‘Akha’ floating clinics bring healthcare to Assam’s remote villages

In India's northeastern state of Assam, despite significant gains in recent years, infant and maternal mortality rates are a cause for concern. But a network of mobile boat clinics known as Akha, the Assamese word for hope, is proving to be a vital link to healthcare. The initiative has brought doctors, medicines, vaccines and basic laboratory services to communities in 13 districts across the state that have limited health facilities, if any. In our next report, we take you aboard these floating clinics. The mighty Brahmaputra River criss-crosses its way through Assam, a state of more than 30 million people. Hundreds of thousands of these live on chars, or temporary river islands and sandbars, where access to even basic health care can be a challenge. More than 2,000 such chars or temporary river islands dot the state, where there are limited health facilities and little or no manpower, according to the local government. Consequently, residents often have little choice but to travel to distant health centers on the mainland for even routine treatment. There is no sub-center or medical facility here, not even a mini primary health center. People here are suffering a lot. If someone has to deliver a baby, they have to travel to Mukalmua or to Bhangnamari or Kurihamari, where there is a mini-PHC. It is against the dismal backdrop that the Akha Boat Clinic initiative has become a vital link between remote riverine communities and the public health care system. Launched in 2005 by the non-profit, the Center for Northeast Studies and Policy Research, The initiative began with a small experiment to take health care to communities that conventional services struggle to reach. Two decades later, it has expanded to 15 boats, supported by Assam's authorities and UNICEF. According to UNICEF, the fleet operates across 13 districts, reaching approximately 20,000 people every month. The boat clinic was introduced in Nalbari district in 2009 and since then we have been providing health care services in inaccessible areas that are not connected to any health care facilities. Since 2009, this program has been running with the support of Center for Northeast Studies and Policy Research and National Health Mission. We are currently covering approximately 25,000 people. Each boat functions like a mobile health center, with medical teams providing consultations, distributing medicines, administering vaccines and conducting basic laboratory tests. A central focus of these services is maternal and child health, in a bid to help reduce mortality rates that exceed the national average. The mobile boat clinics provide antenatal care check-ups for pregnant women and routine immunization for the newborn babies. We are servicing the remote area of North Bay District, around 26 sore areas. In each month, we are trying to cover each area. And mainly, we are targeting the pregnant women who need the antenatal care checkup and the newborn babies who need the routine immunization and the normal babies. The significance of these floating clinics becomes even more apparent during floods in Assam. This year, severe flooding across the state claimed more than 100 lives, highlighting the risks faced by communities living along the Brahmaputra and its tributaries. In such conditions, a clinic that can travel by river is not merely a convenience. It is the only reliable link between an isolated village and the public health system. The ACHA initiative shows how mobile healthcare can adapt to the geography and its particular challenges, rather than expecting patients to overcome it.