided with the Gorkha National Liberation Front (GNLF) agitation in India. This movement occurred in North Bengal, for a separate Gorkhaland state in India for the Nepali speaking population in the hills.lx Just as we have seen in Bodoland, the overall

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violence experienced on Bhutanese territory consisted of several discrete events and categories. This low-intensity violence also overshadowed the gradual inroads being made into Bhutanese territory by the armed organizations into its territory. One of the important impacts of the protests in southern Bhutan was the damage to infrastructure including health facilities, and low-intensity violence, but not a fullblown insurgency. In addition, there were also measures at peace and reconciliation subsequently, but at this stage evidence is purely observational and anecdotal. At the same time, these models there were also cases of health workers being attacked and medicines being looted, but there are no statistics of these incidents being provided. Prior to the armed conflict of 2003, this phase of civil unrest was also marked by low-intensity cross-border violence. By 1998, the following statistics in Table 7.2, extrapolated from the Proceedings of the National Assembly of Bhutan, give an index of the internal security situation that emerged as a consequence of the protest movements. Table 7.2 Violence due to Civil Unrest 1990–1998 in Southern Bhutanlxi Serial Number

Nature of Incident

Number of Reported Incidents

1

Murder

72

2

Kidnapping

241

3

Injuries

692

4

Rape

63

5

Attacks on Security Forces

67

6

Injuries to Security Personnel

41

7

Armed Robberies

1028

8

High jacking of Vehicles

63

9

Killing of Members of Armed Group

12

10

Destruction of Houses

66

11

Arrests of Members of Armed Group

118

12

Destruction of Health Institutions

12

13

Burning and Bombing of Schools

29

14

Damage to Forest Office

21

15

Damage to Guest Houses

5

16

Damage to Revenue and Customs Office

4

17

Destruction of Agriculture Centers

4

18

Destruction of Irrigation Channel

1 (Teklai) in Gelephu cost Nu. 48.860 million

19

Destruction of Electric Pylon

17

20

Destruction of Bridges

16

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7.5.2 Entry of Militant Organizations from India and Armed Conflict in Bhutan 7.5.2.1

Discovery of Militant Camps

In addition to internal civil strife, the major disruption in the southern border was directly connected to the actions of the militant groups, who have played a significant role in several of the events discussed in the book until now. The early 1990s marked an important shift in the entire security scenario from the perspective of Bhutan. The strategic decision of various armed organizations in India (especially ULFA, NDFB and KLO) to enter Bhutanese territory and establish camps inside the southern border districts from the early 1990s posed geopolitical challenges of an order that had not faced the country since intervention by the British in the previous century. Until then endemic malaria and deep forests had proved to be a suitable deterrence against incursions in the distant past. Yet, the ingress of armed organizations into the once seemingly impenetrable forest areas drove Bhutan to fundamentally rework the nature of its security strategy. Conflict in Assam, which had only indirectly impacted Bhutan, now drew the country into the ambit of India’s regional counterinsurgency strategy. With such a large presence of armed actors across a vast front, which extended across modern-day Dzongkhags of Chhukha, Dagana, Pemagatshel, Samdrup Jongkhar, Samtse, Sarpang and Zhemgang (see Fig. 7.1), it is imperative to have an understanding of developments that occurred in the area. The location of Sarpang especially became critical, given that it adjoins Kokrajhar district (of which Milon was then a part). Of all the armed groups involved, the cadres of BLTF, although situated in Bhutan at various times, were able to exit well prior to the 2003 Operation All Clear (i.e. the military operation led by Bhutan against KLO, NDFB and ULFA). The positioning of these camps and the manner in which they were established is still open to interpretation. In terms of the discovery of these training camps, it can be inferred that ULFA had initially entered Bhutan in 1992 (taking advantage of the unrest in South Bhutan) for a variety of reasons, most importantly them being the increased deployments of the Indian Army.lxii One of the earliest references to what became known in the National Assembly of Bhutan as the ‘ULFA-Bodo problem’ coincides with the unrest of the late 1980s, and the first phase of the militant violence. In these incidents, we do not have evidence of temporary or permanent camps being set up. There are reports of about 1,000 Bodos taking refuge in Bhutan in Samdrup Jongkhar in 1989.lxiii There were early reports on problems of safety for Bhutanese transiting through India and also the possible obstacles that would be created to the Dungsam Cement Project due to the Bodoland agitation.lxiv By 1998, this flagship project had experienced serious delays due to risks envisaged as a consequence of insecurity on transit routes for equipment and labour.lxv In Pemagatshel, the winter border trade at Chowki was being disrupted by militants, who were also engaging in illegal fishing and poaching inside Bhutan.lxvi A group of militants was also sighted

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upto 15 kms inside Bhutanese territory.lxvii It is only in 1997 that a serious cognizance is taken, of the extent of the militant problem. There were increasing number of reports received of a more permanent presence of militants and also incidents of Indian troops entering Bhutanese territory.lxviii In addition to the Dungsam Cement Project, militancy had also started impacting the Kurichhu Power Project.lxix One of the earliest discoveries of camps was by the Forestry Division under the then Ministry of Agriculture: The Deputy Minister for Agriculture said that the Forestry Division under the Ministry of Agriculture carried out patrols in all the Dzongkhags for the protection of the wildlife sanctuaries and reserve forests. For the areas in the south bordering Assam, forestry patrols were conducted regularly in Kalikhola, Sarpang, Manas, Nanglam, Samdrupjongkhar, Bangtar and Daifam. While patrolling the forests in these areas the forestry patrol teams had encountered groups of well armed ULFA and Bodo militants dressed in military uniforms. The forest guards, however, could not confront the militants who carried sophisticated weapons while they themselves were very poorly equipped. Such incidence have been reported by the Agriculture Ministry to the government.lxx

In addition to threats from militants, there was ambiguity regarding the role of Indian security forces. Apart from regular reports of harassment and checking of Bhutanese vehicles, raids by Indian troops in Sarpang were reported. An incident from 1998 is indicative of these problems: The Kalikhola Chimi submitted that the people of Nichula Geog in Kalikhola Dungkhag would like to report that on 19th May 1998, about 165 armed Indian soldiers from across the border entered Allay and Katarey villages in Nichula Geog and terrorised the people. All houses in the villages were raided and their belongings, including official documents of the Gup, were thrown all over the place. A total of Nu. 65,000 was looted from the houses and eight people were severely beaten up.lxxi

By 1999, we find the overall deterioration in the situation. The outlay of the Kurichhu Hydel Project had by then increased to Nu. 4,000 million from its original outlay of Nu. 2,500 million.lxxii We also see direct reference to the attacks on Gelephu–Bongaigaon road in and around Milon: The Sarpang Dzongda clarified that the Bhutanese travelers were attacked between the Gelephu checkpost and in a forested place called Bangulu in Deosiri in Assam. In the last 18 months since November 1997, thirty-three vehicles have been robbed including two vans of Bhutan Posts and Telegraph. Of these 33 vehicles, 24 belonged to private individuals, six were Government vehicles and three were vehicles of Government of India personnel working in Bhutan. Apart from these, it is also reported that many other Indian vehicles had also been attacked. Such attacks were perpetrated mainly by the ULFA militants fighting for the independence of Assam from India, Bodos fighting for a separate state from Assam and the Santals who were in conflict with the Bodos.lxxiii

7.5.2.2

Escalation

From 1997–1998 onwards, we also gradually see an escalation in the severity of the problem. One of the first attacks was the killing of four Bhutanese policemen and injuries to three others in August 1997 in Nganglam; an attack that was attributed to

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the armed organizations from India.lxxiv Bhutanese security forces travelling through India were also ambushed and there is confirmation on the presence of 21 camps inside Bhutanese territory.lxxv With parallel negotiations starting with ULFA and NDFB, from 1998 onwards, we see the increasing reluctance of the groups to either accept the existence of the camps or dismantle the camps and exit Bhutan. Apart from the unwillingness to send high-level functionaries for negotiations, the militants increasingly obstructed routine developmental work by Bhutanese officials. One of the approaches taken by 1999 was a policy of blocking the supply of food from Bhutanese shops to militants and a decision to arrest anyone suspected of assisting them under the National Security Act.lxxvi This was leading to threats on shopkeepers. For instance, it was reported from Pemagatshel that: ……because shops in Panbang were closed down whenever the militants arrived, they had warned the shopkeepers that they would one day blast their shops. The militants had told people in Changnar Zam that they faced no difficulty in getting supplies from other places but the shopkeepers in Panbang kept their shops closed whenever they came. The Chimi (local official) submitted that the people lived under constant fear on account of the militants and requested the government to consider providing adequate security for Panbang Dungkhag.lxxvii

By 2001, the increasing threat on shops had extended to other border towns as well: …...that the shopkeepers in the border town of Kalikhola, Nganglam and Bhangtar had closed down their shops and decided to move out from these places to ensure that the militants could not obtain any supplies from them. The closing of these border towns have caused great economic loss and hardship to the shopkeepers and tremendous difficulties and problems for the local people in the nearby areas.lxxviii

Between 2001 and 2002, the establishment of these camps also meant the adjacent forest areas on the Indian side became a buffer zone and extremely crucial to the overall politico-military survival of the organizations. Protection of these interests led to extreme brutalities, in the immediate vicinity of Bhutan, which attracted the attention of both the Bhutanese and Indian authorities. The first set of attacks were directly on Bhutanese citizens and led to temporary closure of travel for Bhutanese on National Highway 31 in Assam. This was an arterial road in India that was utilized by Bhutanese to travel between the border towns Samdrup Jongkhar, Gelephu and Phuentsholing. Another set of attacks were massacres of Indian citizens living on the Indian side of the border, of which the Dadgiri massacre gained notoriety. Some of the major attacks on Bhutanese citizens include the following: • On 20 December 2000, two trucks, one belonging to the Royal Bhutan Police (RBP) and the other belonging to a private citizen were set on fire near Santabari, Assam.lxxix • On 20 December 2000, a vehicle belonging to the Samdrup Jongkhar Dzongkhag administration was hijacked and burnt down. Its passenger Sonam Dorji, the Dzongkhag Registration Officer and the driver, Tandin Dorji were kidnapped and they were released only three days later.lxxx

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• Two buses coming from Samdrup Jongkhar to Phuentsholing came under heavy gunfire near Gossaigaon on the then National Highway-31 in Assam. The driver and a passenger of one of the buses were killed and 19 passengers were injured. There were 33 bullet marks on one bus and 22 bullet marks on the second bus.lxxxi • On 21 December 2000, a truck belonging to a businessman from Nganglam was stopped on the road from Highway-31 to Nganglam at a place called Rangapani. An amount of Nu. 10,000 was taken from its owner and he was along with the truck. Ten passengers were kept behind as hostages. When the Royal Bhutan Police at Nganglam went to check the next day on 22 December, they found the bodies of all 10 hostages at the site of the incident.lxxxii • On the same day, a group of Bhutanese trading soya beans was attacked at their camp in Bangmari, Assam. Their huts were burnt down and one man was shot dead and another was seriously injured.lxxxiii • On 31 July 2001, a landmine on the road between Sarpang and Gelephu, was detonated under a truck belonging to the Manas National Park. Five persons were killed, including the son of representative of the National Assembly and eight persons were injured, including a four-year old girl.lxxxiv The massacre at Dadgiri village (in the vicinity of Milon) was another such incident. In a single incident alone 22 persons were killed, 15 persons including six belonging to a police rescue team were injured. The Asian Age of 28 October 2002 provides a description of the massacre, which occurred less than two kilometers from the modern-day Bhutan gate: …...militants at 2.00 a.m. on Sunday cordoned off Dadgiri village under Runikhata police station and singled out persons who had migrated to the village very recently from the bordering districts of West Bengal. They abducted 31 villagers and took them near Gelenphu road, about 2 km from the Indo-Bhutan international border. The militants then asked the villagers to stand in line before they brutally gunned them down. Twenty-two villagers died on the spot, while nine others were seriously injured. The injured were taken to a hospital in Bhutan. The victims have been identified as Bihari Muslims and Nepalis who work as daily wage earners, cart-pushers, rickshaw pullers and petty businessmen trading goods across the border to Bhutan. A villager then misinformed the Runikhata police station that personnel of the Royal Bhutan Army had shot dead the villagers. On receiving the information, a police team immediately rushed towards the area where a landmine had been planted under a culvert on the Bhanga river by the militants. The mine blast was followed by indiscriminate firing by the militants who were lying in wait on either sides of the road.lxxxv

In a subsequent report, it was found that there was no security post in Dadgiri (which was a Recognized Forest Village and still is an RFV) in the immediate vicinity of the border (See Photo in Appendix 1). Moreover, residents had already been paying a ‘tax’ to the militants, ranging from Rupees 2,000–20,000 and survivors said that the massacre was unexpected.lxxxvi

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Armed Conflict on Bhutanese Territory and Its Aftermath

There is now clear evidence that militants did not enter Bhutanese territory as a short-term strategy. In many cases, they crossed over into Bhutan with their family members.lxxxvii The topography of the border districts of Bhutan (which was an unguarded open border), the thick forest cover and rivulets, as well as contiguity with Assam and North Bengal made it more secure than locations such as Bangladesh or Myanmar. Reports from around 2003 testify to the extent of the militant presence. For Bhutan, there were three major challenges. First, the supplies for the militants was coming in from villages across the border, through unguarded routes.lxxxviii There was a fear expressed in the National Assembly that attacks on militants on Bhutanese territory might lead to violence and protests, in the villages in Assam from which these groups drew their support.lxxxix The second problem was the extent of the camps and the depth of the camps within Bhutanese territory. The third was the that despite five rounds of protracted negotiations between the armed organizations and the Royal Government of Bhutan (RGoB) there were no indications of the groups willingness to exit Bhutan peacefully. Rather there was a creation of newer camps in direct defiance of the various National Assembly Resolutions, including one ULFA camp being opened on the strategic Samdrup Jonghkhar-Trashgang highway in the interior of Bhutan.xc From a military perspective, with approximately 5,177 security forces deployed by 2003 across the East and Southern Dzongkhags,xci Bhutan did not enjoy adequate advantages in terms of manpower or firepower when compared to the armed organizations in the early stages. What we see is the National Assembly Debates progress in important contingency plans (including the creation of pre-designated relief camps, emergency funding and pre-positioning stocks of essential supplies).xcii The theme that emerges is the creation of a singular alignment between national strategic objectives and society-wide mobilization, which enabled the RGoB to proceed with the operation by December 2003. What the Bhutanese security forces did have as an advantage was the fact that they were fighting in their own territory and had very good access to information on the location of these camps. At the peak of the crisis, Indian estimates showed approximately 4,000 militants were living in camps inside Bhutan. The report shows that at the time of its filing, the organizations were facing extensive food crises: North-east separatists holed up in camps inside the Himalayan kingdom of Bhutan are facing acute food shortages with federal troops choking their ration supply routes, officials said. On Friday, an Indian Army patrol along the Bhutan border apprehended 10 porters from Assam carrying food supplies for the militants. “The porters were released but we arrested one ULFA militant who was leading the group into camps in Bhutan with huge stock of food grains and other essentials,” an Army statement said. Militants of the outlawed United Liberation Front of Aosm (ULFA) and the National Democratic Front of Bodoland (NDFB), both fighting for independent homelands in Assam, were forcibly collecting rations from border villagers to the meet the crisis according to the statement. Both the ULFA and NDFB have well entrenched bases in Southern Bhutan from where they carry out their hit-andrun guerrilla strikes on federal soldiers in Assam. Intelligence officials say there could be more than 4,000 ULFA and NDFB rebels in Bhutan. “A few arrested militants said during

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interrogations that cadres were facing the worst winters in the Bhutan jungles with food shortage adding to their woes,” an intelligence official said. “A number of militants in the Bhutan camps were hit by disease but with troops blocking the entry and exit routes along the border, they were unable to get medicine supplies and other essentials,” the official added. Bhutan has admitted that ULFA alone has six camps in the country, including the outfit’s general headquarters and military training bases inside the thick jungles of in the Southern Samdrup Jongkhar district. The NDFB has seven camps in the tiny Buddhist Kingdom.xciii

Official estimates by the RGoB submitted to the National Assembly showed a slightly lesser number: ULFA had eight camps with about 1,560 militants, NDFB had eight camps with about 740 personnel and KLO had about 430 militants (with camp numbers unknown).xciv The question of military operations, conducted inside Bhutan, by Indian troops was ruled out by Governments on both sides. Yet a report in The Sentinel of 8 January 2003 highlights the depth to which camps had been established in Bhutan’s territory (and also the ambiguity surrounding the situation): The outlawed NDFB today claimed that a 60-hour shootout inside Bhutan between its cadres and the Indian Army that began on Sunday has left several of its men and ten Indian troopers killed. A statement from NDFB’s ‘western command’ ‘commanding officer’ A. Goyari and his deputy Mahiraja Basumatary received by local newspaper offices said that a 50-member Indian Army contingent attacked the group’s Kawapani ‘battalion’, 45 kilometer inside Bhutan on Sunday, leading to the shootout. The NDFB statement claimed that in the 60hour gun battle, 7 of its cadres besides 10 Indian soldiers died and 15 other Indian Army men sustained injuries. They also claimed to have seized several weapons from the Indian troopers. A top army official contacted by this newspaper at the IV Corps headquarters at Tezpur said no such incident has taken place. “There is no question of the Indian Army entering Bhutan to raid NDFB or any other Indian rebel bases inside that country,” the Army official said on condition of anonymity.xcv

The continuous violence at the border, especially cross-border attacks on Indian security forces, led to increasing pressure on the Bhutanese authorities to act against the militant groups. While the preconditions for Operation All Clear (December 2003-January 2004) have been mentioned earlier, a catalyst was possibly the formation of an armed group inside Bhutan, consisting of Nepali dissidents, and encouraged by KLO, NDFB and ULFA. The Assam Tribune of 17 July 2003 hints at the formation of the group, Bhutan Gorkha Liberation Front (BGLF). The outfit was to be based in southern Bhutan with the ULFA, NDFB and KLO providing weapons training and logistical support. As the report states: The development is seen by Delhi as an attempt by the underground outfits of the Northeast to scare the Royal Government into submission. The Royal Government of Bhutan which has been pressurizing the ULFA and KLO to shut shop and leave may be weary of keeping up the pressure that it now has a new front to tackle. The birth of a new outfit came in even as ULFA ignored yet another deadline to quit Bhutan. The June 30th deadline of the Royal Government of Bhutan was the eighth deadline ignored by ULFA. What is even more interesting is during a debate in the ongoing session in the National Assembly of Bhutan, several members brought to the notice of the Royal Government that ULFA was about to start fresh training programme of its cadres from this month in the Kingdom. Speakers after speakers urged the Royal Government to take note of it and act. The Royal Government in the last session of the Assembly had given a deadline to the ULFA to shut down its headquarters first and then fold up its training camps.xcvi

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On 15 December 2003, Operation All Clear was launched against the militant presence in Bhutan, with Indian support for logistics and medical evacuation. How the operation transpired and the exact details in terms of casualties are not fully known. Broadly speaking, the operation, which was conducted under direct command of the monarchy, was militarily successful, and served as a deterrence against future incursions. An assessment, which was done after the military operations were completed showed that the scale of the militant problem was extensive. Official figures state that 144,000 rounds of ammunition and 841 firearms were captured in addition to light artillery and anti-aircraft weapons.xcvii Thirty camps and 35 training centers located across Samdrup Jongkhar, Sarpang, Zhemgang and Samtse Dzongkhags were destroyed, while 485 militants and an unknown number of women and children were handed over to the Indian authorities.xcviii

7.6 Conflict and Border Malaria Official accounts on institution building of Vector Borne Disease Programme (VDCP) based in Sarpang (which is the centrally mandated agency for surveillance, control and elimination of vector borne diseases across the entire country) do not mention any impacts of the conflict situation, despite the situation in Chirang and Kokrajhar that has been documented in the book.xcix Deriving the impacts of the conflict on Bhutan’s health system becomes extremely challenging. For instance, a major policy document of VDCP provides detailed narrative on its organizational development. Yet, this account of institutional development does not seem to be punctuated by any major disruptions despite extensive armed activity in the border areas. The studied silence on spillover effects of conflict on the Indian side is contrary to the cross-border perspective under which one must take into consideration the connections between similar units of analysis on both sides of the border. We ask the question that if health provision in the border areas on the Indian side were significantly impacted by conflict, were health services in Bhutan also impacted? The problem of Cross-Border Malaria has found continuous mention in the scientific literature under consideration. As a concept, the WHO defines, Border Malaria as ‘malaria transmission or potential for transmission that takes place across adjacent administrative areas that share an international border (or lie at a specified distance from an international border)’.c Further, it is clearly specified that the problem of ‘Cross-Border Malaria’ has two components: a) transmission linked to the movement of infected people across borders; and b) transmissions that occur as vectors across the international land boundaries or are concentrated adjacent to them.ci The problem of cross-border malaria is also linked to political factors. The WHO recognizes that: ‘Border malaria may also occur due to limited or no access to malaria prevention, diagnosis and treatment interventions and sub-optimal surveillance response as a result of the remoteness and/or political complexity of border areas’.cii Addressing the problem of border malaria requires innovative solutions given that reduction in transmission can be hampered by: ‘political unrest, difference of social and economic

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development, weak surveillance and response systems, insufficient access to health service, and differences in national malaria policies, treatment-seeking behaviours and other factors’.ciii The questions being raised go well beyond the immediate science of malaria prevention and elimination, but rather places the problem in terms of coordinating the developmental trajectories of the impacted nations. Until now, only two accounts provide some indication of the impacts of the conflict on Bhutan’s health system. The APMEN Report of 2009 acknowledges the weak state of health service provision on the Indian side to shortages of services and supplies due to conflict, which hampered cross-border collaborations. Further, the report provides one instance where the main hospital in Gelephu was overburdened by cases emanating from India in the 1990s.civ A recent report of 2015 directly states that the militant activities hampered health services in Bhutan. Bhutan’s Malaria control and elimination strategy was an example of routine cross-border collaboration. India was instrumental in establishing and supporting the National Malaria Eradication Programme (NMEP) which was started in 1965 (after the first National Malaria Survey of 1962).cv This subsequently became the National Malaria Control Programme (NCMP) in 1985 with the programme being fully administered by Bhutan. The NCMP transformed into the VCDP in 2003, with the responsibility of preventing diseases such as malaria, dengue, kala-azar and Japanese encephalitis. Post-1985, the situation is described by the APMEN Report: Over the years, several efforts were made to establish cross-border mechanisms for Bhutan and India to improve malaria control, surveillance, information sharing, and research. For instance, in the beginning years of the malaria control programme, IRS campaigns were synchronized along the border: IRS coordinators would meet at the border, celebrate, then spray two kilometers along each side of the border.cvi

However, the contemporary literature re-affirms that cross-border collaboration is weak, and we do not find a mention of these early efforts. In order to make a preliminary assessment of the impact of conflict on malaria control in Bhutan, two sets of historical data are analyzed to identify key trends being discussed above. We provide data on fatalities occurring in the course of militant violence in various stages of the Bodoland Agitation between 1992 and 2012. This is taken as an index of violence on the Indian side. Casualty data is drawn from the SATP data series on militant violence pertaining to the Bodoland Movement from 1992–2001 and casualty patterns from BTAD districts 2001–2012. A second set of data is drawn on historical data available on the Slide Positivity Rate (SPR) in Bhutan. We use SPR rate in and around transformation of the NMEP to the NMCP as it marked a cut-off point where it is fully staffed by Bhutanese health personnel (Figs. 7.2, 7.3). A parallel reading of the two trends indicate a very tenuous relationship between the violence and unrest connected in Assam, and the spike in the SPR rate, which climbed steadily from 1986 onwards. In addition, there is a small spike in 2008– 2009 which coincides with an increase in Indian patients, in the Sarpang Dzongkhag Hospital.cix This also coincided with the 2008 violence between Adivasis and Bodos in Kokrajhar. This correlation is tentative at best, and a reading of VDCP’s institutional development which was written in 2015, clearly mentions that the rise in

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Analysis of 2320 FataliƟes AƩributed to Miitant Violence and Bodoland AgitaƟon in India: 1992-2012 400 350 300 250 200 150 100 50 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Fig. 7.2 Analysis of Militant Violence 1992–2012cvii

Slide PosiƟvity Rate (SPR) Historical Trend for Bhutan 1983-2012 45 40 35 30 25 20 15 10 5 0

Fig. 7.3 Slide Positivity Rate for Bhutan 1983–2012cviii

Malaria cases was a combination of a number of factors. These include decentralization of control to the Dzongkhag level, reduction in IRS (Indoor Residual Spraying), stock out of medicines and discontinuing of voluntary labour scheme, resistance to chloroquine for P. falciparum treatment and cross-border daily wage labour.cx As the report states, there was a major impact arising out of conflict: In the 1990s Bhutan was also affected by the armed insurgency in Assam, India. Indian separatist groups established illegal camps in Bhutan’s southern forests, from which they were not ousted until 2003. Because of this instability, malaria control and prevention in the southern villages became very difficult, and active surveillance and IRS activities were halted. Early DDT resistance and resistance of P. Falciparum infections to chloroquine and sulfadoxine-pyrimethamine were also noted during this time. As a consequence, malaria cases rose to the highest ever recorded number—39 852—in 1994, with 62 malaria related deaths; 42.3% of cases that year were due to P. falciparum infection and API peaked at 114 per 1000 population. In 1995, 23195 cases were recorded.cxi

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The halting of surveillance and IRS activities in the Southern forests, due to the presence of illegal militant camps was a major factor in the health crisis of 1994, where nearly 40,000 patients were diagnosed.cxii The surge in SPR between 1990 and 1993 coincides with the timeline in which militants started entering Bhutan. It also coincides with the destruction of health facilities, in the late 1990s that was discussed earlier. Contrary to expectation that armed conflict would be a substantive barrier to healthcare, it can be stated that by the time of Operational All Clear in 2003, which was Bhutan’s largest military engagement, crucial changes in malaria control strategy had already been made. While we see a substantive caseload in that year 2003 (3806), it still represents a downward trend, which remains constant. cxiii If there was any impact on the health system of Bhutan, it occurred in the earlier phases which preceded the 2003 military engagement. Given the scale of the violence that has been summarized, the reduction in malaria related activities had serious implications for Bhutan’s health system. Yet, as the statistics show, despite the period in which militant presence in the border area peaked, the malaria control strategy was able to bring about a gradual reduction in cases and increase its footprint. This newer strategy, which emanated from sovereign choice, also had repercussions for the border communities, especially in terms of treatment-seeking behaviour.

