COMMUNITY HEALTH SERVICES MADHYA PRADESH
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- Title
- COMMUNITY HEALTH SERVICES MADHYA PRADESH
- extracted text
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RF_IH_8_SUDHA
- 2.
a-
EVALUATION OF COMMUNITY HEALTH SERVICES
by
Dr. Edwin Arthur,
Community Health and Development Department,
Padhar Hospital, P.O. Padhar, Distt.Betul, M.P.
Padhar Hospital of Distt.
Betul, M.P. has now
developed a well organized Community Health and Development
Project, covering important services such as:
Community Health
Agriculture
Ho rt i culture
Fisheries
Live-stock
Bee-keeping
as health is clearly linked with overall development.
All
the above services are being carried out among the neglected
sections of tribal population. Per capita income is Rs. 780/-
per annum, literacy rate is only 7.3 percent.
Community Health Project
was initiated in 1976*
It was taken up in 30 villages within lO.k.m. of the
Padhar Hospital.
Its objectives included, for example,
reduction of IMR by 50 percent and reduction of morbidity
rates> especially malnutrition.
Drinking water was also made available by
drilling over 1000 tube-wells or hand pumps, as this is
a water scarcity area.
,
::
•
A
ilE
SE
Nutrition was given special attention.- Nutrition
education, growing of protective foods, kitchen gardening,
life-stock programmes, etc. were attempted.
Evaluation
Apart from evaluation team meetings and re-surveys,
independent evaluation was carried out "by the staff of
Research and Evaluation Section of Christian Medical
Association of India, Bangalore, in December, 1979
In. a period of only two years,
3
Crude birth rate reduced from
55 to 25
I MR reduced from ...
... 1J5 to 108
III
Degree
Malnutrition
xj.1 x»e&
x t!c riaxuuun
non reduced
reaucea 21
,.
o
from percent^ percent
Vit.A Deficiency reduced from
5.7
1.5
percent6 percent
Apart from substantial progress in the health
indices, Community development is also being attempted
through agricultural extension, animal husbandry,
kitchen gardening etc.
For success, the team also
need to have dedication determination and toleration.
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M.P-2
No. 901
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Health
M.P.
Padhar Hospital Community Health Project
JSadhar P.O., Batul District
1.
Started in 1975
2.
Coverages R. 10 km. circle around Padhar, 82 villages
and a population of about 36,000 are the target group.
Activities.
a.
Home visits including relevant health education;
b.
treatment of minor illnesses with sale of medi
cines;
vitamin A doses given to deficient cases on the
spot;
c.
4.
d.
MCH services in hospital OPD, plus immunization
and health education in OPD and wards;
e.
school health services with medical, dental and
eye check-ups;
f.
Proposed soil testing facilities and good seeds
at cheap rates.
Personnel & Training.
a.
Hospital Employees including a senior nurse
a lab. technician-cum-driver, health educa
tors and an ANM. Other staff join periodically.
b.
Village Health Workers and traditional attendants/
dais are being trained.
Propose to check work of
5.
Supervision and Records.
VHW ordanance weekly.
6.
Community & Other Participation. Hope that VHWs will
be paid by own villages (50 p. per household p.m.)
through perhaps the Pan.hayat. Dais will be paid as
traditionally by the family she serves.
7.
Sponsorship & Funds. The Evangelical Lutheran Church
of M.P. is the sponsor. Funds for 3 years are pro
vided by a German mission especially interested in
prevention of blindness.
8.
Evaluation. Daily and weekly team meetings and base
line survey followed by a resurvey ^focussing on
g
ju “
<->
X
,O ..c - 4>«>u <JQ7
3.
2
No. 901
cases of '.malnutrition,vitfiAideficiencyoa'nd..scabies
rates after one year.
9.
Problems.
a. The team are not tribals with one exception and do
not speak Gondi, the tribal dialect (though lessons
are being given);
b. Morale_6f team working on low pay and difficult
conditions;
d.
suspicion of the Gonds who have been exploited
for generations;
negative attitude to family planning
e.
resistance to change;
f.
taboos affecting health and nutrition.
c.
10.
Outlook. The present project is a pilot one.
work for expanding are already being made.
11.
Contact. Dr V.A. Moss, Padhar Project.
12.
Reference;
1976.
Ground
Paper presented at the National Symposium,
i-’
THE ROLE OF CATTLE riREEDUSG AS fl DEVELOff«4T TOOL B) RURAL AREAS
A brief analysis of the nature of the exiotinig technology.
In the transfer of technologies to rural areas, it hag been out coramon
experience that when a technology demands a high level of capital invest
ment and a wide contact with bureaucracy, inrffJstry and urban centres as
preconditions for Its adoption, the benefits are usually siphoned off amongst
the already economically and socially powerful rural elite.
An argument often put Forward in defence of such transfers is that a per
colation effect takes place which benefits the weaker sections.
Ths frosh
inflow of investment helps in building uo an agre-baaed industrial infra
structure which increases the employment potential.
However, the rats of
increase in the income of the rich and the poor io so disparate that the
economic gap between the two is further widened.
The poor become increasingly
dependent upon the rich and loss inseterc of their own destinies.
3ur attempts at taking technology directly to the under-privileged groups
have encountered tremendous obstacles.
The rural elita, intent on retaining
their stranglehold on a semi—feudal economy, fight tooth and nail against any
drastic changes in the economic and social hierarchy of their society.
bureaucracy remains indifferent.
The
Lack of finance inhibits investment and
limits access to more remunerative markets,
Industry often remains s ceptical
about ths ability of such groups to successfully adopt a technology which
demands proper management.
1st us examine this process although briefly and superficially at this stags,
with reference to the technology of cattle breeding.
A cross-bred cow can,
Prepared by ths Kishore Bharatl Group, P.O. Halhanwada, via Oankhodi, Diet.
Hoshangabad , Madhya Pradesh 461 9'10
A modified version of this note was published in SCIENCE TUQAY,August 1977,
page 9, unoer the title "Goes cattle-breeding help the rural peer?"
2 »-
in many ways, be Regarded as a machine.
It coverts fodder into more
highly valued milk with an efficiency that earns a profit for its owner.
if sillfully managed it can become a rsguler income source and capital
accumulator for its owner.
Seen in this light, a cross-bred cow in a
Village can be visualised as a cottage industry.
Ths collsctivc axperiance of using this cottage industry as s development
tool in rural areas has shown that the cattle breeding tactinology too is
elitist,
for example, with regard to capital investment, present rends in
institutional financing nut tho oroso-brad cow beyond the roach of th©
following categories s the small and marginal farmer, the landless agri
cultural labourer, the village artisan the petty shop-keeper and the
tribals and adiVasia dependant on forest nroduca for a livelihood.
St
would be instructive to reflect that those categories constitute over seventy
percent of tho rural population.
The sophisticated nature of thia tsctmology is further illustrated by the
technological tie-isps it demands.
Artificial insemination with frozen semen
requires foreign collaborations for the supply of progeny-tested soman and
liquid nitrogen containers for storing the semen.
The intensive veterinary
earn demanded by a cross-bred cow brings in the pharmaceutical industry
for the supply of veterinary formulations and preventive vaccines.
On
another level, when the market for milk is saturated, there is increasing
pressure to convert milk into milk products like butter-milk powder, cheese
ate.
Industry provides the conversion technology.
increasingly dependant on Industrial
Rural areas thus become
expertise, technology and finance.
This dependance soon siphons off a significant portion cf profits for the
maintenance of high-salaried dairy technologists and managers.
Large
marketing networks and intensive advertising campaigns to sustain and widen
markets eat further into these profits.
The owncreaeHa progressively earns
less for his efforts.
Given the more reminerative prices and greater demand for milk and milk
fxjducts in urban areas, ths phenomenon of rural areas dependant upon and
prot^'ting for, urban areas anon becomes an unavoidable reality. In trying
3
:■
to reach these markets fresh relationships have to be created with the
bureaucracy of transport licensing and taxation officials and veterinarians.
Policy makers ignore another important aspect of cattle breeding.
The
largo green fodder requirement of a cross-brod cow makes it nocessary to
convert the much valued land under cereal production to the cultivation of
fodder and ingredients of concentrates.
scarce fertilisers too are diverted.
Expensive irrigation facilities and
In the process there is a loss by a
factor of about five in the total energy output par aero of land.
The
argument that milk contains essential oroteina for bridging ths protein gap
in India is not valid.
What we lad; is sufficient calorics, not protein.
Hilk has no special advantages over a combination of cereal and dal with
regard to calory and protein content.
The large farmer and trader will, however, strongly lobby for the adoption
of this technology.
It io mors remunerative and, therefore, in their interest
With their greater buying power they soon increase ths demand for unnecessary
consumer goods and thus perpetuate a pattern of industrial growth that is
irrelevant and damaging for the weaker sections.
Are there alternative technologies available which can bring about an
scchcmic and social equalising effect in rural areas?
Is there a possibility
of making cross-breeding more appropriate and less dependant upon high
finance and industrial and urban collaboration?
Can one design and carry out
experiments to test possibilities like 8
1) converting marginal land into rain-fed pastures
ii)
using liquid semon stored in coconut water or other
cheap media in place of more expensive frozen semen
iil) evolving low-cibet refrigeration techniques for milk
storage to replace expensive chilling unite
iv) Improving and rationalising local veterinary medicines.
.« 4 s.
Thu notional policy on cattle breeding han till nou favourtsd the elite®
Hou can this policy be modified to make rural development noro tha developBrant of the poor and less that of the rich1?
intertsst in eroes-bred co;® ?
Why is there a disproportionate
-hy not buffaloes or goats ?
The com, no
doubt, is a raare efficient machine and can he Improved genetically through
But Bu faloes are corohardy and easier to maintain.
Their
with it3 higher fas content, is mre acceptable in the market.
Goats
cross breeding.
milk,
are cheaper in tex^a of capital Investment and maintenance,
flare important,
they can live off poor quality grass and scrubland and, tlierefore, do
raise problem of converting cereal lands to fodder.
increases the employment poimtial of the young in villages.
other valuable oroducns like mutton, mohair etc.
not
Thieqj maintenance
They give
These and many more
questions nead anowerti aw!, acre important, concrete alternative courses of
action*
ft ffiaPOSftt
Uhile ths preliminary note has briefly touched upon the problems encountered
In taking cattle breeding to the weaker section, it is the intengicn of this
study to examine noro closely the reasons why Govcrn^ont and private sponsored
programmes have largely faaneifitad only ths big land amors and traders in
rural areas.
To do oo it io nscasssry to analyse the economic, social and
political impact of these programmes and the role of Govomment, industry,
multinationals and aid agencies in their implementation.
It is also the purpose of thia etudy to take a critical look at experiment^
action programmes which take cattle breeding directly to ths exploited sections
of rural society.
Tho problorns oncouitorcd by these under-privileged group®
adopting thia technology are numerous, they relate largely to finance, feed
and fodder availability, accuse to racket a, the attitude of bureaucracy,
industry and rural elite grotpo, and cooperative effort within community axj
intar-comrunity groups.
-3 5 3-
Given the sophisticated nature of technology involved in cattle breeding,
it is imperative to look for methods for making it more appropriate for the
rural poor.
Thia study will, therefore, focus on specific areas like
development of pasture lands, ths improvement of indigenous veterinary
medicines, the possible use of liquid semen in place of frosen semen, the
possibility of substituting or complomentIng cross-brad cows with buffaloes
goats or sheen and develops sit o f cheaper milk storage and processing
equipment.
July 26, 1977
43
BHARATI
Kishore Bfaarati, Village Palia Piparia, P.O. Malhanwada,
Via: Barikhedi,. District Hoshangabad, Madhya Pradesh 461990,
Grans ZISH0BEB3APATI, was established in 1972 ana registered as
a Society two years earlier (1970).
Historical Background s
A group of‘individuals with diverse professional background,
including field level experience ir/ural education end development,
gathered together in 1970 to evaluate the strategies for rural
development adopted until then audio explore alternatives.
The
□embers of this Working Group undertook several field trips to
study the -work done by Gandhian and non-C-andhian agencies in rural
areas.
These studies were followed by detailed analysis of social-
economic implementation of such work.
/efforts
started
for
As the ideas crystallised and
general direction of exp erim entat icn became clear,/financial resources]
procuring land and searching for full-time workers atd volunteers.
An important principle was followed, from the outset:
all
resources, financial as well as human,, will be raise c/'rcm within
India.
No help of any foreign agencies or donors will ever be
sought or accepted.
