Health–Related Activities

Kaniguma & Kerpai Health Centres

SwasthyaSwaraj runs Health Centres at two locations in Thuamul Rampur Block which are severely deprived of health facilities. The Health Centre at Kaniguma village in the Kaniguma Gram Panchayat- 55 km from the district headquarters of Bhawanipatna and 20 km from the block Headquarters at Thuamal Rampur. The health centre located in a humble, rented structure has a dedicated team of 5 doctors who have come from different parts of the country, catering to people from greater than 150 villages, more than 20-gram panchayats from 4 surrounding Blocks/ Talukas.

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SwasthyaSwaraj runs Health Centres at two locations in Thuamul Rampur Block which are severely deprived of health facilities.

The Health Centre at Kaniguma village in the Kaniguma Gram Panchayat- 55 km from the district headquarters of Bhawanipatna and 20 km from the block Headquarters at Thuamal Rampur. The health centre located in a humble, rented structure has a dedicated team of 5 doctors who have come from different parts of the country, catering to people from greater than 150 villages, more than 20-gram panchayats from 4 surrounding Blocks/ Talukas.

The health centre at Kerpai village in Kerpai Gram Panchayat is 100 km by road from the District headquarters of Bhawanipatna and 77 km from the Block Headquarters at Thuamal Rampur. This area is a scenically beautiful, unique, inaccessible location which is an epitome of deprivation. All the villages of Kerpai and its neighbouring Gram panchayats of Silet (recently carved out of Kerpai) and some villages of Nakrundi gram panchayat (total 38 villages)  are part of our comprehensive health program. This is practically an area ‘where no doctor has gone before’.

Services offered –

  • Both health centres provide 24×7 emergency services – medical emergencies, deliveries, care of newborn, minor medical and surgical procedures and OPD services.
  • Resident doctor and  staff run the clinic every day
  • Outpatient Clinic once a week (on the village market days)   is attended by many doctors to attend to a large number of patients turning out.
  • In-patient services for admitted patients with 4 beds
  • Comprehensive laboratory services including all essential biochemical tests with 2 trained senior lab technicians. Rational use of investigations is strictly adhered to.
  • The pharmacy where  principles of rational drug use policy are strictly followed
  • Swasthya Samvaad – Health education to the public
  • Referral services  to a higher centre by Jeep Ambulance and accompaniment by staff
  • Regular in-service  training for the staff nurses and other clinical staff

In the pipeline –

  • Shifting of the Kaniguma health centre to a larger facility with more space for 8 beds in the inpatient ward including emergency care & neonatal care, emergency obstetric care, larger laboratory and pharmacy, along with better residential facility for the staff.
  • X-ray facility  at Kaniguma
  • Registration of the health centre  under Odisha State Clinical Establishment Act
  • Transportation being the worst bottleneck preventing people to access health facilities in this area, Swasthya Swaraj is planning to bring out various transportation facilities suitable for the hilly, inaccessible areas.

 

Both the Health Centres  are venues for training and ongoing education programmes for grass root level workers  ( Swasthya sathis & Shikhya sathis), Field animators, community nurses, staff nurses, lab technicians, medical students  and also a meeting and relay point for the entire organisation and a launch pad for all the Extension Outreach Clinics

Antenatal & Under-five Clinics – Extension Clinics/ Outreach clinics

In the area we work, the maternal mortality is unacceptably high and the under-5 child mortality is 284 per 1000 live births. 74% of Infant mortality rate is neonatal deaths. Malaria in pregnancy is to the tune of 27-32% which leads to maternal and foetal complications and low birth weight babies.

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In the area we work, the maternal mortality is unacceptably high and the under-5 child mortality is 284 per 1000 live births. 74% of Infant mortality rate is neonatal deaths. Malaria in pregnancy is to the tune of 27-32% which leads to maternal and foetal complications and low birth weight babies.

Regular high-quality antenatal care is the first step towards reducing maternal mortality and morbidity and ensuring neonatal survival. As the most vulnerable group- pregnant mothers and under-five children are not able to walk long distances to reach the health centres, SS has organized regular extension clinics targeting pregnant women and under-five children (ANC-U5 clinics).

These clinics are conducted in 8 locations regularly once in 2 months when the whole team reaches out to far-flung areas in a mission mode. In each location people from 5-6 villages come together. In each location, this is a mini village festival.

The activities include:

  • Control of malaria in pregnancy is given very high importance in the ANC programme. All pregnant mothers and under-five children are screened for malaria and anaemia with blood tests.
  • Anthropometry, growth monitoring, child health record, ANC card, Vit. A and Albendazole to all U5 children at intervals of 6 months.
  • Detailed physical examination of the ANC and U5 children
  • Nutrition supplements to all and take-home supplements to pregnant mothers.
  • Health education and counselling.