7.7 Bhutan’s Strategy for Malaria Control The collapse of health systems in the border areas closest to Bhutan paved the way for emergency response and civil society intervention, in Malaria control on the Indian side as can be seen in the international medical mission’s intervention for Malaria control in undivided Bongaigaon and Kokrajhar including Milon. The presence of externally humanitarian organizations, although necessary in certain circumstances, do not have the capacity to provide services to communities beyond the emergency. The exit of organizations, in a situation where state capacity is already weak, drives individuals to resort to health-seeking behaviour, which further results in worsening economic and health outcomes. As seen in Chap. 4, strengthening the state-based health system is a durable solution over the long term. In contrast, although impacted by conflict, the state-led health system in Bhutan actively sought to rework its strategy, which was coping in an increase of malaria cases, from both sides of the border. A cursory examination of malaria control post1996 provides some aspects of a revised approach, which led to the scaling up of the NMCP and its ultimate transformation into the expanded VDCP in 2003. If conflict was a factor in the obstruction of malaria activities, there is no evidence, even in the 2015 Report that NMCP tried to directly engage with members of the armed organizations, to enhance access for malaria control activities. The Report only mentions that for the years 1996 to 2005: ‘The major goals of the VDCP during this period included accessing remote and rural, hard-to-reach populations,

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combating malaria transmission through cross-border prevention and management, and increasing public awareness of malaria’.cxiv As reported then, the presence of militants was known to communities and functionaries of government departments (such as the Forest Department) inside Bhutan, especially in the remote areas. Limited interactions also occurred as militants and their families would sometimes procure food and everyday essentials from markets. One can, therefore, theorize, on the very real possibility that malaria technicians and village health workers would have encountered some militant presence, during their routine surveillance and control activities (which possibly became a catalyst in closure of programmes). If the presence of militants was an obstruction, then a locally negotiated solution to enhance routine anti-malaria activities would be a logical step. However, without any evidence on these micro-level negotiations, the literature points to a conflict-proofing strategy that sought to build a system, which was resilient in the face of exogenous shocks. Given the necessity of the situation, and the targets set up by higher authorities, the NMCP regardless of the very real presence of militants, chose to go ahead with its work. A second pathway arises from the nature of militant presence itself. Narratives from former women militants who were staying in Bhutan show that many camps were deliberately placed inside the densely forested areas.cxv As malaria control activities were limited to populated hamlets and their surrounding areas, there was possibly no necessity of entering into their campsites or the surrounding forest areas. This equilibrium of course shifts after 1996, when the militant presence went from a passive presence to active interference and we start seeing armed attacks on Bhutanese citizens. With insecurity spreading, there were also substantive damage to the Bhutan–India bilateral trade as well as losses to industrial units inside Bhutan. Yet, between 1997 and 2003, where tensions and confrontations escalate between the armed groups and Bhutan (and with increased diplomatic pressure from India), we still see a continuation of the malaria programme. The report attributes the improved NMCP strategy to a dual strategy of halting IRS and replacement with extensive distribution of ITNs.cxvi Second, the creation of ‘rapid response teams’.cxvii Third was the ability of NMCP to ensure that at a minimum, microscopy should remain functional in all health centers.cxviii Fourth, the creation of a resilient national logistics and supply chain, which coordinated across districts and sub-districts to prevent any stock-outs. One of the major innovations was the setting up of the Health Trust Fund of Bhutan in 1998 to ensure that there were sufficient financial resources for procurement of essential drugs and equipment for the primary healthcare system.cxix Lastly, improving the reporting mechanisms of cases and stratifying cases into the Categories N1 (resident of Bhutan/indigenous visitor), N2 (Foreigner for overnight stay) and N3 (Those who are engaging in daily wage labour).cxx This connects with some restriction on accessing healthcare for those crossing the border, who are not in the N3 category, thereby reducing the caseload in the health facilities.

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7.8 Returning Back Across the Border Gate, Health-Seeking Behaviour and Post-Conflict Recovery Until now, we have sought to provide a narrative, which highlight the interactions of two types of boundaries. One the geographical border, which separates two nation-states, but whose border communities are connected through shared cultural, economic and political interdependence. The second boundary we have sought to examine is that set by the occurrence of disease. While it served as a deterrent to external intervention in Bhutan, it also became a key indicator on the deficiency of colonial development. The historic underdevelopment of the area and remoteness of the region also made it central to the armed mobilization of the once peaceful border communities. The demographic changes brought about the conflict, whereby displaced persons, gradually moved deeper into the forest areas, closer to the international boundary, also meant higher vulnerability to disease and declining health outcomes. Till the reform process of 1996–1997, the connections between the border communities on both sides was deep enough that people from Milon sought medical treatment from Bhutan on a regular basis, which was a rational outcome given the geographical proximity of the two areas. Although malaria did always exist as a cross-border issue, access to healthcare in Bhutan offsets the deficits created by absence of sufficient state-based healthcare in India. In fact, transformation of the various strands of malaria that existed in the area prior to boundary demarcation, into a cross-border problem, is a recent development. On the one hand, there were very few recognized forest villages, in and around Milon in the past, given that most land was under Reserved Forest. The problem of crossborder malaria was not a salient one, in view of the sparse population and remoteness of the area. The long-time residents of the area could enter Bhutan for treatment. Encroachment of forest land was occurring from the era before independence, but the conflict accentuated and magnified this process. The existence of relief camps, in Milon, led to a massive impact in Gelephu. Of special interest are the statistics between 1996 and 1997, which show that in 1996 there were 15,696 positive cases, while in 1997 there were 9,029 cases. This drop coincides with the reform discussed earlier of which the earlier semi-formal system of access to healthcare in Bhutan for local communities was slowly revised. The system of forest governance on the Indian side, in the BTAD area, ultimately, becomes a structural barrier. As settlements in Reserve Forest areas are not supposed to exist, outreach services by health workers are not extended into encroached forest villages (whose residents constitute a major portion of the population). Given Bhutan’s health system which provides free healthcare, it is also necessary that its health services are provided primarily to its citizens. The short narratives highlighted below capture these dilemmas, to show how health-seeking behaviour changed since 1996. In the earlier days, treatment in Bhutan was a primary option for those in the Recognized Forest Villages. As stated by a respondent BCTY (a licensed pharmacist):

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Koroipur SD was established in the year 1964, prior to this period families (Nepalese) went to Bhutan for treatment. Though, our family never went to Bhutan for treatment I saw many of my neighbors going there (to Bhutan for treatment).cxxi

A respondent KB recollects the days when healthcare was provided in Bhutan and when this stopped. This narrative confirms the above trend, which was discussed in the various sources mentioned above: Yes! Yes! Yes! When I was in Middle and High School, not once not twice, I went many times to Bhutan Government hospital. Their government hospital charge Two Rupees for registration fees. With this Two Rupees we received good treatment. If the patient had to be hospitalised and spent the night, the bed charges for one day was Rupees 15. Personally, while studying in Class X, I could appear for the SSLC pre-test exams. Looking back to my records, I find I was hospitalised in Bhutan Government hospital. This was in the year 1988. All this I benefitted from Bhutan hospital but not from Koroipur State Dispensary. The services which Guwahati Medical College and Hospital offered, I got in Bhutan for Rupees Fifteen per night. I was admitted for six days in the Bhutan hospital. It was as if the entire people from the area went to Bhutan for treatment. You know when did Bhutan stopped the services for the Indian people? It is when there was huge migration in the area, when thousands of Indians started going to Bhutan seeking treatment, Bhutan stopped the services. How could a foreign country provide health services to such a big population from outside? People from the area have been living their lives deprived of welfare schemes and services. You know it is tough to pinpoint a year when the services in Bhutan stopped but definitely it stopped when people seeking treatment in Bhutan government hospital increased in number. If we talk about villages in this area, the original villages are Milon and five others. The other villages that we see today are all forest encroached areas. Once there was a big increase in the number of people seeking treatment in Bhutan Government Hospital the Bhutan hospital adopted a different measure by charging a higher amount for the treatment. In this way, slowly people stopped going for treatment to Bhutan because the cost was high. Probably all the free services in Bhutan government hospital stopped by the year 1996. People went to Bhutan in case of serious illnesses and delivery. From my family, I took the pregnant women for delivery to Bhutan. We would spend the night there. There were very few educated people in my area and so I always felt it was my duty to take people to Bhutan and for that, people relied on me. From 1990-1995 I took many women for delivery to Bhutan. There is a man who is now working in Gujarat. I had taken his mother for delivery to Bhutan when she was pregnant with him.cxxii

Another respondent CBC mentions: The dispensary in Koroipur, though a government establishment, has never till date conducted any procedure free of cost. NRHM comes to treat only the Adivasis and does not bother itself with the Nepali community. Only from 2015, the border guarding force has been helping the Nepalis. They bring in veterinary doctors, hold medical camps, give good medicines. Previously, all Nepalis in Milon used to go to Bhutan for malaria treatment. “Bhutan ne humko bachaya” (Bhutan saved us)! However, since the Nepali-Bhutanese conflict, it has been difficult for them to go there. SDY’s daughter was even vaccinated in Bhutan. His son was however vaccinated in Bongaigaon.cxxiii

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7.9 Conclusions: Building a Case for Grass Roots Health Cooperation in the Indo-Bhutan Border Areas The recognition of Bhutan’s vulnerability to cross-border transmissions of disease from India is no doubt an extremely serious issue, which has major implications for its health system. Yet, it would be critical to point out that there are serious disparities in health outcomes and access, between the border communities in Bhutan and India. Some of these disparities are a product of the developmental trajectories taken by two distinct nations. The long cycle of unrest and armed violence played a substantial role in worsening health access for communities in the study area. In the case of Bhutan, quality healthcare is available, including the existing Central Research and Referral Hospital (CRRH) in Gelephu, which was constructed through bilateral development cooperation.cxxiv With the end of the insurgency and the advent of a new peace accord, there is a strong potential for cooperation between health institutions at the district level. It is necessary to ensure that the Bhutanese healthcare system does not get overwhelmed by Indian patients, yet some local-level agreements or protocols can be developed. One critical area is developing protocols by which medical care for serious emergency cases, especially deliveries, can be facilitated in designated health institutions especially in Sarpang and Gelephu, for patients living within 0 to 20 kms of the international boundary. The second would be knowledge transfer, technical capacity building and exchange of health professionals at the district level. While there is a strong need for cross-border collaboration, it is necessary to also understand the social determinants of health on both sides of the border. Thus, joint studies on common cross-border health problems by district-level authorities and health institutions on both sides of the border would go a long way in sensitization and knowledge exchange. Third would be to experiment with the incorporation of value-based indicators, such as Gross National Happiness (GNH), and the management practices it has generated in the health sector in Bhutan. As the chapter has shown, relations between communities in the border, does not necessarily imply creation of new mechanisms that will facilitate cross-border interactions. Rather, the effort should be to recover and revitalize the older interdependence, which was existing before the conflict. It also implies that sub-national health institutions must collaborate on humanitarian grounds, as the well-being and economic development of border communities will contribute to the overall development of the border area, which are proximate to each other.

Appendix 1: Some Photos of the Indo-Bhutan Border

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Fig. 7.4 Photo Showing the Bhutan Border Gate at Gelephu

Fig. 7.5 Photo Showing a View of the Bhutan from a Border Village on the Indian Side

Appendix 1: Some Photos of the Indo-Bhutan Border See Figs. 7.4, 7.5 and 7.6. Notes i

Doevenspeck, Martin. 2011. Constructing the border from below: Narratives from the Congolese–Rwandan state boundary. Political Geography 30: 11–14. p.5. https://doi.org/10.1016/j.polgeo.2011.03.003.

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Fig. 7.6 Photo showing The Concept of Gross National Happiness (GNH) Explained in a School in Sarpang

ii iii iv

v vi

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Baud, Michiel., and Willem Van Schendel. 1997. Toward a Comparative History of Borderlands. Journal of World History 8(2): 211–42. p. 212. Ibid., 216. Mohan, Deepanshu., Tanuja Raghunath, Sanjana Medipally. 2017. Governing Dynamics of Cross-Border Trade: A Case Study from the Indo-Bhutan Border Region. https://www.sadf.eu/wp-content/upl oads/2017/02/29-FOCUS.N.29.Governing-Dynamics-of-Cross-BorderTrade.pdf. Accessed 11 June 2020. Bhutan Map Portal National Statistical Bureau. 2020. Main Map. https:// www.nsb.gov.bt/map/main/map.php. Accessed 11 June 2020. The Case History has been constructed from three rounds of interviews with Respondent Chitra. Interviewed by LB and SDS. Dates of Interview. 20 September 2016, 19 October 2016 and 30 November 2016. RBKI Village, Chirang (BTAD), Assam. Interview with Respondent RENS. Interviewed by MJM. Date of Interview. 10 June 2016. RPBLRI Village, Chirang, BTAD (Assam). Barpujari, H. 1951. Early British Relations with Bhutan (1825—1840). Proceedings of the Indian History Congress, 14: 254–259. p. 254. Ibid. Bello, D. 2005. To Go Where No Han Could Go for Long: Malaria and the Qing Construction of Ethnic Administrative Space in Frontier Yunnan. Modern China 31(3): 283–317. p. 288. Barpujari, H. 1951. Early British Relations with Bhutan (1825—1840). Proceedings of the Indian History Congress, 14: 254–259. p., 258.

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Misra, Sanghamitra. 2005. Changing Frontiers and Spaces: The Colonial State in Nineteenth-century Goalpara. Studies in History 21(2): 215–246. https://doi.org/10.1177%2F025764300502100204. See the folk legend of Zaolia “Dewan” in Boro, Anil. 2010. Folk Literature of Bodos. N.L. Publications: Guwahati. pp. 169–170. Misra, Sanghamitra. 2005. Changing Frontiers and Spaces: The Colonial State in Nineteenth-century Goalpara. Studies in History 21(2): 215–246. p. 222. https://doi.org/10.1177%2F025764300502100204. Barpujari, H. 1951. Early British Relations with Bhutan (1825—1840). Proceedings of the Indian History Congress, 14: 254–259. p., 256. Ibid., 256–257. Wangyal, Sonam B. 2006. A Cheerless Change: Bhutan Dooars to British Dooars. Journal of Bhutan Studies 15(02): 40–55. https://himalaya.soc anth.cam.ac.uk/collections/journals/jbs/pdf/JBS_15_02.pdf. Accessed 12 March 2020. Murty, E. 1970. Bhutan Expedition: Private Deliberations Between Sir John Lawrence and His Chiefs. Proceedings of the Indian History Congress 32: 329–337.p. 333. McKay, Alex. 2007.Their Footprints Remain: Biomedical Beginnings Across the Indo-Tibetan Frontier. Amsterdam: Amsterdam University Press. p. 173. Ibid. Majumdar, E. 1996. Ugyen Kazi: The Diplomat of the Druk Land. Proceedings of the Indian History Congress 57:823–830. p. 828. Endle, S. 1990. The Kacharis (Bodo). Delhi: Lowprice Publications. p. 21. Originally the text was published in 1910 and reprinted in 1990. Morris, C. 1935. A Journey in Bhutan. The Geographical Journal 86(3): 201–215. p. 204. https://doi.org/10.2307/1786019 Mitra, Debamitra. 1995. The Nepalis in Bhutan: Past and Present. Proceedings of the Indian History Congress 56:825–832. pp. 826–827. Morris, C. 1935. A Journey in Bhutan. The Geographical Journal 86(3): 201–215. pp. 205–206. https://doi.org/10.2307/1786019 Wangyal, Sonam B. 2006. A Cheerless Change: Bhutan Dooars to British Dooars. Journal of Bhutan Studies 15(02): 40–55. https://himalaya.soc anth.cam.ac.uk/collections/journals/jbs/pdf/JBS_15_02.pdf. Accessed 12 March 2020. Majumdar, E. 1996. Ugyen Kazi: The Diplomat of the Druk Land. Proceedings of the Indian History Congress 57:823–830. McKay, Alex. 2007. Their Footprints Remain: Biomedical Beginnings Across the Indo-Tibetan Frontier. Amsterdam: Amsterdam University Press. p. 173. Ibid. See Ministry of Health, Royal Government of Bhutan. 2020. Overview. https://www.moh.gov.bt/about/overview/. Accessed 9 March 2020.

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Nandini (2011). The Logic of Location: Malaria Research in Colonial India, Darjeeling and Duars, 1900–30. Medical History 55. pp 183–202. https://doi.org/10.1017/s0025727300005755. Bhattacharya, Nandini. 2012. Contagion and Enclaves: Tropical Medicine in Colonial India. Liverpool: Liverpool University Press. For a detailed history of trade and commerce see Sarkar, Ratna., and Indrajit Ray. 2007. Journal of Bhutan Studies 17: 1–21. https://him alaya.socanth.cam.ac.uk/collections/journals/jbs/pdf/JBS_17_01.pdf. Accessed 8 April 2020. Also see Pommaret, Franscoise. 2000. Ancient Trade Partners: Bhutan, Cooch Bihar and Assam (17th - 19th Centuries). Journal of Bhutan Studies 2(1):1–26. https://himalaya.socanth.cam.ac. uk/collections/journals/jbs/pdf/JBS_02_01_02.pdf. Accessed 9 March 2020. Business Bhutan. 19 June 2019. Boulder Export From Gelephu To Bangladesh Resumes. https://www.businessbhutan.bt/2019/06/19/bou lder-export-from-gelephu-to-bangladesh-resumes/. Accessed 11 March 2020. Ministry of External Affairs (MEA), Government of India. Treaty of Perpetual Peace and Friendship Between the Government of India and The Government of Bhutan 8th August 1949. https://mea.gov.in/bilateral-doc uments.htm?dtl/5242/treaty+or+perpetual+p. Accessed 12 March 2020. Ministry of External Affairs (MEA), Government of India. 2020. India Bhutan Friendship Treaty, 2nd March 2007. p.1. Accessed https://mea.gov. in/Images/pdf/india-bhutan-treaty-07.pdf. Ministry of External Affairs (MEA), Government of India. Treaty of Perpetual Peace and Friendship Between the Government of India and The Government of Bhutan 8th August 1949. https://mea.gov.in/bilateral-doc uments.htm?dtl/5242/treaty+or+perpetual+p. Accessed 12 March 2020. Ministry of External Affairs (MEA), Government of India. 2020. India Bhutan Friendship Treaty, 2nd March 2007. p.1. https://mea.gov.in/Ima ges/pdf/india-bhutan-treaty-07.pdf. Accessed 12 March 2020. Bhattacharya S. 2013. International health and the limits of its global influence: Bhutan and the worldwide smallpox eradication programme. Medical history 57(4)461–486. https://doi.org/10.1017/mdh.2013.63. Ministry of External Affairs (MEA), Government of India. 2020. IndiaBhutan relations. https://www.mea.gov.in/Portal/ForeignRelation/India_ Bhutan_2019.pdf. Accessed 1 March 2020. Bhattacharya S. 2013. International health and the limits of its global influence: Bhutan and the worldwide smallpox eradication programme. Medical history 57(4)461–486. p. 480. https://doi.org/10.1017/mdh.201 3.63. Ibid. Ibid.

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Tashi, Tobgay et.al. 2011. Progress and delivery of health care in Bhutan, the Land of the Thunder Dragon and Gross National Happiness. Tropical Medicine and International Health 16(6): 731–736. p. 732. National Assembly of Bhutan. 1991. Proceedings and Resolutions of The 70th Session of The National Assembly of Bhutan. p.7. https://www.nab. gov.bt/assets/uploads/docs/resolution/2014/70th_Session.pdf. Accessed 15 March 2020. Ibid., p.7. Tashi, Tobgay et.al. 2011. Progress and delivery of health care in Bhutan, the Land of the Thunder Dragon and Gross National Happiness. Tropical Medicine and International Health 16(6): 731–736. p. 732. https://doi. org/10.1111/j.1365-3156.2011.02760.x. Ibid. Ibid., p.734. National Assembly of Bhutan. 1991. Proceedings and Resolutions of The 70th Session of The National Assembly of Bhutan. p.7. https://www.nab. gov.bt/assets/uploads/docs/resolution/2014/70th_Session.pdf. Accessed 15 March 2020. Ibid. Ibid. Bhattacharya S. 2013. International health and the limits of its global influence: Bhutan and the worldwide smallpox eradication programme. Medical history 57(4)461–486. p.465. https://doi.org/10.1017/mdh.201 3.63. Penjore, Dorje. 2004. Security of Bhutan: Walking between Two Giants. Journal of Bhutan Studies 10(9): 108–131. https://himalaya.soc anth.cam.ac.uk/collections/journals/jbs/pdf/JBS_10_09.pdf. Accessed 4 March 2020. p. 123. Mitra, Debamitra. 1995. The Nepalis in Bhutan: Past and Present. Proceedings of the Indian History Congress 56: 825–832. p. 828. Ibid., p. 830. For specific changes see Piper, Tessa. 1995. The Exodus of Ethnic Nepalis from Southern Bhutan. Refugee Survey Quarterly 14(3): 52–78. pp. 58– 59. https://doi.org/10.1093/rsq/14.3.52. Mitra, Debamitra. 1995. The Nepalis in Bhutan: Past and Present. Proceedings of the Indian History Congress 56: 825–832. p. 830. Piper, Tessa. 1995. The Exodus of Ethnic Nepalis from Southern Bhutan. Refugee Survey Quarterly 14(3): 52–78. https://doi.org/10.1093/rsq/14. 3.52. Mitra, Debamitra. 1995. The Nepalis in Bhutan: Past and Present. Proceedings of the Indian History Congress 56: 825–832. p. 830. Also see Middleton, Townsend. 2013. States of difference: Refiguring ethnicity and its ‘crisis’ at India’s borders” Political Geography (35):14–24. https:// doi.org/10.1016/j.polgeo.2013.01.001.

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National Assembly of Bhutan. 1998. Translation of The Proceedings and Resolutions of The 76 th Session of The National Assembly of Bhutan Held from The Fifth Day of the Fifth Month to The Seventh Day of the Sixth Month of the Male Earth Tiger Year (June 29th To July 30th, 1998). pp. 148–149. https://www.nab.gov.bt/assets/uploads/docs/resolu tion/2014/76th_Session.pdf. Accessed 14 March 2020. National Assembly of Bhutan. 2000. Translation of The Proceedings and Resolutions of The 78th Session of The National Assembly of Bhutan. p. 61. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/78th_Session.pdf. Accessed 14 March 2020. National Assembly of Bhutan. 1989. The Resolutions of The 68th Session of The National Assembly (23.10.89 - 31.10.1989). pp. 2–3. https://www.nab.gov.bt/assets/uploads/docs/resolution/2014/ 68th_Session.pdf. Accessed 14 March 2020. Ibid., p.17. National Assembly of Bhutan. 1998. Translation of The Proceedings and Resolutions of The 76 th Session of The National Assembly of Bhutan Held from The Fifth Day of the Fifth Month to the Seventh Day of the Sixth Month of the Male Earth Tiger Year (June 29th To July 30th , 1998). p. 175. https://www.nab.gov.bt/assets/uploads/docs/resolu tion/2014/78th_Session.pdf. Accessed 14 March 2020. National Assembly of Bhutan. 1995. Translation of The Proceedings and Resolutions of The 73rd Session of The National Assembly of Bhutan Held from 10th August to 2nd September, 1995. p. 96. https://www.nab.gov.bt/ass ets/uploads/docs/resolution/2014/73rd_Session.pdf. Accessed 14 March 2020. Ibid. National Assembly of Bhutan. 1997. Proceedings and Resolutions of The 75th Session of The National Assembly Held from 20th June to 16 th July, 1997. P. 163. https://www.nab.gov.bt/assets/uploads/docs/resolu tion/2014/75th_Session.pdf. Accessed 14 March 2020. Ibid., pp. 165–166. Ibid., p. 168. National Assembly of Bhutan. 1998. Translation of The Proceedings and Resolutions of The 76 th Session of The National Assembly of Bhutan Held from The Fifth Day of the Fifth Month to The Seventh Day of the Sixth Month of the Male Earth Tiger Year (June 29th To July 30th, 1998). p. 199. https://www.nab.gov.bt/assets/uploads/docs/resolu tion/2014/76th_Session.pdf. Accessed 14 March 2020. National Assembly of Bhutan. 1999. Translation of the Proceedings and Resolutions of the 77th Session of the National Assembly of Bhutan. p. 112. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/77th_Session.pdf. Accessed 14 March 2020. Ibid., p. 75.