This decision is based on the understanding that
a meaningful solution can only emerge from within the depths of
India's own culture, struggles and genius.
The MadSya Pradesh Government gave 150 acres of lend to
Eishoie 3tn r ati to organise
district.
its activities in May 1972 in Hoshangabad
At about the same time, the Department of Education, Govt.
of Madhya•Pradesh, allowed Zishore Bharati and friends Rural Centre
to start a Science Teaching programme in 16 middle schools of
Hoshangabad district with the objective of introducing 'discovery
approach1 to the learning of science.
44
Objectives i
The purpose of fee Association as incoroporated in its
Memorandum, of Association is to experiment in rural education and
to start, promote and assist educational institutions with a view'
to cultivate free thinking, ani^n innovative aid enterprising spirit
among the children
of Indian villages.
The objectives have been
further defined as an experiment in rural education and development
by creating an economic infrastructure, ard radically overhauling
the present education system to suit village conditions.
In this
manner, it is hoped that tte fruitless c ity-bound migration of
village youth in search of scarce menial jobs would be reversed.
"Thatever is done at Kishore Bharati is guided by the principle
that th? relationships it builds up with the surrounding population
be totally free of any touch of charity, patronage op-dependence, Its
performance must encourage local initiative and. promote grass-roots
organisation.
The clearest indication of success will be the speed
with which the villagers assume responsibility for their own develop
ment and thus, render the services of institution superfluous in
course <£ time.
Programmes :
It is not always possible to quantify the effects of educational
and developmental programmes, especially if thqy relate to changes in
social attitudes, building up of a raticnnl leadership and questioning
of traditional structures.
She focus of Kishore Bharati1 s work lias
been on programmes which resulted in such unquantifiable effects.
However, a summary is presented below of whatever can be quantified.
The following data can be urderstood meaningfully only if analysed in
the total socio-economic perspective of a strategy for development.
- 45
i)
Irriipation Programme (Ring wells)
a)
Total number of newly operational well s
305
— Old vzell s deepened
— New wells sunk
198
107
b)
Number of farmers benefitted
209
c)
Number of villages benefitted
91
— Hoshangabad District
— Narsinghpur District
63
28
d)
Increase in irrigated area
e)
Estimated benefit to the region:
— Minimum increase in value
of produce
Rs.
12,50,000/- year
— Potential increase in
value produce
r><.
27,00,000/- year
— Minimum inc rease in fam
profi ts
Rs.
2,50,000/- year
— Potential increse in farm
profits
Rs.
12,50,000/- year
— Minimm gain for farm labour
Rs.
— Potential gain for farm
labour.
ii)
iii)
2,456 acres
3,00,000/- year
4,70,000/— year
Cattle Development Programme (breqdiry. with half bred bull)
a)
Number of local cows bred
109
b)
Number of farmers bene-fitted
73
c)
Number of villages benefitted
25
Agricultural Extension and. Research
Approximately 75 farmer families have directly benefitted
from advice aid training on improved agficultural practices as well
as from distribution of high yielding varieties*
A number of experiments are
being conducted to evolve more
economic ways of fam production, ccnpositing and irrigation.
project is being taken up to design and test the concept of a
A
46
village sylvi—pasture for collective management by tbs entire
community.
iv)
Cottage Industries 8
Several surveys have been conducted to explore the potential
of developing cottage industries in rural
reference tcSanktedi Block.
areas with particular
Projects on tte manufacture of chokes
foylube lights and carpentry were executed to study the problems
involved in training, procu-rement of raw materials and ra rketing.
Individuals an? groups have been
inputs of training and
promoted with the help of
fresh
tenk credit in cottage industries such as
tailoring, leather work aid dairying.
Studies are continuing on
the feasibility <£' using cottage industries as a tool for the
economic development <f weaker sections of society in rural areas
through such field-level experiences ate surveys.
v)
Science Teaching Programme;
The objective of the programme is to explore the extent to
which it is possible to introduce qualitative charges in formal
education system within the cors traints. of Government administered
schools.
The programme has evolved ate introduced an
environment-
oriented 'discovery approach1 to the learning of science in village
schools.
vi)
a)
1 dumber of middle schools under trial
b)
Number of Blocks affected
2
c)
Number <f Govt, teachers trained
40
d)
Humber of children who have completed.
the programs
1,050
e)
Number te children current in schools
1,500
16
Hon-formal Education t
A .group of 8 boys have undergone a 2-year fam-based experi
mental education programme whose objective was to explore the role of
education in building up youth leadership.
47
Literacy classes hate been conducted for essentially Imdless
labour groups, both children and adults, to develop methods©? learning
in such special cultural and economic situations.
A group of 8 small and marginal farmers have core together to
improve their economic status through cross-breed cattle. Tie group is
undergoing a planned experimentation in group dynamics as a means for
social development.
vii)
Health Education and research'.
Studies have been conducted on the status of health services
provided, by the Government in rural areas and. of the traditional
services available in the villages.
Through close interaction with
the health attitudes of rural communities, a concept of relevant
pattern of medical infrastructure for rural areas is being evolved
for testing.
Special audio-visual exhibitions have been designed ad held to
comnunic pte with, seni-literate aid illiterate adults and school child
ren on tie relationship existin'; betvzben health status of people and
conditions of extreme poverty and exploitation.
Work camps and discussion groups have boon conducted far
medicos to probe the relevance of medical education and modern health
services in the context of nutritional deprivation, unemployment and
lack of resources in rural communities.
viii)
Cooperatives i
Attempts hove been made to study the possibilities of developing
village cooperatives around activities such as health, cottage indus
tries, rural credit, irrigation and electric power.
In all of these
attempts,the rolo cd inherent constraints to cooperative movement was
investigated.
Significant conclusions have emerged concerning cons
traints such as mutual distract, caste barrier, economic disparities
histosy of corruption in previous attempts and the negative role of
political control
by the village elite.
..............
48
Workers :
Pa 13 workers : about 10
Voluntary worterst
£ large number of people help organisation
in a variety of ways by providing infrastructural support as well as by
periodically participating in different programmes at field levels
—
A group in Bombay helps in fund raising,, purchasing and market
ing, income tax and legal affairs, public
relations and
developing contacts with Government and industrial groups.
—
• A group of faculty members and research students at Delhi
University is responsible for the academic development of
th; Science Teaching Programs,
This group has the support
of the University Grants Commission to work in the Hoshangabad
District fee? conducting teacher-training and school follow-up.
—-
A group from different Post Graduate Colleges of Madhya Pradesh
is responsible fa? the biology and environmental portion of the
Science Teaching Programme.
—
A number of individuals frem the All India Science Teachers
Association (Physics Study Group), TIP2, Ill’s (Kanpur and
Powai), University of Kajastbun have helped in significant
way in Science Teaching programme, farming surveys etc.
—
Several people from moshangabad district actively help in
explaining the organisation’s objectives an3 programmes to
local people.
—
A largo number <f young people from urban backgrounds spend
periods ranging from a few days to several weeks at Kishore
Bharati participating in different activities and learning
about t'je problems of rural;work.
Workers on Deputation »
Professional individuals atxl otters from Government institutions
interested in Kishore Bharati’s activities have been allowed short-term
49
and long-tern deputations to wo:& with us.A Plant Physiologist-curs-
Agronomist iron Mahatma Phule Krishi Vidyapith (Baburi, Distt. Ahmed-
nagar, Maharashtra) has cone to Kishore Bln rati on a 3-year deputation
to bad cur programme on farm research, production and training. An
Assistant Professor of Biology from n Madhya Pradesh Post Graduate
College has been allowed deputation for 3 years under a University
Grants Commissicn achene to work in the Science Teaching Programme.
A young veterinarian was sent by National Dairy Research Institute,
Kamal to help in a short-term animal husbandry project.
Several
faculty members of Delhi University have spent 'whole semesters in
Hoshsngabad district conducting teacher—training and doing school
follow-up with University Grants Commission support.
These examples
illustrate and establish Government's willingness to participate in
rural level activities of voluntary agencies.
Looking Ahead i
Kishore Bharaii’s work during^he last 5 years has been
subjected to in-depth analysis which has revealed critical problems
concerning the tnture of educational change and development.
comparison of its own experiences with those
A
Government and
other voluntary agencies reveals tint most cf the educational and
developmental activities benefit, end thereby strengthen, mainly the
middle-level end richer fanners, and thus help widen tin poverty gap.
In order to be relevant to th landless labour, rural artisan atd
marginal farmer groups, the programme will have to focus their
attention on increasing tte
consciousness of these weaker sections
towards the constraints which withold
their development.
-50
APP1GAH3. PA7.U.?K’AN M2.CUIAL TBUST
This institution located at Mahatma Gandhi Seva Mandir,
252, S.7. Road, Bandra (West), Bombay 400 050 (TF: 533262) was
founded in 1971 in rnemeiy of Appasaheb Patwardhan by Sri Annasaheb
Sahasmbuddhe, a prominent leader of the Sarvodaya movement.
It
was registered as a Society and Trust in 1974.
Objectives ;
The objectives as given in its Constitution are tos
1.
Arrange for study and research in the teachings and
practice of the late Appasaheb Patwardhan, a great
exponent of Gandhi ji’s concept of a demonetised.
social order;
2.
Undertake all-round village development programme;
3.
Train illiterate and literate farm youth;
4.
Start agro-industrial training centres;
5.
Conduct'correspondence courses on modern rural
6.
Arrange for publication
development techniques;
of ideas and teaching of the
late Appasaheb Patwardhan in suitable foims;
7.
Undertake agriculture extension programme;
8.
. Adopt villages as experiment in social change;
9.
Strive for social reconstruction; and
10.
Cany on other activities to achieve the above
objectives.
Programmes ?
Agriculture in 12 villages covering about 200 families,
village industries in 5 villages covering about 20 families,
~5i
education and training in 20 villages covering aboit 300 families
and other programmes like livestock development, community health
and family welfare and popularisation of appropriate technology.
Workers :
The institution has 4 full-time paid workers besides
6 voluntary workers.
Development
Planning
and.
Technology
shahdol
some alternatives for the Indian case
1977
***»**-Sr**-M-****-i!-iHt-******4f-*********«***-i'r*****»4t-«"iMH(-»Ht- #«■**«#♦*
(In this paper the process of development has been
subjected to a critical analysis in terms of the
inception of concepts of development, planning and
technology over periods of time. An attempt has been
made to indicate how contemporary concepts control
economic, social, and political trends today and how
they are insufficient to solve present problems of
underdevelopment. Some suggestions have been offered
as examples of such solutions taking a specific area
in India as the reference base. A hypothesis is
advanced that while the concept of development in a
particular social system determines the nature of
planning and the technology used, nevertheless, it
is possible for technology, when systematically used,
to challenge and change the concept itself.)
DEVELOPMENT
PLANNING
TECHNOLOGY
January
1977
shahdol
****************it***^*****tt*******#^***^«-************^*****
Shahdol is the name of a district (an administrative
unit) in a province of Central India. It has an area
of 14,000 sq. km, and an approximate population of
1,100,00 - roughly the size of Northern Ireland. In
Madhya Pradesh, the province in which Shahdol lies,
there are 45 such districts and 36 of these are held
to be "economically backward". Shahdol is declared as
"better developed", The key index chosen for deter
mining the extent of development by the Government is
the per-capita investment. Within the district there
are thirteen coal mines, thirteen bauxite mines, a
large paper mill, a caustic soda factory, a thermal
power station, a busy railway line, and a thriving
transport business. The total investment is roughly
of the order of Rs, 1,000 million, giving a per-capita
investment a little under Rs. 1.000 - this figure
falling above the official line of "developed". The
district has been chosen as the reference base as it
clearly demonstrates the classic case of unbalanced
underdevelopment.
2
Development
Change is a part of nature. Some events occur with
starting rapidity such as the leap of electrical charges
across two electrodes, and <we occur with the passing of
large time periods - time as we are conscious of it - such
as the evolution of man from the apes. With the change
in nature, living organisms have to adapt and, therefore,
change in order to survive within nature. In human society
too, as the forces of technology, production, and procre
ation change over time society takes on new shapes - some
times with quantitative transformations and occasionally
with qualitative leaps.
