One afternoon, a month before cyclone Yaas ripped through the region, a severe storm struck Sagardwip, a remote island on the Bay of Bengal and a part of the Sundarbans delta, situated at the point where the river Ganges flows into the sea. Winds whipped up the deep dark waters of the river Muriganga, a distributary of the Ganges that separates the islands from the mainland, swished through leaves and tops of trees and hissed through the grass below. But an eighty-year-old man, an islander, was gasping for breath. His son, Srikrishna Das, rushed him to the local hospital but the old man’s oxygen level was dipping and his condition was deteriorating steadily. Doctors on duty advised that he be shifted to a more advanced medical facility on the mainland, but on his way there he died. “Perhaps if we had the option of travelling by road to reach the hospital on the mainland instead of by river, we could have made it in time to save his life,” says his son, a 40-year-old trader. 

During health emergencies, people living on the delta islands of the Sundarbans, are often referred by local doctors to hospitals on the mainland for critical care as in the case above. They then have to travel by boat across rivers because many of these remote regions are not connected by road or bridge. Frequently delays occur in undertaking the journeys because during inclement weather water travel is not permitted because of the danger of boats capsizing. Delays occur during good weather too especially when tides begin to ebb, making movement of vessels difficult and often water levels become so shallow that boats get stuck on the riverbed.

Interestingly, plans to construct a bridge over a strategic stretch of the river has been in the pipeline for several years. The suggestion that a bridge ought to be built for commuting between Sagardwip and Kakdwip which is the closest port on the mainland, unhindered by weather or water levels is understood to have been made by subsequent West Bengal governments. Currently Chief Minister Mamata Banerjee’s interest in Sagar Island is rooted in her keenness to develop the region as a tourist attraction which is already a site of pilgrimage, hosting as it does the Sagar Mela, the second largest religious fair in the country after the Kumbh Mela. Every year, in mid January, hundreds and thousands of pilgrims throng the island to bathe at the confluence of the river and the sea, a religious ritual considered auspicious.

Islanders claim that Banerjee’s government has flushed the region with a large number of public doles. “Not just the schemes for poor people like free ration to BPL (below poverty line) families or for women, like the Lakshmi Bhandar Scheme, which provides monetary assistance to women of BPL households or for girls, like the Kanyashree, which awards monetary sops for the education of female members of the BPL family, but she has also invested in the healthcare sector by introducing free-of-cost medical insurance schemes like the Swasthsathi,” says a schoolteacher in Sagar Island.

The state government has also introduced a water ambulance service for the islanders. There is a water ambulance service that was earlier provided only during the days of the Sagar Mela.  At this time health emergency services receive an additional boost and not just water ambulances but even air ambulances, namely helicopters, are kept on standby so that the sick can be airlifted and taken to the mainland for treatment if required.

Since the decision to extend the water ambulance service to the locals for the rest of the year came into effect a few years ago it has helped the locals. “It is now available for the region’s islanders seven days a week. Other than the four to five hours per day when the tide is low (timings change according to the lunar cycle), the service can be availed any time of the day or night”, says an official. He says that on an average three to four patients use the services of the water ambulance per day. The phone number of the service is printed in bold letters across the sides of the vessel and people who want to book it need to call up. “Depending on where the vessel is situated at that point, it becomes available,” he explains. “If the ambulance is anchored at Sagardwip, it is ready to move within ten to fifteen minutes. However, at times the vessel is already engaged and if that happens then the patient needs to wait until it returns after dropping off other patients. Discussions are on about dedicating at least one more boat for use as a water ambulance and that would go a long way in dealing with this concern.” The water ambulance is fitted with rudimentary medical equipment including oxygen cylinders and stretchers as well as lifejackets. A hundred rupees is the one-way charge and it includes the travel cost of one patient and a maximum of two persons who are allowed to accompany him or her.

Islanders say that while this service is very helpful, it is limited in its ability to deal with the magnitude of the problem. “It alone is not enough to solve the serious issue of health emergencies in Sagardwip and the nearby islands,” says the school teacher. “Timely medical intervention is crucial and the process of transporting the sick by the water route is not just time-consuming but also fraught with difficulties and discomfort as far as the patients are concerned.” It entails shifting the patients first onto a regular, road ambulance from the rural hospital where they are admitted or from their homes, bringing them to the only port on the island, which is at least 15 kilometres from the nearest and main hospital in Rudranagar (located at central Sagardwip), taking them off the car ambulance and carrying them on a stretcher to the dock and onto the water ambulance. After reaching Kakdwip, the port on the mainland, the patient would need to be carried from the dock to another car ambulance on a stretcher and then finally driven to the hospital on the mainland. “If there is a bridge connecting the island to the mainland, the car ambulance can go directly from the rural hospital to the hospital on the mainland.  Only that would adequately address the plight of the people of the island,” the school teacher says.

