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India: Why dissent matters in a democracy - The Case of Dr Binayak Sen

by Patralekha Chatterjee, 27 May 2009

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Asian Age, May 27, 2009

There is much to celebrate. Dr Binayak Sen has been finally granted bail by the Supreme Court. The 59-year-old doctor and human rights activist has paid a steep price for defending the health and rights of tribal communities in remote pockets of Chhattisgarh: two precious years of his life spent within the four walls of Raipur jail, and denial of medical treatment at a hospital of his choice despite a heart ailment and worldwide pleas from Nobel laureates, human rights activists, doctors and numerous concerned citizens.

The personal ordeal of Dr Sen, winner of the prestigious 2008 Jonathan Mann Award for Global Health and Human Rights, appears to be temporarily over. But the issues thrown up by the Binayak Sen case go beyond an individual, his iconic status, or the suffering of his family. They raise inconvenient questions about India today, which can be dodged only at great risk.

“The bail has nothing to do with the ongoing trial. It’s the discretion of the Supreme Court to grant him bail. But the trial will continue”, said a miffed Raman Singh, Chhattisgarh’s BJP chief minister, immediately after the order of the country’s highest court.

Dr Sen was arrested under the Chhattisgarh Special Public Security Act in May 2007 for suspected links with Maoist rebels. The prosecution has failed to throw up legally-admissible evidence to support the accusations in the chargesheet till date, and this is not for want of trying.

Here’s a bit of context to Dr Sen, the public health activist. I caught a glimpse of the man’s vision on a visit to the health clinic in Bagrimnala village, a tribal backwater plagued by malaria and malnutrition in Chhattisgarh’s Dhamtari district, in mid-April this year.

When Dr Sen and his wife Ilina started the clinic in the late 1990s, Bagrimnala had no electricity, like so many other surrounding villages. Ghasia Ram Netam, a health worker with Rupantar, the non-governmental organisation (NGO) founded by the Sens, introduced himself as the first tribal youth in his village to be trained as a laboratory technician. Every week, before he was arrested, Dr Sen used to visit the village clinic. The makeshift laboratory in the clinic was equipped to diagnose falciparum malaria, for example, and give results within 48 hours.

This timely diagnosis and immediate referral to district hospital saved many tribals from certain death. The nearest government-run primary health centre is seven-km away and the doctor is frequently absent — an old, familiar story.

The two years that Dr Sen languished in jail, much of the work he had pioneered has been undone. If the clinic, which provided low-cost medical care to those living within a 50-km radius and who cannot access health services easily, has not shut shop completely, thanks must be given not only to Dr Sen’s wife Ilina and the dedicated Rupantar staff, but also to a band of young doctors from Jan Swasthya Sahyog (JSS), a community health group in neighbouring Bilaspur, with whom Dr Sen had been affiliated. They took turns to visit the clinic once a fortnight.

Now, had Dr Sen been the kind of doctor who was content with being just a clinician, I suspect there would have been no trouble. But the activist doctor, a gold medalist from Christian Medical College, Vellore, understood “public health” in a much wider sense. That logically led to his interest and involvement in human rights issues, which had started coming to the fore in the mineral-rich, newly-created state of Chhattisgarh, impacting the health of some of its most vulnerable people.

As is well known, Dr Sen’s troubles have their roots in his vociferous criticism of the Salwa Judum (Peace March), allegedly initiated by the people of Chhattisgarh in 2005, to oppose Naxalite violence in the state.

Human rights activists, including Amnesty International, differ. They say that Salwa Judum is actually a state-sponsored attempt to clear Maoists out of Chhattisgarh, ultimately giving companies better access to the state’s abundant natural resources.

“Dr Binayak Sen questioned those policies of Chhattisgarh state which have led to large scale displacements of tribal people, their growing impoverishment and starvation deaths”, notes Indian Doctor in Jail: The Story of Binayak Sen, a booklet issued by Doctors in Defence of Dr Binayak Sen (May 2008), a group of men and women who personally know Dr Sen and his work. Dr Sen was troubled by the impact of these displacements on the health of the people, the report observes.

This brings one to the tough questions that need to be debated. Many say that the Chhattisgarh government may have erred in denying Dr Sen proper medical treatment but that it is not a “black-and-white case”.

The local press in Raipur, which blacked out the Binayak Sen story apart from faithfully reproducing whatever the state government was putting out, asserts that there can be no smoke without fire and that Dr Sen “is a closet Naxalite”. Indeed, one of the accusations against him is that he took up the issue of prison conditions after a Naxalite prisoner wrote from Raipur Central Jail about the inhuman conditions there. Another is that Dr Sen met a prisoner in jail, though totally in accordance with the law and procedures laid down by the jail authorities.

Assuming that Dr Sen’s understanding of the Naxalite problem in Chhattisgarh is not the same as that of the Raman Singh government, the inconvenient question is that in a democratic country which finds itself grappling with complex issues such as the challenge posed by Naxalites, does a concerned citizen have the right to dissent or not?

And if someone does veer from mainstream beliefs and official assumptions, should he or she be locked up?

The Binayak Sen case may or may not be the black-and-white story that much of the national and international media is trying to portray. But neither is the narrative of the spreading influence of Maoists across vast swathes of India.

The conflicts over land and natural resources that are erupting as backward Chhattisgarh seeks to forge ahead have a lot to do with the grievances of tribals who constitute one-third of the state’s population, and who feel they are being exploited. Naxalites are tapping into these grievances. As we have seen, and continue to see, the purely “law and order” approach has not worked in containing the Maoists. The ground situation is a lot more complex. Acknowledging a citizen’s right to have and espouse dissenting views, in this context, is not only a sign of a liberal government, it is also the right strategy. Out of the melee of the diverse voices can come ideas that could be more effective.

We must not silence dissent in Chhattisgarh and elsewhere, not only because of what Nobel laureates, Amnesty International or Human Rights Watch may say, but because doing so would be suicidal for democratic India.


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