Making a career out of compassion

Since opening his first clinic in 1979, Dr. Jack Preger has devoted his life to helping India’s impoverished

Dr. Jack, pictured here in Calcutta, said he will return to the region after his visit to Kingston.
Dr. Jack, pictured here in Calcutta, said he will return to the region after his visit to Kingston.
Credit: 
Photo supplied by Terence Tay

Dr. Jack Preger says he has lost touch with what a “normal life” is supposed to be.

Ever since 1972, when he graduated from the Royal College of Surgeons in Dublin and ventured to Bangladesh to provide medical assistance to refugees of the Indo-Pakistan War, Preger has worked tirelessly to help the sick and impoverished in the region.

In 1979 he traveled to Kolkata, set up an illegal street clinic, and started the Calcutta Rescue Foundation. Today, the group provides free medical care and education to the poorest people in Kolkata and rural West Bengal.

At 76, “Dr. Jack,” as he is known to his patients, said he plans to keep working as long as his health allows. Preger will give the 2006 Chancellor Dunning Trust Lecture on October 19 at 7:30 p.m. in room 202 of the Policy Studies Building on campus.

He recently spoke to the Journal about his exceptional life and the progress he has made in one of the poorest corners of the world. 

The following is an edited transcript of the interview.

The Journal: Let’s start by talking about what your organization, Calcutta Rescue, is doing right now, in 2006. 

Jack Preger: We’ve got four free clinics in Kolkata, and two schools. We’ve also got outreach programs, where we go into the slums and deal with the health problems there. There is also preventative care that we do, immunizations and such.

There are specialty areas within each clinic: one does TB cases in the rural area outside Kolkata, and we do a street medicine program that is just for families living on the street itself, which was started in January this year.

We also have a handicraft workshop in the city and two weaving centers in the countryside, as well as a program for arsenic filtration to the north of Kolkata. That about covers it. 

You initially went to Bangladesh to do medical work in 1972. What was it that compelled you to leave your safe and comfortable life in England and head overseas, to an area so recently torn apart by war?  

I had trained in medicine to do that kind of outreach work, and I was going to go to the Caribbean to do work in a hospital there, but I was in a hospital in Dublin and there was an organization working in Bangladesh after the war ended, so they were calling for nurses and doctors to go there.

I went to work with refugees from the war, and set up my own clinic and children’s program later on. I had to leave in 1979 when I found out the organization I worked for was trafficking children.

I reported it to the government, but unfortunately they were also trafficking children, so I was forced by that regime to leave the country.  

There are so many areas in the world, and people who need medical assistance like what Calcutta Rescue provides. Was there something about India and Kolkota that led you to set up your medical organization there, or was it just a matter of circumstances? 

It was partly the language. You see, the Bengali language is spoken in Bangladesh and West Bengal, so I was already familiar with it. Another reason was that I was familiar with the kind of diseases that the people were suffering from.

Bangladesh and West Bengal were all one country at one time, and many Bangladeshis were living on the streets of Kolkota. One of my patients in Bangladesh even came to me in Kolkota, he had immigrated illegally to visit my clinic. 

You’ve encountered a lot of government resistance to your work, from being jailed in 1981 to having re-entry visas refused time and time again. How has this influenced your ability to help and make progress in the region over the years? 

I worked for so long to expose this trafficking of children, and the Bangladeshi government asked the government of India to get rid of me. They said that I was a missionary and all that stuff.

I was arrested and on trial for eight and a half years, so I was under trial but allowed to work in India, and the aim of the trial was to deport me: they were keeping me there to deport me.

Sir Edmond Hilary of Everest fame was the New Zealand High Commissioner in Delhi and he got the charges dropped. After that, the government wanted money for visas and whatnot, and I had to pay for a new one each three months.

I just recently got a five year visa, so I have to make sure I live long enough to make it worthwhile. I had to pay £90 for it! I asked them if I could have a refund if I expire before it does. 

Obviously, you are working to treat people with a wide scope of illnesses, from things that are unheard of in Canada, like tuberculosis and leprosy, to diabetes and heart disease. On top of that, you run school programs, arsenic filtration programs, and the list goes on. What are the main goals and the main focus of the group, on a micro level and in a larger scope?  

In the clinics, preventative care is a big goal. Nobody gets medical treatment unless they agree to undergo a medical session with information about the importance of general hygiene, immunization, natal care.

It is very difficult to change the living conditions of the slums and even in the villages, because even though the people understand the importance of clean water and that basic stuff, it is very expensive and difficult to obtain it. There are powerful groups, corporations, the bureaucracy and administration, so to change living conditions on a large scale is very difficult. There have been terrible floods in Calcutta, so we have been working where people are living in impossible conditions, to distribute plastic sheets for shelters from the rain.