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National Assembly of Bhutan. 1998. Translation of The Proceedings and Resolutions of The 76 th Session of The National Assembly of Bhutan Held from The Fifth Day of the Fifth Month to The Seventh Day of the Sixth Month of the Male Earth Tiger Year (June 29th To July 30th, 1998). p. 57. https://www.nab.gov.bt/assets/uploads/docs/resolu tion/2014/76th_Session.pdf. Accessed 14 March 2020. National Assembly of Bhutan. 1999. Translation of the Proceedings and Resolutions of the 77th Session of the National Assembly of Bhutan. p. 118. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/77th_Session.pdf. Accessed 14 March 2020. National Assembly of Bhutan. 2000. Translation of The Proceedings and Resolutions of The 78th Session of The National Assembly of Bhutan. p. 52. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/78th_Session.pdf. Accessed 14 March 2020. Ibid., p. 52. National Assembly of Bhutan. 2001. Translation of The Proceedings and Resolutions of The 79th Session of The National Assembly of Bhutan. p.76. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/79th_Session.pdf. Accessed 14 March 2020. Ibid., p.113. Ibid. Ibid., 114. Ibid. Ibid., 114. Ibid., 264. Anand, Manoj. 2002. Bodos Kill 22 Bihari Muslims and Nepalis in Kokrajhar. Asian Age, October 28. Correspondent. 2002. Datgiri Villagers flee homes, admit paying ‘tax’ to NDFB. Newspaper Clip [On file:edition unspecified], October 28. See Goswami, Roshmi. 2015. Of revolution, liberation and agency: aspirations and realities in the lives of women combatants and key women members of the United Liberation Front of Assam (ULFA). New Delhi: Heinreich Boll Foundation. https://in.boell.org/sites/default/files/ of_revolution_liberation_and_agency_aspirations_and_realities_in_the_ lives_of_women_combatants_and_key_women_members_of_the_uni ted_liberation_front_of_assam_ulfa.pdf. Accessed 13 February 2020. National Assembly of Bhutan. 1999. Translation of the Proceedings and Resolutions of the 77th Session of the National Assembly of Bhutan. p. 99. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/77th_Session.pdf. Accessed 14 March 2020. National Assembly of Bhutan. 2001. Translation of The Proceedings and Resolutions of The 79th Session of The National Assembly of Bhutan. p. 81. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/79th_Session.pdf. Accessed 14 March 2020.

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National Assembly of Bhutan. 2002. English Translation of the Resolution of The 80th Session of The National Assembly. p.81. https://www.nab. gov.bt/assets/uploads/docs/resolution/2014/80th_Session.pdf. Accessed 15 March 2020. National Assembly of Bhutan. 2003. English Translation of the Resolution of The 81st Session of The National Assembly of Bhutan. p. 31. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/81st_Session.pdf. Accessed 12 March 2020. Ibid., 30. Correspondent. 2003. ULFA, NDFB rebels face food shortages in Bhutan camps. The Sentinel, January 20. National Assembly of Bhutan. 2003. English Translation of the Resolution of The 81st Session of The National Assembly of Bhutan. p. 24. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/81st_Session.pdf. Accessed 12 March 2020. Special Correspondent. 2003. Seven of our men, 10 Indian troops killed in Bhutan raid: NDFB. The Sentinel, January 8. Barooah, Kalyan. 2003. ULFA, NDFB join hands with KLO in Bhutan. The Assam Tribune, July 17. National Assembly of Bhutan. 2004. Translation of The Proceedings and Resolutions of the 82nd Session of The National Assembly of Bhutan. p. 108. https://www.nab.gov.bt/assets/uploads/docs/resolution/ 2014/82nd_Session.pdf. Accessed 11 March 2020. Ibid. Also see Kumar, Parveen. 2004. External linkages and internal security: Assessing. Bhutan’s operation all clear. Strategic Analysis 28:3: 390–410. https://doi. org/10.1080/09700160408450144. See Ministry of Health. 2010. Bhutan National Malaria Control Strategy 2008–2013 Vector-borne Disease Control Programme (VDCP) Bhutan. https://extranet.who.int/countryplanningcycles/sites/default/ files/planning_cycle_repository/bhutan/malaria_programme_bhutan. pdf. Accessed 19 September 2019. Also see Yangzom, T., Gueye, C.S., Namgay, R. et al. 2012. Malaria control in Bhutan: case study of a country embarking on elimination. Malaria Journal 11(9): 1–12. https://doi.org/ 10.1186/1475-2875-11-9. World Health Organization (WHO). 2018. Evidence review group on border malaria Meeting report, 10–11 May 2018 World Health Organization, Geneva, Switzerland. p. 1. https://www.who.int/malaria/mpac/ mpac-october2018-session6-border-malaria.pdf. Accessed 14 September 2019. Ibid. Ibid.

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Ibid., p. 2. For an illustrative example see Parker, D.M., Carrara, V.I., Pukrittayakamee, S. et al. 2015. Malaria ecology along the Thailand– Myanmar border. Malaria Journal 14: 388. https://doi.org/10.1186/s12 936-015-0921-y. Gueye, Cara Smith., and Thinley Yangzom. 2009. APMEN Report: Bhutan and Cross-border Malaria. p. 3. https://pdfs.semanticscholar. org/edc8/5c4cd1e8fc61d3b5b47c896e9a953d8bef37.pdf. Accessed 20 September 2019. Ministry of Health Bhutan and the World Health Organization and the University of California, San Francisco. 2015. Eliminating Malaria: Case-study 9/Climbing towards elimination in Bhutan. Geneva: The World Health Organization. p. 10. https://globalhealthsciences.ucsf.edu/ sites/globalhealthsciences.ucsf.edu/files/pub/mei-bhutan-case-study.pdf. Accessed 19 September 2019. Gueye, Cara Smith., and Thinley Yangzom. 2009. APMEN Report: Bhutan and Cross-border Malaria. p. 7. https://pdfs.semanticscholar. org/edc8/5c4cd1e8fc61d3b5b47c896e9a953d8bef37.pdf. Accessed 20 September 2019. Compiled from SATP. 2020. https://old.satp.org/satporgtp/countr ies/india/states/assam/data_sheets/ndfb/casualties.htm; District level information for BTAD is compiled from SATP. 2020. https://www. satp.org/datasheet-terrorist-attack/fatalities/india-insurgencynortheastassam-baksa; https://www.satp.org/datasheet-terrorist-attack/fatalities/ india-insurgencynortheast-assam-chirang; https://www.satp.org/datash eet-terrorist-attack/fatalities/india-insurgencynortheast-assam-kokrajhar; https://www.satp.org/datasheet-terrorist-attack/fatalities/india-insurgenc ynortheast-assam-udalguri. Accessed 3 January 2020. The numbers are extrapolated from SPR data provided in Ministry of Health Bhutan and the World Health Organization and the University of California, San Francisco. 2015. Eliminating Malaria: Case-study 9/Climbing towards elimination in Bhutan. Geneva: The World Health Organization. pp. 13–17. https://globalhealthsciences.ucsf.edu/sites/ globalhealthsciences.ucsf.edu/files/pub/mei-bhutan-case-study.pdf. Accessed 19 September 2019. Ibid., 17. Ibid., 1. Ibid., 12–13. Ibid., 13. Ibid., 15. Ibid. See Goswami, Roshmi. 2015. Of revolution, liberation and agency: aspirations and realities in the lives of women combatants and key women members of the United Liberation Front of Assam (ULFA). New

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Delhi: Heinreich Boll Foundation. https://in.boell.org/sites/default/files/ of_revolution_liberation_and_agency_aspirations_and_realities_in_the_ lives_of_women_combatants_and_key_women_members_of_the_uni ted_liberation_front_of_assam_ulfa.pdf. Accessed 13 February 2020. Ibid., 3. Ibid., 37. Ibid., 21. See Asian Development Bank. 2006. Bhutan: Health Care Reform Program. https://www.sabin.org/sites/sabin.org/files/restricted/ADB_ Bhutantrustfundeval_33071-BHU-PCR_06.pdf. Accessed 12 June 2020. Ministry of Health Bhutan and the World Health Organization and the University of California, San Francisco. 2015. Eliminating Malaria: Case-study 9/Climbing towards elimination in Bhutan. Geneva: The World Health Organization. p 15. https://globalhealthsciences.ucsf.edu/ sites/globalhealthsciences.ucsf.edu/files/pub/mei-bhutan-case-study.pdf. Accessed 19 September 2019. Interview with Respondent BCTY. Interviewed by MJM. Date of Interview. 20 December 2016. Koroipur Bazar, Chirang, BTAD (Assam). Interview with Respondent KB. Interviewed by Respondent MJM. Date of Interview. 14 December 2016. Milon Bazaar, Chirang, BTAD(Assam). Interview with Respondent CBC. Interviewed by TRPTI. Date of Interview. 14 June 2016. Milon Village, Chirang, BTAD(Assam). See Consulate General of India, Phuentsholing, Central Regional Referral Hospital at Gelephu. https://consulatephuentsholing.nic.in/?7202?005. Accessed 24 November 2020.

Chapter 8

Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland

Abstract On 27 January 2020, the Government of India, State Government of Assam and representatives of the key political groups of the Bodoland Movement (ABSU, NDFB, BPF and United Bodo People’s Organization UBPO) entered into a final political settlement. The final Accord or Memorandum of Settlement (MoS) sought to establish a new political configuration, by establishing the Bodoland Territorial Region (BTR) with several new proposals for enhanced administrative autonomy, reconstruction and economic development (as well as enhanced cultural protections for the Bodo community in terms of linguistic recognition). It is important to gauge the scale of the reconstruction challenges posed for the proposed administrative structures. Towards this purpose, the chapter highlights the challenges posed by two major humanitarian crises, which preceded the signing of the settlement. The chapter highlights the scale of reconstruction challenges through case studies of the two recent humanitarian crises that occurred. The most recent occurred in 2014–2015 which was preceded by the 2012 violence between the Bengali Muslim and Bodo communities. Cumulatively, the crises witnessed more than 800,000 people being displaced as a result of the conflicts. The upheavals of the 2012 ethnic crisis did not impact the study area directly as the direction of displacement was away from the Indo-Bhutan border areas. There were indirect impacts of the vicinity of the study area due to closures of the border gate, thus affecting the ability of those who rely on daily wages from Bhutan for their livelihoods. However, the 2012 crisis set the stage for the systematic entry of several externally based humanitarian response organizations, some of whom also intervened to mitigate the impacts of forced displacement in the 2014 cycle of violence. It is the latter episode (in which the Milon area was again severely affected) that is the central focus of the chapter. In addition, there was a degree of organizational learning, which allowed for a more sustained response by district-level authorities. When analyzing the evidence, it becomes imperative to understand the problem of post-conflict recovery in the newly defined BTR in its totality. The chapter widens the canvas of the book to highlight the fragility in a comparative context, by including findings from the adjacent district of Kokrajhar. It also outlines the scale of the challenges faced by those responding to the two crises. Unlike the 1996 and 1998 crises, the crisis of 2014 (which is the focus of the chapter) response was qualitatively different and there were important efforts at peacebuilding by both the Bodo and Adivasi communities. © Springer Nature Singapore Pte Ltd. 2021 S. Sinha and J. Liang, Health Inequities in Conflict-affected Areas, https://doi.org/10.1007/978-981-16-0578-9_8

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Keywords Humanitarian · Response · Community-Based · Conflict Early · Warning · Rehabilitation · Community · Peacebuilding

8.1 Introduction The chapter sets the context of the 2012 and 2014 humanitarian crises, and provide a micro-picture of events and processes, which highlight the two distinct, yet overlapping, layers of humanitarianism. The lessons from both crises have not been sufficiently documented, yet a number of insights can be provided from the review of data collected during both episodes of conflict as well through key informant interviews (and also follow ups conducted since then). While the focus of the next chapter is on recovery and rebuilding, the current chapter seeks to outline the scale and scope of both crises. While a diverse set of organizations responded to the back-to-back episodes of large-scale forced internal displacement and eventually exited from the context, they did bring in a variety of new ideas, opportunities, methodologies and programmatic approaches. They also added visibility to the situations, which would not have garnered adequate attention. In many cases, they also worked beyond the glare of media reportage to promote indirect non-violent approaches to conflict resolution. Both conflicts led to new collaborations between external organizations, civil society organizations based in Chirang and Kokrajhar (and other parts of BTAD) as well as district-level authorities, with several efforts made to mainstream conflict programming into existing disaster response mechanisms. It must be noted that, the period, between the years 2012 and 2015 was marked by intermittent violence, military and paramilitary operations and waves of unrest. Their exit was also a lived reality, for the affected communities who temporarily depended on these organizations for their sustenance in the emergency phase. Unlike the first wave of externally based NGOs working in the region in the early 2000s, which has been discussed earlier, the new wave of external intervention was distinct whereby the information landscape had been completely transformed. There was also an exponential increase in the number and types of humanitarian actors who participated in the response. In order to increase methodological rigour, the case studies of the two crisis have been constructed utilizing a number of sources ranging from data gleaned from published and unpublished internal assessments reports of various organizations (and later in the damaged villages), secondary data from official government sources, local media sources and field observations.

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8.2 Violent Borderlands: Conflict Between Bodos and Bengali Muslims and the Humanitarian Crisis of 2012 As specified earlier, the daily insecurity that resulted from several years of protracted violence, contributed to a highly polarized environment, which became conducive to large-scale disruptions. Targeted killings, extortion, levying of ‘illegal’ taxes, abductions, obstruction of essential services and threats to life were woven into a fabric of everyday violence. The 2012 conflict was distinct for three reasons: a) it coincided with transformations in the information landscape where social media also became a salient factor in accentuating the conflict; b) the existing structures of conflict resolution and community dialogue broke down to the extent that the scale of the violence could not be contained by the local law and order machinery; and, c) the extent of internal displacement went beyond the existing district boundaries and spilled over into neighbouring districts, particularly Dhubri (which is on the Indo-Bangladesh border). One of the major findings from that time was that existing civil society organizations, did not anticipate that ordinary people (of both communities) would participate in the wholescale destruction of their neighbouring villages and residences in the retaliatory violence, on such a large scale. The crisis was not a sudden onset disaster but a culmination of long process of ethnic polarization in the region, between the two communities. Although there were community-level indicators present that a conflagration would possibly occur, the information flow was insufficient to design large-scale actionable preventive measures. In the 2014 crisis, on the other hand as will be discussed later, innovative inter-community dialogues occurred that contained the direction and type of violence.

8.2.1 Background to the 2012–2013 Humanitarian Crisis While the 2003 Memorandum of Settlement (MoS) has been discussed in detail earlier, it must be mentioned that the BTC, its associate institutions and infrastructure were continuously evolving. The transfer of power between the state and council was a process that was occurring in the backdrop of protracted low-intensity violence. A vital aspect of the 2003 MoS was the exclusion of other groups especially the NDFB from the dialogue process. The provisions of the MoS also led to political mobilization by non-Bodo communities, the detailed history of which is beyond the scope of the chapter. A number of political organizations resorted to large-scale mass movements in the post-accord phase in order to defend their interests in the face of perceived Bodo domination making the region prone to instability. Some of the prominent examples include the Sanmilita Janagosthiya Sangram Samithi (SJSS: United Ethnic People’s Struggle Committee) and Ana-Bodo Surakhya Samity (ABSS: Non-Bodo Protection Forum).i

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8 Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland

An early analysis of the triggers for the 2012 crisis pointed out that the violence actually escalated in May 2012 with complex developments related to the All Bodoland Minority Students Union (ABMSU) and subsequently in July 2012 two student leaders were assassinated.ii The wave of retaliatory killings that occurred subsequently, including the killing of four Bodo youths a few days later transformed into a full-fledged inter-community conflict by the end of July 2012. A total of 101 persons were killed in the course of the crisis and 88 persons injured. Moreover, these killings and injuries were mainly a result of the use of firearms and explosives.iii The targeted killings, retaliatory violence and the pervasive atmosphere of hostility perpetrated by the armed actors culminated in a massive out-migration from both Bodo and Bengali Muslim villages throughout the BTAD region.

8.2.2 Scale of the 2012–2013 Crisis and Challenges Faced by Humanitarian Actors According to figures from the Assam State Disaster Management Authority (ASDMA) at the peak of the crisis there were 485,921 persons displaced living in 340 Relief Camps spread across Barpeta, Bongaigaon, Chirang, Dhubri and Kokrajhar districts.iv By September 2012 camps slowly started closing and about 2,40,333 displaced persons were residing in 217 ‘formal’ relief camps.v By 31 January 2013 there were still 38,959 persons still residing in ‘formal’ camps.vi Political instability was combined with continuous population shifts and makes the official figures only a rough approximation. For instance, a serious incident occurred when on 9 October 2012, The Assam Tribune reported that 40,000 internally displaced persons could not be accounted for in the camps in the Dhubri district and they had simply vanished (but not returned to Kokrajhar their place of origin).vii Large-scale looting from the abandoned houses of consumer goods, electronics and the illicit sale of looted cooking gas cylinders were some of the consequences of the aftermath of the violence.These pre-existing political dynamics also define the recovery phase as well. While many organizations attempted peacebuilding activities, the recovery phase did not dilute the level of mistrust. Controversy arose over the BTC’ s declaration that only those internally displaced persons who can provide proof of being residents of BTAD, through producing land-ownership documents would be allowed to access the official rehabilitation packages and return to their villages (many of which were actually destroyed).viii This was further complicated by an economic boycott at the community level that was subsequently overcome several months later.ix In the end, despite several setbacks including the Baksa massacre of May 2014 where 45 Bengali Muslims were killed in one incident alone near the Beki River in Baksax ; it is to be noted that there was further no large-scale ethnic riots between the two communities of the scale seen earlier.

8.2 Violent Borderlands: Conflict …

271

8.2.3 Access to Healthcare during the Crisis Phase While the chapter outlines the living conditions of internally displaced persons, certain conflict factors also possibly worsened health inequities during the emergency phase. It would be a grave misunderstanding that the displaced population was homogenous, that they were unskilled, living with low annual incomes and mainly agriculturalists. A number of skilled workers, as well as professionals who were working in the major towns of the BTAD were also forcefully displaced due to the ethnic violence. Similarly, children living in the relief camps were not ‘homeless’ or ‘destitute’ prior to the crisis. They were school-going children whose schools were destroyed in the violence and who now lost their regular school calendar by virtue of being displaced.The post-displacement crisis in school enrollment and the number of children who lost access to the mid-day meal scheme is yet to be determined. The displacement of such a large population included a large number of ASHAs Accredited Social Health Activists (ASHA), Auxiliary Nurse Midwifes (ANM) and ‘Anganwadi’ workers (who are part of the Integrated Child Services Programme: ICDS). These community workers are at the forefront of state supported health and nutrition at the grass-roots level and the forced displacement of entire populations from villages also meant that these workers were also forced to take shelter in the relief camps. The collapse of these community-health and public nutrition systems had serious consequences on the most vulnerable populations, i.e. pregnant women and children below 5 years. During its most acute phase about 6,000 children were reported to be sick in the camps.xi This mass displacement of health workers also meant the collapse of ongoing immunization programmes and the loss of health records. Other effects of the conflict as witnessed in the field were the inability of Doctors, ASHAs and ANMs to access camps and work in camps due to ethnicity. Bengali Muslim healthcare workers were unable to work in Bodo camps and viceversa. The collapse of health and public nutrition systems in the destroyed (or evacuated villages) was also marked by parallel stresses being exerted on local health (and nutritional) systems in the areas that began receiving displaced persons. This arose due to the need to extend services (and also the necessity of providing resources) to absolutely new populations whose origin was outside the jurisdiction of existing structures; this was a contingency that was neither predicted nor planned for. There were cases of existing sub-PHCs (like Bengtol in Chirang District) that were converted to relief camps which meant an immediate end to regular services being provided. There was an increased workload for Doctors, ANMs and ASHAs who began working with new patients for whom they had no medical records or detailed case histories.xii The extent of this can be gauged by the fact that in the Bilasipara sub-division (in Dhubri) the existing sub-PHC became responsible for extending services to around 4,000 internally displaced persons (IDPs) in four camps adding to the normal workload.xiii Other critical services were also impacted such as pre-hospital emergency care due to the overstretching of such services as well as the unwillingness of ambulance drivers (and medical staff) to venture into volatile areas. The shortage of doctors

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8 Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland

was acutely felt, and at the peak of the crisis there were just 117 doctors available for treating the camp population of more than 400,000 people.xiv

8.2.4 Assessment of Water, Sanitation and Hygiene (WASH) in Select Camps in the Post-Emergency Phase The equitable and regular access to the supply of water (including clean and safe drinking water) is essential in emergency situations. The contamination of water sources as well the existence of non-hygienic waste disposal posed an extremely severe risk in terms of the spread of water-borne disease. One of the major features of the emergency was extremely poor conditions in Water, Sanitation and Hygiene after the official emergency was declared as being over. A field assessment in February 2013 (well after the initial crisis) is indicative of the distribution of population in camps (the locations being coded due to security concerns) with respect to amenities.xv The importance of this data is that it also assessed conditions in “makeshift” camps where returnees were being housed (especially in Kokrajhar) which was the most severely affected district. The size of the population with respect to basic access to amenities is extremely critical and marked a continuation of the emergency conditions even in the postemergency phase. By then most of the big humanitarian organizations had exited the location and highlights the problem of humanitarian exit (see next Chapter). At the time of assessment, there were no formal waste disposal mechanisms observed in these camps leading to major issues in sanitation. These indicators also hide a serious gender variation in terms of access to amenities. The non-segregation of bathing cubicles and toilets as well as the lack of lighting in these areas (as none of the camps were electrified) had a disparate impact on women. In the first case, it led to the inability of women to access basic facilities during the day; in the second, it enhanced the probability of assault and other forms of violence. These impacts were already added to the effects of displacement mentioned earlier and were unmeasured (Tables 8.1 and 8.2). Table 8.1 Water and sanitation conditions in “Formal” relief camps in Chirang district (February 2013)xvi Camp code

Current camp population

No. of toilets

No. of hand pumps

No. of bathing cubicles

Camp 1

493

10

10

3

Camp 2

1080

20

7

10

Camp 3

426

5

2

0

Camp 4

300

12

7

12

Camp 5

167

11

13

10

Camp 6

300

3

2

2

8.2 Violent Borderlands: Conflict …

273

Table 8.2 Kokrajhar District: Water and Sanitation Conditions in “Formal” and “Makeshift” Camps (February 2013)xvii Camp code

Camp population

No. of toilets

No. of Hand pumps

No. of bathing cubicles

Camp 1

300

0

1

0

Camp 2

7400

20

10

0

Camp 3 (makeshift)

1600

0

10

0

Camp 4 (makeshift)

1898

20

20

0

8.2.5 Nutritional Assessment in the Relief Camps During the Crisis The data presented above is indicative of a larger macro-level picture and shows the extent of the crisis. One of the major characteristics of the crisis was the absolute lack of household-level data on patterns of food consumption, health indicators, and access to nutrition, maternal and infant mortality. The situation deteriorated rapidly and major gaps emerged between the needs of the affected communities and inappropriate relief materials being provided. The interdependence between public nutrition, health service provision, adequate water and sanitation as well as acceptable shelter was a critical observation. A nutritional assessment and survey was done by staff members from the disaster relief NGO of which the co-author was a part (mentioned earlier in Chap. 1). An emergency nutritional programme was conducted between September and October 2012 across various camps. A total of 2,526 children between six and 59 months were surveyed in 19 camps (of a total of 220 Relief Camps) spread throughout three districts. Of the children in the sample, 1,452 were living in camps in Chirang, 485 in Kokrajhar and 535 in Dhubri. A total of 286 [11.11%] cases of Moderate Acute Malnutrition (MAM) and 49 cases of Severe Acute Malnutrition (SAM) were recorded in the sample (Fig. 8.1, Table 8.3).xviii

8.2.6 Measurement Problems in Crisis Situations: The Crisis of Habitat Destruction in 2012–2013 Many organizations exited by 2013 based on clear downward trends in the number of persons residing in the camps, and existing figures from ‘formal’ relief camp data actually masked the process of the return of IDPs and their consequent living conditions. The data did not account for the living conditions of those returning to the villages from the camps. The return of internally displaced persons was occurring in villages where there was the systematic destruction of houses. This destruction of shelter and habitat has also meant a destruction of all household assets as well.

274

8 Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland Gender DistribuƟon of SAM and MAM (6-59 Months) Male

Female 157 129

34

15 SAM

MAM

Fig. 8.1 Results of nutritional assessment in the 2012 conflictxx

Table 8.3 Results from a Nutritional Assessment during the 2012 Conflictxix District

MAM SAM Total Sample size Percentage of children Percentage of children detected as MAM with SAM

Chirang

171

22

1454

11.76

1.51

Kokrajhar

69

11

485

14.20

2.26

Dhuburi

59

11

587

10.05

1.87

299

44

2526

11.83

1.74

Total

With the closure of these official government camps, the population was relocated multiple times till the verification process was completed. The final relocation of the affected population from the camps back to the fully destroyed villages was done by locating the affected population in ‘makeshift’ camps that were on the fringes of the demolished villages. The replication of camp like conditions in the place of origin, but without the IDP camp infrastructure had actually meant the prolonging of the humanitarian crisis. An estimate of the systematic destruction of shelter and habitat can be seen in the figures below. The data shown below is from anonymous local government sources and outlines the situation in February 2013.xxi The data describes the shelter damage in 80 villages from a sub-division of Kokrajhar District. The villages have been coded due to the sensitive nature of the data. For the sake of convenience, the villages have been grouped into four clusters of 20 villages each. The data is to be treated as a representative sample of a larger process of systematic destruction of property. The total cumulative number of houses which have been intentionally destroyed and burnt fully in the sample sub-division is 6,268, while those partially damaged is 1,001. However, this is only an estimate in one sub-division and estimates from Kokrajhar sub-division or Chirang are unavailable despite the occurrence of a comparable degree of infrastructure destruction. The systematic destruction of villages which was verified through actual visits to accessible locations was indicative of a

8.2 Violent Borderlands: Conflict …

275

Fully Burnt/Destroyed

184

201 194 166 112

111

35 4

50 1

ParƟally Burnt

0

19 0 0

4

47

38 0

129

121

31 21 41 1 0 0

0

52 15 20 0

0

82

20

90

4

Fig. 8.2 Destruction of Houses in Cluster 1 Sub-Division X (with total houses fully destroyed in the cluster being 1,417)xxii Full Destroyed/Burnt

ParƟally Destroyed/Burnt 189

185

131 110 103

93

123 74

50 57 30 11 21 10 0

1

22 0

2

0

1 10

9

0 11 40 60

34 19 1

0

0 70

Fig. 8.3 Destruction of Houses in Cluster 2 Sub-Division X (with total number of fully destroyed houses in the cluster being 1,072)xxiii

high amount of coordination and planning behind the eviction process. The destruction of villages also meant the obliteration of schools, religious structures, public health centers (PHCs), Anganwadi centers and shops (Figs. 8.2, 8.3, 8.4, 8.5, 8.6).

