Tuesday, July 14, 2009

Bringing Out The Dead

Only dalits wield the scalpel in Tamil Nadu’s mortuaries. Successive generations work in sordid conditions and see no way out, finds PC VINOJ KUMAR

FIFTY-THREE-YEAR-OLD U Vijayan has had several close brushes with death, in a way. Working as a mortuary assistant in the Government General Hospital (GGH) in Madurai, he dissects an average of five to ten bodies daily. He is one among the scores of dalits who do post-mortems at government hospital mortuaries in Tamil Nadu. With over two and half decades of service in the mortuary, and over a thousand dissections under his belt, he now does his work with clockwork precision. Poring over the post-mortem table, it takes him just about two hours to remove the vital organs from the body. Few doctors are able to match that.
In mortuaries across the state, bodies are dissected by workers like Vijayan — doctors just examine the organs and give the post-mortem report. Barring a few, most mortuaries are in an awful state, with not a hint of modernisation. Workers still use hammers and chisels to break open skulls. Autopsy rooms, where bodies are dissected, lack proper ventilation, are poorly maintained, and a foul smell invariably hangs in the air. Posing as activists in some instances, TEHELKA interacted with the dalit mortuary workers to elicit information about their appalling work conditions. What emerged was a sordid tale of exploitation of dalit workers.
Across Tamil Nadu, mortuary work seems to be set aside exclusively for dalits. The only members in post-mortem rooms from other castes, are doctors. Due to an acute shortage of mortuary staff, hospitals engage casual workers to do autopsies and to remove unclaimed bodies, in addition to using the services of the in-house sanitary workers. Casual workers too are mostly relatives of dalits working in the hospitals. Their only source of income is the occasional ‘tip’ from relatives of the deceased who come to collect the bodies after post-mortem. Muniyamma, one such worker at the Tindivanam government hospital, earns around Rs 800 per month.
Those who work at hospitals attached to medical colleges in urban centres earn substantially higher incomes. For instance, the workers at the Chennai GGH, attached to the Madras Medical College (MMC), earn up to around Rs 8,000 per month.
Among permanent hospital workers, few non-dalits volunteer for mortuary duty. “Only dalits are assigned work in mortuaries. Others refuse to work there. For them, it is taboo to even touch dead bodies,” says Viduthalai Veeran, a dalit activist. Veeran is a senior leader of Adhi Thamizhar Peravai, an outfit that works among Arunthathiyars, a dalit sub-sect in Tamil Nadu.
Many Arunthathiyars are employed as sweepers and scavengers in municipal corporations and other local bodies. They also work in government hospitals doing the same work. Many take up the work after futile hunts for ‘respectable’ jobs. S Babu, an Arunthathiyar, had registered with the state employment exchange in 1981. He had studied up to Class VIII. For nearly five years, he didn’t get a single interview call. In 1986, he got calls for nearly 30 interviews for posts of security guards in various state government departments. But he was selected for none, though his father —who died when he was just four — was an ex-army man. Finally, in 1987, Babu was appointed as a servant at the Manaparai General Hospital. It was a grade higher than the post of sanitary worker — a job his mother was doing at the Trichy General Hospital. But his joy of landing a respectable job was short-lived. For, three years later, he was fired and appointed as sanitary worker at the same hospital where his mother worked. “I refused to join duty, protesting against my demotion. But the hospital officials promised I would soon be elevated to my old position,” says Babu. It didn’t turn out that way, though.
The son of a sanitary worker ended up doing the same job as his mother in the same hospital for nearly two decades. From 1991 to 2008, he remained in that post, despite his constant struggle for justice. Along with other sanitary workers — who were all dalits — his job included regular postings at the mortuary. “Sanitary workers are posted periodically at the mortuary for three months on a rotation basis,” says Babu, who finally got his promotion in 2008. Most government hospitals adopt this system of apportioning mortuary work among dalit sanitary workers.
IN THE Madurai GGH, about 93 sweepers were recruited in 2006, including non-dalits. In fact, of the 47 male workers, only 27 were dalits. Usually, sweepers are posted in the mortuary on a rotation basis. However, none of the nondalits opt for mortuary duty. Only the dalits take turns. “There is no compulsion. We opt for the work voluntarily,” says Perumal, one of the dalit sweepers.
Bilawady, another dalit worker, says they have no qualms about non-dalits not doing mortuary work. “It is only people like us who have done such work traditionally,” he says. Both Bilawady’s parents had been sweepers. His father worked in the Madurai Corporation and his mother at the Madurai GGH. There are many like Bilawady. At the Chennai GGH, 42-year-old Thirupal, an Adi Andhra — a dalit sub sect in Andhra Pradesh — got the job of his mother, who had worked as a sanitary worker in the same hospital. Thirupal works at the mortuary, where he stitches up bodies after post-mortems. Several mortuary workers tell similar stories — of being natural choices for mortifying, inhuman work. But what is common in their attitude towards the work is a deep-set fatalism. It’s as if they see no way out of the cycle of exploitation.
HOWEVER, IN the overall scheme of things, the state’s role too can’t be condoned. Many dalit workers told TEHELKA that they ended up in the hospitals as sanitary workers or mortuary attendants because they were never offered any other job. Vijayan, the mortuary assistant at the Madurai GGH, for instance, had registered with the state employment exchange hoping to land a government job. What he never fathomed was that he would be sleeping with corpses during his night shifts. Vijayan had attended interviews for the posts of watchman in different government departments, but with no luck. But when he attended the interview for the mortuary assistant job, he was selected. Since his time there from 1983, he says he is yet to come across a non-dalit worker volunteering for mortuary work.
Many like Vijayan are aware that they are working in unhygienic conditions and risk contracting infectious diseases. Yet, they do not take even the most basic precautionary measures — some don’t even wear hand gloves while dissecting the bodies, leave alone masks, gum boots or aprons, though the hospitals are ready to provide them. Many workers have died at an early age — in their forties or fifties — while in service. At the Chennai GGH, three dalit mortuary workers have died in the last decade, allegedly of tuberculosis.
When told about the plight of the workers, Dr GR Ravindranath of the Doctors Association for Social Equality urged the government to take urgent measures to alleviate the socio-economic conditions of the dalit workers. “The government has to ensure that at least the children of these workers have a better life. They should be provided with free housing and their children with free education,” he says.
The doctors too have their share of woes. Their demands to upgrade facilities in the mortuary have fallen on deaf ears. “We are treated in a stepmotherly fashion,” says Dr R Selva Kumar, additional professor of forensic medicine at MMC. He says sufficient funds are not allotted to improve and upgrade facilities at the mortuary. For instance, workers at the mortuary in Chennai GGH use outdated dissection tools. They still use a manual saw to open the skull, while an electrical stryker-saw available in the market — costing about Rs 1 lakh — can do the job quicker. Dr G Natarajan at the Madurai GGH expressed similar sentiments
THERE IS also a dearth of qualified doctors to do post-mortems in the state. There are only about 25 forensic medicine specialists in the 15 government medical colleges. In over a hundred taluk and district hospitals, non-qualified medical personnel — doctors specialising in other branches — are handling post-mortems. Each year, only three seats are available for postgraduate forensic medicine in Tamil Nadu. “The number of seats has to be increased so that more qualified personnel can be posted in the hospitals,” says Dr Srinivasa Ragavan, professor of forensic medicine. In 2008, the Madras High Court had passed an order to impart post-mortem training to all government doctors dealing with medico-legal work. But there has been no follow-up on this order, say doctors.
Dalit workers and doctors have been crying themselves hoarse for a revamp of mortuaries in the state. It would be a move that would not only respect the departed, but also value the role of the living working among the dead.
WRITER’S EMAIL vinoj@tehelka.com
From Tehelka Magazine, Vol 6, Issue 26, Dated July 04, 2009