In the pipeline –

  • Setting up of community based therapeutic nutrition rehabilitation centres in these 8 locations where  ANC-U5 clinics are being held. These centres will be community education centres and demonstration centres on nutrition.
  • Immunization programme to be taken up in areas where the coverage is near zero.

 

Community-based Malaria Control Program

Malaria being the foremost cause for mortality of under-five children, maternal mortality and morbidity,  reduced productivity among the locals and highly endemic to our field area, the aggressive malaria control programme that SS runs is both clinic-based as well as community-based reaching out to the field areas with preventive and curative services. 

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Malaria being the foremost cause for mortality of under-five children, maternal mortality and morbidity,  reduced productivity among the locals and highly endemic to our field area, the aggressive malaria control programme that SS runs is both clinic-based as well as community-based reaching out to the field areas with preventive and curative services. Early diagnosis and complete treatment of malaria:40-50% of the patient load coming to both health centres have malaria- falciparum malaria being the predominant one ( >90%). Both health centres provide facilities for admitting and managing severe malaria cases which is a medical emergency. This reduces death rates, especially of many under-five children. The field staff and grass root level workers are trained in rapid diagnostic test (RDT) of malaria and thus detecting malaria without delay and initiating treatment. DOT (directly observed treatment) in malaria is often needed in the villages as the mothers are illiterate and do not force the children to complete the treatment. The first dose is given by the staff on the spot and subsequent doses are supervised by Swasthya sathi in the village. Swasthya Swaraj laboratory services in malaria are excellent and exemplary available round the clock and managed by expert lab technicians. 

Preventive services –

  • Training of the Swasthya Sathis, field animators and community nurses on various aspects of malaria. They are able to pick up danger signs of severe malaria and refer immediately.
  • Mass screening for malaria in collaboration with the government’s DAMAN programme periodically.
  • Regular IRS (indoor residual spray) in collaboration with NVBDCP.
  • Malaria awareness programmes in the interior areas through street theatre, songs, dance and videos in the village meetings.
  • Training programmes  on malaria to students, teachers,  guruguniyas ( traditional tribal healers)
  • Intensive activity-based malaria education activities in 15 government primary schools.
  • Mass health education programmes through cycle rally, public meetings etc in connection with National malaria day annually.
  • Training programs for school teachers and  local traditional healers in malaria
  • Active screening of all pregnant women and under-five children regularly for malaria detection and treatment.

In the pipeline –

  • Consolidation of gains in malaria control through behavioural change so as to lose the high endemic status of malaria in the block
  • Participation in artemisinin resistance study with St John’s Research Institute, Bangalore.
  • Malaria resource centre in one location

 

Community-based Tuberculosis Control Program

High prevalence of Tuberculosis with its high death rates in our block is an indicator of the poor socioeconomic condition of the tribals and the general population.

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High prevalence of Tuberculosis with its high death rates in our block is an indicator of the poor socioeconomic condition of the tribals and the general population.

TB control programmes are well coordinated between clinic activities and field activities. Special TB clinics are run once a month in both health centres (fixed days set aside). TB patients are provided health education, counselling regarding treatment adherence and follow-up and emotional support. Patients are also provided with a travelling allowance for bus fare, transport facilities when needed and a nutritious diet. All TB patients are also given take-home nutrition supplements along with drug supply.

The TB control program is supplemented by a unique patient tracking system of reminder postcards to the villages with patients

World TB Day on March 24 every year is celebrated in both centres with much publicity and is an occasion for mass health education and public meeting.

Community-based therapeutic management of Severe Acute Malnutrition

50% of our Under-five children are underweight while 60% are stunted in height with 20% being severely malnourished (SAM). This makes essential a decentralised approach to community-based therapeutic management and nutrition rehabilitation centres which will also serve as hands-on training centres for mothers and adolescent girls who are the future mothers.

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50% of our Under-five children are underweight while 60% are stunted in height with 20% being severely malnourished (SAM). This makes essential a decentralised approach to community-based therapeutic management and nutrition rehabilitation centres which will also serve as hands-on training centres for mothers and adolescent girls who are the future mothers.

Swasthya Swaraj has initiated steps to set up these centres in 8 locations. In each location, children from 5-6 villages will benefit. The centres will be known as  Gaon Poshana  Gharos ( Village Nutrition Centres) and will be run with the help of community nurses, Swasthya sathis and field animators and mothers’ club members.

 

Help us support long-term change towards access to healthcare services at the grass-root level