8.3 The Intervening Years 2013 to 2014 The intervening years, between the 2012 and 2014 crises, were marred by incidents of militant violence and unrest across the BTAD area. Whereas district authorities and local civil society organizations attempted to bring peace through various activities, the nature of everyday violence and bandhs proved to be serious obstacles in bringing about genuine reconciliation. These intervening years were marked by

276

8 Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland Full Destroyed/Burnt

ParƟally Destroyed/Burnt 332

272

260 256 201 138

104

88 64

25 14

33 1

0

0

81

70 70

75

44

40 10

0

0

0

16

0

13

36 0

0

0

0

23 16 0 0

36 0

Fig. 8.4 Destruction of Houses in Cluster 3 Sub-Division X (with total number of houses fully destroyed in the cluster being 1,860)xxiv Fully Destroyed/Burnt

ParƟally Destroyed/Burnt 303

290 214 85 27 0 2 0 14

179

175 119

73 1 18 103

0 160

46 0

0 19

118 113 93 170 361 160

2

8

0

87 2

0

0

Fig. 8.5 Destruction of Houses in Cluster 4 Gossaigaon Sub-Division X (with total number of houses fully destroyed in the cluster being 1,919)xxv

targeted killings, abductions, attacks on security forces, grenade blasts, arrests and detentions among several other types of incidents. Major incidents of massacresxxvii of civilians in the intervening years of 2013 and 2014 further led to large-scale counterinsurgency operations. This deterioration of the political environment contributed to the preconditions of the 2014–2015 humanitarian crisis. The BTAD Violence Epidemiology and Conflict Early Warning Framework attempted at recording daily violence between 2012 and 2015. It was intended to be a risk analysis tool that would also allow for creating a rudimentary security risk index and decision support tool to assist local-level programme planning for the disaster relief NGO alluded earlier. While it was an approximate measure, the database provided some idea on the nature and direction of violence. Overall the database recorded 365 fatalities, 230 injuries, 45 abductions and 244 surrenders/arrests between August 2012 and January 2015 among various other incidents.xxviii It was not successful in terms of predictive capacity and did not anticipate the sudden outbreak of the December 2014 conflict. It also shows the importance of

8.3 The Intervening Years 2013 to 2014

277

Fig. 8.6 Photo of makeshift camp on edge of Village 54 (built on a destroyed school) as a shelter to host returnees from Relief Campsxxvi

having multiple sources of data and building more holistic monitoring tools, rather than be purely reliant on secondary sources. The trends, however, could also be a gross underestimation, given the report discussed below (Fig. 8.7). A report in The Assam Tribune in 2014 assessed the previous five years of conflict in BTAD. The report from 2014 provides an idea of the insecurity of the intervening 100 90 80 70 60 50

FataliƟes Injuries

40

AbducƟons

30

Surrenders/Arrests

20 10 0

Fig. 8.7 Monthly violence August 2012 to December 2014

278

8 Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland

years. With 3,500 cases of rioting and 1,300 abductions between 2010 and 2014, the BTAD was considered to be one of the most disturbed areas in Assam. As the report states: Peace-keeping in the Bodoland Territorial Autonomous Districts (BTAD) has remained a distant dream, with those at the helm of affairs utterly failing to ensure security of human lives and property year after year, leaving the common man under constant fear. Nearly 3,500 cases of rioting reported in the last five years have made BTAD by far the most disturbed area of Assam in recent times, if not the country. Be it incidents of uncontrolled use of arms or spurt in the number of abduction and extortion cases, lawlessness of almost all forms has become a recurring affair in districts like Kokrajhar, Chirang, Udalguri and Baksa. While nearly 900 innocent persons (murdered) were killed in the BTAD in the last five years (including those killed in the 2012 ethnic clashes), the damage caused by anti-social elements during the period to villagers’ property will run into several crores of rupees, if at all they can be quantified. Security forces, during the period, managed to recover about 730 firearms and nearly 3,500 rounds of ammunition. Police also registered 507 cases under the Arms Act during the period. The success rate being negligible, BTAD recorded over 1,300 abduction cases in the last five years. Rise in the number of extortion cases also leaves the law-enforcing agencies red-faced time and again. The ongoing targeted killing in BTAD is further adding fuel to the fire with already 33 lives lost. Senior police officials camping there said that gun-running is still very much prevalent in the areas and the unabated use of legal and illegal arms has posed unprecedented challenges before the security forces.xxix

The recovery process, for all the communities affected by 2012, was marked by a struggle for basic survival. The relocation from camps to villages and a rebuilding process, with minimal support led to a highly chaotic and prolonged recovery process. At the same time, despite serious incidences of violence, members of both Bengali Muslim and Bodo communities did try and overcome the differences, whether facilitated by civil society or through their own community-based initiatives (see Chapter Nine for some examples).xxx Nevertheless, the massacre in Manas, near Beki, should have served as a possible warning for the conflagration of December 2014 in terms of motive, method and the inner fractures within the overall armed movement that led to such an outcome. In the case of the Milon area, the re-emergence of conflict led the communities affected in 1996 and 1998 to once again flee to the camps.

8.4 Violent Borderlands and the Prelude to Peace: Violence Between the Bodo and Adivasi Communities 2014–2015, a New Humanitarian Crisis and Its Aftermath As the analysis indicates, the prioritization of humanitarian organizations was on post-conflict recovery in Bodo and Bengali Muslim villages affected by the 2012 riots. By late 2013, most responses had transitioned into different sectors of programming or exited the region. In some cases, responses to emergent conflicts and disasters in other parts of country reprioritized resources allocated for post-conflict recovery. By 2014, it can be said despite ongoing societal tensions, existing mechanisms were

8.4 Violent Borderlands and the Prelude to Peace …

279

adjusting to a context of a tentative peace. However, there was no anticipation of the crises of December 2014, which was nearly of comparable scale. Certain qualitative differences in the response of 2014 do stand out when compared to 2012. The first was that unlike the 2012 crisis where there was a breakdown of restraint and wanton destruction of entire villages, several joint preventive measures were taken by Bodo and Adivasi forums that avoided further damage. Second, in terms of organizational responses, there was a high degree of organizational learning at the district level by the various departments involved in the response such as the District Disaster Management Authorities (DDMA), National Rural Health Mission (NRHM) as well as developmental organizations, who by now had some contingencies in place to respond to the crisis. The catalysts for the outbreak of the violence is difficult to determine. In the days immediately before the massacre a few incidents occurred. Two militant cadres were killed in Chirang near the Indo-Bhutan border.xxxi In addition, media sources also reported a grenade blast that inured three persons in Kokrajhar on 22 December 2014.xxxii Broadly, it is understood that a coordinated massacre of Adivasi civilians was carried out on the night of 23 and 24 December, across Sonitpur, Biswanath Chariali, Kokrajhar and Chirang districts in areas bordering Arunachal Pradesh and Bhutan, respectively. This was rapidly followed by retaliatory violence between both Adivasi and Bodo communities, and an exodus, in the midst of violence to relief camps, over an extensive area. Early reports mentioned variable figures, with 34xxxiii deaths being reported in the initial days. The final death toll was tentatively determined by the 4 January 2015. Approximately 81 persons were killed in the violence: 66 Adivasis, 13 Bodos and 2 from other communities.xxxiv District-wise data indicates that there were 44 fatalities in Sonitpur, 34 in Kokrajhar and 3 persons killed in Chirang.xxxv However, figures on those missing or injured is yet to be fully determined. The exact number of indirect deaths, arising out of camp conditions, remain unmeasured, yet compared to our descriptions of the 1996 and 1998 crises, and with the emergence of NRHM, substantive reductions did occur. By 2014, a consortium of humanitarian organizations, with extensive response capacities and the ability to operate on scale, had established a presence in the BTAD (as a consequence of the previous crisis). For those involved in planning and conducting the response to the crisis, the primary challenge was to ensure that lifeline services reach the maximum number of displaced persons and that the living conditions within the camps did not deteriorate further. An overview of the field data collected is indicative of the enormity of the challenge. A disaggregated analysis of the affected districts showed minor variations in the humanitarian situation inside the camps, as the overarching outcomes was similar across a wide geography. Data collection at the time of the crisis was fraught with methodological challenges, which necessitated the collation of a diversity of sources. In the case of Chirang and Kokrajhar, for instance, most of the violence and displacement was close to the international border with Bhutan, which was not well connected and highly militarized. However, it must be mentioned that in the case of both crises, there were no obstacles to data sharing by government officials at the district level on the humanitarian situation; the challenge for all responders was to

280

8 Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland

Table 8.4 Distribution of displaced communities as of 10 January 2015 in Kokrajhar districtxxxvii Subdivision

Number of camps

Number of bodo community displaced

Number of adivasi community displaced

Kokrajhar

23

11,177

36,541

Gossaigaon

18

2947

18,429

Parbatjhora

2

0

2496

14,124

57,286

Total Overall Displacement

71,410

ensure accurate data collection and make standardized inferences, in a situation where there was diversity of assessment toolkits being used (depending on the requirements of the specific agency involved).

8.4.1 Camp Locations The scale of the violence-induced displacement was extremely difficult to determine. On 31 December 2014 it was reported that there were overall 28,6270 displaced persons in 139 relief camps: 23,5385 persons were displaced in Kokrajhar (across 92 camps), 34,296 displaced persons in Chirang, 1,1527 displaced persons in Sonitpur (12 camps) and 5,062 displaced persons in Udalguri (9 Camps).xxxvi By 10 January 2015, the numbers were again variable, with 71,410 and 19,876 in Kokrajhar and Chirang, respectively. Milon was one of the major locations in Chirang, where relief camps re-emerged for the since 1998 (Tables 8.4, 8.5). In the case of Chirang, the problem of listed and unlisted camps was a significant one, as seen in the situation of unlisted camps below, where nearly 6,000 individuals resided in unlisted camps (Tables 8.6, 8.7).

8.4.2 Access to Healthcare During the Crisis Phase The dislocation of such an extensive population, in a short span of time, with very little prior warning meant that the district-level response systems were overstretched. Unlike the previous crisis, the distances between relief camps and district centers was much more, thus straining the existing humanitarian logistics and supply chain. Healthcare provision, which was already dismal in the pre-2014 period, was further worsened given the pervasive sense of insecurity. Health access was problematic. For instance, in the case of Chirang, the major health institutions were more than 50 kms from the relief camps. Individuals were reduced to living in overcrowded conditions, without adequate shelter or sanitation facilities. There was an acute shortage of resources and breakdown in food supplies, no organized cleaning within the

8.4 Violent Borderlands and the Prelude to Peace … Table 8.5 Distribution of 47,718 displaced persons in Kokrajhar sub-division as of 10 January 2015xxxviii

Name of camp

281 Total persons residing in camps

Pakhriguri LP School and Church

6818

Serfanguri

1434

Athiabari Forest Office and Church

5461

New Bashbari School

3373

Uttar Bashbari LP School Kariagaon LP School Ultapani LP School

246 0 714

Duramari LP School

1889

Uttar Sarlapara LP School

1111

Duramri ME School

859

Lungsung Moinaguri

1170

Sarlapara BOP SSB

4485

Jaypur Manglajhora

1567

Patgaon HS School

5607

Lungsung Kadamguri LP School

3179

Lungsung Salbari LP School

1412

Lungsung Indrapur LP School

2145

Gaurinagar LP School

800

Jithpur Monglajhora LP School

890

Deka Damra LP School Bishmuri Bazar Garlabari LP School Labanyapur LP School Khangkra BADA LP School Total Number of Persons

1378 762 1872 406 140 47,718

camps and the non-maintenance of constructed toilets. An assessment report by a humanitarian organization done in Chirang states: Out of 16 camps, 14 camps have access to 1 to 2 hand pumps or well for drinking water and other household purposes. 2 camps (X and Y) are receiving water from tankers provided by Public Health Engineering Department (PHED). Women in the camps mentioned that they have to fetch water from the hand pump or well a number of times in a day as they have very few utensils to store and they are located about 500 meters away in large camps. PHED is installing hand pumps in some of the visited camps. People are not filtering the water which is being used for drinking and cooking purpose. People have few utensils which they are using for collecting water as well as cooking; hence, they don’t have utensils to store drinking water. Out of 16 camps, everyone from 14 camps are going for open defecation. 2

282

8 Responding to Conflict: Humanitarian Action and Peacebuilding in Bodoland

Table 8.6 Relief camp details as of 8 January 2015xxxix Serial number Name of camp

No. of men No. of women No. of children Total

1

Molandubi LP School

2

Deosiri BRO Office

780

565

755

2100

3

Milon Relief Camp

1875

1797

2488

6160

4

Mohanpur LP School

569

301

330

1200

5

Nagdolabari LPS

695

679

1326

2700

6

Paschim Golajhar LPS and 2 No. Gorsingpara

385

378

714

1477

7

Kungring HE

169

152

278

599

8

Odalguri LPS

692

569

789

2050

9

Bhurapur Adivasi Swahid Bhawan

665

634

1281

2580

10

Jaoliabari Advisai Camp

124

107

69

300

11

Birgaon

127

108

65

300

12

Total Camp Population 6238

5413

8225

19,876

Table 8.7 Details of additional unlisted camps located during assessmentxl

157

123

130

Total No. of households

410

Serial number

Name of camp

Total number of camp residents

1

Nilaguri

328

509

2

Kaola Bazar

427

2986

3

South Simblabagan

128

578

4

Khagraberi

113

500

5

Bogori

86

400

6

Bordhonga

205

865

Total Camp Population

1287

5838

camps, Molandubi and Simblabagan LP School, have access to 4 temporary and 1 school latrines, respectively. However, only women are using these toilets and men are opting for open defecation. PHED is installing temporary toilets in some of the visited camps. People don’t have soaps, toothpaste or other personal hygiene items. Women and adolescent girls mentioned that they don’t have sanitary cloth or napkin for their menstrual hygiene. Women are taking bath in river or near water source in the open.xli

Risks to highly vulnerable populations such as infants and pregnant women were further compounded by breakdowns in the existing monitoring systems. The pervasive fear impacted ASHA workers, who in many cases were unable to access the relief campsxlii and conduct routine activities. One of the most severe consequences

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of this was the breakdown in the provision of specialized care for women experiencing pregnancy (in all stages of pregnancy) as well asthe lack of specialized care for infants. The absence of ASHA workers to monitor the situation of mothers and infants implied a higher risk of non-detection of medical emergencies. Based on the data provided, it was estimated that by 31 December 2014 in Chirang there were 295 pregnant women, 1,129 children in the age range of 0–1 years and 2,492 children in the age range of 1–5 years living on the camps.xliii In Kokrajhar 593 pregnant were in the relief camps.xliv The absence of ASHAs after the initial outbreak also implied non-distribution of basic supplements such as iron, folic acid, calcium and vitamins (as well as special nutritional supplements). Risk of violence by various armed organizations who were still operating in the Indo-Bhutan border region was also an important variable that further heightened the vulnerability of those displaced in the crisis (which is also the reason why most relief camps had police or army pickets or posts manned by other security forces).xlv Lastly, existing resources themselves were insufficient. Analysis done at the time showed the fact that the current number of ambulances deployed for servicing 1,9366 displaced persons was eight which implies a ratio of 2420 relief camp inmates being serviced by one ambulance.xlvi Cumulatively, between 26 December 2014 and 8 January 2014, a total of 11,869 persons were treated in the relief camps in Chirang.xlvii The disease profile was as follows: 1,102 cases of Diarrhea, 403 cases of dysentery, 2,619 casesof fever, 59 injuries and 7,686 were classified as others.xlviii Accounts from that time highlight the interplay of the above factors and the grievous effects of camp conditions on the highly vulnerable population of both communities. On 30 December 2014 The Sentinel reported: An infant identified as Razita Narzary, lodged in a relief camp, died of illness at a local hospital in Chirang. Razita’s father has still been missing.xlix

The Sentinel of 4 January 2015 further reports: A 10-day old child died in a relief camp in Chirang district. The child has been identified as Mainu Murmu, daughter of Sunil Murmu, a resident of Rajajam village under Sidli PS Chirang District. They were living in Krishnapur LP School relief camp following the massacre by NDFB. Talking to media persons, Sunil Murmu said that Mainu was ill since the last two days. “But we did not get any medical assistance here in the relief camp and hence her condition became worse. She died today at around 7.30am,” he said. Murmu also alleged scarcity of baby food in the relief camp.l

Conditions such as those mentioned above were systematically experienced across the vast geography of displacement. An account from a camp in Biswanath Chariali approximately 300 kms away was reported in the Assam Tribune of 28 December 2014: Barki Hasta (30), a eight-and-half month pregnant woman, is saying she is feeling some unusual pain in her abdomen ever since she made a lucky escape with her husband Binod Marandi from the native Balidunga on that fateful night when miscreants opened fire. Makon Orang, another eight-and-half month pregnant woman, too is panic stricken. Her two children are have caught fever and at night she becomes worried as she knows that there will be no

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doctor on duty from 10pm till 8.00am. Many other lactating mothers complained that they had to share a small blanket with their children in the relief camp. Somehow though, the agony, distress and helplessness of these traumatized children, pregnant women, lactating mothers and elderly remain unheard in the corridors of power both at Dispur and New Delhi.li

The report further goes on to state that not a single child specialist was deputed for any of the three relief camps in the area, and where nearly 900 children below 5 years of age lived (of which 200 were in the 0–12 age range): Worse, only two doctors have been released by the government for each relief camp who carries their duty in shifts from 8am to 10.00pm. Records of the relief camps reveal that a number of children and elderly developed viral fever and other complications have also gone up in the last few days. An official of the Joint Directorate (Health) admitted that specialized and emergency care for infants and the pregnant women are not in place, but hastily went on to add that packets of iron tablets for pregnant women are available. Ironically, however, the official has no answer on how many pregnant women are presently housed in the relief camps evidencing the hollow part of the relief work. The official requesting anonymity, said that baby food packets (Lactogen and Cerelac) are also distributed among children depending on their age in all the three relief camps set up in Tinsuti High School (ME/LP), Samukjuli LP School and Samukjuli Church. Strength of the medical team is negligible keeping in view the number of inmates in the three relief camps. There are 6,000 inmates in the three camps. “There remains only one doctor at a time. In night hours there are none, they only come in the morning,” said an elderly inmate of Tinsuti High School relief camp, a fact later confirmed by health officials.lii

Despite the above situation, it is important to state that, compared to the 1996 crisis, the presence of the NRHM and transformations in information technology did have an impact on the condition of the camps. Given the scale of the situation, districtlevel health authorities in Chirang and Kokrajhar did attempt to maintain accurate information on pregnant women and infants in most listed camps, once the camp situation stabilized. Camp-wise tracking of pregnant women, infants and others at risk was attempted and provision of up-to-date information on the details of doctors was also an important change seen from the earlier days. As stated by a government doctor overseeing camps in one of the border areas in Kokrajhar district, which was severely affected, accuracy of data was maintained by also relying on communitylevel data that was generated by camp committees which was quite reliable and allowed for tallying with existing records.liii Also given that the pattern of fleeing and clustering of camps was village-wise, camp committees were able to collate community-level information (Figs. 8.8, 8.9).

8.4.3 Impact on Children As will be seen, the impacts of violence on children, which include both direct impacts and indirect impacts, was a major point of concern that spanned both the 2012 and 2014 crises. It must be noted that there are very few policy frameworks, which address the issue of children who are forcefully displaced due to conflict, despite the fact that they constitute a significant proportion of the population. Some

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Fig. 8.8 Photo showing relief materials from 2014 conflict in Chirangliv

Fig. 8.9 Photo showing a public health centre in Kokrajhar converted to relief camp in 2014–2015 Bodo-Adivasi violencelv

major vulnerabilities of children were accentuated, across both, the 2012 and 2014 crises: erratic food and drinking water supplies; deterioration of Anganwadi services; breakdown in protective environment due to relief camp conditions (overcrowding and lack of shelter); vulnerability to sexual and other forms of violence; and impact on education and problem of ‘out-of-school’ conditions. While there has been no systematic evidence generated until now on the impact of education and conflict in the

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259

245

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221 136

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CLASS 4

CLASS 5

7 KG

UKG

CLASS 1

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Fig. 8.10 Distribution of 1,121 OOS children by year of study in select relief camps in Milon area after 2014 conflictlvi

area of study, the prolonged nature of displacement did impact the system in two ways: first, children who were living in camps were unable to attend school; second, schools became designated relief camps across all affected districts, leading to their closure (and impacting those students who were enrolled and not displaced). A micro-analysis of out-of-school children in the area utilizing community-level data (i.e. lists maintained by camp committees) points to the seriousness of the problem being highlighted (Fig. 8.10). The impact on school and college students affected all communities and can be further gauged by a report published in The Sentinel from 4 January 2015: The students languishing in the relief camps after the massacre in Kokrajhar and Sonitpur districts, especially those who are to appear for the Higher Secondary and HSLC (matriculation) final examination to be held in February, have been affected badly as many could not take their books with them and the environment in the relief camps is not conducive for studying. When this reporter visited several relief camps like Mainaguri, Soralpara, Karigaon, Joypur, New Bashibari, Mosalpara, Samsingkhela, Ultapani, Kachugaon, students, especially the HSSLC and HSLC examinees, lamented that they have not been able to study as they were living in panic and fear and there were no rooms in the relief camps. Mithisar Basumatary, who is appearing for the HSLC examination in February, said that they wanted to return home but due to their prevailing situation and lack of security, they feared being attacked. The examination is drawing close but they are not being able to prepare well.Another BA third semester examination candidate Karishma Iswary said they wanted to return to their homes as there was no environment for studies in the relief camp and there were no tools to read books (Fig. 8.11, 8.12).lvii

8.4.4 Community Perspectives: Conflict Early Warning and Fleeing One of the most important findings of the literature on conflict-induced displacement is that it does not affect all households uniformly and has major implications for the recovery phase. Thus, a study in Northern Uganda found that ‘households in the

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Fig. 8.11 Photo of a “Relief Camp” inside a school building premises in Kokrajhar after the December 2014 conflict

Fig. 8.12 Relief camp conditionslviii

top three quartiles of pre-displacement assets appear to have recovered a portion of their consumption, though with significantly reduced education and wealth levels’.lix Moreover, the study found that there ‘is no recovery for the bottom quartile households, who appear to be trapped in a lower equilibrium’.lx Findings from Burundi indicate that ‘it takes 8 to 10 years after return before the level of welfare of the displaced converges to that of the non-displaced’.lxi While this would mean longer recovery cycles which require sustained support, an explored dimension in this literature is whether systems of community-based conflict early warning and prevention has an impact on the recovery cycle. For instance, in the study area, post 2005–2006 (i.e. post rehabilitation), Adivasi and Bodo settlements had started to co-exist. In 2014, there are narratives that show Adivasis being warned in advance of the major militant attack. The warning turns out to be given by their Bodo neighbours in a nearby locality. As the accounts being described show that interpretation of signals can vary within the same village itself (i.e. among the residents who did and did not receive the waning). Yet, approximately ten kilometres away, in a connected sequence of events on roughly the same day, we also have instances where members of the Bodo community did not receive any

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Fig. 8.13 An armed Santhali man guarding a partially destroyed village in Chirang after the 2014 conflictlxii

warning of an armed attack against them by Adivasis. Alternatively, in one instance warning was received but not communicated (see Chap. 1). This was detrimental to the manner in which both communities could rebuild. In the first instance, the Adivasi men who escaped after receiving the warning, returned back to their locality to rebuild, immediately after the incident (with women and children staying on in the relief camp for reasons of safety). In the second case, the Bodo village that was attacked suffered grievous casualties, and was dispersed and broken up into a number of settlements, several kilometers apart (with people not returning back to their original home). In the new settlements, we see a fall in attainment of education, health and rehabilitation. In the experience of RH, an Adivasi male of 35 years, who is a community mobilizer (and works with all communities) said that the degree of warning was enough to make alternative arrangements. He is from Bogori Village (Fig. 8.13). We are Adivasis and our family were informed by some Bodos we knew well that ‘some trouble’ is going to break out. ‘You people had better be prepared’, we were told.So, we quickly managed to sell off most of our buffaloes at throwaway prices. We sold a buffalo costing Rupees 10,000 for as little as Rupees 3,000. But with that money, we managed to buy food the first few months and were better off than others.lxiii

Another perspective is provided by an Adivasi woman who escaped to the camp in 2014. They were able to escape with some assets, and mentions about the assistance given by the Nepali community: We, as much as our capacity and possibility allowed, took rice, paddy, utensils and clothes with us to the camp. Whatever we took we kept in the Nepali friends’ house in Milon. We used to take our paddy from there and boil it, dry and take to the rice mill. In this way we managed to stay in the camp. On the other hand, we also received rice, salt, oil, potato, chilli etc. So, we had not have such a tough time.lxiv

On the other hand, there was a case where the warning was just enough to flee from their house. In this case, DW an Adivasi woman, who was in the lower side of Fulbari village states: We came to knew about the conflict from the people who used to go for daily wage work in the Bodo villages like cutting paddy. The Bodo people told those workers that ‘do not come

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to our village as conflict is going to start. People may kill you all if you come to our place so go back home and take some steps to be safe.’ On that day the workers went back home and in the evening they saw VXYZV militants come and burn the houses. We ran to Milon but could not take anything while running to the camp. Before running we threw our utensils and pots in the jungle. After some time, we came back to our home in search for our utensils and pots which we threw before running and took them to the camp. We stayed in the camp forseven months. We could not go for labour work for 2 months since we feared that they would kill us.lxv

The uneven spread of information can be gauged by the two accounts of the same incident. As stated by KS of Fulbari village: When the 2014 conflict broke out, the people of Fulbari were informed by the people of Milon and Koroipur that conflict had started. They also asked them to remain alert. On 24th December 2014 the militants came from the Bhur River side and started firing. They entered the village from the upper side of the village. They fired and burnt down the houses in the upper side of the village. One man from the upper side of the village did not run while the militants were firing. He was killed by the militants when they found him. Women and children were sent to the relief camp in Milon when all the upper side families started fleeing their homes. Men from their part of the village remained back to guard the village. The men had a hard time in guarding the village. They used to sleep in the jungle during the night. They could not sleep properly as they had to remain alert and prepare against any attack. They used to be in groups while guarding the village. They also used to cook food in groups. They got ration from the relief camp while they were guarding the village. He said people who could not take their cattle to the camp lost their cattle. And many others lost their livestock. The men who remained back to guard the village used to eat the hen and other things. People’s paddy which was not harvested got spoilt in the field.lxvi

MS who was there in the locality at that time, but fled with her family, as they did not receive warning: When the 2014 conflict broke out, the militants entered the village from the upper side of their village. They started firing and burning houses. One man was killed in our side of the village. When the people started running from their side of the village we also started to run along with the others and reached the relief camp in Milon. The men were left to guard the village. We could not take anything to the camp. Though our cattle were lost, our houses remained. Our crops were also eaten by the elephants. Only the houses in the upper part of the village were burnt. The lower side houses were saved because our men were guarding it.lxvii

RPMD also from the same locality describes the journey to the relief camp: Before running to the relief camp we saw houses burning and they could hear the sounds of gun fire. After this we started running. We fled at around 4 o’clock in the evening and reached Milon around 7 o’clock. They were scared while running away but at the same time there were people who were guarding and doing duty with bows and arrows helped them to reach the camp. We went to the relief camp and did not take anything with us. We left everything behind including the rice. We lost our rice, house, clothes, utensils etc.After we left, our houses were burnt. During the conflict the people ran separately. My family went to Milon Relief Camp. We were in the camp for six months. My two sons had suffered from fever while in the camp. Some people from outside came and gave them medicines; and, they recovered. If those people had not come my children would have died..lxviii

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The lack of warning is especially catastrophic for those who directly suffer the death of a family member. While, the interviewees above took shelter in the camp, the life history of Roshmi (name changed below), from the hamlet (see Chap. 1), highlights the multi-layered vulnerabilities and risks faced by such individuals.

