Re-visiting the site of the first clinic at Middleton Row.


        Rain dripped on to the edge of the dark railway platform at Howrah station. Jack crouched to speak to one of the destitutes, stretched out amongst the dirt and litter. He had come to give an injection to her husband whom he had seen the night before. But when the woman's feeble voice revealed that he had gone somewhere else that night to escape the station authorities, a knot formed in his stomach. Without the medication he had brought, the man would probably die. And he would need successive injections on days to follow. 

        On an impulse, he told the woman to bring her husband the next morning to the place where he stored his medicines. He could treat the sick man there. He did not know that this patient would be the first of tens of thousands to follow over the next 14 years, in the same place. 
        -At the side of the road.


Middleton Row Pavment Clinic, circa 1990 Treated up to 500 Patients a Day

        I tried to imagine Jack's feelings as we strolled slowly down that familiar stretch of pavement towards where his first clinic was born. Even although I had only worked there for a few weeks years ago, the memories were  rushing back. He stopped to return friendly waves and greetings from the owner of one of the pavement tea stalls. Everybody knew Jack!         

        We both fell silent as we reached the spot where Jack's work in Calcutta had begun in earnest - a stretch of dusty broken pavement, perhaps 70 yards long, and ending where Middleton Row turns at right angles under the gaze of St Thomas's Church. Just before this, stand the Presbytery gates, and the little lodge which once housed the medicines, equipment, medical records, and the tarpaulins to protect the heart of the clinic from the elements. It was under this sagging canopy (which had to be regularly emptied during monsoon rainstorms to prevent it collapsing from the weight of water) that Jack had sat six days a week for 14 years amongst the organised jumble of boxes and medical paraphernalia, supported by his entourage of paid Indian staff, and senior volunteers.

Jack With Assistant Doctors at The Former Middleton Row Pavement Clinic, circa 1990
        The fringes of the pavement clinic were exposed to the tropical sun, except for an area adjacent to the gates, where a large spreading tree benevolently extended its leafy branches, creating a shaded area for the clinic’s “headquarters” By late afternoon every day, this amazing medical facility had all magically disappeared back into the gate lodge, leaving the pavement empty and thoroughly unremarkable - exactly as we perceived it now. But no other city street in the world can have witnessed the human dramas enacted here, with up to 500 sick and injured people a day coming to receive the compassion and care dispensed by a man whose life had been transformed by an old bible bought for sixpence, decades before. The same sidewalk had also seen hundreds of youthful travellers, who had willingly sacrificed their onward itineraries and travel budgets to work for Jack instead of enjoying the beaches of Goa, or the temples of Bangkok. Many of those young people would return as volunteers on future visits, others would set up fund raising activities in their own home town. Few of them would ever forget.

         "Why on earth did you choose this posh street for the clinic in the first place?" I asked.

         "I didn't at all. I was staying here at the YWCA - they accepted male guests - and got to know a priest who offered me a small building in the Presbytery garden opposite the church which I could use for storage of medical supplies and documents"

        "At that time, I had just stopped working with Mother Teresa's Brothers in the Home for Sick Destitutes at Howrah, and was treating destitutes who were living in rail stations, under flyovers, inside drainage pipes, along the river, and other places. I used to see and examine them one day, and return the next with medicines and things, but this was very time consuming. Also, some street dwellers from Park Street started to ask for treatment, but they were constantly being moved on by the police, and it was often very difficult to locate them again. Eventually I passed the message that they'd better come to me in Middleton Row, and that's how the pavement clinic started really - I never actually planned such a concept, it just happened by itself"

         "But why did you stop working for Mother?" I ventured.

         "I anyway wanted to work in a secular programme, but additionally, although I have the highest possible respect and love for the wonderful work Mother is doing, her organisation is basically missionary and meditative, definitely not medical, and frankly, the two do not mix. Medicine is a full time hands-on affair, and you cannot just drop everything because it is time for prayers or Holy Mass. As a doctor, I found this difficult to go along with, particularly here, where there is so much suffering and so little adherence to the basic rules of hygiene - for example, there was no segregation between those suffering from tuberculosis and the others, so the disease spread quite needlessly, and I really couldn't accept this. A visiting orthopaedic surgeon friend of mine once asked one of the nuns what she did if somebody was in severe pain, and she said 'we pray for them' Things may have changed since then, I do hope so"

         Jack stared up meditatively into the branches of the big tree.

