This study is part of a long-term project to secure fisher community livelihoods and wellbeing, the Wildlife Conservation Trust led by their Riverine Ecosystems and Livelihoods Programme (REAL). My study was an internship project and its objective was to understand the environmentally and socially driven health challenges faced by fisherwomen in Bhagalpur and Pashchim Champaran districts of Bihar and to explore the accessibility and reach of healthcare systems for the fishing communities. The research was conducted based on qualitative research methods and analyzed using the thematic analysis method. A total of 77 women aged 15-68 from nine settlements were interviewed using a semi-structured questionnaire. Focus Group Discussions (FGDs) were also conducted with fisherwomen and other stakeholders involved (ASHA workers, local doctors, government officials including public health engineering department engineers and Bihar urban infrastructure development department responsible for the water supply.

The work revealed significant concerns about water quality, sanitation, and access to healthcare. Drinking water samples showed values slightly over permissible limits of arsenic, fluoride, iron, nitrate, and E. coli contamination. In Bhagalpur, a city more developed in terms of surface water infrastructure, fisher women reported that they suffered from inconsistent water supply and poor sanitation. Fisherwomen in Bagaha in Pashchim Champaran relied heavily on tube wells and households lacked proper solid waste and sewage management. Women reported more prevalence of water-borne health issues like typhoid, diarrhea, and Pelvic inflammatory disease in Bagaha than in Bhagalpur. Mental wellbeing and emotional stress experiences were prominently reported, driven by socio-economic stress, outmigration of men for work, and inadequate healthcare services. These findings identified critical gaps in improving attention and health support services for fishing communities including improving their awareness and self-reliance in Bihar’s Gangetic plains.