8.4.5 Community Perspectives: Mapping the Challenges of Post-Conflict Recovery Through the Life History of Roshmi—A Bodo Woman Whose Husband Went Missing in the 2014 Conflict (All Names and Locations Have Been Changed)lxix Roshmi, a Bodo woman is originally from Ambari village and presently living in a hamlet called Sonapur created by a number of households after they moved out of a relief camp. They did not return to their original village. Their village was attacked without any warning. The detailed case study maps out the challenges at the household level, for a single woman headed household, trying to build back from the conflict shock. It is possible that the respondent’s case was reported in the newspaper article cited earlier. When the hamlet was located, a few humanitarian organizations had provided some assistance, especially water sources. It is neither encroached nor a fully recognized forest hamlet. In other words, it might be recognized and demarcation is possibly done but it is dependent on the various pending approvals. It is at a distance of more than ten kilometres from the main market and government dispensary of Koroipur. She presently has three daughters and one son. The Bodo– Adivasi conflict of 2014 saw her life turning upside down. Counting Losses of 2014 Conflict Her husband was a daily wage labourer and they had no land for cultivation. On 24 December 2014, he went for daily wage labour in a nearby village called Nangdorbari. Fighting broke out between Bodos and Adivasis and her husband went missing. The people from relief camps along with the Army went searching around the place where he was working but unfortunately, they could not find his body. She says the ‘they cut my husband’ when the search team of security forces and locals confirmed his death when they discovered his clothes and shoes that were scattered at some distance from where he worked that particular day. But they never found the body. Roshmi and her family fled their village and went to live in Oxiguri LP School Relief Camp where they stayed for a month. It was tough living in the camp and all she got to eat was some rice, dal and potatoes given as relief by the government. Her health deteriorated as just a month before the conflict, she had delivered a baby girl. She remained in the relief camp as she was told that she could get compensation for her losses only if she remained in the relief camp. But she got nothing as she was denied any compensation because her husband’s dead body was never recovered.

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She said: ‘While I lived in the relief camps with all the losses and emotions, all that I received was the tent, rice, dal and sympathies of people around’. Even as she was reconciling herself with her husband’s death, the infant daughter also died in the relief camp. ‘One day, the baby started to cry from the morning, yelling and kicking her legs with great pain. Some NGO people helped take the baby to Kajalgaon Civil Hospital but she did not survive and died the same day’. Roshmi feels that some daina (witch) is involved in taking away her daughter from her as she says ‘many people in the camp would come and see and kiss the baby because she was so cute and they felt pity as she had no father. One of them must have been a daina and killed my daughter’. Settling into a new place Roshmi had a very difficult time because of the mysterious disappearance of her husband and the death of her baby. She still had to look after her three other children, two daughters and a son: Although we had small quarrels over family issues, I was never worried when my husband was alive. I used to work hand in hand with him to keep the family going. Even when I was pregnant I used to go for work to help my husband. We used to go and collect firewood in the forest and sometimes in the river. Together we brought back the firewood for selling in Koroipur market.

Her brother, a farmer advised her to move to Sonapur (where he also lived in a nearby village) and she also felt the need of getting some land for her son in the future. My sister and I were the first to come to Sonapur as soon as I heard that there would be a land distribution here (for families affected by the violence). I was allotted 8 bighas of land.

She feels that land in Sonapur was not distributed equally, but still it was land she got. Now she feels insecure as the previous year, the ‘phakras’ (armed militants) had come asking the new families to move out of this land. She feels insecure as ‘once more they (militants) send us a notice, we will have to move out even if the forest people (the forest department) allows us to stay’. In the beginning of her stay in Sonapur, Roshmi was supported by her brother who gave her some rice. She went to catch fish and collected wild vegetables and sold them in the market. ‘My husband’s family could not support us because they themselves had nothing’. She also had to spend Rupees 2,000 for one of the closing rituals of her dead husband recently. Their ‘house’ was built in one day. The tin roof was brought from her previous house in Amguri and she made walls from the plastic tirpal (sheet) which she received from some NGOs. I did not receive any compensation because my husband’s body was not recovered while other families who incurred loss of lives or injuries received huge compensation even up to 5 lakhs. I did not even receive the compensation amount of Rupees 50,000 as my house in Amguri was neither destroyed nor burnt during the conflict. I just received some help in cash from some NGOs.

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Building Back towards a Resilient Future Roshmi now earns through hazira (daily wage labour). She also has a kitchen garden from where she is able to sell the produce in order to purchase other essentials: My previous house in Amguri was better. I planted some chillies and maitha (sour leaves) in the present village (SN) but some insects destroyed it. In the previous year (2015) I had given out our land for mustard cultivation to others and got Rupees 500 as rent for the year.

When she does not find any hazira (daily wage) she goes to the river where she catches small fish, crabs and snails and sells them in Koroipur market. She recently tried a new business, i.e. purchase vegetables from other villagers to resell in Koroipur market: It gives me a slightly better earning but the effort and time is extreme for me. I have to go early in the morning in search of vegetables, by noon I come back home to prepare lunch and then leave for Koroipur daily market to occupy my place for selling the vegetables. I take the last vehicle from Koroipur that goes towards our village. By the time I reached back home its 7.30 pm. I have to walk for about three kilometres after getting down from the vehicle to reach our village since there is no vehicle that goes till the village.

In her earlier village, she used to supplement her income with brewing and selling rice beer. Now she has never been able to invest any money for brewing rice beer and she is also not sure if it will sell in this new place. We hardly cook meat in the house nowadays. We are not vegetarians but I am unable to buy meat with my little earnings.

Almost all the profit she makes from selling vegetables in Koroipur is just enough for her transportation and to buy rice: I earn a maximum of Rupees 150 in a day. I buy five kilograms of rice for Rupees 110, Rupees 20 goes for the travel and ten rupees for salt and other essentials.

She often is in debt with the Koroipur shopkeepers. Comparing the shopkeepers of Koroipur with shopkeepers in her earlier village of Amguri, she says: The Amguri shopkeepers were never bothered if I bought things from their shop on credit but in Koroipur I have often been shooed away.

She had a debt of Rupees 60 at the time of the interview—20 to another vegetable vendor she took money from, 10 rupees in one pharmacy for some medicines she took, 10 rupees to a neighbour and 20 to the auto rickshaw driver. She hopes to clear the credit in a few days and is careful about visiting familiar shops to win the trust of the shopkeepers from whom she can get help during emergencies. The family eats twice a day, once in the morning and once in the night. Whenever she feels tired she is reminded of the fact that the family would go hungry if she did not go out for work, and hence she never takes any off days from her work, ‘we have not been able to have a satisfactory meal since the day my husband went missing’. Children out of school and working In terms of schooling she said: ‘None of my children are going to school at present’. Her eldest daughter who is 15 years old is working as a house maid. She studied

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till class II. She started working when she was very young, ‘ever since she started to wear a dokhona’ (the traditional dress of Bodos). She does not know how much she earns now but reckons it must have increased from the Rupees 2,000 she earlier got.Whenever her daughter sends her money, she buys some 20 kg of rice for the month. Once in a while she also gets a thousand or two as extra money from her daughter. Recently, her second daughter has also left home to work as a house maid to help her mother and sister maintain the family. While still in the relief camp, Roshmi’ s eight-year-old son was taken by a group of people to study in a residential school (Ashram school) in the neighbouring Baksa District. Roshmi was already sad with the death of her husband and missed her son terribly and so during one of the vacations, ‘when the other parents from the village went to pick their sons from the school I went with them and brought him back and never sent him back to the school again’. He does not go to school now because there is no school in North Simlaguri. Life in the present village She does not get any PDS rations in the present village (Sonapur) though in the previous village she got ration rice four times. She has a job card which she submitted to the VCDC as she was told that on giving the ration card, she would be paid cash. In terms of access to healthcare, she says: When we fall sick, we go to Koroipur (government hospital). The children never fell so seriously ill till date so I have not needed to take them outside except to Koroipur. With two-three tablets they (the children) are fine.

When anyone in the family falls ill, the daughter sends the money and if not, she manages somehow. She also goes to a place where there are NGO workers and if she asks, they will give her medicines. In Koroipur, she gets some treatment for typhoid and malaria. Though their earlier village Amguri was much easier to get to the hospital but she is here with the hope that her son will have land in the future. But ‘if there is no chance of getting land here at all, then I am ready to move back to my old village’. Roshmi was a member of a village Self Help Group (SHG) back in Amguri. Their SHG used to spend a portion of group funds to purchase pork during the week long Bwisagu (April Harvest Festival) festival. The meat was equally divided among the group members: I remember that I received around 2 ½ kg of pork every year during the Bwisagu festival. My husband and I together used to borrow money from the SHG during emergencies. It was a good source to borrow money because it charged less interest from the group members.

Roshmi is still a member of the Amguri SHG but her association with the group has diminished because of the distance: I also have very little time to spare to be involve in its activities because I am busy working the whole day. I have failed to attend the meetings of the groups many times so I had to pay fine to the group. I am actually unable to pay those fines because I have money enough just to be spent on food.We could not celebrate the Bwisagu festival of 2015 because of the conflict in 2014. My experiences were too bitter to go for enjoyment.

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Roshmi was living in the Oxiguri relief camp during the 2015 Bwisagu festival season. The people were rendered helpless, as they had lost all their harvest and livestock during the conflict. Above all, living in the relief camp with all the sorrows and grievances they did not have any reasons for celebration. ‘All we could do was to grieve over our losses and watch the nearby villages enjoying Bwisagu festivities’. Even after the people resettled in Sonapur we were not in a position to afford to celebrate Bwisagu of 2016. The wounds of 2014 conflict are not yet healed; the people were still struggling to build their homes in their new village. We had nothing to harvest, the spring had no difference for us, it was too early for the villagers around to involve into these newly settled group of people living near their village for the festival.

Roshmi and her neighbours decided that they would be celebrating the forthcoming Bwisagu festival (harvest festival) of 2017. They feel that they would gain some stability by then and they would be in a position for the festival. Roshmi’s neighbours, in their previous village used to even invite the Santhals and would even go and dance in the Santhals house as a sign of friendship and inter-relationship. All that is over now (Fig. 8.14).

Fig. 8.14 Mapping of Post-Conflict Risk and Protective Factors of Health

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8.5 A Case Study: Challenges in the Planning and Management of Large-Scale Humanitarian Operations in the Aftermath of the Conflicts (2012–2016)lxx The provision of life saving humanitarian aid to those affected by natural disasters and conflicts poses several challenges to those involved in the planning and management of such responses. As indicated in the chapter, the scale of forced internal displacement, in both crises, involved the provision of relief material by state and civil society organizations to nearly 800,000 affected persons. Based on an interview with a humanitarian aid worker who worked in the region, in the aftermath of both conflicts, in post-conflict recovery in the aftermath of 2012, and who was involved in the entire response and recovery cycle from 2014 through 2015 (in the IndoBhutan border blocks), some critical challenges, insights and recommendations can be brought out. In the aftermath of the 2012 crisis, an internationally funded consortium had emerged in BTAD, consisting of three types of organizations: organizations headquartered internationally with semi-autonomous regional branches and response capacities located in India; local organizations based adjacent to BTAD but with prior experience in relief and rehabilitation; and, civil society organizations doing long-term developmental work that were located in BTAD. One of the important challenges to keep in mind was that for some members of the consortium, parallel responses especially around 2014–2015 were also being managed in two other simultaneously occurring projects. One was in KarbiAnglonglxxi and the other was a response to large-scale displacement in the aftermath of an episode arising out of the Nagaland–Assam boundary dispute.lxxii From a managerial perspective, the challenges, although occurring across multiple sites, allowed for some degree of comparative analysis. For aid workers, the prioritization was the provision of both food and non-food items (NFIs), which were essential to sustain life in the relief camps, with the entire logistical and supply chain system aligned towards this purpose. The scale of the tasks can be gauged by the fact that in the recovery phase, the organization, to which the respondent belonged, was supporting nearly 300 affected villages across two districts, while in the response phase which was centered around relief camps, they were reaching out and providing relief materials to 300–400 new households every day. The multiplicity of tasks can be gauged by the fact that humanitarian aid workers had to ensure the adequate raising and channeling of financial resources, conduct field assessments, set up field operations, hire local staff, create transportation systems, coordinate with government officials, identify vendors for supplies, ensure accurate beneficiary lists, conduct monitoring visits, ensure safety of staff, negotiate with local stakeholders, liaise with the community leaders and various other tasks throughout the entire project cycle. Most importantly, all these tasks were to be conducted in a limited window of time in an insecure context and where relief camps were selforganized on ethnic lines. Relief camps were exclusively either Bengali Muslim,

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Bodo or Adivasi. The delivery of aid to camps would always run the risk of being perceived to favour one community over the other. In this situation equally critical to these administrative tasks are the normative frameworks that define humanitarian work; whereby, aid workers have to strive to ensure that concepts such as Do No Harm,lxxiii Humanitarian Accountabilitylxxiv and core humanitarian principles such as Neutralitylxxv are incorporated into the entire response. For the case of the 2014–2015 conflict, the initial challenge was that of access, given the multiplicity of security forces who were operating in the affected areas, and the dearth of information available. Once permissions were obtained, the challenge was to ensure that assessments were conducted. However, given the paucity of accurate maps, there were situations where villages would have the same names. Alternatively, while relief camps were being set up, it was also seen that several were not recorded in the government list. Regardless, of the quality of data available, it was stressed by the respondent that one cannot lose sight of the broader humanitarian situation inside the camps, where risks of disease were accentuated due to the erratic relief supplies and deterioration in water, sanitation and hygiene. Minimizing the spread of disease, where government health centers were already weak or nonfunctional was an immense challenge and even minor ailments if untreated could become emergencies. In other cases, the emergency situation was declared as being over by local authorities, despite relief camps still existing, which further added to the camp situation. In the border areas, where relief camps were located, provision of water highlights the uniqueness of working in an area governed by the Sixth Schedule. Three categories of land exist in BTAD: Revenue Villages, Recognized Forest Villages and Reserved Forest. Another informal categorization are communities who were displaced earlier and settled in Reserve Forest areas (or those who encroached forest land in search of livelihoods and settled inside the Reserved Forest areas). This is made even more complicated by the existence of temporary relief camps established in forest areas in the immediate aftermath of earlier episodes of violence or in 2014, but the residents have not returned to their original habitation (which could be a recognized forest village or revenue village). For construction of water points and sanitation facilities in revenue villages and recognized relief camps, approvals were normally sought from the Office of the District Commissioners. However, Forest as a subject comes under the Bodoland Territorial Council (BTC), the problem of informality became a serious one, given that a majority of camps in 2014–2015 in and around Milon were on forest land. Furthermore, with such a huge population living in these situations of informality, even the provision of clean and safe drinking water to these communities became complicated. Another technical problem faced by the respondent was that the depth at which groundwater could be extracted was at 100–150 feet, and required special Mark-III deep bore tube wells which were more expensive and in limited supply. Complicating the problem further principles of neutrality would require siteselection in a way that both communities (Bodo and Adivasi) could access the handpumps, despite the existing polarization. The non-availability of water sources had compounded the crisis, as women and children of both communities had to travel

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long distances, to access water sources, through a hostile environment, making them vulnerable to highly vulnerable to violence. A major learning from the respondent was that skillful negotiations were needed to traverse these boundaries of informality and formality, where demarcations between recognized forest villages, forest land and encroached land were unclear. As no construction can be done on forest land, site selection required an attention to detail and transparency, whereby the approvals from the BTC were a minimum requirement to ensure any construction of the hand pumps. While this took time, eventually these were forthcoming. Another balancing act in the negotiations was that depending on the composition of the VCDC and local interests, recommended sites from the VCDC could be seen to benefit one or the other community. Again a tradeoff would have to be made in some cases, where although the site for the hand pump would be finally located proximate to one community in order to get the VCDC or higher authorities on board, and it was also situated in a way that was close enough to the other community as well. An important observation made by the respondent was that over time, the pre-existing interlinkages and co-dependence led to the utilization of these sites by both Adivasi and Bodo communities, despite the existing hostilities. Eventually the communities arrived at an informal arrangement whereby Bodos and Adivasis would draw water at different times and there were no incidences of conflict around water (while at the same time reducing the distances for water transportation for vulnerable women and children). An effort was also made at community ownership, as these hand pumps were located in remote areas, with some degree of financial contribution made by the communities to maintain the hand pumps and creation of water committees. Local contractors residing close by were also identified and they were given six-month to one-year service contracts, while users were trained in basic repair and maintenance. They were also linked to mechanics in Kokrajhar and Bongaigaon. The respondent also made observations regarding the pattern of recovery, and their programme conducted both conditional and unconditional cash transfers to beneficiaries. Interestingly, the respondent found that unconditional cash transfers were more effective in reviving market linkages and in many cases the Nepali owned shops that were not affected in 2014–2015 led the way in sustaining the displaced Adivasi and Bodo population. The revival of local markets also allowed for the reconstruction of livelihood patterns and improved food intakes, whereby households could diversify food intake options by accessing the local markets. Another observation made by the respondent was that individuals from Bhutan, who had links with the nearby VCDCs like Koroipur, on an individual initiative would provide relief material in their individual capacity. While there were no cases of obstruction faced by the respondent by either the security forces or armed organizations, the prevailing security situation was of concern and there were only limited timeframes under which they could function. The relationship with the communities improved over time, and local staff who belonged to either Bengali Muslim, Bodo and Adivasi community could work in villages and camps of either of the communities. In the relief phase, there were instances of beneficiaries attempting to secure more relief supplies, but there were methodologies of

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cross-checking developed, such as the use of special tokens and relying community data, which contributed to equity in distribution. The respondent also installed complaint boxes in project sites to allow for additional monitoring. One major lesson was the importance of working with community leaders and youth organizations, specifically the student unions. Field staff who were locally recruited became critical to the information flow, as some key members would have formal or informal linkages with the prominent student unions. This allowed the organization to enhance its management of security risks and movement into field sites. Coordination with district authorities was an area that could be improved, as despite data sharing, there were very few formal district-level coordination meetings between the state and civil society organizations. Furthermore, the organizations while working in border areas were unable to converge their work with existing government schemes such as the Border Area Development Programme (BADP) or compensation schemes for victims, for their programming, due to either the dearth of information or these tasks being outside the accepted project frameworks. While the respondent did provide regular reports to the Offices of the Deputy Commissioners, the creation of such mechanisms would have enhanced the nature of the overall response. The process of closing and exiting for humanitarian organizations is also a difficult one, at both the organizational and individual levels. Given that deep local-level linkages are made, there were very few humanitarian organizations, who stayed back in BTAD and transitioned from humanitarian work into peacebuilding or longterm recovery. Looking back, the respondent felt that much closer coordination with BTAD-based civil society organizations and a transition into developmental work would have been an area of further fruitful collaboration. New horizons have now opened up, such as joint management of climate risks, water governance, forest management and convergence of risk frameworks by improving coordination mechanisms between VCDCs, DCs, BTC and DDMAs. An effort is also recommended to identify hidden tensions and new sources of conflict, and address them through improved risk governance. With the advent of peace, developmental deficits can now also be addressed with Corporate Social Responsibility (CSR) funds to supplement government schemes. There is also a necessity to allow for channeling of nationallevel funding for disaster risk mitigation to the local level and making VCDCs more responsive to these arenas identified above.

