Determined Doc

September 7, 2012

He came to the Sultanate three decades ago to set up a health clinic in Ibri, which lay undeveloped amidst Bahla and Yanqul infamous for superstitions and witchcraft those days. Salim Joseph meets up with Dr. Seetharam Bhat, an authentic eyewitness to the gradual societal transformation in Al Dhahirah region in Oman

What anyone could expect when he lands in a semi-desert plain where development is just at its infancy? May be no roads, no electricity, no proper buildings, no telephone connections…Dr. Sitharaam Bhat had no great expectations. But he was a modern medical practitioner and he had in fact landed in a place where people knew little about modern medicine. Majority of them even could not tell between a general physician or a veterinary doctor!

That was July, 1979 and Dr. Bhat, in his late 20’s came from the Indian state of Karnataka to Ibri in north Oman to set up a clinic. A house made of wood and mud was transformed into a clinic and he was alone, not even a nurse to assist him. The Government hospital at Tanam, some 15 kilometres away from Ibri, had five doctors and in the area there wasn’t another single health clinic.

There wasn’t electricity and his sponsor had given him a lantern to survive the nights. There wasn’t a single shop in the vicinity from which he could buy some soft drinks or other provisions. It was extremely hot and he slept on the terrace of the clinic, which was to be also his residence for the next 23 years. On day one he had just one patient, two next day and none on the third day. But slowly patients started trickling in. Some came on donkeys and some in the pickups from remote villages. His life as a doctor in rural Oman had begun, and he thought the time machine had landed him in the preceding century.

Reasons could have been aplenty for anyone to believe so. This region that lay tucked between the southern foot of Al Hajr AI Gharbi Mountains and the Empty Quarter was ‘inhabited by jinns’. Wilayat of Ibri was trapped between Bahla and Yanqul where people said witchcraft was in practice. Even the traditional treatment with hot metal rods (wasem) could be seen only as uncivilized if not savagery by a modern medical practitioner. And people talked about ‘atheisa’, a big fly who hit them often causing breathing problems and allergic reactions.

“But the Ministry of Health already had its presence in the region with its office and Tanam hospital. They were creating awareness among people on modern medicine and they guided me as well and provided me support,” recalls Dr. Bhat. A couple of doctors who came before him to set up private clinics in Ibri had left for unknown reasons, but he was to stay. He did stay at the same place, at the same building, added a lab, a pharmacy, a dental unit and led a modest life never thinking of escaping to cities. He was in fact destined to be an authentic eyewitness to the gradual societal development of rural Oman.

Setting up the clinic

A graduate from Mysore Medical college, Dr. Bhatt came to Oman after doing a diploma in pathology from Kasthurba Medical College, Mangalore and working in India for six years. “I had my financial problems and had one of my cousins along with his wife working in Tanam hospital as doctors. They helped me to come over and my sponsor Mohamed Hameed Salim Al Mandhary wanted a doctor, to open the clinic here,” the 64-year-old begins his tale.

It was Al Nahda clinic at the beginning and at a later stage it changed to Al Dhahira Polyclinic. Ibri was a vast area with a lot of surrounding villages and it had a sizeable population of around 25000 people. “From Bahla to Yanqul or up to Wauqba and places up to Hafeed bordering UAE, people started relying on Tanam hospital and my clinic in Ibri. If somebody is not happy with government hospital he will come to me,” he says.

When he started getting patients, Dr. Bhat found it very difficult to communicate with them as he didn’t know Arabic. “My sponsor’s brother’s son Suleiman who is now working with the ROP helped me. He used to sit with me in the clinic whenever he had free time and I slowly picked up,” he says.

At that time the main health concern was malaria. “In the early 80’s seven out of 10 patients came with malaria and the disease’ presentation was in varied forms besides high fever. Even those came with itching got diagnosed for malaria. However, later on we see that the malaria eradication programme becoming 100 percent success in Oman,” Dr. Bhat points out.

But were people aware of modern treatment methods? They had their own traditional methods and the main one was wasem, which was widespread in Dhahirah and Dhakliyah regions. There were wasem practitioners who used hot metal rods, which will be pressed into several places on the body that differed as per the ailment. “It’s still in practice today, as far as I am told in several areas. People used this method even in paediatric cases. But it’s interesting to note where they press the hot rod, like for oral ulcer they place it on the back of the neck. They were treating several other diseases as well including sciatic nerve problems. Many got infected and used to seek modern medicine later on.”

In fact, the immediate acceptance of intravenous injection happened because of its similarity with wasem, Dr Bhat points out. “Besides, they wanted immediate relief. If we refuse to give injection, they will quarrel with us and even nowadays it happens so.”

Emergence of more clinics

Dr, Bhat had a tough time, initially. He had to wait for almost two years to get a nurse. “Female patients were asking for lady doctors. Many didn’t have any idea about what the doctors are. Some thought we could treat even their animals including camels. A doctor had to build up trust like in no other place.”

Three years later, more clinics, labs and pharmacies emerged which included Dr. Nair’s clinic now functioning as Oman Medical Complex. Dr. Bhat had his clinic renamed Al Dhahira in 90’s which was the initial name of Oman Medical Complex. “Now we have around five private clinics here in the area besides the Government Ibri Hospital which got established in 1995 and the government primary health centre. 

The support from the Ministry of Health was excellent, he asserts. “From the ministry we got proper guidance. They conducted regular inspections and we had we had their support. They were also doing awareness campaigns to introduce modern medicine to the public,” he says acknowledging the great assistance and guidance from Ali Khalfan Al Mandhary, the senior administrative director of Tanam Hospital at that time.

People were goodhearted and began trusting the doctors. They came to know about clinics by word of mouth. The communication problems subsided but their demand for immediate relief remained. “It’s changing now, thanks to the education and another 5-10 years it may change completely,” he exudes hope.

Now, sitting pretty in a clinic with all facilities, examining patients, giving them advices and prescribing them medicines, Dr. Bhat hasn’t put out of his mind those days when there wasn’t any scanning machines to diagnose diseases, those days when he had no telephone connections, those days when people bitten by scorpions came with the culprit trapped in a jar and those days when he went to Bedouin’s places to treat patients.

Now who else would want to recall those days?  Ibri has caught up with the 21^st century, passing two centuries in three decades time, but the traces of old customs and practices remain, at least in the minds of several, he adds.

Three decades back

• Remote villages had very little access to modern medicine and hospitals
• Wasem, the use of hot metal rod, was the main traditional method of treatment
• Scorpion bites besides sting by wasps and honeybee were common those days. People used to put scorpions in a jar and bring it to hospital along with the patient
• Malaria was most common and seven out of 10 patients were diagnosed of malaria
• Marrying from the family was common, which led to severe heart diseases and Down’s Syndrome among children
• People often complained about atheisa, a fly which caused them breathing problems, wheezing and other allergic reactions
• Patients came on donkeys and in pickups
• Some brought their camels thinking that these doctors could treat their animals as well
• The psychological disorders were blamed on jinns and witchcraft and sorcery were being reported from neighbouring areas