Adnan Singh, 56, looks intently at the swollen leg of Kanta Bai. For about 10 minutes he stares at it from different angles. He then asks her to take her tongue out. As Kanta Bai obliges, he looks at her tongue for another five minutes, after which he examines her eyes.

This detailed examination goes on for about 20 minutes, followed by a profound declaration: “Tumhe thhand lagi hai (you are down with cold).” Singh then gives her some white powder folded neatly in a piece of paper.

On the veranda behind Singh lies a man on a cemented slab — on drip. “Isko TB hai..paani chadh raha hai (he is suffering from TB and is on a drip) ” says Singh.

On the front, at the entrance, a few other villagers wait for his diagnosis.

Singh has all the pretensions of a doctor — he prescribes medicines, administers injections and even performs minor surgeries. But he is not a doctor. He is not even a doctor’s assistant or a paramedic, popularly called compounder.

He is, hold your breath, a peon at the local government ayurvedic hospital at Girwar village in Abu Road block of Rajasthan’s Sirohi district.

And if you thought the hospital at Girwar with a peon practicing as a doctor was an aberration in the district, you could not be further from truth.

It’s the rule.

Of 67 ayurvedic hospitals in the district, only 32 have qualified doctors in charge — the remaining 35 are at the mercy of peons or compounders, like Adnan Singh.

“There are 18 hospitals in the district that are being run by peons,” confirms Kanti Khatri, an official at the district ayurvedic office in Sirohi. Most hospitals where the peons or compounders have taken charge are the ones where either a doctor has not been appointed after the last one left or those appointed have not taken charge, Khatri says.

Adnan Singh assumed charge at Girwar hospital and graduated to being a ‘doctor’ from a peon in 2009, when the hospital’s lone doctor was transferred. “The government has not appointed another doctor. Despite our pleas to the district administration, the position has been lying vacant since 2009,” says Balkrishna Sharma, a resident of Girwar village.

Sharma, however, acknowledges that the peon has knowledge of ayurveda and his presence at the hospital is better than having no one at all. “He has been with the hospital for so many years that he has learnt the tricks of trade,” Sharma says.

When peons turn doctors
Originally from Jodhpur, Adnan Singh joined the hospital in Girwar village in 1984. Having made the village his home since, he has done well for himself. He built his own house on the outskirts, educated his children, and married them off.

Clearly Singh’s years of practice as a ‘doctor’ have given him confidence about the trade. “Photograph me with my patients,” he says, posing for the camera at his home.

It’s noon, and Singh, after seeing patients at the hospital, is back home, where he will continue seeing patients all day.

But Singh’s confidence notwithstanding, this trend of peons turning into ‘doctors’ is a dangerous one, says Dr Nidhi Audichya of Aajpura hospital, one of the 32 hospitals that have qualified doctors in charge.

Blaming the government for creating this impasse, she says, “Though they are popular with tribal people in the block, avurvedic hospitals have been left to die a slow death. There has been absolutely no attempt to recruit new doctors, though there is a dire need to do so.”

The administration, instead of appointing new doctors, is meanwhile giving additional responsibilities to the existing ones. Dr Nidhi Audichya was ordered to take charge of another hospital in the adjoining area which was till now run by a peon. Her husband, Dr Parijaat Audichya, also an ayurvedic doctor posted at a hospital in Kiverli village, has also been asked to take additional charge of a hospital at Ore village.  

While the hospital at Girwar and others have compounders, or at least peons like Adnan Singh to take care of, many others, like one at Uplagarh village in the hilly side of the block, have turned into shelter for animals or inebriated people.    

A hospital lies in disuse
The Uplagarh hospital was abandoned by its peon in 2008 after the hospital’s doctor died in an accident. The peon, villagers say, practiced in his own village, though he drew salary from the hospital. “We see him once in a while — he lingers on in the village for a few hours and then returns,” says Kalicharan Garacia, a former school headmaster from the village.

Built in early 1990s, the hospital, aimed at catering to about 30 tribal villages, was very popular with residents of the area. Wary of allopathic medicine, they flocked to what they called the ‘jadi-buti ka haspatal’.

But it has been lying abandoned since 2008. Like in Girwar, residents’ plea to appoint another doctor has not been met here as well.

The building, on paper built at a cost of Rs 5 lakh, is fast turning into a ruin: its plaster has peeled off and roofs of the four rooms leak during monsoon. If not for a red ‘plus’ sign on one of the front pillars, it would have been difficult to tell that it used to be a hospital.

“It a classic case of administrative apathy for the needs of people in a far-off tribal area,” says Kalicharan.

Villagers recall the hospital’s popularity when it opened and wonder why the health department has not cared to appoint another doctor. “People from far-flung villages used to come to this hospital,” recalls Shantilal, who had consulted the doctor on several occasions when the hospital was in operation.    

After the doctor’s death (he died while crossing the flooded Battisa river to reach the hospital) residents have appealed the block administration through their panchayat every year to appoint another doctor. But to no avail.

“At one raatri cahupal (night meeting) organised by the district collector near the hospital a years ago, we had reminded him about our plea to send a doctor here. Although he said he will direct the health department to do the needful, nothing has happened yet,” Noparam, a resident, says.

Not willing to give up, the residents made another attempt to get the hospital up and running when they appealed to the block administration to order a appointment of a doctor during the ongoing ‘prashasan gaon ke sang’, a drive by the Rajasthan government to send district officials to villages to address their grievances.

Acknowledging the appeals of the villagers for appointing doctors in hospitals run by peons and compounders, district officials say senior officers in state capital Jaipur have been informed but they are helpless till the government sends more doctors to the district. “The district cannot do anything if the state doesn’t fill vacancies.  Last month 187 new doctors joined the department, but only one was sent to the district,” Kanti Khatri, the deputy district ayurvedic officer says.

His senior officer, Shyam Sunder Mishra, was on leave at the time.