8.6 Preventive Measures and Peacebuilding at the Community Level The humanitarian situation in 2014 was indeed problematic, and shortfalls have been documented by various assessment and fact-finding reports. However, a major lacuna of these reports (and probably because they directly studied the relief camps) was the lack of documentation of initiatives that sought to prevent and control the

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violence, which could have spiraled out into full-fledged ethnic conflict between the two communities.lxxvi This layer of peacebuilding, whereby initiatives were taken by the key leaders of political parties and student unions who are seen as conflicting parties, tend to be overshadowed in the major fact-finding report of the conflict. Also excluded are peace initiatives at the local level, which emerge from the communities themselves without any external organizations shaping or directing them. The question is whether peace initiatives or the types of actors implementing them are acceptable because they do not necessarily conform to the dominant normative paradigm (i.e. they possibly could have been violent actors with a seemingly poor record)? Alternatively, as the role of the Nepali owned shops show, they might not necessarily have sought to build peace consciously, yet they provided an alternative which was more effective and sustainable. Thus while external assessments and fact-finding missions might draw some degree of national attention over the short-term, there is a need for longer-term granular analysis of the post-crisis situation. This is especially needed to identify less visible local capacities and structures that support community level peace processes. In the case of the 2014 humanitarian crisis, one of its key characteristics was the degree to which pre-emptive and retaliatory violence, was condemned on a mass scale, by all the major stakeholders. What emerges from a retrospective analysis of the events occurring then was that violence as an instrument of securing political recognition was itself rethought, and there were calls for unity between both the Bodo and Adivasi communities. A report in The Sentinel from 29 December 2014 is indicative of this universal condemnation. We also see the former chief of the BLTF, now in charge of the BPF (who were in power in the BTC between 2003 and 2020) and the leaders of the ACMA as well as BCF (the Adivasi militant groups who are on ceasefire) all come together: BTC chief Hagrama Mohilary and leaders of various Adivasi militant organizations including Adivasi Cobra Militants of Assam, Birsa Commando Force, shared the dais in various peace meetings organized in Kokrajhar district on Sunday in a bid to bring back peace and understanding among the people of both communities. The Adivasi Sahitya Sabha and Santhal Students’ Union gave company to the militants while BTC chief Mohilary was accompanied by his BTC colleagues including EMs and MCLAs.lxxvii

The report further states: This is the first public meet by BTC chief after massacre of Adivasis as he was away in New Delhi. The presence of large numbers of leaders of both the communities and the people of both Adivasis and Bodos simply exposed how much the people are fed up of communal violence and are yearning for peace and are eager to go back home. Mohialry said, “We have suffered a lot during the last twin communal riots in 1996 and 1998 and cannot afford to have another as it takes years to build a home. Speaking in the same vein, Adivasi Cobra Militant of Assam (ACMA) chairman Zabrius Khaka said, “The communal fire burns us all alike destroying everything that we have and we shared and it is time that we realize and work for development of the family, the village and society.lxxviii

Another report highlights the coming together of 26 major student unions, under the leadership of ABSU and AASU in visits to relief camps in Chirang.In a significant statement during the joint visit, the AASAA president on 31 December 2014 said

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that the incident can be attributed to the extremist elements, and ‘not by the Bodo Community as a whole’.lxxix He further said that, ‘both the communities were peace loving people and so permanent peace must be reestablished’. This was also marked by the determination of residents of the relief camps themselves to maintain peace and amity. Thus there is a report in The Hindu that profiles two women Churamoni and Sangita. Churamoni is Adivasi and Sangita is Bodo. Both had given birth on Christmas, but had to immediately take shelter in the relief camp. As the report states, the naming rituals could not be completed because of the conflict, it was decided by both communities who were living in adjacent camps (near a mini-PHC) to complete the rituals for both the children in the camp: Sangita and her husband Rabi Basumatary, followers of the Bodos’ “Bathou” religion, decided to name their baby boy ‘Christmas.’ Churamoni’s family is planning to observe the ‘Neem Dak Mandi,’ the Santhal community naming ritual, in the Adivasi camp at the Champaboti Mini Public Health Centre. “The ‘Dargin’, the woman, who helps the mother deliver the child, will serve each camp inmate a cup of Neem Dak Mandi — neem leaf cooked with rice gruel — and convey the name given to the newborn,” explained David Murmu, secretary of the Joint Committee formed to maintain peace in the camps. He said Churamoni’s family had got the confidence to observe the ritual at the camp itself as the inmates of the two shelters had vowed to maintain peace at any cost.“Representatives of the two camps held a meeting at Champaboti market on December 25 and decided to maintain unity and amity among ourselves at any cost. We also formed a joint committee to share the relief materials among us,” said Phulen Chandra Basumatary, president of the joint committee at the Bodo camp located at Champaboti market which is named after the river that flows in the area.lxxx

8.7 Conclusion The chapter until has now has sought to provide an overall situational analysis of the scale of the humanitarian crisis experienced in the BTAD between 2012 and 2015. In the case of 2012 crisis, whereas district-level authorities were unable to cope with the scale of the disaster in the initial days, externally based organizations became critical in providing humanitarian services inside relief camps. On the other hand, in the case of the 2014 crisis, district-level authorities were much better prepared, with detailed monitoring of vulnerable populations (especially women and children) and a more consolidated response in terms of health provision. While externally based organizations played a significant role in the response, it must be noted that there was a dearth of resources available for long-term recovery work. Further, while coordination problems did exist in terms of regular consultations, there were no obstructions to data sharing in both cases. The challenge was to make the imperfect information actionable and useful for improving overall humanitarian outcomes. Militant activity was certainly a pervasive factor and most security strategies of humanitarian organizations entailed strategies of acceptancelxxxi combined with basic principles of neutrality. However, in the years under study, two major incidents were recorded in November 2014 that underscored the problematic security situation: the

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first which involved the abduction of two humanitarian workerslxxxii by militants and the other involved the kidnapping of an ambulance driver.lxxxiii While these incidents did not lead to a complete breakdown of reconstruction activities, they did signify the fragility and constraints on the aid system that had developed locally, one that is based on moral ascendancy of non-violence, in a situation of extreme polarization and violence. Yet, regardless of the level of violence, the eventual release of the humanitarian workers after several days of captivity without ransom, pointed to the possibility of ethical actions by non-state armed actors and the existence of a space that could be built upon. As the next chapter indicates, there was a drastic fall in the levels of militant violence, especially from 2017 onwards, despite the organizational and recruitment structures being relatively intact. The history of humanitarian aid in BTAD is, therefore, incomplete without acknowledging the post-humanitarian reality, when organizations sought to exit. The next chapter seeks to investigate the puzzle of endogenously driven recovery and reconciliation. The chapter examines new directions in peacebuilding and identifies an alternative set of pathways that highlight community driven processes. Notes i

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Bhattacharyya., and Jhumpa Mukherjee. 2018. Bodo ethnic self-rule and persistent violence in Assam: A failed case of multinational federalism in India. Regional & Federal Studies. p. 10. https://doi.org/10.1080/135 97566.2018.1478293. Asian Centre for Human Rights (ACHR). 2012. Assam Riots: Preventable but not Prevented. https://reliefweb.int/report/india/assam-riots-preven table-not-prevented. Accessed 10 January 2020. Doctors for You-Northeastern Regional Office (DFY-NERO). 2013. Joint Assessment Report of the Ongoing. Humanitarian Crisis and situation of Mass Internal Displacement in the BTAD region of Assam. p. 3. [Unpublished Report]. Assam State Disaster Management Authority. Camp & Camp Inmates In Kokrajhar &Neighbouring Districts (Date: -04/09/2012). p. 2. Ibid. Doctors for You-Northeastern Regional Office (DFY-NERO). 2013. Joint Assessment Report of the Ongoing. Humanitarian Crisis and situation of Mass Internal Displacement in the BTAD region of Assam. p. 3. [Unpublished Report]. Staff Writer. 9 October 2012. No Trace of Missing Camp Inmates. The Assam Tribune. https://www.assamtribune.com/scripts/detailsnew. asp?id=oct0912/at07. Accessed 10 May 2020. Ibid. Bhattacharya, Pramit. 3 December 2012. The contours of the Assam conflict. https://www.livemint.com/Home-Page/xbg1mdvGmK77gsdeze ZGkJ/The-contours-of-a-conflict.html. Accessed 5 June 2020.

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Author Unknown. 11 May 2014. Assam: Death toll reaches 45 after two more bodies are found. https://www.firstpost.com/india/assam-death-tollreaches-45-after-two-more-bodies-are-found-after-recent-violence-151 8059.html. Accessed 25 February 2019. NDTV. 5 August 2012. 6000 children in Assam relief camps reported ‘sick.’ https://www.ndtv.com/india-news/6000-children-in-assam-reliefcamps-reported-sick-495531. Accessed 15 January 2020. Doctors for You. 2012. TISS-DFY Response to Ethnic Violence and Internal Displacement in BTAD Region August–September 2012. [Unpublished Report]. p. 2. Ibid. Pandey, Alok. 7 August 2012. In Assam, even 1000 doctors would not be enough. https://www.ndtv.com/india-news/in-assam-even-1000doctors-would-not-be-enough-495951. Accessed 10 January 2012. Doctors for You-Northeastern Regional Office (DFY-NERO). 2013. Joint Assessment Report of the Ongoing. Humanitarian Crisis and situation of Mass Internal Displacement in the BTAD region of Assam. [Unpublished Report]. p.13. Ibid. Camps coded due to security reasons. Ibid. Camps coded due to security reasons. Doctors for You. 2012. Chirang, Kokrajhar and Dhubri, Mid Under-Arm Circumference (MUAC) Assessment Data. [Unpublished Database]. Ibid. Ibid. Data provided by Anonymous. 26th February 2013. Ibid. Ibid. Ibid. Ibid. Field Photo (co-author). February 2013. Firstpost, 2014. BTAD Violence Epidemiology and Conflict Early Warning Framework is an unpublished internal record of the daily violence that was utilized to understand the conflict dynamics. Its intended purpose was to supplement analysis during the response and beyond. At the outset the results being discussed are only indicative, tentative and illustrative of small localized efforts that emerged during the response post-2012. Ray, Sanjoy. 10 May 2014. BTAD records 3,500 riot cases in 5 years. https://www.assamtribune.com/scripts/detailsnew.asp?id=may 1114/at08. Accessed 5 June 2020. Mander, Harsh. 23 February 2013. Love in times of slaughter. https:// www.thehindu.com/opinion/columns/Harsh_Mander/love-in-times-ofslaughter/article4442201.ece. Accessed 11 June 2019.

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Sharma, Anup. 22 December 2014. Two NDFB cadre killed in Assam. https://www.dailypioneer.com/2014/india/two-ndfb-cadre-killedin-assam.html. Accessed 5 June 2020. Correspondent. 22 December 2014. Grenade blasts rock Kokrajhar, 3 hurt. https://www.assamtribune.com/scripts/detailsnew.asp?id=dec2314/ at054. Accessed 1 April 2020. Our Bureau. 24 December 2014. Tuesday Terror. The Sentinel, December 24. Staff Reporter. 2015. Normalcy Returns to violence-hit areas. The Assam Tribune, January 4. Ibid. Anonymous. 2014. Rapid Assessment Report Bodo – Adivasi violence in BTAD and Sonitpur District. [Unpublished Report]. p. 5. Office of Deputy Commissioner, Kokrajhar. 2015. Cumulative Status of Relief Camp as on 10.01. 2015. p. 1. Office of Deputy Commissioner, Kokrajhar. 2015. Camp Wise Status of Inmates as on 10–1-2015. p.1. Office of the Deputy Commissioner Chirang. Camp Details 8.1.2015. p.1. Field interview with All Bodo Students Union (ABSU) office holders. 7 January 2014. Chirang, BTAD (Assam). Anonymous. 2014. Rapid Needs Assessment Report 28th & 29th December, 2014. [Unpublished Report]. p.3. Field Interview with ASHA Worker. Milon. Author Interview. 8 January 2014. National Health Mission(NHM), Chirang. 2014. Details of PW (Pregnant Women) in the Relief Camp. p.1. National Health Mission (NHM), Kokrajhar. 2014. Relief Camp wise PW List. Interview with Security Forces personnel, 9th January 2015, Kokrajhar. Anonymous. Cumulative Report as of 8th January 2015. p.1. Ibid. Ibid. Correspondent. 30 December 2014. Operation against ultras: CM puts onus on Centre. The Sentinel, December 30. Correspondent. 2015. Infant dies in Relief Camp. The Sentinel, January 4. Ray, Sanjoy. 2014. Camp Inmates yet to get adequate relief. The Assam Tribune, December 28. Ibid. Anonymous Interview. 10 March 2020. Chirang, BTAD (Assam). Field Photo (co-author). 8 January 2015. Field Photo (co-author). 9 January 2015. Community Level Data compiled from Raw-Lists of Camp President and Relief Camp Committee, Milon. 8 January 2014. Field Photo (co-author). 9 January 2015. Field Photo (co-author). 9 January 2015.

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Fiala, N. 2012. The Economic Consequences of Forced Displacement. HiCN Working Paper 137. https://www.hicn.org/wordpress/wp-content/ uploads/2012/06/HiCN-WP-137.pdf. Accessed 12 October 2013. p. 2. Ibid. Verimp, P., and Munoz-Mora, JC. 2013. Returning Home After Civil War: Food security, nutrition and poverty among Burundian households. HiCN Working Paper 123. https://www.hicn.org/wordpress/wp-content/uploads/ 2012/06/HiCN-WP-123-updated3.pdf. 20 October 2013. p.1. Field Photo (co-author). 28th Dec 2014. Interview with Respondent. 26 November 2016. Bogori Village, Chirang District, BTAD (Assam). Interview with Respondent. 12 September 2016. Fulbari Village, Chirang District, BTAD (Assam). Interview with Respondent. Interviewed by LB and SDS. Date of Interview. 25 June 2016. Fulbari Village, Chirang District, BTAD (Assam). Interview with Respondent KS. Interviewed by SDS. Date of Interview. 22 December 2016. Fulbari Village, Chirang District, BTAD (Assam). Interview with Respondent MS. Interviewed by LB and SDS. Date of Interview. 30 November 2016. Fulbari Village, Chirang District, BTAD (Assam). Interview with Respondent MPRD. Interviewed by LB and SDS [Translation] 26 June 2016. Fulbari Village, Chirang District BTAD (Assam). The Case History was documented based on multiple rounds of interviews conducted by MJM in Sonapur Village. The dates of interview were: 23 June 2016 and 13 August 2016. Sonapur Village, Chirang, BTAD (Assam). Interview with Anonymous. 15 March 2020. Location undisclosed. State Interagency Group (IAG), Assam. 2013. First Sitrep On the Karbi Rengma Conflict in Karbi Anglong Inter Agency Group-Assam. [ Unpublished Report]. Misra, Udayon. 2014. Assam-Nagaland Border Violence. Economic and Political Weekly 49(38): 15–18. Conflict Sensitivity Consortium. 2012. How to Guide to Conflict Sensitivity. [https://local.conflictsensitivity.org/wp-content/uploads/2015/ 04/6602_HowToGuide_CSF_WEB_3.pdf]. Accessed 16 March 2020. See CHS Alliance, Group URD and the Sphere Project. 2014. Core Humanitarian Standard on Quality and Accountability. https://corehu manitarianstandard.org/files/files/Core%20Humanitarian%20Standard% 20-%20English.pdf. Accessed 15 March 2020. See United Nations Office for the Coordination of Humanitarian Affairs (OCHA). 2012. What are Humanitarian Principles. https://www.unocha.org/sites/dms/Documents/OOM-humanitarian principles_eng_June12.pdf. Accessed 14 March 2020. Delhi Solidarity Group. 2015. Recent Militant Violence in Assam: Report of a Fact Finding Team.

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Correspondent. 2014. Adivasi Militants share dais with Mohilary to appeal for peace. The Sentinel, December 29. Ibid. Correspondent. 2014. Peace Meeting held in Chirang District. The Assam Tribune, 31 December. Talukdar, Sushanta. 31 December 2014. Bodos, Adivasis maintain peace at camps. https://www.thehindu.com/news/national/other-states/ bodos-adivasis-maintain-peace-at-camps/article6739713.ece. Accessed 3 March 2020. Fast, L et al. 2015. The promise of acceptance as an NGO security management approach. Disasters 239(2):208-231. https://doi.org/10.1111/disa. 12097. Correspondent. 3 November 2014. Demand to release abducted workers. https://www.telegraphindia.com/states/north-east/demand-to-rel ease-abducted-workers/cid/1624830. Accessed 4 November 2014. South Asia Terrorism Portal. Chirang (Assam): Timeline (Terrorist Activities) -2014. https://www.satp.org/terrorist-activity/india-insurgencynorth east-assam-chirang-Nov-2014. Accessed 7 June 2020.

Chapter 9

Conclusion: Towards Post-conflict Recovery, Social Elasticity and Restoration of Health Equity in Bodoland

Abstract The concluding chapter of the book advocates for a reconceptualizing of peace in the conflict-affected borderlands along India and Bhutan. The chapter summarizes key understandings of the challenges of post-conflict recovery in Bodoland. Drawing on the evidence presented in the previous chapters, the chapter outlines the notion of Social Elasticity (SE) as a mechanism to rebuild peace at the community level. Developing this notion further, it sees Healthcare Settings as having immense untapped potential for realizing the goal of peace and advocates for mainstreaming Health Equity into the post-conflict recovery programmes that are envisaged under the Memorandum of Settlement (MoS) of 2020. The MoS has led to the creation of the new Bodoland Territorial Region (BTR). The chapter outlines key principles underlying the Health Equity Restoration Model and pathways through which key clauses can lead to reimagining the nature of peace in the future of BTR. The chapter concludes with a change story that highlights how simple and innovative methodologies can transform situations of conflict and individual lives in an incremental manner. Keywords Post-Conflict · Recovery · Social Elasticity Framework · Health Equity Restoration Model · Transboundary Healthcare Cooperation · Memorandum of Settlement (2020) · Bodoland Territorial Region (BTR) Peace Accord · Community Peacebuilding through Ultimate Frisbee

9.1 Introduction In situations of armed violence where international agencies are not in a position to intervene to shape the localized pathways of post-conflict recovery, it becomes imperative for stakeholders living in the context, who are seeking to promote a permanent peace, to strengthen existing structures and processes of local governance, regardless of how imperfect they may seem. The most recent Memorandum of Settlement (MoS) that was signed in 2020, and for all its perceived limitations did have one important achievement. The agreement was able to draw out the remaining cadres of the anti-talk faction of a long running and well-armed organization like the NDFB (all the factions of which have now been dissolved) which has been in existence for © Springer Nature Singapore Pte Ltd. 2021 S. Sinha and J. Liang, Health Inequities in Conflict-affected Areas, https://doi.org/10.1007/978-981-16-0578-9_9

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nearly 34 years. One of the most innovative aspects of the MoS is the importance attributed to Healthcare and Education in the actual text of the agreement. In the Indian context, these aspirations have been absent in the texts of several sub-national peace accords until now. The success of these particular clauses of the MoS, would require an alternative, evidence-based strategy and policy pathway, which has not been the hallmark of how peace accords until now have been implemented. Accountability to the communities, in non-political arenas such as education, health, water, sanitation and hygiene, disaster management and sports, among many others, will be needed. In fact, it can be said that with the dissolution of the armed elements, the Bodoland movement has entered its most challenging phase, where decisions made by the key political stakeholders at this point in time will have significant long-term impacts. In a way, it marks a return to the historical juncture, where non-violence was the preferred route of achieving political recognition, albeit in circumstances that are completely transformed. The individual scars of three decades of conflict combined with years of underdevelopment and political fragility make the pathway of post-conflict recovery extremely challenging. The success of the developmental vision of the MoS rests significantly on the outreach and consensus building with other ethnic groups living in the BTR. For this, bridges must be built at every level, at the grassroots between communities, between institutions at the meso-level and between political parties at the top. A pro-active administration that inscribes deep conflict prevention measures into its existing systems will be needed. The chapter argues for a design of sustainable, longterm interventions that enhance grassroots inter-community cooperation and builds on a concept of Social Elasticity (SE) that emerges through the data archive and narratives of the book. This can be done through revival of local markets, education, sports, cultural exchanges and other arenas, not traditionally seen within the ambit of peacebuilding would significantly enhance the probability of the success of the peace process. SE must also percolate upwards, and reflect the cooperation and collaboration at the community level. Most importantly, by being in a borderland, with the onset of peace, significant gains from the local border trade and historical market linkages with Bhutan could provide another platform, for enhancing the welfare outcomes of communities in the area of study.i Lastly, the public health institutions, which are supposed to be crosscutting and universal in nature, also have the potential to create these linkages. Given the burdens of conflict discussed until now, these mechanisms must be revived locally, with potential for drawing on lessons and collaborating with Bhutan’s functional health system, just across the border gate. In our discussion, we provide a combination of generalized and specific recommendations, based on the content of the previous chapters (and also drawing on peacebuilding practice in the area by other civil society organizations and forums).

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9.2 Peacebuilding and Health Equity: Going Beyond “Resilience” in Policy Design Armed violence and ethnic conflict that emerged in the aftermath of peace accords (1993 and 2003), and the low-intensity conflict through multifarious insurgencies, that formed the backdrop of the book, seem to pose intractable problems that are seemingly impossible to overcome. The conflict shaped a highly complex reality, for the vulnerable populations in the borderlands, of both India and Bhutan. The number of conflict-affected families across Bodoland, in the successive waves of violence, has not been estimated. While it is publicly acknowledged that more than 4,000 persons have been killed in armed violence alone, the excess in mortality and morbidity for all displaced communities which were actually preventable (arising out of prolonged stays in relief camps and lack of support thereafter) will never be known.ii The pressures on households in these formerly violence-prone areas are further accentuated by inequities created through crippling poverty, inadequate resources, ecological deterioration, frequent natural disasters and more recently, worldwide pandemics. The negative impacts of these are disproportionately borne by the poorest and most marginalized populations who live on the edge of survival. Even the smallest disruptions push these families over this edge and plunge them into ill-health and ill-being. As the book has shown, the impacts of long-drawn, low-intensity violent conflicts are different and need to be treated as such in policy work. In addition to direct impacts such as deaths, injuries and displacement, the indirect impacts weaken governance and delivery of essential services to its citizens. The impact of conflicts on livelihoods, healthcare, education and shelter intersect with poverty, gender, ethnicity and stage-of-life to create health inequities among different sections of the disfranchised populations. While largely negative, the research and past experience has taught us that these impacts are by no means uniform or simple, linear or direct.

9.2.1 Impacts of Armed Violence Are Non-Uniform as Opposed to Universal The level and type of effect it has depends on the class (poverty status) of the household, the ethnicity of the community (and hence relative position of power), gender (women and girls suffer disproportionately), age (children are highly vulnerable and at risk of being exploited, abused or trafficked) and displacement status (forcibly displaced households suffer disruption and loss which many a times are beyond their coping capacities). Alternatively, displacement status in this context also implies whether displaced families choose to return to their place of origin or whether they migrate further into the restricted Reserve Forests in and around the border areas.

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9.2.2 Complex Interplay of Loss and Suffering Losses and suffering interact in complex ways that enhances the vulnerabilities to ill-health for displaced and non-displaced populations. Without effective support— either from the state, civil society or from society—these individuals and their families can suffer catastrophic health outcomes. Furthermore, the lack of resources, and a collapsed health system, pushes individuals into an arena of pluralistic healthseeking behaviour, in which, sometimes the required treatment is not accessed at the correct time. Impacts can also translate into heightened levels of domestic violence and alcoholism, which become further sources of stress.

9.2.3 Effects Being Non-Linear The long-term impacts of conflict on survivors are found to be non-linear. It does not follow a particular timeline but it is more like balance scale where survivors try to balance the risk and the protective factors which keep them well. With risk factors outweighing protective factors following severe losses of every type in conflict, these survivors and their families are highly vulnerable to ill-health. To help balance out the risk factors, they would need help and support at different points of time, sometimes much after the episode of the conflict. In fact, as many of the life histories have shown, humanitarian assistance is actually needed well after the conflict is deemed to be over.

9.2.4 Indirect, Deep and Long Term The loss of life, injuries, loss of shelter, food, livestock are the direct losses. The conflict also severely affects secondary but critical health promoting factors such as income, livelihoods, nutrition, health, education, social networks and relationships. These indirect losses have much deeper, longer term tertiary consequences on affected households. For example, children could become more prone to trafficking and exploitation when parents send them out to work due to hunger and loss of livelihoods. Thus, if the effects of conflict are so complex, deep, indirect and long term, then can the treatment of it be any less? In order to dovetail our recommendations for peace design, we seek to provide a multi-layered set of recommendations that builds from the micro-level (community-level) to the meso-level (recommendations for implementing key clauses of the peace accord and recommendations for the existing governance structures). Our recommendations build on the community perceptions regarding identity formation that can be inferred from the narrative. We take into account the fact that

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ethnicity is malleable. While it is underdevelopment and inequity that drives conflict, it is in the process of convincing communities to jointly overcome developmental deficits that is the key challenge. In an earlier project in the area, connected with developing a community-based system of early warning for natural and human-made disasters (2016–2017) the authors found that the affected communities preferred to participate in peacebuilding activities, when they are not framed or explicitly called ‘peacebuilding’.iii For instance, when called for a ‘peace meeting’, communities would forcefully bring their grievances to the fore. For a community traumatized by loss and suffering of recent conflict and on alert for any sign of an impending one, calling for a ‘peace-committee’ meeting was enough of a signal to panic about the possibility of an outbreak of conflict; inevitably leading to mobilizations and security-dilemmas.iv Conflicts driven by identity while also being structural are only one of the many sets of behaviour that individuals engage in. On a day-to-day basis, the struggle for meeting basic needs and navigating the breakdown of governance are also major priorities. One useful framework, which is emanating from the local turn in peacebuilding debate that requires further development, is the building back of everyday peace.