Where man can anticipate the change in nature - as in
the case of a flood - he can also prepare to meet the
change, He is, therefore, looking ahead into the future with
his !,conscious!’-ness and preparing the necessary require
ments - such as a dam to control the change for his own
benefit. This act of preparation involves the theoretical
conceptualisation of the change and its alternative, as well
as the practical activity required to actually control the
change process. We define this process of controlled chang e
as development, the conceptual preparation as planning,
and“the techniques used to control as technology. All three
are functions of man’s ability to gather, analyse, and
utilise information.
Concepts of development are wedded to> how men perceive
change and what is beneficial to them. There is, therefore,
both a recognition of nature’s influence as well as the
conception of conscious intervention to modify and regulate
the influence. These concepts have themselves changed
over time as man has become more aware of his environment
and his ability to control it. Thus, in nineteenth -century
India, development was perceived essentially as an act of
God who made the rain fall and the sun shine. All that man
could do would be to till the land, scatter the seed,protect
his possessions, and hope for the best. As human knowledge
increased, however, twentieth-century India has begun to
increasingly understand the dynamics of nature and the
means to control it. Development is now no longer merely
a matter of hope but a conscious intervention to increase
wealth.
The present concept can be variously described as
"increase in GNP"; "to make people self-reliant"; "to
eradicate poverty"; "give each individual the opportunity
to live a complete life". It adds up to an image of man
controlling nature to produce abundantly for general
distribution and happiness, within the framework of each
individual working to fulfill his own needs. And "development
for India connotes the example of a "developed" nation in the
West using modern technology and planning to produce in
super-abundance.
Is such a concept sufficient as well as necessary?
3
World development today has produced development in one
of its parts while producing underdevelopment in the other.
To understand that this is inevitable one must look at the
nature of development in an advanced nation-state and compare
it with the process in a backward one:-
6
The USA uses over M x 10 kcal, of energy per .capita
in order to give a per capita Gross National Product of over
& 2800. India consumes under 2 X 10° kcal, per capita to
give a per capita GNP under & 100. The USA uses only
8.16 x 10 kcal to provide food for an average US resident,
of which, further, a mere 18$ was used on the farm. If all
the world had the same per capita dnergy bill for the entire
food chain, a quantity equal to two-thirds of the 1970 world
commercial energy use -would have been consumed for this
purpose. This kind of energy consumption is just not
possible for universal development.
There is, further, a dynamic relationship between,
food, energy, production^ and money. An underdeveloped
nation trying to increase agricultural production by using
Green Revolution techniques is dependent upon fertiliser
purchases - amongst other things - from the richer nations.
A rise ih fertiliser import prices will critically affect
production on the farm forcing the government to purchase
grain abroad, further depleting foreign exchange reserves
and the ability to purchase fertiliser abroad. The exchange
between nations thus forces states of dependence and,
therefore, under development.
Even within a nation Green Revolution techniques do
not remove disparities. Studies have indicated that the
nature of land distribution and the "underdevelopment" of
most small framers makes it possible only for the richer
peasants to use these techniques and increase production quite often replacing food crops with more profitable eash
crops. Even Gobar Gas (methane gas from manure) plants
accentuate disparities. It is estimated ■ that the minimum
economy-size plant for a family has a 200 cu.ft.capacity,
an investment of Rs. 3500, and needs 12 cattle to support
it. For an underdeveloped nation, with an estimated 40$
living below an official "poverty" line, the majority of
agricultural families would not be able to afford a Gobar-Gas
plant.
There are, therefore, certain restrictions within
the relationships between man and nature, and man and man
which make development, in the sense in which it has already
taken place in the developed nations, a near Impossibility.
If Shahdol is one of 9 districts, out of a total of 45, which
may be called well-developed then the task of removing
disparities within an underdeveloped nation alone are
staggering. Even if Shahdol provides a model - which it does
not - the restrictions on the processof change are clearly
evident. Let us take a look at some selected indices of
the district:
The working population is 37.2$ of the total population
and of this only 7.7$ are engaged in mining and manufac
tures, 83.8$ are in agriculture (30$ as labour). The
land, yields over 64$ of the Domestic Product while
manufacturing industry, construction, and power yield a
little under 14$.
There are 1977 villages and, of these, 95 villages and
8 towns are electrified covering 7608 consumers. 1183
prima-ry schools have 941941 students. 191 secondary
schools have 25,764 students. 36 higher secondary schools
with 10,181 students. 3 colleges with 907 students.
Average literacy level of 14.59$ (5-78% for women). There
are 14?4 km of metalled roads and 557 km of motorable
dirt roads.
The local RTO has registered 25 private buses (for
passengers); 514 trucks (for goods); 219 private cars;
100 two-wheeled vehicles; and 1 taxi.
Such a level of development is incredibly low when compared
to that of a developed nation, assuming that the norms set
by developed nations are acceptable.
The conflict between man and nature on one hand and
the conflict between man and man on the other make the possi
bility of rapidly developing the backward areas of Central
India a remote one. If present concepts of development are
unable to answer the. very questions that they themselves
raise it is clear that they are inadequate and other concepts
must take their place. What would be the nature of these
new concepts? In the past the concepts have undergone
change when man has begun to increasingly understand his
relationship to nature and to other men and thus plan to
control the conflict through the application of technology.
We must, therefore, look into the nature of planning and
technology in order to answer the question of change.
Planning
As the process of development has taken place in a society
the conflict inhebent within it has given rise to new sets of
problems replacing the old ones. Thus, industrialisation,
welcomed all over the world as the harbringer of plenty
and prosperity in the late nineteenth century,gave rise to
new social tensions. As early as 1815 individuals like
Robert Owen were beginning to predict that, unless the new
instruments of production were intelligently controlled,they
would destroy the very process they had begun. In England,
in 1909» the Government discovered that the process of industri
alisation was creating slum conditions in urban areas where
the workers lived in apalling living conditions giving rise
tp malnutrition and ill-health. This was exposed when recruits
from such areas were found to be too weak to raise rifles
during the Boer War.
In India, in 1947, the first Indian
government of the newly independent nation found that the
struggle for independence had given rise to a host of
aspirations in the masses for a better life and the government
was forced to respond to these aspirations through legislative
and administrative measures. 200 years of unfettered industrial
growth in the USA finally culminated in enormous pollution
problems. Some were so severe that rivers such as the Buffalo
and the Cuyahoga are declared official fire hazards. Organised
protest by consumers and citizens forced the US to take
cognizance of its. environmental problems on a temporary basis
5
In 1948 and. a permanent one in 1956. A 72 year old Federal
law banning the dumping of industrial pollution into navi
gable waterways went almost completely unnoticed until its
70th birthday when the first of some 30 Injunctions were
brought against a fraction of the approximately 40,000 daily
violators.
The response everywhere to these new conflicts has
been organised attempts at planning for control.
In England
the Government passed the Town Planning Act in 1909 which
gave the State, for the first time, the power to dictate
how private property in land was to be used.
In 1951 the
Indian Government embarked on the First Five-Year Plan for
planned growth. In the 1970s the US Government has enacted
a series of laws to regulate the environment. Planning,
therefore, has been resorted to in order to transform into
reality the concepts of development.
It is obvious that Planning has failed to remove the
real roots of the conflict. Industrial slums, poverty,
and pollution have not only persisted but increased inspite
of legislation and protest. Why is this so?
Planning can be described as possessing a number of
qualities.
It may be either Imperative or Indicative
depending upon the degree of State control. Indicative
Planning may be Active or Passive, depending upon the
degree of control by the public sector over the economy,
and Normative or Systems, wherein social and institutional
dimensions may not or may be considered. The nature of
the interlinkages in a planning exercise between different
components of the plan can give it either a Sectoral bias
or a Spatial one. In the territorial sense /planning may
be distinguished as being either Single-Level or Multi
Level. In this context planning in India may be charac
terised as being Indicative, Normative, Single-Level, with
heavy emphasis on the sectoral approach.
This, however, does not explain the philosophical
foundations of Indicative Planning nor why it has failed
to justify the concept of development. The basic hypotheses
on which planning theories are based are the Theory of Ring
Models, the Theory of Central Places, and the concept of
the Economic Landscape, Underlying these is the stress
upon the modernising role of cities. This Growth Centre
model envisages the organisation of geographical space
around a focal point of interaction which sends out growth
"impulses.” into the surrounding space and thus serves to
develop that space.
When applied to Area Planning the Growth Centre
approach emphasises that?
a.
any policy of development must inter-link the
various sectors of social and economic activities;
b.
these interlinkages can be understood from the
locational distribution of the activities; and
c.
cities radiate modernisation impulses and hence, the
nature of their Interlinkage to the rest of the area
must be to improve accessibility.
6
All three may be conveniently illustrated, with.reference
to the reference, districts
1.
The State-run thermal power station presently generates 60
MW of power. The annual consumption in the district is
3,177,195 units. The povfer station is being expanded t^o
generate a total of 3^0 MW. But the power will not be fed
to local industries nor will it send out growth impulses
into the surrounding area. The district centre, 40 Km
away, has the only industrial estate in the district with
five plots. Three are occupied by a government mills
scheme and the fourth by a sodium silicate manufacturer
(capacity 27 tonnes per month capacity).
2.
Bones are collected by a dealer at one of the market
centres from tribals who come from the forests with
their collection of bones, horn, and hides. The tribal
gets Rs.650 per tonne of bone (Rs 13 per head load
carried on foot for a minimum distance of 8 km) and the
dealej? sells it to the next larger collector 300 per tonne.
Subsequently, the bone is sent to the metropolis from
where it is exported to the West to obtain precious
foreign exchange. The free play of market forces is
thus suitable for colonising the space and not for the
collective well-being of the community which is the
purpose of area development planning.
3.
The private paper mill is the largest in Asia with a
production capacity of 250 tonnes of paper per day. It
was set up in 19&5 under Government sanction with the
understanding that it would, employ 80$ of its personnel
from the local area and would be situated at the confluence
of two rivers so as to reduces the dangers of pollution.
The factory was actually situated 22 km upstream of the
recommended site, and it presently has only 20$ of its
3000 employees from the local area. In 1967 an official
committee found that 157 villages downstream of the factory
were polluted and 30 were declared badly affected. The
mill requires 32 cusecs at its lowest ebb. Hence, the
mill constructs an earthen dam across the river depriving
villagers of irrigation and drinking water. A survey
in 1973 revealed that the death rate of cattle was 1*1-1$
higher downstream of the factory than in areas upstream
of the pollutant discharge point. It also indicated a
fall in milk yields of 29.3$ due to the polluted water,
and a rise in the incidence of skin disease with
increased contact of humans with the river. The paper
mill has exhausted the supply of bamboo in the district
arid has recently embarked on plantation of eucalyptus
trees which will be used in the manufacture of paper
but will also further lower the water table and reduce
the meagre supplies of well-water. Planning has so far
made an attempt to reduce the technical affects of
pollution and preserve the profits of the paper mill
but not assessed the damage to the rest of the local
economy nor taken steps to prevent it.
TECHNOLOGY
The relationship of technology to planning and
development has already been made clear. It is'the
instrument whereby the interaction of man with nature is
controlled for the benefit of man. Hence, if not controlled,
it is destructive to nature - a fact of increasing apparence
7
as nations battle to control both the environment as well
as environmental pollution. Technology also plays a role
in the interaction of man with man because modern produc
tion management consists of the increasing division of
production into its components and hence the increasing
specialisation of human labour associated with production.
Thus man gets alienated from other men in production through
the agency of technology. Technology is here reflecting
the inherent conflict within the very concept of develop
ment which it is a servant to.
Let us examine the application of modern technology
in India with reference to the Paper Mill. It is the big
gest in Asia and the most modern when it was set up in
1965. The suppliers of equipment for the Mill read like a
Who’s Who of American and European industry:Paper machine- Beloit Corporation, USA
Electric machinery- Westinghouse Electric,USA
Controls- (Taylor Instruments, USA
Digesters- Tala-Johnson (foreign collaboration)
Knotters- Kamyr- Durban, Sweden
Chlorination Tank- Stebbing Engg. Co. USA
Chlorine Mixer- IMPCO, USA
Hydrating Jordans- Jones- Majestic, USA
So much for ‘’self-reliance". Technology transfer
has taken place on a massive scale. The initial
capital investment was of the order of Rs.300
million, a cost probably only justified by the
high profitability of the plant- Rs 60 million
are the declared profits per year.
The paper mill consumes 450-500 tonnes per day of
bamboo(now brought from forests further than 300 km away
since all local preserves have long since been exhausted).
