Interview with Dr. Temmy Sunyoto in India

In the states of Chhattisgarh and Andhra Pradesh, in central India, MSF is providing healthcare to people caught in a conflict between the government and Maoist insurgents known as Naxalites. This low-intensity conflict, which has been ongoing for 40 years, flared up in 2005. In the midst of the growing violence, an estimated 56,000 people have been driven out of their homes and are now staying in 23 government-run camps in Chhattisgarh. The rest of the population is either living in displaced settlements scattered around villages in Andhra Pradesh and along the border, or hiding in the Naxalites-controlled areas where they live in the forest with very little access to healthcare. Doctor Temmy Sunyoto spent 6 months on the project supervising the local medical teams.

Who are the people MSF is trying to reach?

They are tribal people. They're somehow outside of the system.  They aren't registered by the state, and they normally live in the forest and depend for their livelihood on the forest for food, shelter and everything else. It's quite a traumatic for them to be surrounded by violence; their villages are being burnt down, they have to move to camps, and they lose their freedom of movement. So that's why, due to the high security situation in Chhattisgarh, some people are fleeing from their homes to the surrounding states of Andhra Pradesh, Madhya Pradesh, and Orissa.

What kind of activities is MSF is doing there?

Basically, we have a project in the camps and we also do outreach activities in the villages with our mobile clinics. MSF is trying to find people who have fled their homes and lack of basic healthcare, by working from the border in Andrah Pradesh, for example. We set up clinics in the open, sometimes under the trees. We really want to earn people's trust in Chhattisgarh.

The second axis is our work in the camps because people there are also the victims of this conflict. The camps are run or supported by the government, and they provide some primary healthcare. So we focus on malnutrition. We have a therapeutic feeding centre on ambulatory basis and we come every week to find malnourished children and run a nutrition program. 

What kind of challenges do you come across while trying to work with the population hiding in the forest?

I would say that the challenges are huge. Firstly, it's trying to locate them because we're chasing ghosts. They are trying to avoid everybody and it's completely understandable. Secondly, the security situation is still very tense, and we cannot move very freely inside the Chhattisgarh state because there are lots of operations going on.

When you manage to reach this population what kind of medical problems do you find?

They are mostly linked to the recent living environment changes people have gone through. They barely have basic provisions like food and clothing and they live in unhygienic conditions so we found a lot of skin diseases, malaria, and respiratory problems.

What has this experience brought you on a professional and on a personal level?

On a professional level it was very interesting and challenging especially to see how different it is to work in a conflict setting in Asia. It was also interesting on a personal level. One day we managed to save a woman who had already lost her baby and was the mother of four children and was hiding in the jungle. After 12 hours of labour the husband managed to call us and we managed to bring her to the hospital and save her life...it really shows how important the work of MSF is there, because there are other people like her, and she was lucky enough to be saved. I hope we can save more lives there; it really touched me because I can imagine these people having nowhere to go, and they're dying in their villages and have no resources.