9.3 “Social Elasticity” (SE) as a determinant for Sustainable Everyday Peace While implementing projects connected to humanitarian response or peacebuilding and by virtue of being reliant on external donor funding, organizations tend to implement concepts that have been developed externally. Increasingly, there is being critiqued as ideological imposition on communities which themselves have rich cultural traditions and social mechanisms that include endogenous forms of conflict resolution. The methodologies and formats of these community institutions do not necessarily fit into the standardized outcomes of what has been defined as ‘liberal peacebuilding’.v One of the key contributions of this debate has been directing attention of policymakers to what is called the local turn in peacebuilding; a perspective which provides a useful starting point for interpreting the processes being discussed. At the same time, through the analysis of various cases being presented, the chapter also seeks to add some additional assumptions, which can allow us to sharpen these analytical perspectives that embody the local turn. As stated by Mac Ginty and Richmond, they consider the local, as a distinct level of analysis and an arena for policy advocacy: By “local” we mean the range of locally based agencies present within a conflict and postconflict environment, some of which are aimed at identifying and creating the necessary processes for peace, perhaps with or without international help, and framed in a way in which legitimacy in local and international terms converges. This peace is normally an everyday and emancipatory type, in which authority, rights, redistribution and legitimacy are slowly rethought, and are reflected in institutional and international architecture.vi

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However, despite being a distinct level of analysis, it does not preclude incorporation of norms, ideas and processes, which are external to the site: A key descriptor of ‘local’ is that it is differentiated from the national and international, although of course any boundaries are blurred by the fact that all agency is networked in an increasingly complex manner. The local is not necessarily exclusive of the national and international. Indeed, it is often much less ‘local’ than imagined, and is the product of constant social negotiation between localised and non-localised ideas, norms and practices. It can be transnational, transversal and be comprised of a geographically dispersed network.vii

The advantage of this perspective is that it allows for giving analytical weightage to processes that are beyond the realm of international peace monitoring. Peace may not necessarily emerge because of any intentional design or externally imposed template. Alternatively, they can parallel ongoing peace processes. The emergence of this localized layer of peace consequently is a product of ‘everyday’ interactions: The pursuit of everyday tasks may allow individuals and communities in villages, valleys and city neighbourhoods to develop common bonds with members of other ethnic or religious groups, to demystify ‘the other’ and to reconstruct contextual legitimacy.viii

While the literature has successfully opened up many new vistas for analysis, there is no suggested pathway by which this ‘every day’ peace can be implemented, which is also a strength of the concept. We can only contribute to this framework, by giving examples of some recent innovations in projects. Many a times, we see relationships between ethnic communities getting strained and at times collapsing altogether. But we can take heart that in the many narratives of survivors in the waves of ethnic conflicts in Bodoland, the fixed notions of us–them/ victim–perpetrator/ friend–enemy is challenged. We see that ordinarily in people’s lives, ethnic boundaries tend to be porous which allows people from different ethnic communities to cross over in their daily interactions with each other. Hence, various economic, social, cultural, religious and even political transactions happen across ethnic boundaries. We visualize this fluidity of ethnic boundaries as elasticity, whereby regardless of the degree of tension exerted on the social relationships at the community level, the probability of getting back to some degree of normality exists and never disappears completely. This elasticity also has a cross-boundary dimension, in everyday community links with Bhutanese citizens across the border. Traces of the past do live on in people’s memories, in tradition, folklore, music and other such sites including earlier marketrelationships where the customer and the seller actually know each other. To simplify this further, we see ethnic relations, not necessarily as cymbals clashing together, but as two ends of an accordion, which stretch, separate and join back. Even in the most extreme situations, there are small spaces, where people do exercise restraint even if engaging in violence elsewhere.ix In this narrative below, we see a person about be killed, but is then saved by one of those attacking him. The Milon camp and its environs had become a battlefield, which saw a prolonged phase of combat between the Bodo and Adivasis. The respondent ESR describes the context of the battlefield: The members of community X from Milon started to move to places where they were in a majority. If not during the day, then at night, all the women and children were moved to a

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safe place. It was mostly the men who stayed back in the village to protect it from robbery and attacks. Most of us fled to Patgaon, while some fled to villages in the north and others fled across the River Aie (which flows in from Bhutan) before moving to the relief camps in Asrabari. I have seen the battles with my own eyes. I met an old man in Patgaon and he used to take me along to the battlefields to collect the arrows shot by the Y community. Every time he went, I would accompany him to the battle fields. For five days both communities used to fight and chase each other. Often the people did not have the time to eat their meals. The entire scene used to take place in the banks of a river called Nijila. The people of the Y community from the relief camp made numerous attempts to attack our village (see Chapter 5: author’s note). As the security forces guarding Milon camp were at times behind them, their attacks would go deeper into our areas. We used to guard the opposite river bank and when the charging enemy group approached our side, we would release arrows in order to stop their advance.x

It is in one such battle that this incident stood out: Even though I was small, I was very dedicated in collecting the arrows. I never realised that the arrows coming from the opposite community could ever hit me. I used to hand over the bundle of arrows to those elders who could use the arrows. A person just needed a bow in the battle field, one could even pick the arrows shot by the opposite community and use them. I never shot an arrow myself, I just picked them up so that they could be re-used. The old man whom I accompanied did not know to use the bow and arrow, so it was our duty to pick the arrows. We used to carry back thick bundles of arrows on our return from the battle field. An uncle was also in our group and we were mostly the three of us whenever we went to the battle fields. I remember one incident with this uncle. He went hiding towards a man from community Y who was constantly shooting arrows standing on a rock and shot him on the forehead with a catapult. The man fell and was down for at least 15 minutes. The uncle said that he should be dead and he must go and cut him with the knife to be sure. But grandfather stopped him from doing this. After 15 minutes, I saw the man run for his life.xi

Expanding the enabling conditions that allows people to make such important moral decisions in the heat of battle is the real challenge for peace design. The very same respondent had seen a young boy being beheaded and a girl being killed in a previous incident, and the events could have had a very different outcome.xii What drove the person to intervene and stop is the question. Was it a memory of old friends from the ‘other’, or that the action would be a violation of the moral code of the tribe or was it individual conscience? Or was it a mix of all the unconscious reasons? Whatever be the reason, older ties between the communities in preventing violence did play a role in other instances too. At time of the interview PSRN, an elderly Adivasi lady, 55 years old, was living together with her husband at their younger son’s house. They have two sons. Her husband is around 70 years old. Both of them spend their time with their three grandchildren. Her daily routine is to take care of grandchildren and she helps her daughter-in-law by cleaning the surroundings, and washing utensils. She finds that washing utensils is easy for her because there is a water channel that passes by their house. They now live in Fulbari village, which was burnt down in 1996 (See Chapter Five). PSRN recollects: We are originally not from here. Earlier, we had three to four bighas (over an acre) of land but our land was taken by the river Teklai. Only half a bigha of land was left. We gave it to one of the villagers there and came to Fulbari ten years ago. Our previous village was a mixed village with Bodos, Santhals and Muslims living there. We had very good relationship

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with the Bodos before 1996 and also between 1996 and 1998. Both the communities enjoyed some of the festivals and occasions together. Bodos invited Santhals and Santhals invited Bodos. We enjoyed drinks with meat. They were very good to us. Even now we are invited to enjoy some festivals and occasions with them. Whenever we return from spending time in the houses of our Adivasi relatives, our Bodo friends and their children would greet us and ask about our health. We miss them and they too miss us. We are still having a good and strong relationship as we used to have before 1996, during 1996 and after 1996. In the first conflict of 1996, the Bodos did not allow us to run from our village. They said, “Do not run from the village. We will not fight. Whatever is happening is in other places. We should do nothing about this. Bodos and Santals did not fight in our village. We were together as we were before. And that is why we lost nothing and no one killed. But due to bad luck, our land got eroded by the river. So, we came to Fulbari for land purposes. When we settled here ten years back, we had a very tough time. Whatever we had brought from home, we soon finished it and then suffered a lot for food. We collected Kapu and Bengo (wild vegetables), boiled and ate it. We did not collect Kulu, because it is intoxicating. Sometimes my husband used to sell firewood very cheap. Those days there was less demand for firewood. I was always worried as there was no water supply nearby. There was no ring-well as we have today here. We used river water for all purposes. Rainy season we easy for finding water, but in the dry Winter season, it was very tough. We would all wait for rain to fall. We use to look up to the sky for clouds. During winter season, we would fetch water from the Bodo village nearby. The Bodos of the village were good and so said nothing to us. Whenever it rained, we used to run to collect water from the river. Whoever goes first, would collect the water from the river. If late to reach, then have to go to Patgaon which is very far from here. Now we are much better off as there is ring well in the village for water for drinking, cooking and washing. We also cultivate paddy, mustard, til (sesame) etc. During the first two conflict of 1996 and 1998 our village was not affected and we were well and busy with our work. We enjoyed good food and drink in our own homes, but in the recent conflict of 2014, we were affected.xiii

In terms of pathways, regardless of the level of violence, a minimal semblance of the past interactions (which were not necessarily always conflictual) always remains and needs to be gradually expanded, through small interventions that are not very visible or attract significant attention. Agencies—whether government or non-government—engaging long term with communities in areas of conflict, firstly need to recognize the fluidity of ethnic boundaries and then identify spaces in which social elasticity can be promoted. This elasticity must be carefully cultivated and nurtured across various age groups and among different categories of stakeholders. After a bout of conflict that severely strain the relationship between communities, interventions that restore older linkages must be designed in an appropriate manner. And where social relationships are not as elastic, it can be made so. For, while we do talk of restoring and promoting past linkages, the concept of social elasticity does not exclude the possibility of evolving newer web of linkages too. In a multi-ethnic context, only when social relationships are strong, will there be ownership over the peace processes and also the possibility of sustained peace. Though seemingly easy, there are challenges in doing this which need out-ofbox thinking and energy to surmount. For example, where do children, studying in what are single ethnic schools (due to segregation of schools along the medium of teaching), living in homogenous ethnic enclaves, get a chance to interact with children from other ethnic groups in order to transcend their ethnic boundaries? Similarly, women in rural areas whose social interactions are largely restricted within

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the confines of family, their village or nearby market places, how do they get to come in contact with the ‘other’ to develop and practice social elasticity? Where opportunities are absent, one has to create it. Where conflict is a reality in the everyday lives of people, then should peace between communities also not be so? An everyday peace implies three principles to make it workable: restoring social capital where it can be restored, transforming it where it is broken and building where absent. Three small cases, which embody these principles are discussed below.

9.4 Developing Social Elasticity—Some Experiences 9.4.1 Saving the Tractor of an “Antagonist” During 2012 Bengali Muslim–Bodo Conflict Somen is a staff for a social organization. He is from the Bodo community. In the 2012 conflagration (see Chap. 8) there was no violence in his own village, but there were two relief camps opposite his village where there had been instances of conflict. He recounts: I was in office on the day of the outbreak and was trying to coordinate between members of the two communities in my neighbourhood to maintain peace. However, the rift between the two communities had already widened by then. Even all the staff had switched off their phones, perhaps to avoid being included in calls to fight, so I was unable to communicate with anyone. I received a phone call from my colleague who is a Bengali-Muslim. She asked me where should she flee to, and where can her family hide. She could not come to the office since there were many Bodo villages on the way. I asked her to go to one of the Muslim majority areas and stay there for the night as they would be safer there. I received a phone call from a friend in my own village saying some people of our community from the neighbouring were fiercely demanding that he hand over the tractor of a Muslim man he had rented for use and which was in his custody. They probably wanted to burn down the tractor. He was scared and about what to do. I counselled him that if a police complaint is filed, he would be held responsible for giving away the tractor. Anyway, he does not have anything against Muslims, so why go through all this trouble? The man agreed. I advised that he should not face the hostile outsiders alone, but gather more of our fellow villagers and together they protected the Muslim man’s tractor.xiv

While seemingly a minor incident, the loss of such an expensive asset, itself, could have triggered another subset of events. One of the complications, the authors would like to add, is that rumours and propaganda spread much more easily due to social media and the ease of mobile communication. Small events (whether factual or constructed) can get magnified beyond proportion and result in huge exoduses of people (without any way of verifying the veracity of a particular report).

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Fig. 9.1 Fuel Efficient Wood Stove Trainingxvii

9.4.2 Wood Stove Making in Chirangxv Like Frisbee with children, opportunities are also found in everyday life, to increase social elasticity among various groups. Whether it is the school improvement committees, or a committee to organize women’s day or village response groups to stop domestic violence, every space and event can become opportunities to get ethnically different groups to get used to working and co-existing together. In another case after the 2012 conflict which drove deep wedges the Bengali Muslim and Bodo community, the ant organized wood stove making trainings. Bodo women learnt from the Bengali Muslim counterparts how to make newly designed mud stoves which were more efficient, consumed less firewood, were smokeless and easier to maintain. Sixteen Bodo women from villages in Amteka, Patabari and Rowmari participated in the training held in the ant’s campus in Rowmari. There were two trainers and under their guidance, working in teams of two, the trainees learnt to mix in the right proportions of soil and cow dung and shape the low-fuel and low-smoke wood stoves. Mitidon, one of the organizers of the training and also a trainee herself said that ‘some of our Bodo women walk for 2–3 kms in search of firewood and so, fuel efficient stoves will be very much helpful and save their time and also money spent in firewood’.xvi Laughing and learning together, it was encouraging to see women from communities supposedly “in conflict” work together to help find solutions to day-to-day problems faced by village women (Fig. 9.1).

9.4.3 Peace School (Suluk-Gwjwn Vidyalaya), Kokrajhar (Established with Support from NERSWN- Northeast Research and Social Work Networking)xviii This school was started in a village called Jawarbil by two teachers with the help of communities of nearby villages. It was named Suluk-Gwjwn Vidyalaya because the

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Fig. 9.2 Suluk-Gwjwn Vidyalaya, Kokrajharxix

words Suluk in Santhali and Gwjwn in Bodo mean peace. The school was initially started by a development organization called NERSWN in what was initially a relief camp of Adivasis displaced in the 1996 conflict. The leadership and also members of the organization were largely Bodos but started the school as a form of reconciliation between the communities. The school was built with locally available material with the help of communities from the neighbouring eight villages. Initially it had only one teacher but it now has seven teachers with more than 360 students. The school does not charge any fee from students and the teachers—all Adivasis—receive grains from the villagers as their monthly salary. The teachers are all graduates and instead of moving to the nearby town for better prospects, they have been motivated to stay and teach in the school (Fig. 9.2).

9.5 Overcoming the Perils of Rapid Exits: Transitioning Between Humanitarian Action and Long-Term Peacebuilding Humanitarian response by its definition consists of largely short-term material and logistical help extended to communities to save and sustain lives in the aftermath of a disaster or conflict. In areas of long-drawn, generally low-intensity strife punctuated

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with episodes of inter-community violence, it is not easy to neatly divide the conflict history into pre-conflict, conflict and post-conflict as it is not clear when one begins and when one ends. This significantly challenges linear recovery models which divide interventions into emergency relief, restoration and recovery. There is a need to recognize these blurred boundaries and design interventions which actually transcend these boundaries. For example, at which point do we start building people’s resilience and increase their coping capacities? Should it be before the conflict—which could be at any point in their lives or is it after a conflict and prepare them for future eventualities? Then, which part of disaster recovery will it be? Emergency, restoration or rehabilitation? Or is it all of it? In such situations, the inability of the state’s relief mechanisms to fulfil its obligations and provide essential services to its citizens is a hallmark of the political environment. Therefore, we ask the question whether in such a scenario, is it reasonable to expect the state to effectively take over and look after the needs of its citizens, once the humanitarian aid agencies leave after distributing relief or doing some recovery work? In this book, we find that “exit” is highly problematic. In the crises of 1996, 1998, 2012, 2014 which affected and displaced hundreds of thousands of people, humanitarian agencies played a major role in providing much needed relief materials. Some, after 2012, even attempted longer term livelihoods recovery projects that spanned a year or more. Yet, the experience in Bodoland, with large-scale humanitarian organizations, which were largely professionalized, was ambiguous. The problem of introducing newer resources into an already insecure context, by itself poses several risks. The earlier intervention in the early 2000s by the international medical mission showed that if quality healthcare is being provided, then organizations need to strategize about alternative forms of sustainability, or at least exit, after verification that their programmes if taken over by state agencies are working sufficiently well. Furthermore, the question of externally driven templates is problematic, as sometimes solutions might involve departing from rigid project outcomes, timeframes and even commonly held principles (especially neutrality). The transition from the emergency phase, through relief provision to IDP camps (which are a visible manifestation of the conflict) to engaging with the lesser known and more invisible process of return, implies adjustments to what organizations originally set out to do. The humanitarian organizations and the aid workers worked with admirable intentions for achieving a greater common good. The problem has been the methodology, timing and process of exit. There are very few experiments with this process and many organizations possibly exited at the time when those who were displaced sought to return ‘home’ and perhaps needed the maximum assistance. Regardless of the imperfection of local-level processes, deeper coordination with the district administration could have improved the situation. It also shows that organizations have to invest in understanding the context and creating indicators for exit that are much more accurate. There is also a need to develop genuine local-level partnerships, including ones that are seemingly unrelated and lateral, but have potential for expansion of the concept of elasticity over the long term. Partnerships that are carefully crafted and genuine which that seek to confront problems through dialogue are much needed.

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There is also a necessity of focusing on negative cases and outcomes. Studying and acknowledging what went wrong in a particular programme would possibly be more beneficial than only documenting good practices and success. Local-level partnerships become invaluable in negotiating the problem of exit. As the book showed, post-2012 and 2014, short-term humanitarian relief following the outbreak of violence was available. But in addition to relief, deep, long-term interventions (which the state was ill-prepared to provide) were also sorely required. In the absence of that, ill-health and ill-being persisted for a long time for the most vulnerable families. A major lesson that was learnt over these two crises is that there is also a necessity for other strategies that appear seemingly simple. The Road from Development to Humanitarian Relief: Perspectives of a local agency. Being purely a development organization, the ant had never done any relief since it was set up over a decade ago. But the 2012 ethnic conflict between the Bodos and the Bengali Muslims saw hundreds of thousands of people suddenly sheltering in relief camps. The India operations office of an international relief agency approached the ant to partner with them to distribute relief. They would be getting the money from another large bi-lateral humanitarian aid agency. Desperate to help people in the camps and also attempting to understand how large-scale humanitarian aid works, the organization agreed to partner. The first round was smooth as it was quick and within two months, relief materials had been distributed to over 35,000 families. the ant was impressed by the speed and efficiency of the operations. Six months later, they were approached by the humanitarian agency again. Most people had now returned to their homes and did they now require help in restoring their livelihoods? Of course, they did. A much larger new project worth 400,000 US Dollars was sanctioned for restoring the livelihoods of 1750 families. The project would be for a year. The implementation experience this time round was somewhat different. The documentation and reporting requirements would need a qualified team specialized in humanitarian work led by a well-qualified and experienced project coordinator. The salaries to be paid for such staff was way beyond the salary scale followed by the ant. It was nowhere remotely close. Then, the office and facilities required for such qualified staff to work in was beyond what the organization could offer on its campus. A new office was hired in the nearby town for the team to sit in. New furniture and equipment was purchased. A few experienced field staff of the ant was seconded to this new team since the professionals from outside did not know the field area. Soon, it became apparent that the style and manner of working, when it came to dealing with the community, was very different from what the ant as a development agency was used to. Whereas relationships for the ant was long term and one invested time in community processes, the new team was under tremendous pressure to help the target number of households in a short time. For a development

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agency conscious of its pro-poor image and which had started using motorcycles only recently, the number of SUVs hired by the new team to move around the project villages was problematic in terms of community perceptions pertaining to NGOs. In a few months, except for signing cheques and making payments, there was not much in common between the ant and its recovery project. Somehow, the ant saw the project through as the help was much needed by the community, but wished things could have been done differently.

9.6 State-Led Peacebuilding and Reconstruction: The Need for Convergence and Accountability Regardless of the volume, depth and scope of localized community-based peacebuilding conducted by civil society and humanitarian aid agencies, it would be a significant error, if these routes are conveyed to be the dominant paradigm. One of the reasons these cases are discussed is because they are actually outliers and exceptions. Unlike other countries, India’s approach to conflict management within its boundaries is determined by a mix of military necessity, the ability to rework existing territorial configurations, distinct negotiating tactics (that move parallel to military force) and infrastructure centric post-conflict recovery models. This is applicable when we study examples of sub-national conflicts across Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland and Tripura, which are all having significant populations residing in the extensive international borders. Despite military asymmetries and extreme levels of violence in the past, the domestic conflictmanagement strategy deploys methodologies and templates made available through the Constitution.xx The flexibility underlying this creates enough channels for negotiated settlements with the leadership of the armed organizations who seek to represent (or are able to portray) that they represent the key interests of their specific community. The aftermath of these negotiated settlements until now have not been effectively evaluated, yet two findings are somewhat certain, that also echo across the region. The outcomes of these peace accords are seen to be counterintuitive to accepted international practice. Until now these areas, especially those created through political settlements, have not seen structural transformations in development outcomes; and, we see the possibility of worsening indicators in education, health and other indexes as peace progresses. This sets the stage for the future re-emergence of a new form of contestation. This is particularly true of the Sixth Schedule Areas, where despite marginal improvements in infrastructure, issues such as lack of employment opportunities for youth, lack of higher education opportunities, abysmal state of schools and absence of

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quality healthcare for the population are among some of the several other challenges that remain.xxi The current model of peacebuilding tends to diverge from the aspirations of the communities as well as their built-in strengths. Recognizing these realities itself is important. State-led peace processes are extremely narrow, with their focus on issues of power redistribution, rehabilitation of armed combatants and securing of development packages. They leave the major implementation to state authorities, but there are very few mechanisms in place to evaluate peace in these contexts, i.e. measurement in terms of community effectiveness and impact. Nonetheless, if the text is broken down, the MoS of 2020, which conceptualizes the BTR, is actually quite distinct, from what was being done traditionally. While we will specifically address these pathways around the 2020 MoS subsequently, the following recommendations focus on what is needed immediately in the short term.

9.6.1 Ensuring Essential Services and Conflict Adaptation We have seen that areas of the study tend to suffer from poor governance. In areas of localized fragility such as these, essential government services are compromised; and, people living in such areas find it difficult to demand accountability of agencies. These agencies themselves find it difficult to manage core social programmes and functions with limited resources. At the same time, national level policies rarely provide policy guidance for addressing the needs of conflict-affected populations, especially those who are forcibly displaced.xxii State governments are left to respond on their own and the response is very inadequate and arbitrary. Humanitarian aid agencies on the other hand do not have the mandate for maintaining a permanent presence. Local development NGOs cannot substitute or replicate what the state should be doing as part of its mandate. As a result, the population does not secure the entitlements for which they are eligible and are left struggling to survive with inadequate resources. In the end, restarting and reinvigorating government-led social welfare programmes is the key long-term solution for which there is no substitute in the context studied until now. To reduce localized fragility, capacities must be built to ensure that the state fulfils its obligation and not reflect equities arising from local political processes. With reductions in overall violence in the BTR, there is now an opportunity to restart and rebuild these governance and service delivery structures. This should be done in a focused and phased manner. This means expanding the definition of health to also ensuring services and programmes that go a long way to promote health and well-being and prevent illnesses and ill-being.

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9.6.2 Ensuring Food and Livelihood Security Ensure food and ensure work. In the book, we see that survival stress increases exponentially for families whose lives are disrupted by violent conflicts. And this stress plays out on their bodies making them extremely susceptible to ill-health and ill-being. Critical support of nutrition keeps up their immunity and helps them from falling sick. Free or subsidized rations must be ensured for at least six months till the displaced families are able to settle down and find some sustainable ways to earn an income. Many families who flee in a conflict leave their identity and other documents behind. Not having sufficient documentation, they are unable to access various entitlements. This should be waived off for accessing basic entitlements. Supplementary nutritional programme scheme such as the Integrated Child Development Scheme (ICDS) which provides nutritional support to young children under six years, pregnant women, lactating mothers and also to adolescent girls must immediately be implemented soon after any disaster. Even if the programme was not being executed properly in the area earlier, additional funds and support must be made to kick-start the programme following a conflict. If the ICDS programme would have been started and continued, the tragic cases of illnesses, deaths and also risk of child exploitation we encountered in this book might have been prevented. Similarly, additional funds have to be earmarked to ensure that the government’s flagship employment guarantee programmes such as the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) actually work. While building community assets, the conflict-affected families could have been assured of some income to buy food and to take care of their essential needs, including that of health. In the absence of that, families were forced to go hungry or cut down trees in the forest for selling as firewood leading to ecological degradation. Food for Work programmes as well as distribution of livestock especially farm animals (given that they are necessary for agricultural production) as rehabilitation could also be started.

9.6.3 Education for the Protection of Children While education is a fundamental right for development of children below 14 years in India, in this book we see that it is a critical tool of protecting children from abuse and exploitation after a conflict or disaster. When education is suddenly disrupted, young girls could be sent out to work being at risk of getting abused and exploited. Then, parents desperate for some education for their children’s future also send their very young children far away to hostels outside the state. Many a times, they are not even very clear about who is taking the children and where. Children do not get to come home for years at a stretch, at times they go missing forever and many a times, parents are unable to stay in touch with their children. Special scholarships for students affected by conflicts must be made easily available.

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Agencies working on restoration after a conflict would also do well to think of the needs of students—especially girl students—after a conflict. Even a simple measure such as providing bicycles for students would be of immense assistance for those who are displaced and cannot access their earlier schools. Free student hostels and residential schools for children will also help some children stay in schools as apart from losing schooling, where food is also a crisis in the household and if slightly older, these children could be sent out to work. The extent of human trafficking from the relief camps and informal villages in the border areas was extremely high during the years of conflict. The NEDAN Foundation is based in Kokrajhar, and works on rescue and rehabilitation of survivors of trafficking across the BTR. The organization is also involved in sub-regional cooperation on child protection and rescue and has collaborations in Bangladesh, Bhutan and Nepal. Between 2004 and 2018, the organization rescued 1156 persons, mainly women and children, from the BTC area, from locations within and outside Assam.xxiii Between April 2016 and March 2017 alone, 96 persons of whom 78 were children were rescued. Fifty-five children from Saralpara, a location that is contiguous with Sarpang (Bhutan) and site of many relief camps in the after 2014xxiv were rescued. The organization provides an example of cross-cutting collaborations that are effective. After the rescue from Saralpara, NEDAN Foundation realized that there was an urgent need for a school in that area and through cooperation with the Assam State Commission for Protection of Child Right (ASCPCR) and with the permission of Deputy Commissioner, Kokrajhar and with help of Sashastra Seema Bal (the SSB is the designated Border Guarding Force for the Indo-Bhutan and Indo-Nepal Borders), established a Community Model School. This school is now in the process of mainstreaming with Sarva Shiksha Abhiyan (SSA), a programme of Right to Education Act, 2009.xxv

9.7 Transforming Inequity, Restoring Equity in Healthcare in a Post-Conflict Borderland: Some Pathways In the book, we see that the rise of violent militancy in Bodoland interspersed with waves of ethnic conflicts sounded the death knell of the health system. It collapsed so badly that the health centres could not even respond to emergencies and epidemics following ethnic conflicts. Their bodies already weak from malnourishment, conflict-affected families were very susceptible to illnesses. And so, when they do fall sick, availability of quality healthcare services at the right time could prevent small illnesses turning into health catastrophes. Health services need to be made available beyond the relief camp, i.e. when returnees go back to their villages or when they move to a new site which may be far from their original village or a health centre. Having lost a lot of their assets and also not having had the chance to earn while living in relief camps, it is difficult to afford proper healthcare. Thus, mobile and door-step health services will help take care of small illnesses and prevent health catastrophes. This should be done regardless

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of whether the hamlet is located in a Reserve Forest (i.e. encroached village) or a Recognized Forest or Revenue Village. Special funds need to be allocated to equip state healthcare centres used by conflict-affected families to respond to their treatment needs. In the absence of quality state health services, they should be issued special health insurance cards for a period of time so that they can access health services in a private hospital. Informal health practitioners and NGOs filled the void left by a collapsed public health system. We have reflected on how traditional medicine as practised by the Ojhas and other practitioners who constitute the informal health system, can actually help in diagnosis of mental illness. NGOs who provided medical relief to large numbers of people in the relief camps and surrounding areas in the early 2000s also contributed significantly to the overall developments. But when they left in 2007, the high quality of care they provided could not be sustained by a collapsed health system, which was just starting to rise with the launch of National Rural Health Mission (NRHM). Buildings, equipment and other physical infrastructure along with some lower level health personnel improved the health centres after the national programme was launched. But the health centres in the conflict-affected areas never got qualified doctors to provide quality services. The negative perceptions about lawlessness and lack of security were sustained long after the conflict and discouraged health personnel from other parts of Assam from serving here. Some health centres function but with either unexperienced part-time doctors (fresh MBBS doctors forced to serve a one year rural posting to qualify for postgraduate studies) or semi-qualified (the three year trained Rural Health Practitioners) or even wrongly qualified (like ayurvedic doctors made to practice allopathic medicine). This has caused people to lose faith in the government health system, and it has become an unpopular choice for treatment. An unresponsive public health system is the biggest cause of indebtedness among poor families and for families completely impoverished by conflict, nothing less than a catastrophe. The health inequities that have resulted from many years of deprivation—of decent healthcare, denial of essential services, meaningful recovery support and debilitating poverty, are still unmeasured. The book until now provides evidence from one part of the border; the impacts across the entire border blocks of the BTR yet remains unmeasured. Vulnerable population groups with special needs have had to bear a disproportionate burden of these health inequities, leaving them susceptible to illhealth, ill-being and even deaths. To recover from such deep-seated inequities, a number of important stakeholders will have to take the responsibility and contribute to revival and restoration. In the Health Equity Recovery Model which we put forth in Fig. 9.3, there are three key stakeholders, i.e. a Responsive Administration, an Active Community and Responsible NGOs which will have to work, where needed, independently, but also collaboratively with each other to ensure health equity among conflict-affected populace. When these three key stakeholders working effectively, then there is a chance for real health equity for the populations.

