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.