Merchant Doctor in Dharavi

In his youth as a student at JJ Hospital, Dr SM Merchant had never ventured into or even heard of Dharavi. He lived in Dongri in those days and Dharavi was just the outskirts of the bustling city. The sexagenarian doctor, who has now been practising in Dharavi for 40 years, says it was happenstance that led him to what was then a marshy patch of land.

The story goes that a compounder told him of a locum clinic that needed a substitute doctor to fill in the hours. “He said he would show me the place, which was in Dharavi, and asked me to meet him outside the Sion railway station at 4 pm,” recalls Dr Merchant. After hours of waiting, the compounder did not turn up and a miffed Merchant went home. A few days later, he heard of another locum clinic in Dharavi and was asked to “sit around and read” there until the regular doctor returned.

“But I found myself very busy with the patients and I picked up pace from the very first day,” says Dr Merchant. The compounder who had stood him up outside Sion station happened to pass by and burst into the clinic, saying, “You are here! This is the clinic that I wanted to show you that day!” Dr Merchant’s clinical wisdom was a great hit in the area and what was a temporary job became a passion. He went on to open his own private practice near Bismillah Hotel, complete with a low ceiling and a table fan chained securely to a post. For Dr Merchant, Dharavi was his destiny.

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Dr Merchant now works from his dispensary on 90 Feet Road, opposite the Colour Box. It is a narrow room squeezed between a chai shop and an egg distributor. He is unhappy with the number of egg distributors on 90 Feet Road and their business strategy of selling broken eggs for cheap in plastic pouches. Dr Merchant continuously warns his patients – including his compounder, who buy a broken egg or two now and then – of how unhealthy it is to consume these germ-ridden produce.

With four decades of experience in Dharavi, Dr Merchant says that, while people have more buying power, the overall quality of health has declined and people invest in good health only when most required. The most frequent complaints are common colds and fevers, as well as major illnesses like malaria and typhoid. People with tuberculosis used to knock on his doors quite often, but with the intervention of government hospitals and free medicines they have been diverted to larger centres such as Sion Hospital. Dr Merchant says that the number of consultations for cancer has gone up and that diseases like dengue, unheard of some decades ago, are on the rise. “The major reasons for the decline in health would be population, pollution and space. Real estate is so expensive in Dharavi and you will find entire families packed into a 100 sq ft house. Health suffers in such cramped situations,” he observes.

Dr Merchant also points to the endemic problems faced by the Kumbharwada community of potters who live amongst their kilns. Asthma and tuberculosis has been seen in many of them and there are frequent complaints of lung ailments. “I have seen small children use nebulizers here. The government needs to look into these issues and, rather than move them away, needs to consider more tactful means to help the community use its kilns and simultaneously take care of their health.”

At one time Dharavi was infamous for its profusion of illegal country-liquor shops. While the liquor shops have now been pushed into more unmonitored areas, drug use is a major problem, says Dr Merchant. Several teenagers are involved in drug use and drug-related crime, and it is usually their parents who bring them to the clinic. But rehab is an expensive, long-term proposition that most families give up on at a certain a point.

Dr Merchant says that women who come to his clinic are often suffering from a common ailment he calls “male-dominated society.” Some women are pregnant with their fourth child, some are anaemic from fasting, and some cook four times a day for the whole family, but pay no attention to their own nutritional needs.

On most days Dr Merchant has no time to even sit down in his clinic, and says that he often doesn’t tell people where it is. He gives them locations in the vicinity, such as Matunga Labour Camp or Sion, because people tend to raise an eyebrow if he says he works in Dharavi. Nevertheless, clients seek him out from as far away as Virar and Thane. His family lives abroad, but he says he will continue working in his small Dharavi clinic as long as he can. “I cannot imagine a day when I am not working here,” he says, as patients line up outside.

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Dharavi ka Diwali

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It is the busiest season of the year in Kumbharwada, the settlement of potters in Dharavi. Women repeatedly dip diyas into red paint, older women have small stalls on 90 Feet Road and have no time for wasteful chit-chat, perspiring men have heated telephonic arguments about diya orders, and broken pieces of earthenware are scattered across the lanes: it’s business and busy-ness. As in the rest of the city, Diwali arrangements are in full swing, and preparation for Kumbharwada families means not just shopping, but also selling. For the three months leading up to Diwali, families are immersed in the household business of making earthenware – from diyas to idols – for local markets and for export.

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It is the busiest season of the year in Kumbharwada, the settlement of potters in Dharavi. Women repeatedly dip diyas into red paint, older women have small stalls on 90 Feet Road and have no time for wasteful chit-chat, perspiring men have heated telephonic arguments about diya orders, and broken pieces of earthenware are scattered across the lanes: it’s business and busy-ness. As in the rest of the city, Diwali arrangements are in full swing, and preparation for Kumbharwada families means not just shopping, but also selling. For the three months leading up to Diwali, families are immersed in the household business of making earthenware – from diyas to idols – for local markets and for export.