These forests are captive to the Mill. 150-200 tonnes per
day of hardwood are obtained from forests under lease from
a Province 800 km away. Coal for the generation of steam
and power is obtained from three captive coal mines.Various
chemicals, caustic soda, and alum are manufactured in a
sister concern at an adjacent plot of land. The daily
requirement of 160 million gallons water per day is
obtained by impounding the local river into which the
Mill later discharges 14.5 million gallons per day of
polluted effluent. Hence, all the raw materials required
for the manufacture of paper are fully in the control of
the Mill and add to the profitability of the entire venture.
Setting up of ancilllaries or decentralisation- in effect,
the propagating of growth impulses- would be contrary to
the focal point of generating profits.
Given the land on which the factory is situated
(1000 acres); the capital invested (of the order of
Rs.460 million); the land deforested; and the water and
energy consumed: a conservative estimate would put the
alternative foodgrains production possible at 500,000
tonnes per annum. Whether to produce 75jOOO tonnes per
annum of paper or 500,000 tonnes per annum of food is a
question which a concept of development ought to answer
but evidently does not.. This also ignores the damage
due to pollution and deforestation.
8
The problens that are already facing the Indian
nation are quite clear s-
1.
At present ^0$ of the population lives below the
official poverty line.
2.
By 2000 A.D. the population will reach ?00million.
3.
With increasing population pressure on land, ownership
will be fragmented making it all the more difficult
to apply modern technology.
There will, therefore, be a decline in land productivity.
5.
By the end of the century 210 million tonnes of food
grains will be required to feed the population - an
increase of 100 million in 25 years..
6.
There will be the increased need to export goods at
competitive prices in the world market.
7.
Large-scale under employment- and un-employment will
exist in the agricultural sector.
8.
Consequently, there will be large migrations to the
cities.
9.
Disparities in income, health, education, housing,etc.
will continue to grow.
10.
The quality of the environment will Continue to deteriorate
further adding to the vicious'cycle of underdevelopment
and poverty.
What answers does modern technology have for these
problems? There appears to be a broad consensus amongst
policy makers and economists in India on the scope and
content of planning for growth. The consensus focusses on
the need to provide an infrastructural base (land reforms,
public works, education, health, markets, technology, fiscal
and credit policies, water management, and energy) through
State intervention for the development of agriculture and
industry while involving the people in the development
process through various social and political institutions.
In Shahdol district the Government has taken definite
administrative measures to commercialise agriculture by
providing credit to farmers for pumpsets, wells, fertilisers
etc. through the nationalised banks. The Industries Depart
ment has been trying to encourage entrepreneurs to set up
small and middle scale industries and the Development
Corporation has been offering all kinds of financial and
other incentives. Plans have been prepared to build new
roads and metal old ones. The thermal power station is to
Increase its power generating capacity six-fold. The coal
mines have been nationalised and some of the old ones, which
had been closed down by the private owners on grounds of
their being uneconomic, have been re-opened. Three large
schemes for impounding water and building canal systems are
being implemented. Will these schemes work?
9
Under a World Bank scheme Rs. 2.4- million were ear
marked for agricultural development loans in the districtof which only Rs.300,000 were finally.taken. All over the
province, the Financial Corporation sanctioned Rs.55 million
in 7^-75 as compared to Rs.20 million in 65-66, but actual
loans disbursed declined from Rs.1A million to Rs.11 million.
One stretch of road 12 km long has been rebuilt 8 times in
the last 11 years but not yet metalled. The surplus power
cannot be used in the district and will be transferred to
neighbouring growth centres. The production at the coal
mines has increased but productivity has declined. An
earthen dam built at a cost of Rs4250,000 to irrigate an
estimated 200 acres of land is presently Irrigating 9 acres.
Technology, then, obviously does not have the answers
to the problems of underdevelopment and poverty. The neces
sary technological choices and planning models chosen are
decided on grounds other than technical or necessary for
human well-being, Technology is, therefore, reflecting
the conflicts inherent within the concept of development
it subserves. The struggle of man against nature is vividly
reflected in ;a.
b.
c.
the depletion of natural resources;
the deformation of the environment;
the isolation of a process of development.
a.
b.
c.
the general pattern of unbalanced development;
the rising levels of under employment and unemployment;
the alienation of man from his fellow men.
The struggle of man against man is concealed within;-
The answers do not lie with technology. They are wedded to
the concept of development itself. The concept must change
if the process of development is to answer the questions posed
by unsatisfied human needs. When the concept changes then
the application of technology will also change. The concept
of development determines the technology. But how does the
concept change?
ALTERNATIVES
Historically, societies have sought to change the
concept of development when it has failed to satisfy the
needs of society through the planning process and the
application of known technology. Hence, it is the failure
of technology that changes perceptions. It is not the failure
of the theoretical development of science but its application
within certain restrictions that tend to break those restric
tions. Technology must, therefore, demonstrate that it has
the answers but is unable to implement them within a particular
context before that context can be called into question. It
is, therefore, the test of the "appropriateness" of technology
whether it can show its technical competence to solve a
problem >nd at the same time expose the structural limita
tions thai make it helpless so that men may take conscious
action to change the structure they live within. The missing
link in development theory is this Inbuilt ability to rectify
itself. When technology contributes to building this missing
link it becomes appropriate.
10
Technology has three principal tasks to perform within
the realm of underdevelopment
1.
To show that,it can conserve, control, and regenerate the
resources of nature in such a way that it resolves the
conflict between nan and nature. It must lend itself to
planning wi th the environment and not against it.
2.
To illustrate the organic relationship between men and to
trace the root causes of their alienation from each other.
Technology must educate men to work with each other and
not against each other.
3.
To maintain the challenge to the insufficient concept of
development so that the new one may survive to rectify
the old. It must therefore demonstrate in real terms,
however small, the abstract concept of men uniting to
create abundance.
What does this indicate with reference to the base
are of Shahdol? The possibilities have to be- explored
within :1.
The material resources available -12$ arable land under
double-cropping; 1$ irrigated; low crop yields (6 qtl/ha
for paddy); timber from 30$ land under forests(50,000
cu.m, of Sal timber sold by the Forest Department every
season); oilseeds, 200 t Sal seed, Mustard, Groundnut,Rice
Bran, Neem, Karanja, Kusum, Pilu); coal; fireclay; sand;
bauxite; water; Gypsum, Ochre, Limestones Lack, Gum,Tendu
leaf, bones and hides.
2.
The human resource -390,000 working men and women; village
artisans (smiths, carpenters, cobblers, potters, masons);
technical skills (1 polytechnic, one Industrial Training
Institute); social groupings (people organised to parti
cipate in their own development); migratory influences;
selected desires for change.
3.
The educational potential - to illustrate the need for a
new concept of development.
So, taking Rs.10,000 as the provisional upper limit
of capital investment per productive unit, the following
possibilities emerge s-
a.
Soft coke production on a small scale from coal is not
very efficient because of the loss of valuable volatile
matter from coal. An improved process can,however, be
developed whereby at least a part of the volatile matter
is recovered while coking is carried out on a small scale
in simple and inexpensive equipment.
b.
Bauxite mining yields a valuable ore, Bauxite, for manu
facture of Aluminium and a waste material, Laterite,which
so far has found no use. Over 100,000 tonnes of Lateri'te
has accumulated at the pitheads. Research pan be directed
at finding a use for this material-possibly in construction.
c.
The availability of sand and rice-husk points to the pos
sibility of manufacturing rice-husk cement and using it
for construction as well as for the production of cement
poles for rural electrification.
d.
Saw dust, rice-husk, and fireclay can be used for the
manufacture of insulation bricks for use in furnances.
11
e.
Oilseeds, rice bran, and groundnut may be subjected to
solvent extracting of oil in small solvent extractors
specially developed for the purpose.
f.
Yields for most crops are low or failling. The rains bring
large quantities of water which rapidly drains away into
the rivers, and rivulets. Water and soil conservation
can be attempted through the construction of small earthen
dams, afforestation, and the building of tanks for which
the topography is suitable.
g.
The .possibility of setting up mini or micro paper plants
to make a few tonnes of rough paper needs to be explored.
A large number of such plants, while needing considerable
research and development work, would provide immense
benefits since they would be labour intensive, require a
very small resource base, provide for optimum utilisation
of all small resources, and pose much smaller environ
mental problems than the large pap-, r mills considered to
be viable at present.
h.
Bamboo, suitably strapped with steel or nylon wire, may
be used for piping water over long distances in place of
steel,aluminium, or plastic pipes which are beyond the
reach of most farmers.
i.
Bullock-cart wheels with steel rings are not made in the
district but 800 pairs are Imported annually. Both timber
and skills are available locally to develop this industry.
j.
There is a possibility of using Mahua flower, dried and
powdered into flour, as a regular energy enriching source
in the diets of the people.
k.
Animal bone can be crushed to provide bone meal and
fertiliser.
1.
Hides are available as is harra seed and lime for develop
ing a local tanning and leather-product industry.
m.
A case exists for building appropriate training centres
where artisans can be encouraged to develop their tradi
tional skills and use them for furthering economic activity
at the village level by providing tools, construction
materials, and services economically and efficiently.
n.
Technology has the greatest possible potential in the
development of mass education materials centring around
local problems of direct consequence to the people of
the area. A recent experiment has indicated that filmstrips have powerful impact on local people as they can
be made to include local problems, local individuals
and locales, and stay on the screen long enough to permit
critical appraisal of static situations as perceived.The
dynamic relationship is brought out through the movement
of the filmstrip.
o.
Assessment of real needs of people and their correlation
with available resources is another task of critical
importance for technology if the participation of people
in their oxen development is to become a reality.
12
It is now possible to summarise the chief points of
what may be called, the "Appropriate Demand Model" of Develop
ment, Planning, and Technology for the removal of under
development
A.
Development is the process of resolving the conflict
between man and nature on the one hand and man and
man on the other.
B.
Planning is that political exercise in allocation and
management of resources which involves those engaged
in production in improving their mutual well-being,
prevents the harmful by-products of growth, and
conserves the natural resources.
C.
Technology is the medium through which man becomes
aware of the conflict in society and the tool by which
he attempts to understand and resolve the conflict.
To develop a model vision of a better society out
of the dynamics of a collapsing one is a complex theoretical
task; to actualise that model within the reality is an even
more difficult one.
*****
M-P- 7
PROJECT POSHAK : MAJOR EVALUATION
TECHNIQUES
AND
FINDINGS
by
Dr* Tara Gopaldas, Prof, and Head,
Department of Foods and Nutrition, M.S. University of
Baroda,
Baroda - 2.
Project Poshak was a large-scale study conducted between
1971-'75 in Madhya Pradesh, to study the operational feasibility
efficiency, impact and cost of delivering a package of health
and- nutrition services through the existing PHC infrastructure,
to the very young child (6-J6 months of age) and pregnant/
lactating mothers utilizing a 'take-home' food distribution. The
project design included 5 phases: (1) The Exploratory,
which
had an intervention period of 7 months, the main purpose being
to refine and standardize field methodology; (2) The Extensive,
which had an intervention period of 11 months with emphasis on
assessing the operational, problems in large-scale programmes
with -minimal supervision (5) The Intensive, which had an
intervention period of 18 months.
Five-in-depth studies were
conducted on (i) Indigenous weaning food (ii) Pricing the Food
(iii) School VS PHC as an alternative infrastructure (iv)
Cost effectiveness of single and multiple inputs (v) 0n-site
feeding VS 'Take-Home'.
Each of these had their own set of
operational and impact criteria.
The major evaluation technique
was to develop a model that permitted the evaluation of the
efficiency of each Phase, at 4 sequential stages viz.fi]
Logistical delivery of physical inputs to study PHCs/SHCs [ii]
Delivery of services by PHC staff to recipients [iii] Partici
pation by recipients [iv] Cumulative nutritional-health impact
on recipients.
The Exploratory Phase established the operational
feasibility of the approach. Logistical delivery and delivery
of services were 100 percent; participation by the recipients
was 55 percent for food, 45 percent for childcare education, and
55 percent for medical health services.
Despite the short
intervention, impact evaluation showed a def]LHitO
9f
2. . .
-Ox
benefit to intervened subjects in terms of growth, lessened
morbidity, and heightened awareness of childcare among mothers.
The rest of the ’take-home' ration was shared, mostly by
children upto 6 years of age. Experimental villages demon
strated statistically greater acceptance of immunizations;
acceptance of FP was also higher.
The Extensive Phase reflected the reality situation and
is therefore the most replicable.
Even with minimum super
vision and control, participation rate for "take-home" food
was 45 percent and 60 percent at the PHCs and SHCs respectively.