Currently boats, ferries, launches and vessels are the only options for islanders and visitors to commute to and from Sagardwip and the other islands in the vicinity. It takes thirty minutes to travel across the Muriganga river which stretches from Kakdwip to Sagardwip for four kilometres. Sagardwip is the largest island with a population of nearly two hundred thousand, spread over forty-three villages. As pointed out earlier, it has only one port, which is situated at a locality called Kochuberia, in the northeastern bank of the island. Ganga Sagar, the site of the pilgrimage (where the Ganges flows into the Bay of Bengal) is situated in the extreme south, thirty kilometres from Kochuberia.  A temple dedicated to the sage Kapil Muni, who is said to have meditated in this spot centuries ago, has stood here for hundreds of years. However, the original temple is said to have disappeared into the encroaching sea and the current one is believed to be the third reconstruction.

As far as medical facilities are concerned, Sagar Island is considered the region’s best with three government hospitals (the main one is located at Rudranagar at the centre of the island and the other two are located in different parts of the island). In Ghoramara, a nearby island, too there is a primary healthcare centre. Says the schoolteacher, “At the primary healthcare centres, a host of rudimentary medical activity takes place such as the administration of polio vaccines to children and pre or postnatal care.

Here it must be mentioned that the Sundarbans delta is separated into the Indian and the Bangladeshi sides. One-third of it falls into India and two-thirds into Bangladesh. On the Indian side, the distance between the eastern and western ends of the delta is roughly 150 to 200 kilometres and it takes between four and five hours to cover it by road. Eastern Sundarbans comprises 102 islands, only 54 of which are habitable by humans. The rest are covered in mangrove and is the haunt of the famed Royal Bengal Tiger.

There are 102 islands scattered across the eastern part of the delta. 54 are habitable. The rest are covered in mangrove and is the haunt of the Royal Bengal Tiger. The rivers are infested with crocodiles and snakes. 

Recently a part of eastern Sundarbans has been connected to the mainland with a bridge built over the mighty Matla River that slithers through the region like a stupendous snake. The rivers and creeks on this side of the Sundarbans is the habitat of crocodiles and snakes and since ancient times the medical emergencies emanating from these parts included bites of poisonous snakes and injuries from crocodile and tiger attacks.

Human encroachment into their territory and the shrinking of their habitat because of deforestation has long been held responsible for these attacks by wild beasts but in spite of the dwindling numbers, tiger and crocodile attacks continue to be a major cause for concern for doctors in the area.

The sun sets over the Matla River which glides through the Sunderbans like a slithering snake. “Matla” means “drunken” in Bengali. 

The more recent health concern, as far as a section of medical practitioners and doctors of the region are concerned, however, is the possibility that climate change is impacting the health of the Bay of Bengal islanders adversely.

A comparative chart compiled by doctors associated with the Sundarbans Foundation, an NGO based in Goshaba, which conducts regular medical camps among the residents, indicates an annual, if marginal, increase in the number of heat and salinity-related illnesses.  Says Prasenjit Mandal, the founder-director of the NGO, “While it is difficult to establish a direct connection between the slight increase in numbers of certain diseases which our doctors are registering and global warming, there is no denying that increased heat and salinity is a growing concern in the Sundarbans. That this would eventually adversely impact health or even imminently lead to health complications is entirely logical to assume.” 

Dr Prafulla Safui, a medical practitioner associated with the NGO says, “The adverse impact of salinity in water and soil is very evident in diseases like skin ailments which, in my experience shoot up significantly soon after a region has been inundated with sea water after cyclones and floods. Its adverse impact is more difficult to diagnose when the effect is internal, like when it causes a rise in blood pressure, for instance. We cannot currently state with any certainty that there is a connection but over a period of time, it would become more evident.” 

 “We have never witnessed so many cyclones or storms before,” says the Sagardwip schoolteacher, echoing a common refrain in all the islands. “Nor so many floods or so much rain.”

This article is an excerpt from a larger report funded by a grant which the writer had received from international environmental news portal, Earth Journalism Network. Photographs by the author.