Assam, India – The islands on the Brahmaputra river, locally known as “chars”, are the most underdeveloped areas in India’s northeastern state of Assam.

The 2,500 river islands located along the nearly 900km stretch of the mighty river are home to some 2.5 million people, nearly 80 percent of whom are poor, with little access to basic health and education facilities.

The chars have one of the highest infant and maternal mortality rates in the state. In the absence of emergency medical services, it takes 4 to 6 hours for a patient from a char to reach a district hospital for treatment.

Government interventions have been few and far between.

In 2004, a local NGO, the Centre for North East Studies and Policy Research (C-NES) launched the Boat Clinics to provide much-needed medical services to the area, which can only be accessed by boats.

The unique initiative focuses on the immunisation of children, women’s health, family planning counselling and other basic medical needs of the char communities.

Fifteen Boat Clinics operate in 13 districts along the Brahmaputra river, treating about 20,000 people a month for free.

Dr Hasan Rafik accompanies the Boat Clinic in Barpeta district in lower Assam. He says his mobile clinic caters to 33 villages along the river, providing critical health facilities.

“Most common diseases we come across are respiratory tract infections, sinusitis, pharyngitis, tonsillitis, bronchial asthma, skin infections caused by fungus,” he told Al Jazeera.

“Contamination of water causes skins infection since people living on chars use river water for bathing and drinking. Fungal infection is also caused due to people working in paddy fields.”

The state government, National Rural Health Mission and UNICEF now fund the initiative that has become a lifeline for the people living on these river islands.

Text: Saif Khalid