This Phase demonstrated that more efficiency could be built
into the programme by(i) enrolling easily accessible and nonmigratory populations(ii) Seasonal 'take-home' during drought
may be more cost-efficient and manageble.
The Intensive Phase which had maximum supervision and
control showed that (i) it is operationally feasible to attach
small food-mix units to PHCs, (ii) Indigenous multi-mixes are
readily accepted, but those below the poverty line cannot afford
even the cheapest of cheap mixes (iii) Ready-to-eat mixes need
tojrctail at not more than 50 p per kg (iv) The village school
is a good alternative infrastructure to the PHC for 'take-hone'
food distribution to the * below-sixes'
(v)
' Fed-on-site_' feeding
is one and half times as expensive as 'take-home' distribution
but is more efficient.(vi) The synergistic effect of the
;
combine dT'package of nutrition, health and education services
was established.
Utilization of services by the study PHCs went up by 51
percent and 41 percent in the Exploratory and Intensive phases,
respectively.
The cost per child per annum included the i ndi vi dual
costs of logistics, equipment, food supplement, childcare
education materials, medicines/sera, personnel and their trans
portation, and miscellaneous items.
It was found to be
approximately Rs. 208, Rs. 110, and Rs. 308 in the Exploratory,
Extensive and Intensive Phases of the Project.
1 :
4
______
THE HINDU, Sunday, May 10, 1981.
Th© Motion continued
exploit tribals.
different dialect but naxalites, are
The naxalites. by coming to the at home with them because of
help of the villagers, gain their linguistic affinity.
sympathy. No one in the area is . The people of South Bastar ere
ready to furnish information about poor and exploited. This condition
them. Whenever they take shelter of the 'Babes in the Wood' makes
or food in a villager's house, they alluvial soil for naxalite activities.
pay double tne cost.
Most of them work in forest
About 30 young doctors from , depots and in collecting bldi leaves.
adjoining Khammam district are Their weekly payment is not made
believed to be active in Bastar regularly by the Forest Department.
as naxalites. They are learnt to At village Pujari Kanker. 25 tribal
ACOITS in the
" .= north o
„u . has proved to be a good hide- have
and
f
distributed medicines- to . labourers who had been working
villagers.
'
naxalites in, the south are "out for. naxalites.
since February. 5 had not received
The Bastar Police has made payment for many days.
a headache to the administration. . There are five naxaiite groups
arrangements to check the
Tne ' dacoits function on the active in the villages on the border, special
t
The tribals work on contract
of naxalites in the district. and payment is made on the basis
aporoved lines of murder, arson Reports from villages Kotaballi. entry
<
police squads have not so •of per cubic metre work ■ done
and loot Tne naxalites adopt subtler IKamlapur.. Polampalh. Marudoaka, But
f
Cherpalli. Sindurguda. Tarlaguda. far
f
come across any naxalite. The They are ignorant of this system
have a well-organised of' payment and are unable tc
<
Madhya °radesh is among the Nelakanker and Kamalpetta. all on naxalites
system
arid calculate- the actual work, done
<
' 1 States where naxalites are active, the.Andhra Pradesn border confirm communications
'
IInformation about official activities
accord ng to the Union Home this,
Fair price shops are not working
.
is
.conveyedpromptly to them by
Ministry's annual report. In Bastar , No report of crimes committed ■!
properly and at some places ever
the
villagers.
in south Madhya Pradesh bordering by naxalites has reached the authori
The naxalites come under various if they exist, there is no regulai
Andhra- Pradesh and Maharashtra. ties.
supply
of commodities. In many
in the many trucks plying
naxglites. as admitted by the Police.
The.naxalites succeeded in gett- guises
'
villages, there are no schools o
have succeeded in forcing con ing increased rates for Andhra between Andhra Pradesh and there are schools without teachers
tractors to pay higher wages iO labourers for collecting tendu pattas Madhya Pradesh carrying timber ‘The drinking water problem is acute
forest labourers thereby winning (bidi leaves) from 8 paise to 12 and bamboo an£i escape into the and the villagers suffer hardship
the sympathy of the tribal villagers paise per stack of 100 leaves. jungles They get back to their during summer, when water ii
who provide them with food and In M.P. the rate was half of that •' base the same way.
■ nallahs and rivers is limited ant
The area where naxalites are is used by both cattle and . the
shelter.
in A.P,. The naxalites intervened
Naxalites who are active in the to .get the rates enhanced and active is a belt of Doria tribe who people, giving rise to skin trouble
Khammam, Kanm Nagar and thus put an end to their exploitation speak Dorh and Telugu. Living on and other diseases.
Warangal districts of Andhra by Government and private agen the • border, they go to Andhra
The development of the regio
Pradesh and Chanda district of cies... The patwanes too exploit Pradesh for their daily needs Their and ending the exploitation of th"
uiucio by
uy false
ioioc transfer
uoua.ci vi
of ioijm
land marriages take place in A.P The tribals will "aldne make them ir
Maharashtra make their way into the tribals
dense forests of Bastar. A 300 and demand heavy amounts. Tne. villagers are sentimentally attached sulated against naxalite influence.
naxalites
gather
such
information
A
P.
km long bound of Bastar adjoining
Correspondent
Officials find it difficult to talk
A.P. and Maharashtra, with dense from - villagers and then threaten
forests and poor communication patwaris, foresters or others who to them because they speak a1
from Bhopal.
Extremists,
but good
Samaritans
D
A
REPORT OF THE
TRAINING PROGRAMME HELD AT
PANIGA ON, DEWAS
CN
March 15 - 17, 1993.
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HEALTH CARE THROUGH TRADITIONAL SYSTEM OF MEDICINE
xy
PLANNING WITH TRIBALS
SUGGESTIONS
4/
a. Identification of medicinal plants
b. Preparation of 15 herbal medicines for
following minor diseases.
1. W orms
6. Headache
2. Vomiting
7. Whooping cough
12. Constipation
3. White disicharge
8. Joint pains
13. Wounds
11. Gastric trouble
4. Fever
9. Cough
14. Scabies
5. Pyor rhea
10. Dysentry
15. Skin infection
For preparation of herbal medicines
1 b Raipur
1. Dew as
2. Gwalior
2. Bilaspur
11. Gwalior
3. Hoshangabad
3. Jabalpur
12. Raipur
4. Dew as
4. Hoshangabad
5. Ambikapur
13. Surguja
5. Bilaspur
10. Raigarh
14. Betul
6. Balaghat
15. Seoni
7. Morena
16. West Nimar
8. Mandla
17. Jhabua
9. Dhar
By Dr.Y.D.Sohni
iry 1 9v0 to Apr, 199 2 ■ then September 92 to June 1993
1.
Total Districts covered - 20
2.
Total village covered
3.
Total trained persons
- 1146 (504 + 642)
4.
Total workshops on TSM
- 38 (20 + 18)
(7 + 13)
- 260 (Sept.92 to June 93)
No.of workshops in each District.
Hoshangabad
- 2 ( 1+1)
Indore
Bilaspur
- 4
Gwalior
Surguja
- 1
West Nimar
Betul
- 1
Jabalpur
Dhar
- 1
Ambikapur
Morena
-1
Raipur
Dew as
— 9 (6+3)
Satna
Seoni
- 1
Chhindwara
Raigarh
- 2 (1+1)
Mandla
Balaghat
- 1
Jhabua
- 5 (2+3)
- 4 (2+2)
- 1
- 5 (4+1)
- 1
- 1
- 1
- 1
- 1
- 1
WORKSHOPS
ON TRADITION SYSTEM
from January 1990
Date
Place
OF
MEDICINE
to June 1993.
No. of
Village
NO. of
Partici
pants.
Workshop on
1990 s
Feb.20-25
Bilaspar
8
12
Preparation of herbal
Medicines.
May.25 to
June 4
Balaghat
4
10
Identification and
preparation of medicines
July 10-21
Meghnagar
-
Visit to member organisa
tions.
-do-
Se >t.1-6
Khandwa
-
-
Sejt. 19«20
Dew as
5
11
Sept.22 to
0
Oct.2-13
Mhow
-
-
Vist to Mem.Orgns.
-
-
Visit to MemlOrgns.
97
Vaidya Sammelan
15
Preparation of herbal
medicines.
Preparation of 3 medicin
Visit
Nov.27 to
Dec. 2
1991s
May 8-10
Navrachna,Jpr.
May 24-26
Shradha SVY,
Indore-.
June 4-7
Gramin Vikas.
Mandla.
-
15
-do-
June 20-22
Sambhav,Gwalior
-
23
-do-
Aug. 6-8
Seva Kendra,Dewas-
41
-do-
-dc-
-do-
-
41
Oct.4-7
Navracha SSS, Jpr.-
7
Oct. 9-10
Seva Kendra, Dewas-
41
Identi£<fication of local
plants.
Oct.18-20
Navrachan SSS , Jpr.
14
Preparation of herbal
medicines.
Dec.2 7
Eklavya,Dewas
25
Preparation of 3 medicin
20
Preparation of herbal
medicines.
Sept.10-12
-
-do-
1992:
Jan.6-8
Holy Cross Hosp.
AmbiKapur.
-2-
Jan.24-27
Kasturbagram,Indore
35
Preparation of medicine
Jan.29-31
Arada, Kukshi
50
-do-
Feb.6-8
Navrachna,Jpr.
20
-do-
Mar.4-8
Parigaon,Dewas
8
-dc-
Apr.10-13
Gwalior
7
-do-
12
-do-
r. 23-26
Harda
12
.Vorksnops On Traditional System of Medicines,
From Sept. 92 to June 1993
No.of Village
No . of
Participants
1992
1.
Indentification
Village Barwani
of Herbal plants
Vikas Kb a nd Rahtgaon
Sept. 21-24
Di stt.Ho shangabad
’Jith C.C.F.
Pushapkunj Hospital
Students
Indore
'30
70
11
60
15
32
18
24
10
40
10
14
Oct. 19-23
Preparation of
Sewa Kendra
Herbal medicines
Panigaon Dist.Dewas
Oc. 23—31
Preparation of
P.O.Pali
Herbal medicines
Di st.Bila spur
Nov. 4-7-
Preparation of
P.G.Pohri
Herbal medicines
Di st. Gwalior
Nov. 22-24
1 reparation of
P. Mo hana
Herbal medicine
ui£
Gwalior
uec . lb-17
...2/-
// 2 //
No.of Village
No. of
Participents.
33
55
55
iv '3
7.
•
Preparation of
Mission Hospital
Herbal medicines
Compound Ciihapara
J an.11-13
Di stt.Seoni
Preparation of
A.K.S.V.M.S. .
8 College
Herbal medicines
Akai tara
Distt. Bilaspur.
3 Schools
Preparation of
Govt. Vivekanand
6
35
..err.al medicines
College Manindergarh
15
33
15
28
Feb. 4—6
He;.. 23-25
10.
Trainers training
Qatta Mandir
on preparation of
Mandieswar
Herba 1 medicines
West - Nimar
•
March 15-17
11.
Preparation of
Panchyat Bhawan
Herbal medicine
Farkanara
block Kharsia
Distt: Haigarh
Meeting vzith
L..1-.VH.A. Office,
Vi iAI
Consul tant
Indore.
.'.■arch 29-31
Work sliop*
Where
13.
Prepration of
I S S RD Shahpur
Herbal medicine
Distt. Betul
No.o^ Village
No . of Pariicipenis.
10
24
7
15
6
10
April 12-14
14.
15.
I6.
Preparation of
Rest House Manpur.
Herbal medicine
Forest Dept. Manpur
April 28-30
Range.
Preparation of
Rest House Choral
Herbal medicine
Forest Dept. Choral Range
April 28-30
Distt. Indore.1
Orientation
Gorsrmonati Sansthan
workshop on
Ma hoba Distt. Hamirpur
( From MJ >. Dr. Sohni )
(M.P.V, H.A.)
U.P.
Health education
May 3-7
17.
18.
Preparation of
Annpurna Ashram
Herbal medicine
Padaria Block-Kundam
MaV. J-Prlg.
Distt. Jabalpur
Meeting on
Tarun Sanskar
Herbal Care
Padaria Distt.
by UNICff
Jabalpur
18
37
May 16-19
V-
// 4 //
■ •OAkshcp
19.
20.
21.
Where
Preparation of
Forest Dept.
Herbal medicine
Daulatpur teh Sonkach
May 12-14
Dittt. Dewas.
Preparation of
Agriculture Dept.