Numbness Of Death

Muniyamma has dissected over a thousand bodies. She speaks to PC VINOJ KUMAR
Uncomfortably numb Muniyamma has been a mortuary worker for 15 years
MUNIYAMMA STAYS in the small town of Tindivanam, 120 km south of Chennai. This 37-year-old dalit has been working for over a decade at the mortuary in the Tindivanam Government Hospital. She is a physical wreck, addicted to liquor and with little to look forward to. Her husband, a rickshaw puller, died eight years ago, and since then her family has lived off the meagre wages her work at the mortuary provides. Both her children — daughter Valli, 18, and son Manimaran, 14 — have had to discontinue their studies.
“I have cut open over a thousand bodies till date. I can dissect a body in 30 minutes flat,” says Muniyamma. Nearly 15 years ago, it was a neighbour who worked as a sweeper in the Tindivanam hospital, who had suggested that Muniyamma look for a job in the hospital. Muniyamma started frequenting the hospital with the neighbour, doing odd jobs for a while. Soon, her husband suggested that she find some work at the hospital’s mortuary, where a relative had worked earlier.
“My cousin who used to work in the mortuary had died. Natarajan, the mortuary attender, offered to take me in his place. Initially, I used to just wrap up the body in a white cloth after the post-mortem was over. Gradually, I started doing more and more work at the mortuary,” she says. When she started doing dissections, she took to drinking liquor.
“One gets used to alcohol in this job,” laughs Muniyamma, adding that she had skipped her early morning quota of local arrack to be ready for the interview. “We handle bodies that are totally decomposed. We dissect those bodies whose skin peels off when touched. The stench that emanates from such bodies is so overwhelming that it’s difficult to go near them without taking a few pegs.”
For years, Muniyamma has been doing the whole autopsy herself — from knocking off the skull cap using a hammer and chisel, sewing up the body after the post-mortem, and wrapping it up in a white cloth, in a ready-to-bedelivered condition.
What’s more distressing is that for the last three years, she has been taking her 14-year-old son, Manimaran, to the mortuary with her. “He works faster than me. He can complete the dissection in just 15 minutes,” she says with pride.
Each morning, the mother-son duo wake up hoping that some bodies have arrived in the mortuary. Muniyamma is paid about Rs 50 for every dissection she does and on an average, earns about Rs 800 per month. It is her daughter, Valli, who is the source of assured income for the family. She has found a job at a nearby leather shoe company. She earns around Rs 1,500 per month. After serving in a government hospital as a casual worker for all these years, Muniyamma has no job security. Her name is not on hospital records. Only now has she begun to ask: “Will I ever get another job?”
A Tindivanam-based NGO, Social Awareness Society for Youth (SASY), a dalit human rights organisation, has been counselling her to look for a change. “We want to rescue and rehabilitate her,” says VA Ramesh Nathan, director of SASY. Usually it is the state that comes to the rescue of the victim, but in this case, in bitter irony, Muniyamma must be rescued from the grip of a negligent state. It is time the Tamil Nadu health ministry took notice.
From Tehelka Magazine, Vol 6, Issue 26, Dated July 04, 2009

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