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Fig. 9.3 Health Equity Recovery Model: Actions for Restoring Health Equity for Vulnerable Conflict-Affected Populations

9.7.1 Responsive Administration for Restoration of Social Welfare Systems Quality healthcare cannot be delivered sustainably unless there is a well-functioning administration in place. Safety and security are critical for attracting and retaining doctors and other qualified personnel to work in conflict areas. In such an area trying to recover, the top administration and bureaucrats must show the way and infuse confidence in the law and order situation. Staying in their place of posting, especially if in remote areas, sends strong signals of responsiveness through the rest of the system. After decades of weak governance, officers by just being available to solve problems can help overcome the years of mistrust that were built up in what was earlier an unresponsive state. Along with law and order, delivery of essential services to promote health and well-being of people and will have to be resumed. In this, it is recommended that the state prioritizes carefully the type of services it needs to start delivering in a phased manner making sure that the most vulnerable groups are given the first priority while doing so. To balance a highly inequitable system brought about by decades of disruption, a flexible and supportive approach has to be adopted in difficult areas attempting recovery. The state must be ready to allocate extra resources for this. Systems of accountability must be built up even as it gives freedom and flexibility to middle rung staff and managers to innovate and get rebuild broken systems.

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9.7.2 Promoting Transboundary Cooperation in Healthcare In conceptualizing health, we also recommend leveraging the geographical location of the BTR as a borderland and initiating health cooperation with the strong and innovative health system across the border. This is an arena which might have significant dividends, for the villages and hamlets that are interspersed throughout the forest area and living close to the international boundary. It will also help in mitigating the cross-border malaria burden for Bhutan. Based especially on the processes discussed in Chapter 7, there is a need to enhance positive spill-over effects in health. Such collaborative initiatives are already in their incipient stage. It is possible that this re-emergence can be attributed to the receding of what was perceived to be a violent and hostile environment. In September 2019, in Gelephu, for instance, formal meetings of Bhutanese and Indian health authorities, from across Assam, Arunachal Pradesh, Tripura, Manipur, Nagaland and Meghalaya took place. As stated, the meeting, sought to develop strategies for cross-border malaria: The group recommended identifying and connecting the focal points, through joint WhatsApp groups and telephone directories at the state and district level for information sharing and case notification. An in-depth mapping exercise between the malaria control programs that identified and mapped the villages and health facilities along the border was identified as an immediate next step. The Indian and Bhutanese counterparts also identified the need for a process for sharing line lists of identified malaria cases in the border villages and health centres via email. Finally, the need to align and synchronise vector control interventions like indoor residual spraying (IRS) and distribution of long-lasting insecticide-treated nets (LLINS) along the border areas, was a key recommendation from the meeting.xxvi

This dialogue can be translated into policy and both Bhutan and India need to find creative ways by which the principles enshrined in Article 7 of the India–Bhutan Friendship Treaty of 2 March 2007 can be formulated. As stated in the Treaty, Health is one area of inter-sectoral cooperation: The Government of Bhutan and the Government of India agree to promote cultural exchanges and cooperation between the two countries. These shall be extended to such areas as education, health, sports, science and technology.xxvii

The development of workable protocols under Article 7 to facilitate crossborder cooperation for mutual accessibility for emergency health services is one key recommendation. This would especially be in terms of maternal and child health for those forest hamlets that are close to the border. This cooperation can be gradually scaled up. To prevent overwhelming of the health system of Bhutan, the government can seek to reimburse the costs for services of its neighbour. This would be of great importance to poor, vulnerable communities living in border areas.

9.7.3 Active Community Community involvement in management of the health institution is critical to increase accountability and sustain recovery of the health system. Along with individual

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leaders, Community Based Organisations such the student unions, women’s collectives and unions of village leaders must also be involved in managing the health centres and keeping them safe and free from violence. The narratives testify that the perception of “danger” is major deterrent for doctors. Along with the government and civil society, these could involve civil society in reaching out to medical students in medical colleges across Assam with positive and reassuring messages. This would greatly reassure them and reduce their anxieties about serving in an area which has seen conflict.

9.7.4 Responsible NGOs Humanitarian agencies need to be very clear about their exit strategy and have ethical exits that are transparent with accountability towards the communities. It is not sufficient to only ask for accountability from the state. Exiting, too soon and suddenly, could actually harm families who are still highly vulnerable and need support. It could mean negative health consequences, increasing the risk of vulnerable groups with special needs such as pregnant women, children, adolescent girls, the elderly. While handing over to the government is needed, big organizations can think of very small teams, even one paid staff be hired for a year or so for following up. This would help in sustaining advocacy with the district level authorities (and other levels of governance) to honour their commitments. The generation of ground reports and assessments could also help influence the administration to support the affected families with lifeline services. The lack of engagement and advocacy for conflict-specific government schemes, for survivors of violence, such as Project Assist, Project Aashwas (Assam Police) and the 2010 Ministry of Home Affairs (MHA) Scheme for Rehabilitation of Civilian Victims of Terrorist, Naxal and Communal Violence were major lacunas in the overall response.xxviii This arose partly out of templates developed for relief work in natural disasters; and extending it to a situation of protracted, lowintensity conflict. Similarly, with humanitarian agencies working in the border areas, an attempt could have been made through coordination with the district officials, to direct benefits to communities through programmes such as the Border Area Development Programme (BADP) scheme.xxix This convergence is necessary, given that the BADP is present in many border areas, which were (and) are affected by conflict. There is a need for the larger need to invest in coordinating with other organizations and forums already in the area. The non-governmental Inter-Agency Groups (IAGs) set up for disaster coordination in various states in India, though well intentioned, are usually underfunded. Aid agencies must set aside some resources to build up the capacity of such local-level disaster coordination efforts—supporting them in setting up a control / coordination room, involving their members in carrying out assessments, doing some trainings with them, taking their help in planning the exit strategy of the aid agency and involving them in planning for long-term work. If supported, and not taken over by big aid agencies, these local institutions would be in a better position to coordinate with their governments than each humanitarian

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agency trying to separately do so. The IAGs also work at different levels to get the government to respond in crisis and through their network of partners, they keep scanning and monitoring the situation for any crisis/disaster situation which needs intervention. They could take up the long-term monitoring and support functions that is required by those who were impacted by conflict. As part of an ethical exit strategy, aid agencies should invest in and partner with the IAGs or such agencies and its members right from the beginning of their relief intervention and not when they are just about to exit. Lastly, the message for sustainable peace among various ethnic communities has to be built in as part of programming in conflict areas with multi-ethnic communities. NGOs must engage in activities which build social elasticity among communities. This could be involving multi-ethnic teams of community volunteers, creating dialogues between CBOs of different ethnic groups, mixed training and camps with students of different ethnicities, creating multi-ethnic advisory committees. Having civil society join hands with the government and the local community in promoting messages of security and peace can go a long way in changing the negative perceptions of insecurity that persist long after the conflict has ended. Though not easy, deep multi-agency, multi-pronged and multi-layered strategies, would need a revision of existing templates, and methodologies by which the most vulnerable households are supported over the long term. This does not necessarily mean investing in more resources, but rather enhancing the capacity to facilitate convergence with existing and appropriate welfare mechanisms.

9.8 Mainstreaming Health Equity into Peace Accords: The Memorandum of Settlement (MoS) 2020 and Establishment of the Bodoland Territorial Region (BTR) Political analysts who have commented on the 2020 Bodo Peace Accord have till now analyzed developments which reflect the binary interpretations of ethnic questions in BTAD (BTR). As one article states: ‘It remains to be seen how the 2020 Bodo Accord addresses the structural factors that have driven ethnic violence against the nonBodos and fuelled subsequent counter-mobilisations in the past’.xxx The articulation of such concerns, unfortunately, leads those studying the issues to undermine the aspirational aspects of the BTR Accord. One of the major features of the peace process that has not drawn attention was the fact that in addition to the 1,600 plus NDFB cadres, a significant number of militants (about 644) belonging to eight other groups also gave up the path of violence, and laid down their arms in the same ceremony. xxxi This significantly includes the National Santhal Liberation Army (NALSA), which is one of the major Adivasi militant groups formed in the relief camps of 1996 and 1998.

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Can multi-ethnic societies who have experienced extreme violence and witnessed innumerable hardships emerge out of this cycle of perceived enmity? Any reoccurrence of ethnic strife in the aftermath of the peace accord will of course re-affirm these assertions made by political observers and reconfirm the expectation that this attempt at peacebuilding will not succeed. Does this imply that there should be no attempt at making a peace accord functional and that peacebuilding be left solely to those state agencies tasked with accord-implementation? If community peace is an important social determinant to prevent deaths in situations of ethnic conflicts, then what must be done to link the MoS with violence prevention at the grassroots level? There is no clear answer. A review of the clauses of the MoS of 2020 indicates that the demands which were articulated (and accepted) in the tripartite agreement can be classified into two broad categories. The first category involves institutional arrangements under an expanded form of autonomy. These revolve around the core demands for additional legislative powers, expanding the number seats in the existing BTC Assembly, the creation of new districts, creation of Bodo-Kachari Welfare Council for development needs of Bodos outside BTAD, territorial demarcation (inclusion or exclusion into the BTR), rehabilitation of the NDFB cadres etc. The clauses that have not attracted sufficient attention are those that are relevant for the model on Restoration of Health Equity articulated earlier and are more development centric. These would require some sustained and cross-cutting solutions, which involve a multi-pronged approach and lateral partnerships. It would also imply meaningful and deep outreach to all communities. The recommendations made by the book, for these particular clauses are, therefore, to provide a level of specificity, as they connect directly or indirectly with our focus on health and community development. We also provide these recommendations knowing fully well that they are tentative at best. Despite the issues of power (which disbursement of development assistance bring), we hope that through multiplicity of voices, narratives and empirical data, and by engagement with an area over a sustained period of time, some key arenas will be identified and successes demonstrated. There also has to be some degree of universalization, whereby all the affected communities are taken into consideration and are able to access peace dividends. It is to be noted that the MoS does seek to develop several new universities and centres for learning, including institutes for engineering, the arts, rural development and the social sciences, in addition to cultural centres. Based on our model, we limit the recommendations to those with implications for healthcare and well-being. It is our assertion that mechanisms for community participation for clauses on health, education and other social welfare programming should be created. A specialized planning department, with expertise drawn from all ethnic groups in the proposed BTR must be established within the BTC, which objectively assesses the long-term progress of these development centric clauses. From the perspective of the book, three recommendations emerge that require some reflection and action.

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9.8.1 Clause on Financial Compensation for the Next of Kin of Persons Who Lost Their Lives in the Agitationsxxxii The pathway for implementation of the clause would require extensive levels of documentation, utilizing a mixture of community-based data, archived media reports, hospital data (depending on the designated time limits), baseline surveys and other casualty recording tools. The exercise can leverage existing technology, access to information technology especially mobile phone based data, to build comprehensive lists of victims. The major purpose is to ensure maximum coverage. Existing anomalies like, whereby survivors, whose family members are missing, are denied compensation must be resolved, and these families must also be included in the victim lists. Pathways for those injured and disabled due to armed violence must be designed and added to the rehabilitation schemes. This should also be accompanied by a convergent effort, with existing central government schemes for victims of conflict, and those eligible persons, who have been excluded until now, must also be provided compensation. There is also scope for further cross-verification and adding of excluded beneficiaries, under the Ex-Gratia Payment Policy for civilians killed in armed violence, under the Government of Assam, Department of Revenue and Disaster Management.xxxiii

9.8.2 Creation of New Medical Training Institutionsxxxiv The MoS envisages the creation of a new regional institute of medical sciences, an institute for nursing and paramedical sciences and a cancer hospital and medical college. Apart from accessing high-quality medical education, those graduating from these training institutions must serve for a minimum time period in difficult and hardto-reach health centres including those located in the Indo-Bhutan border blocks. New community health centres must be started, and for the border areas especially, a coordinated construction effort through expanding existing sources of funding through BADP and even using available Civic Action Programme (CAP) funds available with Border Guarding Forces would be a necessity. There is also enhanced scope for cross-border cooperation with Bhutan and exchanges across what is known as the BBIN (Bhutan, Bangladesh, India and Nepal) as well as participation in other global and regional networks.

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9.8.3 Comprehensive Drinking Water Scheme for Villages Near Indo-Bhutan Borderxxxv This clause holds promise for innovation, in terms of building community participation. While seemingly lower down in the list of priorities, water consumption is fundamental to disease prevention. With unsafe sources of drinking water being the norm and absence of piped water facilities across the border belt, there is adequate room for building inter-sectoral cooperation, between the border communities, VCDCs, Public Health Engineering Department (PHED), District Health Authorities, Border Guarding Forces (BGFs), education institutions and CSOs that are already located in the BTR. This inter-sectoral cooperation can then be transitioned into other arenas if needed or alternatively remain focused on one particular issue area.

9.9 Conclusion It is extremely difficult to conclude a book such as this, which has attempted at providing an overview of the micro-level challenges facing a rapidly changing and formerly violent borderland. As the newly defined BTR is under transition, it is very difficult to come to a final judgement on whether the peace will last. The work of community development is such that there is no finality or end point, especially for an organization embedded and immersed in a particular society over an extended period of time. The armed conflict in BTR overshadowed other structural problems such as environmental degradation, climate risks, a collapsed health system unable to revive itself and high dropout rates from schools across all levels. By focusing on social welfare outcomes in the conflict-affected areas, we provide a completely distinct interpretation on what transpired in the course of a protracted self-determination movement. This could only happen because a development agency based in the BTR for nearly 20 years and an academic institution sought to study and present the conflict processes through the lens of public health. This approach especially allowed the book to be rooted in the experiences and lives of the community. Despite its many limitations, it is still hoped that the book serves as a record and memorial for those who experienced conflict in this deeply fragmented borderland. The book is also a testament to the abilities of individuals in the most far-flung areas and in extremely difficult circumstances, to survive, continue hoping also build bridges with other communities, despite the tremendous obstacles in their path. We thus conclude our book, with a humble story of social change and include for the readers a final case study, in the Appendix to this chapter, on how a simple game of Frisbee is slowly changing how children think, feel and interact in the multi-ethnic and maybe now peaceful district of Chirang.

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Appendix 1: A Case Study: Ultimate Frisbee in Chirang—175 g of Social Transformation [Jennifer Liang’s Process Documentation] What does it take for creating social transformation? This is a loaded question over which philosophers have philosophized since centuries, reformers have burnt their brains and hearts over; and, on which, writers have written hundreds of thousands of books. Also, this has been pondered upon by many of those who have spent lifetimes working in communities for this magic idea of social change and transformation. For the past 20 years, those at the ant have been searching and working to bring about positive transformation in villages. It is still work in progress and the organization continues to stumble and also fall in its journey. It was 2015 and the community in Milon was still recovering from the trauma of yet another round of violent conflict. Many had been displaced and were still in the process of settling back after spending over half a year in relief camps. The tension between the various ethnic groups was taut, stretched and palpable. Knowing how negative vibes can escalate if left unchecked, the ant was on the look out from something that could build relationships, especially among the children belonging to the various ethnic groups in the area. the ant would not have imagined that transformation would come on the wings of a 10-inch wide, 175 g flying disc? A New Sport called Ultimate Frisbee. As children, the only time people played with Frisbees or flying discs was during annual family picnics or had seen people in foreign films throw it around in beaches. But how was the organization to know, as it was tucked away in a corner of Assam, that Frisbee is actually an organized sport like football, basketball, volleyball. So, when the ant first heard of the game called Ultimate Frisbee, everyone was a bit sceptical. First started in United States over 50 years ago by university students, it has spread to different parts of the world and is expected to become an Olympic sport in 2024. The game is played with the disc being thrown by one player to a teammate who catches without dropping it. The aim is to get the disc caught inside the designated goal zone of your team (Fig. 9.4). Some of the rules of the sport especially appealed to the organization. For one, girls and boys must play together in the same team. Having tried teaching football for girls, pushing girls to play football and failing miserably to mainstream it, it was realized that girls would never stand an equal chance in sports that traditionally was only played by boys. Being a non-contact sport, Ultimate Frisbee is largely played by men and women together. In India, the rules were set in a manner that boys and girls mustplay together in the same team if they want to compete. The next big rule was music to our ears. There are NO REFEREES in Ultimate Frisbee! In the context of a conflict-affected area, this had special significance. With no referee, players have to negotiate and solve any conflicts that arise and fair play is a responsibility of the players themselves. Young people learn the skills of dialogue and non-violent conflict resolution, critical in an area where they have seen the use of violence to

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Fig. 9.4 Children in Milon learn the game of Ultimate Frisbeexxxvi

solve problems within families, village as well as between communities. A Frisbee enthusiast and volunteer NAIHS started teaching the game to children in Milon. Taking off on the Back of a Disc. If the ant wondered how children would take to such an alien and foreign sport, it shouldn’t have worried. The novelty factor was exciting for everyone—for the new players, for the team and for the community. And most important, because it was completely new, it was a level playing field for both boys and girls across all the different ethnic groups. Both girls and boys were starting from skill level zero! The game soon caught on. From just six to seven teams playing in one cluster, the game spread to all the village clusters. The volunteer/consultant had left by then. MRH, the one ant staff who learnt the game from him taught whatever he knew to other staff members and volunteers in the DKA supported Sports for Development project. Before the ant knew it, 3,000 plus children were playing Ultimate Frisbee across villages in Chirang! Spirit added to Enthusiasm. The programme caught the attention of the United Players Association of India (honestly, the ant had no clue that such an association even existed!) and they came to visit the organization. They were excited to find that in Chirang there were more than 3,000 children playing Ultimate Frisbee when in all over India, there were just 4,000 registered Ultimate players! UPAI, as the association is known, decided to mentor the ant’s programme. Since then, MKMN, the dynamic President of UPAI has travelled to Assam again and again to sharpen the game and also take the game

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Fig. 9.5 Photo of the ‘spirit circle’ at the beginning and end of a game of Ultimate Frisbee—All players learn to appreciate each other, award spirit point and give constructive feedbackxxxvii

to other venues. Most importantly, he drilled in the concept of Spirit of the Game (SOTG) into the players who had till then been playing very enthusiastically, but without the spirit of fair play, respect and positive spirit expected of Ultimate Players. The players who were happy scoring goals were (Fig. 9.5). Quite shocked to learn that you can lose up to 20 spirit points and actually lose the game even after they have scored the 15 maximum goals permissible for any team! MKMN himself coached the players, brought in extra coaches and volunteers to train the teams. Apart from honing their playing skills, they taught the teams the importance of the ‘spirit circle’ before and after every single match. It is heartening to see children, both boys and girls, from various ethnic communities unite in a circle of friendship, learning and dialogue, many a times even without knowing the language of the other. Pushing the Envelope Further. Given the legacies of ethnic and civil strife in the region, the ant decided to push envelope a bit further. The organization introduced a rule that in order to compete in a tournament, a team of 20 must have an equal number of players from three different religions and representing at least three mother tongues. Young people, who have never before stepped into the village of another community—sometimes even a rival community—actually going and inviting them to join and play in their team. It is also heartening to see brothers and sisters play in the same match or have fathers from otherwise conservative patriarchal communities take their young daughters behind them on cycles to the town to buy them boots a day before a tournament. the ant has 200–300 youth staying for days on its campus during Ultimate Frisbee tournaments,

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Fig. 9.6 Young multi-ethnic Ultimate Frisbee players of Milon, Chirang Districtxxxviii

but never has it had any problems. Self-discipline and concern for the other become ingrained in them through the game. Ultimate Frisbee is helping transform young people and communities in Chirang slowly, but surely. Moving Ultimate Frisbee beyond Assam. Having experienced the transformative spirit of Ultimate Frisbee, the ant was excited about spreading it all over the Northeast. Over 20 coaches were trained, who are now ready to teach the game to others. The game has been taught to partner NGOs for them to take back to their communities and state (in Manipur and Nagaland) as a peacebuilding sport. Ultimate Frisbee has the potential for being a great peace-building game and socially transformative sport for youth in the region (Fig. 9.6). Notes i

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Correspondent. 25 January 2020. Bhutan hopes permanent peace in Bodoland region with possible new accord. https://www.sentinelassam. com/north-east-india-news/assam-news/bhutan-hopes-permanent-peacein-bodoland-region-with-possible-new-accord/. Accessed 26 January 2020. Press Information Bureau. 2020. Bodo Agreement.https://pib.gov.in/Pre ssReleseDetailm.aspx?PRID=1600717. Accessed 28 January 2020. Anonymous. 2016. Process Document: Development of Baseline Risk and Early Warning Tool. Shiping, Tang. 2009. The Security Dilemma: A Conceptual Analysis. Security Studies 18(3): 587–623. 10.1080/09,636,410,903,133,050. Joshi, Madhav, Sung Yong Lee., and Roger Mac Ginty. 2014. Just How Liberal Is the Liberal Peace? International Peacekeeping, 21(3):364–389, https://doi.org/10.1080/13533312.2014.932065.

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Mac Ginty, Roger., and Oliver P Richmond. 2013. The Local Turn in Peace Building: a critical agenda for peace. Third World Quarterly 34(5):763– 783, https://dx.doi.org/10.1080/01436597.2013.800750. p, 769. Ibid. p, 770. Ibid. p, 769. See International Committee for the Red Cross (ICRC). 2018. The Roots of Restraint in War. https://www.icrc.org/en/publication/roots-restraint-war. Accessed 1 June 2019. Interview with Respondent ESR. Interviewed by [Undisclosed]. Date of Interview. 10 June 2016. [location Unspecified] Village, Chirang (BTAD), Assam. Ibid. Ibid. Interview with Respondent PSRN. Interviewed by SDS and DN. Date of Interview. 12 September 2016. Fulbari Village, Chirang (BTAD), Assam. Interview with Respondent. Interviewed by TRPTI. Date of Interview. 27 June 2016. [Location unspecified] Village, A district in BTAD, Assam. Liang, Jennifer. 19 March 2015. Women of Chirang Teach and Learn in Peace. Unpublished Process Documentation for the Training Programme. Ibid. Photo Credit – the ant, Chirang District, Assam. Field Visit. Community Peace and Social Recovery Fellowship. Project Report. December 2015. Unpublished Process Documentation for the Training Programme. Photo-Credit – NERSWN, Kokrajhar. Sinha, Samrat. 2017. The Strategic Use of Peace: Non-State Armed Groups and Subnational Peacebuilding Mechanisms in Northeastern India. Democracy and Security 13: 273–303. https://doi.org/10.1080/17419166. 2017.1353421. Action Aid India. 2016. Functioning of Autonomous Councils in Sixth Schedule Areas of North Eastern States. https://www.actionaidindia.org/ aadocument/Report%20Book.pdf. Accessed 15 January 2020. Singh, P. 2018. More Norms, Less Justice: Refugees, the Republic, and everyone in between. Liverpool Law Review 39: 123–150. https://doi.org/ 10.1007/s10991-018-9210-5. NEDAN Foundation. 2017. Impact on Child Protection & Adolescents empowering from 25 Displaced Locations Kokrajhar, BTC, Assam. https://nedan.in/home/wp-content/uploads/2018/02/Impact-Rep ort-2017.pdf. Accessed 31 May 2020. p, 13. Ibid. Ibid. Asia Pacific Leaders Malaria Alliance. 2019. Bhutan-India Cross-border Meeting on Malaria Elimination. https://www.aplma.org/blog/136/bhu tan-india-cross-border-meeting-on-malaria-elimination.html. Accessed 31 May 2020.

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