Herbal medicine
Udainagar Teh.Bagali
May 21-23
Distt. DEWAS.
Fifteen medicine
Catholic church
Preparation on
Parsahi
minor eliements
Distt. Bilaspur
June 13-15.
No.of Village
' No. of
Participants
4
30
7
15
17
65
REPORT OF EXECUTIVE SECRETARY
From January 1991 to 31st March 1992.
For MP VHA,- the year 1991 marks a beginning of a new era. . This
is characterised by people’s health movement in several villages
of M.P.
During the last year this association has been able to
develop a systematic method of initiating a health movement at
village level.
Almost all the activities of this association which
includes visiting member organisations, conducting workshops
and seminars,
liasioning with government, publications, consul
tations, etc were focused on people's movement for health
promotion.
The approach is a product of collective thinking
and eftorts of several member organisations,
of VHAI, and some
of the renowned thinkers like Prof.Ashish Bose.
ful to them for their contribution.
And we are grate
With this, I present before
you a summery of all our activities from January 1991 to March 92.
At present, over 300 primary school teachers have undertaken the
task of promoting health in their respective schools and villages.
Of these 70 are from Kundum Block of Jabalpur district, 70 from
Chhapara block of Seoni District and 140 from Pali block of
Bilaspur District.
In all these areas the work began with an
orientation programme for them at Jabalpur, Bilaspur and Seoni
districts.
A more systematic work was also initiated among 20
teachers of informal schools of Seva Kendra, Panigaon.
A follow
up of their work is being done by local voluntary organisations.
At Jabalpur it is done by Tarun Sanskar, at Bilaspur by Gramin
Seva Sanstha, at Seoni by Mission Hospital, Chhapara, and at
Panigaon of Dewas district by Seva Kendra.
The other groups involved voluntarily in health promotion
p rogrammes at village level include 70 Aanganwadi workers and
nearly 20 persons from villages surrounding Neemuch.
In order to initiate voluntarism at Village level we had to adopt
a special health education strategy.
For this purpose this office
prepared some papers and circulated the papers among the member
organisation.
The list of those publications is given separately.
. ..2.
-2«T.S.M. Programme:
With the view of promoting the use of traditional system of medicine,
MP VHA launched a programme called 'Tulsigram.1 Under this p-rogramme
nearly 200-villagers are trained to prepare 15 herbal medicines for
minor ailments.
Some of these persons again organised the training
programmes for other villages.
Information & Documentation Centre;
During the year 1991, MP VHA established an information and docu
mentation centre at the office.
The centre was established ’with
the technical assistance from VHAI.
For this purpose our programme
officer Raksha Singh was oriented at VHAI.
Finances:
Our major donor Christian Aid gave us a grant for the years 1989,
90 and 91.
Since the period of the grant was only upto December ‘91.
We submitted a project proposal to Christian Aid for the grant for
the year 1992.
The grant was sanctioned and we have already rece
ived the amount.
Further contract with Christian Aid will be
finalised only after the evaluation of the work done by the Asso
ciation.
Staff:
At present our staff includes Executive Secretary, one Programme
Officer, An Accountat, Office Secretary and an Office Assistant.
One of our programme Officer Mrs.Pushpa Mahendra recently resigned.
We are grateful to her for her contribution in promotion of
traditional medicines.
Now we are planning to appoint one B.A.M.S. doctor and one more
programme Officer.
Since much of our work is being done in Hindi
the board also approved a post of Hindi Typist.
The details of all our programmes i.e; workshops, seminars, visits
to member organisations, publications etc are givjen in a separate
report.
All the achievements of this association are a result of collective
efforts of our programme officers, our office staff, member organisa
tions, VHAI staff, the donors and MP VHA Board.
We express our
deep sense of gratitude for their contribution and we are also
looking forward for their continuing support in the years to come.
With best wishes,
Sincerely,
Raj Bhujbal,Executive Secretary.
rei'crt
m<
Phe annual General meeting held at Gwalior on Feb.8-10,
important guidelines.
programmes' like :
1.
2.
3.
4.
5.
6.
7.
1990 set
These guidelines included several following
Awareness in National Healthy Policy
Promotion of Rational drug therapy.
Visits to member organisation
Promotion of traditional system of medicines.
Net working
Community health promotion.
Promotion of Nutrition Education.
Al! the programme of MP VHA during the year 1990 were a response to the
above recommendations.
Programme
Place
Date
N o.of Resource
parti- persons
________________ cipants
Indore
Apr.2-'3,9O
60
Bilaspur
&: Raipur
Oct.8-11
16
(Social
action groups)
1. National Health Policy
2. Follow up workshop
on N.H.P.
Dr. A. Dayalchan;
Ms.M.Khale &
Mr.R.Bhujbal
-
3. Rational Drug Therapy
Indore
Sept.90
300
4. Promotion of Nutrition
Education workshop .
Bas tar
June 5-8
40
Ms. Raksha S ing)
Indore
Nov.21-22
13
Mr.R.Mittal &
Mr.C.Finch
5. Workshop on Hospital
Aminis tration
-
1990 is the year in which special emphasis was given on visiting the
member organisation. Some organisations of the following districts
were visited:
N imar
Bilaspur
Sidhi
Raipur
Jabalpur
Chhatarpur
East Nimar
Jhabua
Dew as
Betul
A brief report on different work, programme and visits from
January 1991 to February 1992.
During the last year, I focused more attention in the health
problems related to nutrition of villages and made efforts for
the promotion of health in villages through government teachers
and Anganwadi workers.
The success which we achieved during this period, is mainly
due to a specific strategy that is not imposing any of our
programme on them but only participated in their programme by
providing necessary technical assistance through cur member
organisations.
S'
As a result of these efforts at present.305 teacher•s'(formal
and informal) and Anganwadi workers are providing health
education in their respective villages. This work is being
done purely on voluntary basis.
Sketch of my major activities:
January to Feb.10,1991
AGM work
February to March 2nd
March to April ,
.Office shifting
Establishment
of Information
Documentation
Centre.
Work in the office:
'■
School Health Training, Workshops and follow-up activities:
Programme.
Place
Period No. of Resource
parti persons
cipantsj_________
No.
1.
School Health Workshop
Jabalpur
May 6-9
15
2.
School Health Training
Chhapara
Sept.27-28
75
3.
School Health Training
alongwith Development
of low cost communica
tion skill
Panigaon
Sept.9-11
20
Meena,Teen
Bhujbal &
Raksha.
Ral$sh?
Bhujbal
Raksha
Bhujbal
-24.
5.
School Health follow-up
meeting.
School Health follow-up
meeting.
Panigaon
Oct .4-6
16
Raksha
Panigaon
Dec. 1
. 16
Raksha
6.
School Health Training
Padariya
Jabalpur
Dec.15-18
50
Raksha,
Bhujbal
7. ’
School Health follow-up
meeting
School Health training
Chhapara
Dec.9-11
50
Mrs.T.1 Lal & ADIs
of Chhapara
Pali
Jan.8-11
142 'Bhujbal,Raksha.
8.
Workshops on Community Health:
1.
Community Health workshop .Panigaon Nov.11-14
for member organisation
2.
Community Health workshop
for Anganwadi workers
Podi
Feb.17-20
3.
•
Community Health workshop
Farakanra,
for village animators
Raigarh Feb.22-25
alongwith development
of low cost communication
aids.
Participation in workshops:
Development of low cost
1.
canmunication aids.
Hariyana
Aug.5-9
Member- Organ is ati ons .'.vis it 6d:.l?..
1.
Mission Hospital, Bilaspur
Gramin Seva Sanstha . at Pali,
2.
at Bilaspur &
at JaiJaipur
10
Bhujbal,
Raksha
':80
Raksha
'42
Raksha
-
Raksha
by Raj' & Raksha
;By Raj'.Sc Raksha
3.
4.
Gandhi Ashram, Mungeli
Mission Hospital, Mungeli
5.
60
Community Health Centre, Chhapara
By Raj & Raksha
by Raj.’Sc Raksha
.By Raj. & Raksha
Lahar Samaj Sevi Sanstha at Kharsiya
at Champa
at Jaijaipur
Prem Scwa Ashram, Podi
by Raj s. Raksha
by Raksha
8.
Mission Hospital, Champa,
by Raj & Raksha
9.
Weidner Memorial Hospital, Rizda
Catholic Centre, Parsai
Seva Kendra, Panigaon
By Raj & Raksha
by Raj -Sc Raksha
by Raj,'Raksha Sc Pustpa
12.
Catholic Centre, Maiyharonda
13.
Tarun Sanskar, Jabalpur
by Raj 8c Raksha
by Raj' & Raksha
7.
10.
11.
School Health News letter
A booklet on Nukkad Natak - Street play
A leaflet on balanced diet.
A leaflet on calorie measurements of different food stuffs.
Eye examination kit.
REPORT FROM MARCH 1992 to JUNE 1993
Programme
1. Seva Kendra workers
meeting
2
No. of ParResource
ticipants ___ persons
Place
date
Panigr.on
Mar.12-13,
1992
13
Mr.Bhujbal
Ms.Raksha
••
Mar.25-29
26
Ms.Raksha
3. Teacher's Training on
School Health Prog.
Bilaspur
Apr.6-10
150
Raksha &
Mr.Bhujbal
4. Meeting with DFO
Harda
Apr.21
-
Neemuch
May 11-15
50
-do& Dr.Bhatnagar
6. Workshop with forest
guards(Animators Trg.)
Harda
July 26-30
50
Raksha &Lata
7. Animators Training and
School Health Programme
follow up meeting
Jabalpur
Sept.9-16
70
Raksha & Lata
8. School Health Programme
follow-up meeting &
visit to menber orgns.
Bilaspur
Nov.2-10
35
Raksha &
Dr.Sohni
9. NGO's meeting
Bilaspur
Jan.6-8,93
65
Mr.Bhujbal &
Party.
0. Meeting with BM VPS
women
Indore
Feb.12
30
Raksha
Jabalpur
Feb.21-26
Kasturba- Mar.2-4
gram,Indore
48
Raksha
50
-
Exhibition workshop
Panigaon
Mar.14-17
-
L4. Mestiny at Pushpa —
Hcs>ital
Sendhwa
Apr.2-4
Health Animators Trg.
Meeting with Subseti-bers of HCAN
Health Animators Trg.
L2. Women's Health workshop
-do-
Mr.Bhujbal &
Lata
Mr.Bhujbal &
Raksha.
/
TERMS C? REFERENCE FOR M.P. VHA EVALUATION
Terms of reference by Christian Aid; i.e. the information.
(Reference: Mary Convill's letter dated June 3, 1992 to MP VHA).
1.
The evaluation should not analyse and examine things already
known to Christian Aid,i.e. the information through regular
reports, news letters etc.
2.
It should be an independent analysis of hew MP VHA is respond
ing to the needs of member organisations.
3.
It should include a brief review of who the members are and
what kind of groups they represent.
4.
It should•examine members level of participation in MP VHA
activities.
It should examine the relationship between MP VHA office
and it's members organisations i.e. is their a sense of
ownership, or is it Just a membership ?
5.
6.
It should examine whether MP VHA is making a conscious
efforts of a careful programme strategy for a big state
like M.P.
7.
It should also examine the efforts for the decentralisation
in MP VHA strategy and evaluate its effectiveness.
8.
If MP VHA adopted a strategy of decentralisation then the
evaluation should examine whether MP VHA is dependent more
on its office level resources, or is it using the office
level resources for facilitating networking by members,
mobolising members to make use of each others resources,
co-ordinate with other complimentary organisations, networks,
training groups etc.
9.
It is necessary to analyse the impact of the main programmes
of MP VHA, the mechanism adopted by MP VHA to assess the
impact for its own purpose, and hew this self evaluation
process is being used for re-organising the efforts.
10.
Linking health oriented groups with the Government is one
of the major roles of MP VHA. Therefore it is necessary
to evaluate the effectiveness of campaigning and lobbing
with Government, and also the future role in this area.
11.
The evaluation should necessarily include the resource
management aspect with a special emphasis on the following :
'
i.
What is the effectiveness or otherwise of the
material used by MP VHA ?
ii.
Is MP VHA able to maximise resources by avoiding
duplication of the work and resource investment
carried out by VHAI?
2
i
-212.
The evaluation should look at the MP VHA board, how active,
involved and supportive is it ? How representative of the
membership is it ?