         "They call this a goli tree, you know - 'goli' means a bullet, or one of those herbal medicine balls, because of the round seeds it produces by the thousand. The patients referred to Middleton Row clinic as 'Gazneeechi' which means 'beneath the tree'  We had so many patients in the end that crowd control really became a  problem, as they occupied both sides of the road, and spilled on to it, so there was always the risk of an accident. That was why we opened the second clinic at Nimtallah Ghat on the river, which grew even bigger then this one - up to 800 patients a day! We had crowd control problems there too, as the location is both a bathing place, with a crematorium nearby, and there were conflicts between our patients and mourners, or bathers"

         "You said the Middleton Row clinic was closed as they want to redevelop the land adjoining, but what was the story at Nimtallah, why did that one close too?"

         Jack fidgeted with his shoulder bag, as if to relieve some irritation.

         "Local Mafia basically" He shook his head slowly.

         "We've had many battles with various mafias over the years, but they normally leave us alone in the end, as we never pay up. This time however a new riverside mafia took over, and demanded a 'contribution' for an upcoming festival - or 'puja' as it is known. Ostensibly this was supposed to be towards towards the cost of erecting a temporary shrine, but it was actually pure extortion. We refused therefore, but during the 3-week event we had to make room for the shrine and moved the entire clinic right down to the river's edge. When it finished, they refused to let us move back up, and the riverside conditions were just intolerable. We lasted 3 months there until we could stand it no longer, then relocated to Cossipore. Fortunately the Mafia folks who control the Cossipore area are well disposed to us"

         "So the Mafia is for real, like in the 'City of Joy?"

          "Yes, just as in every big city I suppose, particularly in the third world. But the book itself is not actually a true account, although it is a masterpiece of writing about Calcutta. There are some some wonderfully descriptive passages, and the plight of destitutes and street dwellers is portrayed in dramatic detail. The real doctor however was a Lebanese Christian, not an American Jew as in the book. He was a simple hard working good man, who lived under really very primitive conditions - I was shown his room - as it was going to be my room."

         "Your room?" I asked, thinking I had heard wrongly

         "Yes, I was invited by the committee to replace that Lebanese doctor, who the police would not allow to stay any longer. I was at that time still based in Bangladesh, but I accepted in principle, and returned to Dhaka to await further details. I had no idea how bad postal communications were then, and hearing no more, presumed they were no longer interested. However, a letter had in fact been sent confirming the appointment, but I never received it"

         "And if you had received it, Middleton Row, Nimtallah, Cossipore, the mobile clinic, the school and everything else would not have been born at all"

         "I suppose not" said Jack reflectively. "But I daresay I would have been guided to create something else"

         He positioned himself on the middle of the pavement, and squatted down as though sitting on an invisible chair, then moved to one side, then a little backwards. "This was my spot for 14 years more or less, I can tell by the angle I get on those apartments" I looked across the road and up at the modem block of flats which contrasted sharply with the aging weather-stained buildings adjacent.

        "Some of the residents there were very kind, and helped us you know"

        He was now standing under the goli tree, and examining the wall.

        "They used to send over cold drinks and things during the very hot weather. We really appreciated that"

        He suddenly let out a laugh, holding a half clenched hand in mid air.

        "My stethoscope used to hang down around here on a string from the wall"

        He continued laughing heartily, to my bewilderment, but it was so infectious I joined in anyway.

       "I've just remembered what happened one day here," he said, in between chuckles,

        "We had just hired this fellow called Patrick Gomes as a general helper and interpreter. In the past we had frequently found Patrick on the pavement right here, in advanced states of intoxication with goodness knows what kind of substances, so we decided that if we gave him work, we might not be obliged to step over his unconscious body every morning. Patrick is the progeny of an Anglo-Indian mother and a black father, and actually speaks English reasonably well, but is famous for his malaprops. Anyway, one day I asked for my stethoscope, and Patrick called out in a very loud voice: Bring the doctor his testicles - they're hanging on that piece of string!"

        We were still chuckling as we turned, and made our way towards Jack's recommended restaurant.

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