In northeastern India’s Assam state, a network of mobile boat clinics is providing essential healthcare services to thousands of residents living on more than 2,000 “chars”—temporary river islands and sandbars scattered across the Brahmaputra river. These remote riverine communities often face significant challenges in accessing basic medical care due to geographic isolation, limited infrastructure, and recurring flooding and erosion.

The mobile clinics, operated by the non-profit Centre for North East Studies and Policy Research under the initiative named Akha (meaning “hope” in Assamese), were launched in 2005 to address healthcare gaps in the region. Supported by local authorities and UNICEF, the program has expanded to 15 boats serving approximately 20,000 people monthly across 13 districts in Assam.

Residents of the chars, such as those on Barballa island in Nalbari district, rely heavily on the boat clinics for medicines, vaccinations, and basic laboratory services. “We are totally dependent on the boat clinic,” said Rekibul Amin, a Barballa resident, who noted that women in particular have benefited from the initiative. The clinics focus primarily on maternal and infant health, aiming to reduce mortality rates that remain above the national average.

Official statistics highlight ongoing health disparities in Assam, which has a population exceeding 30 million. The state records an average of 29 infant deaths and 34 under-five deaths per 1,000 live births, compared with national averages of 24 and 28, respectively. Maternal mortality stands at 125 deaths per 100,000 live births, surpassing the national figure of 88.

Medical officers working on the boat clinics emphasize the importance of reaching pregnant women and newborns. “Mainly, we are targeting the pregnant women who need antenatal care checkup and the newborn babies who need routine immunisation,” said Habibul Hoque, a medical officer serving in Nalbari. He added that poverty and illiteracy are significant barriers to healthcare access in these areas.

The mobile clinics serve as a vital link between isolated communities and the broader healthcare system, addressing gaps caused by the state’s challenging geography and resource limitations. By bringing healthcare directly to the chars, the program seeks to improve health outcomes among some of Assam’s most vulnerable populations.