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For those who lack the nimble movements required for mehendi designing, painting diyas is a useful business. Bhanu Devanand Tak, a 40-year-old mother of two, paints pots and about a hundred diyas every day between household chores. She started painting diyas a few years after her marriage and, ten Diwalis later, Bhanu figures she must have painted more than 2 lakh to date. “Earlier, I was only painting diyas and a hundred diyas fetched me Rs. 10. Now I have picked up some decoration techniques as well and that helps me earn twenty bucks more,” she says. The money she earns doing this every year, around Rs. 15,000, is used for buying Diwali sweets and dresses for her children.

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While the earnings from such voluminous orders of diyas seem small, homemakers like Bhanu are undeterred. She says, “My whole day is spent this way. I don’t need to go anywhere to find work and I can manage the household as well. Besides, this keeps me occupied and I don’t indulge in useless neighbourhood gossip this way.” She gives the example of her mother, who makes a living making festival sweets such as puranpoli and rotis for customers on regular days. As an aside, Bhanu adds that she would like to do “something else someday” when her children get jobs of their own.

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Much like Bhanu, a stern old timer called Veni Behn also picked up diya decoration skills from her mother-in-law after she got married. Her family lives in the upper story of the house and the ground floor has been converted into something like a production unit, with wrapping paper, paints and a variety of colourful earthenware strewn around. A bunch of women, including Veni’s daughter-in-law, have their noses buried in their work. Veni’s son Jitendra Valji comes downstairs to investigate the progress they have made and seems pleased. Veni says that women are more talented when it comes to diya decorations. Her son adds that this is a family business in which everyone has a part of play. He runs a store in Thane and complains that the festive earthenware market has been affected by the “Made in China” label found on serial lights and wax candles.

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But the festival of lights is also the bringer of smoke to Kumbharwada. Given the nature of the work, most houses have an accompanying kiln and a water-filled clay-pit. This might be a poetic meeting of the elements, but the kilns burn avidly to produce huge quantities of diyas for Diwali. Doors open onto fumes and most women decorate Diwali wares in the midst of a grey haze.

Hawa Toya, a jolly 60-year-old, is among the Muslim potters who also make diyas for Diwali. She lives in Kutch and is visiting her sons in Kumbharwada. “Over there, we have kilns under the earth, and it is so hot that just a match is enough to light up an entire kiln. We use acacia branches as fuel, unlike the hazardous industrial waste that is used in Kumbharwada. It is less polluting,” she says.

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Nevertheless, most Kumbharwada residents are fiercely protective of their smoke-ridden locality, especially in the wake of the redevelopment proposal. Instead of looking at the respiratory and eye problems brought about by the smoke, they prefer to see their glass as half-full. One woman points out that the smoke rids the area of mosquitoes, which could have been prevalent in the clay pits. She says, “This smoke is our livelihood. How can we blame the kilns?”

Two Doors, Two Choices

There is a dimly-lit community centre with two rooms at Kumbharwada, Dharavi. You reach it after treading clayey paths where workers labour over sacks of mud meant for the potter community. One room is for visits from an allopathy doctor and in the other is a homeopath. No signs advertise the services available at the community centre, but there is a steady trickle of patients, mostly elderly. They enter in a moment of suspense: which door will they choose? Allopathy or homeopathy?

The clinics are part of a charitable trust, the Pramila and Harishkumar Foundation, set up by homeopath Dr Geeta Punjabi in 2009. The 74-year-old veteran meant them to cater for the poor in Dharavi so that they could get quick relief at subsidised rates. The homeopathy centre is currently attended by Dr Poonam Talreja, who has been there since 2010. Her clinic is painted a bright shade of green and most of the space is taken up by trays of bottles of homeopathic medicines. It’s hard to find her unoccupied. As each patient consults her, the conversation is punctuated by the pitter-patter of raindrops on the asbestos roof. The patients queueing outside grumble impatiently in low voices, but are glad that the doctor gives each of them a decent amount of time.

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Dr Talreja says that she has seen some challenging cases cured with homeopathy. “We don’t try to heal just a particular organ, but rather improve the overall immunity of the patient. We won’t claim that all our patients have reached normalcy, but they have surely reached a near-normal state,” says Dr. Talreja.

Sometimes mistaken for a “lady-doctor,” she points out that the commonest health issues she sees in Dharavi are chronic fatigue, joint pains and asthma attacks. “These are mostly female patients. They neglect their health and they hope that if they pop a pill they’ll be fine instantly,” she says, nodding her head. Most of her female patients are daily wage-earners and she says that a quick fix is a must or it could mean losing out on a day’s pay. People also come with digestion problems. “Many Dharavi people have problems such as constipation or diarrhoea, but I am careful before prescribing medicines. I always check to make sure that they have toilets in the vicinity of their homes. Otherwise, it could be a big problem for a patient who has just taken some laxatives.”

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With subsidised rates for medicines (globules are free, tinctures and laxatives are half-price), Dr Talreja says that not everyone is Dharavi is poor. There is a donation box in the clinic and more affluent clients are advised to purchase the medicines at retail rates.

When clients enter the community centre, which door do they choose? Have they made an informed decision about which medical recourse will work best for their health issues? Or do they try both allopathy and homeopathy with the hope that something might eventually work?