The evaluators, at the request of MP VHA should look into all
areas and issues of its own emphasis. In this it should also
be examined whether MP VHA is paying attention to gender issue 3
14. MP VHA should prioritize areas for evaluation, put together
the terms of reference for evaluation, and allow Christian Aid
to comment upon them before the evaluation proceeds.
13.
15.
The evaluation execersises should be carried out with the
fullest participation of staff, board and members.
16.
Finally, the evaluation should be aimed at suggestions of help
ful and practical ways forward for MP VHA.
oOo
~
ViIA EVALUATION - Terms of reference by MP VHA.
Goal;
The evaluation should begin with the consideration of the final
goal of MP VHA i.e.
To improve the health status of the people of Madhya Pradesh
through the efforts of voluntary agencies.
The goal should remain a final reference point throughout the
evaluation.
II.
Strategy;
In the view of the final goal of the association the evaluators
should reflect upon the following questions:
III.
i.
Is MP VHA making any effort to prepare a careful strategy ?
if yes, then how effective is the strategy in making a signi
ficant impact on the health status of nearly 45 million popu
lation of MP.
ii.
Is the strategy geared for strengthening the member
organisation ? If yes, how ?
iii.
Is the strategy based on decentralisation? if yes, then how
is decentralisation reflected in the strategy ? Also what is
the level to which the strategy proposes to decentralise the
functioning - to the level of member organisations or to the
level of people ?
Programmes:
We expect that the evaluators should examine our programmes in the
view of the following questions:
i. Is there any gap between our goal, strategy and programmes ?
ii. Where does the programme planning begins? Are the programmes
planned in VHAI Office at Delhi and then implemented by MP VHA
...3.
-3through the member organisation ? Ctr, are the programmes planned
with people and then the planning of required assistance is
done at higher levels i.e. member organisations, MP VHA and
then VHAI ?
What
iii.
is the internal mechanism of evaluating the impact of
the programmes ?
IV.
V.
MP VHA Publication and other health education materials:
i.
What is the impact of the health education material on people ?
(not only on member organisations)
ii.
What is the final purpose of the material produced by MP VHA ?
Is it aimed at manipulating people to change their health
practices? Or is it aimed at activating people to prepare
their cwn initiatives for health promotion?
Ra^cgrce management:
i. Is MP VHA totally dependent on its office level resources i.e.
office staff and office finances for promoting health'in the state
ii. Does MP VHA make efforts of mobolising the resources of its
member organisation? if yes, how effective is the progess?
iii.
Is the association assisting its member organisation in moboliaing human power and other resources from the grass root level?
How effective is the process ?
VI. MP VHA
Members:
i. What is the status of member organisations? Are they just members
of the institution called MP VHA which provides them some assista-nee from time to time? Or, does MP VHA exist as an association
in which the members perceive a sense of wonership ?
ii. Are the members just being used to implement VHAI or MP VHA
office level programmes? Or, do the members use MP VHA and
VHAI office to strengthen their cwn network ?
VII. MP VHA board:
i. What is the role of board in MP VHA functioning ?
ii. Do the board members actively participate in MP VHA programmes ?
iii. Does the board represent all types of groups and also all regions
of the state ?
Areas of concern:
i. What are the major areas of MP VHA concern and programmes ?
ii. What is the criteria of prioritising concerns and programmes ?
The staff:
What is the role of staff in planning and implementation of the
programmes? Is the staff being used only to implement the programmes
planned by the Executive Secretary and the Board? Or does the staff
plans programmes and then necessary assistance is given to them
by the Executive Secretary and the Board ?
0O0
0O0
0O0
MP VHA's EFFORTS IN PROMOTING HEALTH
THROUGH
PARTICIPATION IN PEOPLE^ PROGRAMME.
I. Village level treatment of minor ailments through herbal medicines:
Two years ago we called a state level meeting of some 75
traditional practitioners of herbal medicines.
Five national
level experts on traditional system of medicine were also
present as the resource persons.
The purpose of the meeting was not to promote traditional
system of medicines, it would have misled us and would have
kept us engaged in developing different methods of popularising
traditional systems of medicines.
CXir purpose was simply to
prepare some common action plan for providing relief to people
as our minute contribution in elivating their health status.
In the beginning, all the participants prepared a list of the
health problems of their respective areas. Finally, the
list of nearly 32 health problems was prepared. There is
nothing new in it. Even the traditional approach begins with
the assessment of the health needs of people.
The real difference between the traditional and the new approach
begins after assessment of the health problems.
Traditionally,
after the assessment we should have gone into the process
of identifying the causes of the problems, its solutions,
interventions, the detail strategies of undertaking these
interventions, and so on.
Finally we would have ended in
preparing one of those massive community health programmes.
We avoided that temptation. For us, those tribals are not
only machines with some technical faults, they are also
humanbeings involved in the process of solving their health
problems. So our further discussion was centred on their
efforts in solving the health problems. This is the uniqueness
of the new approach.
..2.
-2They informed that of all those 32 health problems they were
unable to do anything for nearly 13-15 health problems.
However,
they were confident that herbal treatment was possible for the
rest.
But they were facing several problems in preparing
medicines for those 15-17 minor ailments.
Then we confined our discussion only to the treatment of those
15-17 minor ailments, and our experts decided;! provide necessary
assistance to them in preparations of those herbal medicines.
Thus, they prepared a guideline for the preparations of 15
herbal medicines.
All the participants agreed that those 15
herbal medicines were useful at village level.
Then according to the plan prepared at the meeting, we conducted
several training programmes in the state and trained over 200
villagers in preparing those medicines.
Later these trained
people conducted training programmes in nearby villages.
received information of sane such programmes.
We
It is our estimate
that today there are atleast 300 villages in the state where
villagers avail a facility of treatment of minor ailments through
herbal medicines.
The second step in this programme was to strengthen these trained
villagers in identifying local medicinal plants.
The programmes
of identification of medicinal plants were also organised at
some places.
One of such a programme was organised at Panigaon of Dewas Dist.
This is a tribal belt of the district.
The programme was organised
for those people who were already trained in preparing herbal
medicines.
During the training, the experts on traditional medicine, and the
villagers went into the nearby forest and identified several
medicinal plants.
There was a discussion on all the plants.
The
information was well documented. The villagers also prepared a
herbarium of the medicinal plants and the herbarium alongwith the
information of each plant, is permanently displayed at Panigaon.
.... 3.
-3Ncw it is left upto the experts on traditional medicines to
innovate more interventions for further strengthening of villagers
in the field of herbal medicines.
This may not be an easy process.
It requires a careful translation of modern knowledge and technology
into simple information and easy techniques.
-0-
II.
IMPROVING HEALTH STATUS
THROUGH
NUTRITION EDUCATION
A Workshop on nutrition education:
During January 1992, MP VHA had called a four day workshop for
Primary School Teachers of Pali block of Bilaspur District.
The purpose of the workshop was to prepare plans to improve
health status of villagers through interventions related to
nutrition education. Nearly 142 teachers were present during
the workshop.
In the beginning it was made clear to all the teachers that
eventhough the workshop was organised with the permission of
education department, they were participating only as educated
representatives of villages, and not as teachers. This means
that whatever they would doing during or after the workshop,
will be in their capacity as responsible representatives of
village community.
Therefore the participation in the workshop
was their own choice and we had also assured them that the
education department would not take any action against them
if they would choose not to participate in the workshop.
It
is against this background that we began the workshop.
Communication Strategy:
We did not have to make any efforts to make our presentation
interesting - no colourful flash cards or posters, no puppets
shows, dramas or story telling. Yet when we concluded the work
shop at 5.30 p.m. on the first day, the participants insisted
to have an additional session at night and so we continued the
programme till midnight.
We did organise some independent entertainment sessions, but
the purpose was not to make our presentation interesting.
....2.
-2-
The Goal:
During the very first session of the workshop one tribal teacher
stood up and boldly said "Sir nutrition education is not our
major concern in villages.
The majority of our villagers are
leading good healthy life without your modern nutrition edu
cation, without knowing the names of those vitamins."
"Our major concern", he said, "is the diseases in villages.
We want to reduce these diseases, want to reduce disabilities
and deaths due to diseases.
Instead of wasting your time and
our time in that nutrition education, why not do something
about the real sufferings of our villagers?"
There was much truth in this suggestion of that tribal teacher.
Villagers are neither interested in our nutrition education
nor they are willing to do anything about its promotion in their
villages.
In short,; it is not their programme.
This is the problem; if we claim to do health promotion through
participation in people's programme, how can we give nutrition
education when it is not people's programme ?
It is true that nutrition education is not a people's programme
but improving the health status of their families and their
village communities is certainly a people's programme.
Whenever
people clean their homes and its surrounding, make efforts for
safe drinking water, brush their teeth, take bath, treat people
with home remedies, or take them to the hospitals, they are
involved in the programme of improving their health status.
It is in this people's programme
that nutrition education has
a special place as a necessary intervention, and people are
not aware of it.
Therefore primarily our goal was not to give nutrition education
to people but to make them realise the significance of nutrition
education in their programme of improving health status, and
then give nutrition education as a necessary follow up.
-3-
Objectives:
In the light of the above mentioned goal we had set the
following objectives for the workshop:
1.
To make people aware of the significance of nutrition
education in their programme of improving health status.
2.
To give nutrition education in a manner in which i.
ii.
3.
4.
They would realise their own responsibilities.
They would realise the assistance they require from
Government and from voluntary agencies.
To give guidelines for planning the programme.
To allow the participants to prepare their own action
plans in which -
i.
firstly they would prepare a plan of their own
initiatives in the view of their own resources,
abilities and potentials.
ii. secondly they would prepare a plan of a systematic
assistance to their initiatives.
The workshop was conducted to fullfill the above mentioned
objectives. The foilwing is a brief description of our
presentation.
Definition of health status:
First of all it is important to know what we mean by the health
status. If we say village Rampur is healthier than village
Sitapur then obviously we mean that at Rampur there are less
diseases, deaths and disabilities than at Sitapur.
Without
going into any further details we can say that diseases, deaths
and dissabilities are the three major parameters of measuring
the health status of any village.
Causes of Diseases; External and Internal:
We can measure the health status by diseases, deaths, and
disabilities but we know that deaths and disabilities are
caused by diseases. So if we decrease diseases we will be
able to improve the health status of people.
For this, it
is necessary to examine the causes of diseases.
Most of us are aware of so many causes of diseases ... polluted
air, contaminated water and food, mosquito bites, unhygenic
life style etc. But it is very important to know that we do
not necessarily suffer' from malaria after a bite by an infected
mosquito. If this was the case, then by this time all^the
population of India would have been wiped out. Also all these
who drink contaminated wateis do not necessarily fall sick.
This means that apart from the external causative agents of
diseases, there are some internal factors, which influence of
health.
And one of them is the nutritional status of person.
If a person is weak then there are more chances of him falling
sick than a healthy person.
Also the effects of sickness on
a weak child are often more than on a healthy child.
However
this should only be taken as a norm and not as a rule.
„
The Importance of Nutrition Education:
For improving the health status of vour village, it is very
important that the village environment should be clean, they
should get safe drinking water, etc. Since health is also
related to educational and economic status, attempt should be
made to elivate educational and economic status of villagers.
But it will take several years,should then our children suffer
untill we convert of present villages into those ideal villages ?
What we can do at present in the given situation ?
In comming few years we may not be able to create ideal healthy
environment in our village, we may not be able to improve educa
tional and economic status of villagers, but atleast we can
identify those weak children and take a special care of those
children.
This is certainly possible at any village with little -
training, devotion and efforts.
...5.
-5The tasks before the villagers:
In the light cf all the above discussion we can conclude that
primarily villagers will have to perform the following tasks:
1.
To identify weak children.
2.
3.
To take care of those weak children at village level.
To refer some extremely weak children to hospitals
4.
in time.
To educate villagers for improving nutritional status
of expecting mothers and under five children.
The Role of Government or Voluntary Health Agencies;
1.
To enlighten the villagers regarding the importance of
nutrition in their efforts to elivate the health status of
their village, and also to make them aware of the expected
tasks in it.
2.
If the villagers are willing to perform those tasks at village
level then the government and voluntary agencies should assist
villagers in training some selected villagers in performing
those tasks.
The objectives of such a training is to equip
villagers with knowledge and skills related to nutrition.
This means that :
i.
Villagers should have some knowledge of balanced diet,
different nutritional deficiences, special care related
to those nutritional deficiences.
ii.
iii.
The villagers should be skilled in identifying different
types of nutritional deficiences, they should also be
skilled in identifying those cases of nutritional
deficiences, which require special hospital care.
