Mokama: The Land of Guns and Mustard Fields

The letter was from a friend in Bihar, a nun who had trained with me in medical college. She wrote that a rural hospital there, run by the Sisters of Charity, was urgently in need of a surgeon. Was I interested?

I had just finished by surgical training in Liverpool. I loved every moment of my life in England but was also certain that I would go home soon. The offer from Bihar appealed to my foolishness. I said yes, and four months later, was heading north and east by train from Bangalore. My family was dismayed. Bihar was not a place anyone went to out of choice, it still isn’t. Tell anyone that you wish to work in Bihar and you’ll see eyes go round and big. “Bihar! Why?”

It is one of the most backward states in the country, economically; lawlessness, dacoity and crime are rife. It was far worse in those days, in the early eighties. Mokama,where the hospital is located, is a small rural town on the plains of the Ganges and is a jumble of modest to poor dwellings, hutments and cubby-hole shops scattered on either side of the narrow roads. The hospital is a half-kilometer walk from the railway junction.

The self-contained campus itself was pleasing, with neatly laid-out buildings that accommodate the hospital and the living quarters for doctors and nurses, a chapel and gardens. Abutting chapel and within the same campus was the seminary of Jesuit priests, small by most standards, with one priest and a few novice priests undergoing their training in religious studies. They also tended an acre of land in which they grew pretty much everything that can be grown on the fertile plains of the Ganga including wheat, rice and a variety of pulses.

Thanks to the hectic nature of my work at the hospital, it was at least two weeks before I ventured outside the hospital gates and saw the town of Mokama.

The only vehicle of transport was the cycle rickshaw, a ramshackle affair with a hooded carriage attached to a bicyle. You sat on the narrowest of seats that angled downward and held on to whatever you could while the rickshaw-walla peddled you around the town, stopping to buy provisions, vegetables, sweets and snacks. The roads were of mud and stone and beribboned by narrow drains which serviced the little shops and homes on either side. Walk a few hundred yards and you were in narrower lanes that snaked in all directions and here more homes huddled together. Most people moved about on foot, by rickshaw or in bullock-carts.

Within a period of months, I had made friends with many in town including the young man who sold samosas from his wheeled cart that was always stationed between the vegetable shops and the bank. While he wrapped the samosas in newspaper, I savoured his tea that was flavoured with cardamum or ginger and was fifty paisa a cup. It was still summer, very hot and sultry but the hot cup of flavoured tea was a perfect remedy for work-day exhaustion and was any day perferrable to the numerously-coloured soda drinks lined up outside most shops. (Even now, in India, you will get the best tea in small road-side shacks where it is freshly brewed, vigorous and sweet. The expensive hotels usually serve terrible tea.)

The patients we saw at the hospital came from all classes of society. The general wards with 20 or more beds in each were occupied by those who worked for bigger land-owners or the bhumihars who used them like bonded labour, paying a pittance for a day’s work, giving loans in times of need and thus binding them for life. The hospital was not expensive by any standard but they still found it hard to pay the bills. The poor of Bihar are the poorest I have met. The Sisters of Charity and the Jesuit priests helped to uplift them economically and socially. This happened over several decades (the nuns who came from Kentucky in the US started the hospital in the early 1940s). The bhumihars could opt for the special wards which were more comfortable and private.

I soon found that my training in UK, good as it was, had not prepared me for what I saw in Bihar. Mokama was best known for its two infamous gangs of criminals who regularly settled scores against each other in shootouts that could take place near the railway tracks, in the mustard fields, a deserted building or the center of town. So although I did a lot of regular general surgery, much of the emergency work was to do with gun-battles that ended with several wounded landing up at the hospital, usually at the uncomfortable hours between midnight and 3am. The weapons used ranged from knives, bows-and-arrows, bombs and country-made pistols to the deadly AK47s. Even at those odd hours there would be crowds surging through the hospital entrance and pressing around the doctors with questions. I learnt quickly that it is important at such moments to be very firm. The patient needed urgent surgery, and that’s what I would do. The talking and explaining could wait.

After some initial reluctance and anger, they accepted this arrangement. So after three or four hours in the operating room taking out bullets and sewing intestine – or a limb – blown apart by the injury, I would face the by now diminished number of ‘attenders’ of the patient and explain the injury, chances of survival, the need for more blood etc. As I spoke, I could not fail to notice the gun that often hid behind a shawl wrapped over the shoulders of one or more among them.

I could tell many stories about the cases I came across. The 9-year-old and his pregnant mother caught in the cross-fire in the marketplace; the sub-inspector of police with his guts ripped open; the policeman hemorrhaging from bullets in the chest; the young man whose hands got blown off by the crude bomb that exploded in his hands before he could use them; the 19-year-old whose parents told me – within his earshot – “Let him die, he’s not worth the trouble.”

Instead, I’ll say this much: I could not take it for too long. After a year, I quit, in spite of having loved my job. And years later, I went back with my husband and worked there again for a year-and-a-half. I went because although I was no longer young, I was still foolish. That’s my luck.