Health Intervention

Health Initiative In Kandhmal

Initiative in health has been one of the strategies to intensively address the question of malnutrition, unemployment, health, education, infrastructure and otherproblems through Sangathan’s effort. Our continuous effort has really impacted people’s through Sangathan efforts. The programme has been initiated in Daringibadi block of Kandhmaldistrict in Odisha as a pilot study and now the intervention is activein 4 other blocks of Kandhmal. The objective of this programme was to make these Naxalite affected tribal villages into forward looking villages via mobilizing different government schemes through sangthan. 

Major Objective of Health Intervention:

• To open community health centre to provide basic health services through villager’s contribution.
• To bring behavioural change in terms of using toilets, hand wash, drinking boiled water, using mosquito net and eating habits.
• To promote kitchen garden at village level to fight against malnutrition.
• To empower women by building up strong women sangthan to monitor food and nutrition issues.
• To activate Govt Stakeholders such as ASHA & ICDS worker.
• To facilitate the villagers to avail various Govt. schemes related to health. 

Why Kandhmal

Kandhamal is mostly covered by the hilly terrain. Approximately 71% of the land in district is covered by forest. Kandhmal is highly affected by Left Wing Extremism It is quite difficult for people in hilly andinaccessible regions to access medical facilities as Public Health centers are far from remote villages and private health system is almost absent in the district. Hence, even for the basic treatment or medicines people need to travel long distances, compromising their entire day wage or labour. Moreover, lack of knowledge and usage of basic preventive medicine, further deteriorates the health of the patients in tribal belts. Looking at such challenges a piloting of health kit was initiated and tested in 20 villages of Daringibadi, Kandhamal.

Health initiative is a concept where basic preventive medicine would be given to the community by the trained village based SwasthayaSathi (Health worker). The broader objective behind the initiative was to locally sustain it by community contribution and active participation. Another objective was, linking the communities to the state and central government health schemes and entitlements.

After experimenting health kits in DaringibadiBlock,three more blocks have also been added after two yearsoflearnings.  Those 3 blocks were namely:

1. Baliguda
2. Tumudibandha
3. Kotagarh

Process: –

After several rounds of meetings and discussions with field team and community leaders,the potential villages were identified. Later, team was oriented on filling the survey format. In 2014, a detailed field survey was conducted in the selected 20 villages of Daringibadi,Kandhmal through local community participation with their own financial contribution,  We have done baseline, then compiled and analyzed the socio-economic and health status of the community with current government scheme status, accordingly we decided the strategy to address the health issues along with other local socio-economic challenges.

After completing the survey and its subsequent compilation to analyze the findings was completed,the survey findings were shared with the communities. Later, village committees were formed and the process of community contribution started. As part of the health initiatives, awareness trainings were rendered on different ailments and their possible treatment were provided to the health volunteers (SwastaSathi). They were also provided the information where to approach in specific situations.

As part of the healthcare initiatives, the SwastaSathis are currently aware of the list of medicines and first aid. They also help the SwathyaMitra whose confidences in treating common diseases have increased. They can access health kit for the community and able to manage it independently. The arrangement to provide health kit continues in Daringbadi block, Baliguda, Tumudibandha an Kotagarh blocks and particularly in those areas that are inaccessible to institutional health care mechanisms.

The field level workers (Health Animators) followed up with SwasthyaSathisat regular intervals so that register is maintained properly and medicines are made available to the villagers. One Health animator is appointed block wise to coordinate SwasthyaSathisand monitor the entire process. The Training and orientation was given to new SwasthyaSathis on basic health problems and maintenance of register, usage of general medicines as per the age group and maintenance of resolution by the SwasthyaSathis for independently running the health-kit in the village to avoide the risk of license for administering the medicines without the required degree.

Achievements over the period: The essence of health intervention is that it is being run by community members named SwasthaSathi (health workers0, these SwasthyaSathis were trained on perspective, medicine and their effective operations and now are contributing for the development of their own community by minimizing the effect of severe diseases. Other achievements are as follows; –

1. The most important success in the programme include the medicines on 6 common diseases such as diarrhea, Malaria, allergy, cold and cough.
2. The health kit has been running via community participation and it is helping prevent 2000 families from non-communicable diseases which could get worse/life threatening in case not treated at the primary stage.
3. By running this health centre, the spending on treatment will cut down to 10% for the poor marginalised families who are spending between Rs 6000-15000 annually to cure the illness.

Introducing Kitchen Herbal Garden/Herbal Medicines:

Rural communities traditionally managed primary healthcare conditions first at the household level and which could not be solved at home was taken to the community based healer. Then if both solutions were not found, institutional help was sought from primary, secondary or tertiary healthcare services. More than 80% of the population, according to WHO estimates, continue to rely chiefly on traditional medicine for primary health needs and most of these are based on drugs derived from plants or herbs which reflect the important role play by first two tiers of health system. The traditional health systems are based on sum total of the knowledge, skills and practices based on the theories, belies and experiences indigenous to Indian cultures whether recorded or not.

The Kitchen Herbal Garden concept is the most interesting social innovations of our time since herbs can be easily grown and are cheap, the costs of providing good Medicare to people can be considerably reduced and good health care made available and within the reach of all. It can be usefully replicated in othee communities of the world which also have equally strong traditions of plant medicines.

The Kitchen Herbal Garden package of plant & medicinal herb that are useful in the treatment of common illness like fever, headache, dysentery , jaundice and stomach problems and which can be easily grown in household gardens and directly consumed by people who may require them. The package of plants selected also includes plants useful for preventive and promote health care in primary level for revival of household & community level health care system. This comprises of 14-16 local herb species & the poor families are thought home remedies from it for primary healthcare. This saves almost 50 percent of health exoenses.

Objective of Herbal Kitchen Garden: –

• To promote backyard kitchen garden in order to address malnutrition.
• To promote the usage of preventive medicines using herbal products.

 Progress:

• 5 numbers of families from 17 number of model villages have been selected for Herbal Kitchen Garden.
• Collection of local seeds of 8 verities have been completed at community level which is 4 kg in weight via community contribution.
• We had planted different types of plants in three phases(short term, middle term and long term) i.e., vegetables, green leaf, papaya, drumstick, lemon etc.
• A traditional seed bank will be opened soon at village and gram panchayat level.
• We had introduced “Panchagabya” in 4-gram panchayat which is a natural pest control and bio-fertiliser and will be particularly used for Nutritional Kitchen Herbal Garden.

Impact on Community:

Our continuous efforts have really impacted people’s lives in Daringibadi and other blocks. Now they started believing in resolving their day to days issues without being dependent on any sort of NGO or organization. They firmly believe in collectively building the pressure through sangthan on local and district administration demanding the delivery. Further peoples also understand the long-term benefits for village development. They also realize that if they want to change something first they need to change themselves so that they could move ahead for a successful struggle of equal rights of citizenry in this nation.

Challenges faced during the establishment of health kit in the villages: –

• Villagers do not have faith as they have been cheated through chit fund earlier.
• High expectations of community in context of receiving free services.
• Villages have no weathers roads, distance between wo villages in high and some areas are naxal prone.
• Community’s response is poor despite continuous and regular dialogue with them