Save the Tiger: A Public Health Cause

The past two days, we've been traveling outside Jaipur in a rural area called Ranthambhore, home to some of India's last tigers. Ranthambhore is an internationally known destination in Rajasthan (a helipad was made for Bill Clinton there when he visited the tiger sanctuary), yet the villagers living in the area remain poor. They are subsistence farmers with cattle, crops, rationed water (it's the desert) and many children. We took a tour of their village and it was not as crowded as Delhi, but there were several people living in very humble quarters (pictures to follow).

So what were we doing there, as part of a trip to India to learn about HIV and Public Health Challenges? Well, our first stop was to the hospital, to meet with new executive director Rupinder. She gave us an overview of the NGO that started the Sevika Hospital 18 years ago. The NGO is called the Prakratik Society (Prakratik means environment), and has several subdivision. One of them is Tiger Watch, whose job it is to protect the tigers from encroaching villagers and "rehabilitate" poachers. However, Rupinder told us that while Prakratik's aim is to save the tigers, it realizes that the villagers, whose population has increased from 7,000 to 25,000 in just the past 40 years, are also in dire need of help.

How do the villagers disturb the tigers? These are poor people. They use wood for fuel, and have large families (because they are poor, they are farmers, and they have high infant mortality rates). Their cattle is not of great quality, so it does not produce so much milk. As a result, more cows are needed to produce what a family requires to survive (more animals is also a status symbol among poor farmers). More cows require more grazing area. Looking for wood and grazing area, farmers are increasingly entering Ranthambhore National Park (the park was established in 1955, but recognized as a tiger hunting area by the royal family much earlier). This endangers a natural habitat. There are also poachers coming from the Moriya tribes. Poachers are poor, and the profession is usually passed down from father to son. While all the parts of the tiger can be sold for up to $50,000 in places like China (particularly Tibet), the poacher makes a meager few hundred dollars. Still, in such a poor area of the country, the risk (and the fact that it's illegal) is very much worth it. 20-30 tigers have been poached since the 1950s, leaving an estimated 20-25 currently living in the sanctuary. We went on a tiger safari in two groups of four right after sunrise this morning, and my group ended up seeing only fresh paw prints. But the other group saw four tigers!!!

At first, when I heard Rupinder talking about all the projects aimed at helping villagers to stop encroaching on the tiger sanctuary (she stressed over and over that the ultimate goal was to save the tigers), I felt a little odd. What about the people? Shouldn't the #1 aim always be to help the people? But the founder of the hospital (and of various other projects to help enrich the 100 or so villages surrounding the national park), Dr. GS Rathore, has such an incredibly holistic vision of environmental welfare that nothing is excluded. The tiger AND the villager can and should both be happy. And it started to make sense to me that it is possible to save the tigers and the people. The answer is development. And a leader like Dr. Rathore.

Dr. Rathore grew up in the forest among tigers. His father was a wildlife enthusiast. We met him today; he's apparently very famous and regularly appears on television all over the world talking about the state of the tigers of Ranthambhore. Dr. Rathore went to medical school (which he describes as a bizarre twist of fate, since he'd rather call himself a maverick than a doctor). When he graduated and came back to Ranthambhore, he decided that he wanted to live in the forest again, and that was more important to him than anything else in the world. But to do that, he realized that he needed to get the villagers' support. In a few decades, their population had nearly quadrupled. They were, as I mentioned, using resources from the forest and endangering a reservoir of peacocks, monkeys, spotted deer, and other breathtaking wildlife (we saw it this morning, it really is that beautiful). When Dr. Rathore's father, Mr. Fateh Singh, was the director of the park, he simply built a fence around the park and banned the villagers from entering. Dr. Rathore realized that his father's way would no longer work; there were simply too many people now. They had needs, and he wanted to figure out how to supply them.

For the first eight years after his return, Dr. Rathore ran a mobile health clinic for the villagers, which helped to build rapport and, of course, bring health care to a previously unserved population. Then, he began to do some really creative stuff. To help them reduce their cattle size so that village families could have less cows grazing on park property, Dr. Rathore started an artificial insemination program. He helped villagers artificially inseminate their cows with high-yield varieties that still retained the disease-resistant qualities of local breeds. This increased the output of milk from each cow, while decreasing the amount of graze required to feed it. Perfect!

Another problem Dr. Rathore tackled was the cutting down of trees for fuel. While villagers still depend on firewood, they now have another option. 480 biofuel digesters have now been installed in village homes. All villagers need to do is have two cows (to produce a sufficient amount of dung for biofuel) and 3,000 rupees. The apparatus was formerly free, but it was found that when they were given freely, people didn't maintain them carefully. Now, they do. The process is simple: take the dung, put it in the digester, mix it with water, and the gas produced flows from a pipe into homes. We even got to see how it operates in a typical village home. As I said, they still use firewood, but another intervention gives farmers saplings that they are encouraged to keep alive each year to replace lost trees. If the farmer has kept his tree alive for a year, he gets a nominal reward of 3 rupees. If that same tree is still alive yet another year later, he gets another reward of 4 rupees. And so on.

The hospital is another marvel. We got to see a tour of the wards and the operating theaters (all three of them), and the equipment is impressive (all donated, mostly German). Dr. Rathore has some seriously good money-netting skills! Sophia, Linda, Paul and I even got to see an eye surgery. A little boy had gotten into an accident (according to his dad, who couldn't explain properly, something had blown up). His two eyes were in really bad shape...one was cut right through the middle, and in the other one, the whole iris had been displaced and there were small foreign bodies inside. The surgeon did a great job, and it was a microsurgery...high-tech equipment. Other special services offered at the hospital include sterilizations (they're big on encouraging family planning) and legal counseling for women experiencing gender-based violence (which seems to be a common problem in those villages). Services are offered at low-cost, and for women who've been burned by their husbands, or who are too poor to pay, they are free (poor patients who are able to are also offered the option of doing community service in exchange for health care).

To "rehabilitate" the Moriyas who poach tigers, Dr. Rathore realized he'd need to give them an alternative source of income. He has given them camels for livelihood and they are now protective of the tiger sanctuary. He has also offered them free schooling at Fateh Public School, a very prestigious school in the area (we got a tour, it's a good school by any standards, and simply amazing for village standards). Other groups who get free schooling are farmer's children (continuing with the theme of helping the farmers in order to help the tigers), and girl children.

That's all for now. I was really impressed with the whole scheme. It was a great public health trip. The only part I didn't like too much was sleeping in a non-AC hospital ward last night, and sitting on a bench in the back of the car for almost eight hours in two days. But it was worth it.