Mamata Banerjee’s first trip abroad as chief minister, once she has set her house in order, ought to be to Zimbabwe. Once she arrives in Harare, the chief minister and her entourage should drive to the city’s upscale suburb of Gunhill. India’s ambassador to Zimbabwe, Venkatesan Ashok, or his designated successor, J.K. Tripathi — if he has reached Harare from his current post in Sao Paulo by the time Banerjee makes her visit — ought to be able to easily arrange a meeting between the chief minister and Gunhill’s most famous resident, former Ethiopian dictator Mengistu Haile Mariam.
Colonel Mengistu could give Banerjee some precious advice on how to turn her inane visits to Calcutta hospitals and her incoherent conversations with medical professionals into some productive work that could actually reform these hospitals and make them truly useful to the public, going beyond the media circus that her surprise checks on the administration of healthcare in West Bengal have descended into.
I was in Addis Ababa when Colonel Mengistu concluded that he had to do something about Ethiopia’s derelict and decrepit hospitals with the same passion and sincerity with which Banerjee is approaching the healthcare deficiencies of West Bengal. That was a time when Indian doctors were in abundance in Ethiopian hospitals, drawn by the handsome salaries offered by Emperor Haile Selassie’s government and uncaring of the fact that Jawaharlal Nehru’s India had funded their medical education with public money in the misplaced expectation that these doctors would take care of Mother India’s children instead of Ethiopia’s.
Like Banerjee who concluded after her surprise inspection of the Bangur Institute of Neurosciences that its director, Shyamapada Ghorai, had to take the rap for the institute’s shortcomings, Mengistu initially held the leadership of Addis Ababa’s hospitals to account. And that leadership had a huge component of Indian doctors.
But Mengistu had a luxury that Banerjee does not have in her bid to reform Calcutta’s hospitals. The Marxist colonel got Bulgaria, Cuba and East Germany, among other socialist countries, to send physicians and surgeons to work in Ethiopian hospitals in support of his own red revolution, which needed to be tenderly cared for from Moscow. So Mengistu got rid of the likes of Ghorai whom he blamed for his country’s healthcare woes. In the process, the colonel also saved money because the Warsaw Pact and Cuban doctors were ‘volunteers’ who received their salaries from their national governments.
But nothing changed in Ethiopian hospitals for the better. They continued to be as derelict and decrepit as they were under the Haile Selassie regime, which Mengistu’s band of Marxists had overthrown. As Banerjee will probably realize after numerous surprise inspections, most of the rot in hospitals is caused not by the doctors, but by the equivalent of the Group D staff at the Bangur Institute in other Calcutta institutions.
The so-called medical malpractices in American hospitals are, more often than not, the result of mistakes by staff assisting physicians and surgeons. If a woman’s non-cancerous left breast is mastectomized by mistake, as it has happened many times in hospitals in the United States of America, it is most likely caused by negligence on the part of nurses or other staff who prepared the charts for the surgeons. Which is why hospitals are sued in the US and doctors are usually only one party to the suit. But Banerjee would probably make a surgeon pay for the error and not hold the entire institution to account, going by what one has seen of her hospital inspections so far.
It would be instructive for her to travel to Zimbabwe — where Colonel Mengistu now lives in exile — and find out for herself how he dealt with the curse of Group D-type staff in Ethiopian hospitals some three decades ago. He simply shipped off errant ward boys and the like from Addis Ababa hospitals to the Ogaden where Ethiopia and Somalia were fighting a border war. Since ward boys are not trained soldiers, most of them became cannon fodder in the bloody war.
But Mengistu’s government did not abandon or bury these dead soldiers in the Ogaden. Instead, the regime brought their dead bodies back to the hospitals where they worked and put them on display on the pretext that this was being done for their colleagues to pay homage to those who had died for their country. Actually, the steady flow of body bags from the Ogaden war put the fear of god into the Ethiopian equivalent of the Group D staff of Calcutta hospitals. They knew that if they did not shape up, they would be shipped out. Ethiopia’s hospitals changed, and changed for the better.
If such steps constituted shock therapy for the ills of Ethiopian hospitals, they were also mere stop-gap changes. What truly transformed the fundamentals of Ethiopian medical services during 17 years of Marxist rule was not the use of the stick by a health minister or by the head of government, but a comprehensive overhaul of health policy. Advised largely by a team of over 300 Cuban medical professionals sent by Fidel Castro, Mengistu’s team drew up an altogether new health policy stressing disease prevention or control and rural health services. Community involvement and self-reliance in health activities at the local levels became central to this new policy.
A year after the Marxists overthrew Emperor Haile Selassie, the Dergue, as the revolutionary regime came to be known by its Amharic acronym for the “Coordinating Committee of the Armed Forces, Police, and Territorial Army,” temporarily closed universities and all higher secondary schools. Nearly 60,000 educated men and women who thus became available for the Dergue were asked to fan out among the country’s remote, abysmally poor and mostly illiterate villages to teach hygiene, health standards and local self-government to rural people who had been suffering for centuries under a feudal order.
It is not likely, indeed impossible, that Banerjee would be able to do any of this. By a stretch, the Ogaden war could be compared to the Maoist insurgency in her state. But an elected chief minister in a democracy does not have the power to conscript disobedient, lazy or thieving hospital ward boys and transport them to Maoist-infested districts to face bullets and bombs as punishment. She is in an even lesser position to round up students or the elite of society and send them to rural West Bengal even for a few weeks during the summer break to work for the uplift of poor villagers.
Education, it would appear, is another priority for the new chief minister, judging by her actions in the first few weeks in office. The story of the Indian ambassador’s Ethiopian maid in Addis Ababa was typical of how the Dergue dramatically raised literacy levels during their years in power. This maid was one of Ethiopia’s teeming millions of illiterate people when Haile Selassie was in power.
The Marxist junta ordered her to school as part of a mass literacy campaign, again on the Cuban model. But she refused to be enrolled to study. The maid was in her mid-40s, and saw no point in becoming literate at her age. The kebele, an Amharic word for “neighbourhood,” the lowest administrative unit in Ethiopia, fined her at first. She paid the fine and still refused to study. Eventually, she was sent to jail for non-compliance with the campaign to make all Ethiopians literate.
In Mengistu’s jails, prisoners were not given any food. If someone was in jail, feeding that prisoner was the responsibility of his or her family. This maid’s family sent her food from home for a few days until she was convinced that learning to read and write was better than putting her children through the travails of feeding her daily in jail. She told me that there were thousands of Ethiopians who became literate under duress. When Haile Selassie was ruling Ethiopia, hardly 10 per cent of his people knew to read or write. In 10 years of rule by the Dergue, that figure had gone up to 63 per cent of the population, according to credible statistics of that period.
If Banerjee goes to Ethiopia from Zimbabwe to see Mengistu’s legacy, she may be disappointed though. Many of those who had become literate under the Dergue have slipped back to where they were before the mass education drive once the Marxists were overthrown in 1991. Last month, Ethiopia was trying to get Indian hospitals to run their healthcare, long after abandoning the Cuban approach. There is no doubt that Mengistu committed severe atrocities. But history has been unkind to Mengistu because of those who are selective in judging him. Perhaps this is a time for Bengal to learn from such partisan history.
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