You know, you can do moderate improvement on the spot, but even then, not so much on the large scale. These people are considered illegal squatters on government land, so if you try to even build proper huts for them, it is impossible. We do what we can, but often our goals are to make small changes. 

Why do you think the government doesn’t seem to be taking steps to improve conditions in the slums, or if they have, why hasn’t it been effective? 

There is a large population living illegally in slums on government land, and the government regards them as people they don’t want. In fact, many of these people provide very useful services like rickshaws and women working as housemaids for middle class families. [But] there is such a surplus of population, people living in legal slums and settlements, that the government feels these illegal squatters can be driven out and ignored, without creating a shortage of labor from the more settled slums that are not illegal. There really is no support, nothing available, for these people. 

What is a typical day like for you in Calcutta? 

There never is a typical day; it changes all the time! I do have some meetings that I am obliged to attend. For example, we have a meeting of all the doctors frequently, where we review the cases that come to the clinics and decide which we can take and which we cannot, because of our budget.

I go to the schools on Saturdays, and to some of the clinics as well. We have a clinic for leprosy, one for resistant TB cases, and general clinics, so I go to those. I can’t go everywhere. We have arsenic treatment facilities that are an overnight train away, but I do what I can. 

Do you find that you are able to handle the volume of people and the demand for your services without your resources being overwhelmed? 

No, not at all, we could always do more. We have to be selective, we have to take the medical cases with a reasonable prognosis. We finance quite complicated surgeries and expensive chemotherapies, so we have to decide. It is horrible to do it, but within our budget, we need to look at how many patients we can treat. We have a table of categories, where maybe in one category we can treat 15 patients. Of course, we then treat 30, and we have to worry later on about balancing the budget.

Are there any services you just aren’t able to offer because of financial constraints? 

With HIV, for instance, we have a policy that I don’t like, but we’re really frightened of being overwhelmed with cases and unable to treat them.

A rule was made some years ago that we would only treat the HIV cases who were patients already registered with us and their immediate family, not new cases coming in with HIV. The government provides very little free care for HIV patients. It is estimated that there are between 5.2 and 5.6 million HIV cases, and the government provides about 32,000 people with free treatment. In West Bengal, there is only one place that gives free treatment from the government, and they have 1,000 patients.  

You do so much work in Kolkata. How do you fund all of it and continue to make progress? 

We’ve got returning volunteers who have gone back, over the years, to their own countries and set up registered charities to support us: Britain, France, Switzerland, Germany, Holland, and Norway. This support is crucial to us.  

How much money do you normally work with? How much of it goes right to the streets in India? 

The budget now is about $40,000 (U.S.) per month. People working from other countries are not paid; they pay their own way here or receive a stipend from their home organization. We spend about one third of our budget to pay the doctors, nurses, administrators, who are all local people. 

What do you think are the big challenges that the area needs to overcome to make groups like yours obsolete? Is that kind of change possible? 

I think there is no prospect at all of that happening. The government puts their money into ‘defense’ as it’s called, or planning a mission to the moon.

I suggested publicly that they tell us what it will cost to put an Indian on the moon, and asked why they don’t let other countries put men on the moon or capsules on the moon and start treating the people who are HIV positive or need immediate treatment for their disease. In India right now, of the number of people who need immediate HIV treatment, two or three per cent, get it, either they pay for, it is subsidized or free. The government hasn’t replied to my question yet. 

You are speaking at Queen’s next week. What can students here do to connect to these problems that are so far away, and try to help in some way? 

In West Bengal, if we put in another arsenic filter in a community, 250 families will have clean drinking water. This is what I call “micro activity”: it isn’t much, but it is a step. Most of the things we need, we can buy on the spot or get funding for from big agencies. But these big groups aren’t interested in the ongoing medical care and the ongoing challenges. They regard this type of thing, paying for medicine for HIV, and such things, as a bottomless pit of funding, you see. If you ask for a building, a vehicle, you’ll get it, but few groups are interested in just providing ongoing financial assistance. This is where groups like the Canadian Calcutta Rescue Group helps.  

For more information about Calcutta Rescue Canada, contact Danielle Aird at 613-544-6625 or visit calcuttarescuecanada.org.  

Text Box 

145 – Number of local doctors, nurses, and administrators employed by Calcutta Rescue 

300 – Children receiving free education and food 

$50 (U.S.) – Average cost for medication for an HIV/AIDS in Kolkata patient per month 

$30 (U.S.) – Cost to sponsor the education of one child in Kolkata for one month 

200 to 300 – Patients treated in Calcutta Rescue clinics each day 

When commenting, be considerate and respectful of writers and fellow commenters. Try to stay on topic. Spam and comments that are hateful or discriminatory will be deleted. Our full commenting policy can be read here.