The villagers should be skilled in giving nutrition
education in community.
They will have to be trained
to use their own methods of communication in giving
nutrition education.
6.
-6-
3.
4.
The government and the voluntary agencies should be
equipped to take a medical care of the patients refered
by the villagers.
The Government and the voluntary agencies should keep a
proper record of nutritional deficiencies and keep
villagers informed about the causes of the nutritional
deficiencies in their respective villages.
In this respect they should also provide guidance to the
villagers regarding the necessary steps that the villagers
should take in dealing with their local nutritional problem.
Nutrition Education:
After clearly explaining the importance of nutrition education/
the role of villagers and the role of voluntary agencies the
participants made a demand for nutrition education and for the
skills in identifying cases of nutritional deficiencies.
As per their demand the nutrition education was given to the
participants in the following order of presentation. Here this
order of presentation is very important because every step is
a participation in their priorities:
„
1. Different types of nutritional disorders and diseases.
2.
Signs and symptoms of each type of nutritional disorders.
3.
Signs and symptoms of cases to be referred to hospital.
4.
Special care cf children in each case of nutritional
deficiency.
5.
Concept of balanced diet and how to plan balanced diet
in available food items.
Village Level Planning:
After all the presentation on nutrition education and the skills
associated with it we reminded the villagers and following
expected tasks to be performed in each village:
1. Identification of the cases of nutritional deficiencies
2.
Special care of the identified cases.
3.
Identification of cases to be referred to hospitals'^
Nutritional awareness at village level.
4.
.. .7.
-7We categorically informed the participants that explaining the
task was our limit. It was not possible for us to give guidance
to them on planning village level activities to fullfill those
tasks.
For example, it was not possible for us as to which
procedure they should adopt to identify children. Should it be
done by some formal survey, or should it be done by a casual
home visits? Would the identification be done by different
persons in different parts of village? or should it be done by
only one person in all village.
The participants agreed with us that it would not be possible
for us to plan activities in their villages.
They also agreed
that since socio-cultural structure and leadership pattern in
each village is different, village level planning would have
to be done by the villages seperately.
The participants then prepared their own action plans.
Since
those plans were prepared by the persons who were going to
implement the plans, it was not possible for us to question the
feasibility of those plans. However this does not mean that
the plans prepared by them were perfect, it only means that
they were convinced about the feasibility of those plans. These
plans certainly require some modification during actual implemen
tation.
Follcw-up of the workshop:
1. A news letter:
While the participants are in the workshop they feel inspired
to do something at village level. This enthusiasm is often
temperory because it is product of the social environment
created at the workshop. When the participants return to
their respective villages, they face an adverse environment.
It is the environment in which no one is interested in doing
anything for the health promotion of village. In such situation
a participant feels lonly and his lonliness may lead to
non-action.
.. .8.
-8With the consideration of the above situation, we had requested
the participants to send a detail news of their efforts to us.
So we received several letters from the participants of the
workshop regarding their activities and plans.
We publish
those activities in the news letter.
The news letter is in Hindi and looks like a small news paper.
This
is deliberate, because the villagers give a great
importance to the news published in the news paper.
This news paper is a great help to these village level volunteer.
The news paper establishes his identify as a part of large state
level group involved in health promotion at village level.
i-i.
Assistance by the local Voluntary Organisations:
In some way this has been our draw back.
So far the voluntary
agencies had always adopted a policy of seeking people's assista
nces in their programmes but they are not aware of the strategy
when people seek their assistance.
However it is encouraging that some of our member organisation
are providing systematic assistance to the initiatives taken by
the village level volunteers.
iii.
Personal visits and letters:
Some of these village level volunteers seek assistance through
the letters. In most cases their demands are related to health
education material. For this purpose we have established an
information cell in the office and send necessary information to
them. If the large number of volunteers demand same information
then we publish such information in our news letters and in
•health mirrors.'
Sometimes we also visit our village level volunteers in their
respective villages. Such visits are not always possible for
us but the representatives of loiZal voluntary organisations
visit them often.
....9.
.'Follow-up Workshop;
We have planned to conduct a follow-up workshop for these
volunteers in September 1992.
The purpose of the workshop
is to evaluate the work done so far, to provide more in
formation, to help them to plan their activities more
systematically, and to help them to organise resources
from outside i.e. from Government and voluntary agencies.
Such workshops were held at Kundum block of Jabalpur,
at Chappara block of Seoni and at Panigaon of Dewas District.
ANNUAL REPORT Q? THE EXECUTIVE SECRETARY
FOR THE YEAR 1992-93.
Daring the last Annual General Body Meeting the
General Body MP VHA passed a resolution to adopt a very specific
approach of development, and of health care. According to the
decision, the General Body had directed this office to promote
the new health care approach among the Government and the voluntary
Agencies of the state, produce literature, models etc. Therefore
the efforts were made by the office to follow the directives of
General Body and here is a brief report of the initiatives of
MP VHA in that direction.
In this presentation, firstly I would like to present an overview
of the new approach and then the description of the activities
to promote the approach in the state.
AN OVERVIEW CF THE APPROACH
The final goal of this association is to improve the health
status of nearly 7 million population of the state. However
the members of this association realised that there can be no
significant change in the health status of this vast population
of the state either by the present health infrastructure of
government , nor by the efforts of around 200 to 300 voluntary
agencies which cover less than 3 lac population.
This is evident from the fact that despite of all the efforts of
the government and of the voluntary agencies we are witnessing
almost a steep rise in infant mortality; during 1990 the infant
mortality i.e. the deaths of under one year children per 1000
live births was 110, but it increased to 122 by the year 1992
and there are indications that it must have reached 130 by the
middle of 1993.
Why did our health system failed?
There are two distinct point of views. The views are almost diame
trically opposite. The first is the Government’s point of view and
the second, the people's point of views. The Government's point
of view is discussed in several workshops and seminar, but we
hardly hear anything about people's point of view.
Government's point of view;
According to the health planners of the Government and of the
voluntary health agencies, the major cause of the failure is the
lack of people's participation. They argue that their health
plans are systematic and scientific, but these plans fail at the
level of implementation when people refuse to participate in
those systematic health programmes.
....2.
-2People's point of view:
Viewed from people's point of view, the situation is very different.
Less than 5% people ever depend on the health services of the
Government or of the voluntary agencies. But this does not mean
that people do not do;anything to improve their health status.
Whenever a child falls sick in any village people do not wait for
any assistance either from the Government or from the voluntary
agencies. They collect information from any possible reliable
source, try home remedies, attempt treatment by local medical
practitioners and if all of it fail, they admit the patient in
some highly sophisticated nursing home of urban areas. This is
people's health care system, and despite of its all short comings,
the system is fully sustained by people.
Two systems:
There are two systems; health care by government and second,
the health care by people. Health care by the government means a
movement by government and people are expected to participate
in it. The other alternative is to focus on people's efforts and
provide necessary assistance to people in their efforts to improve
their health status. Thia is an alternative health care strategy
and is adopted by MP VHA as its policy.
The alternative health system:
Eventhough people often make all out efforts for treatment, and
eventhough they spend a large sum of money on doctors, medicines
and on hospitalisation, the net outcome is far from satisfactory.
People's health care system also failed and the major cause of it
is the ever-widening gap between "what people do" and "what they
ought to do." for example, in case of new born 'under weight child',
people make all possible efforts to save the child when it becomes
sick. This is "what they do" and "what they ought to do", is to
take care of the child while the child is in mothers womb.
The role of health agencies:
Peoples effort fail because there is a gap between "what they do"
and "what they ought to do" therefore the role of Government and of
Voluntary health agencies is to assist people in bridging the "gap"
and this assistance is to be provided on the following different
levels:
i.
Health awareness:
Here health awareness means making people' realise the
gap between their present efforts of improving their
health status and the efforts which they ought to
make. Health can never become peoples movement unless
people realise this gap.
.. ..3.
—3—
ii.
Assistance in health planning:
Once people realise the gap between "what they do" and
"what they ought to do", then such a realisation creates
a desire to bridge the gap, and it requires a systematic
planning. Such a planning is a highly technical process
and therefore the health agencies will have to provide
health planning assistance to people in a manner in
which people will understand the process.
iii.
Service assistance!
People can not translate their health plans into action
programmes unless they get an assurance of service
assistance which is beyond their abilities, or the
services which require soma higher level medical or
health care skills and knowledge. For example, it is
the responsibility of the health agencies to make
necessary arrangement for immunisation, provision of
safe delivery, treatment for referred cases, Antenatal
care, Postnatal care etc.
iv.
Assistance in evaluation & monitoring!
i
In this approach the health care programme is basically
people’s programme and therefore the real honest evalua
tion and monitoring of the programme can only be done by
people because it is people who suffer if programme
fails, and benefit if the programme is successful.
The role of the government and voluntary agencies is to
empower people to monitor and evaluate their health
programme.
MP
VHA
PROGRAMMES
I. Health Awareness by Information Assistance:
In any remote village whenever someone falls sick the villagers
are confronted with many questions; what is the sickness ?
is it serious ? can it be cured by some home remedies ? if yes
what are those home remedies ? should the patient be taken to
a hospital ? which hospital ? how much will it cost ? and so on
The villagers then seek guidance of some elderly knewledgebale
and reliable persons. These people are their channels of
information, this is people's health information system.
We have made an attempt to replace people's advoc health infor
mation system by a systematic arrangement called "village level
information cells." So far, we established nearly 35 village
level information cells in different parts of the state. The
cells are being run by villagers under the guidance of local
member organisation of MP VHA. Now the government is also
seeking assistance of MP VHA in establishing such information
cells.
....4.
-4-
The organisations willing to establish information cells in the
villages or communities of their project areas, ask villagers to
select literate village level volunteers. These volunteers are
then trained to establish information cells in their villages.
They are provided with a small kit which includes some health
information material and small books relevant to the health
problems of community.
The objectives of the information training programmes are to equip
village level volunteers to assess the health care needs of
people, to identify sources of information, to collect information
material, to select the relevant material, to classify the obtained
material in categories which are meaningful to villagers, to
disseminate the information even to the illiterate members of
community etc. This is a four days training and is followed by
re-orientation programmes.
The village level volunteers are provided with a proforma to
register health information needs of people. They can make
demand for information from government, voluntary agencies or
from MP VHA. In order to establish a due credibility to their
demands, MP VHA has printed letter heads titled “Village Infor
mation Cell" and at the bottom it is mentioned that the programme
is supported by MP VHA and UNICEF.
The volunteers are also trained to monitor and evaluate their
information programme.
At present the programme is being sponsored by UNICEF and
Christian Aid. During the comming year we are planning to extend
the programme in different parts of the state.
Information assistance through literature*
i. Health Mirrors*
In the view of the health Information demands of people
we prepare health education material in different subjects.
Most of it is circulated among the member organisation
in the form of "Health Mirrors."
Health Mirrors are published once in two months on
various subjects like, dysentry, eye care, tooth care etc.
-5-
i i. Village Level Health News Letter:
Since the activities of the association are going on in
several villages of the state, the news of all these
activities are shared by all the members through a Hindi
news letter titled "GRAMIN SWASTHYA SAMACHAR PATRA."
At present nearly 2000 copies of this bimonthly paper
are circulated in and out of the state.
The news letter also includes health education material
on various subjects.
iii. Information for Voluntary Organisations:
The member organisations make some specific information
demands and these demands are fulfilled by our informa
tion centre and whenever the information is not available
with us we refer it to VHAI information centre.
iv.
Health Education Material:
)
In the view of the present approach, now we are in the
process of preparing some health education material which
will be made available in the form of a kit.
So far the education material on care of under one year
children has been prepared.
Promotion of Traditional System of Medicine:
Nearly 25% population of the state is tribal and hence is dependent
mainly upon herbal medicines for health care. Our effort is to
provide assistance to tribals in improving their health status
through herbal medicines.
We had Igegin our efforts with the assessement of the health
problems of tribals and the efforts they make to deal with it
through herbal medicines. After a systematic assessement, we
called a meeting of some tribals from all parts of the state to
discuss the future strategy of action plan. During the meeting,
which was attended by nearly 75 practitioners of herbal medicines,
the participants prepared a list of nearly 30 health problems and
also informed about the solutions of those problems through herbal
medicines.
However the tribals identified two major areas in which they
needed assistance of MP VHA and its member organisations:
1, Assistance in preparations of herbal medicines:
The tribals requested for assistance in preparations of herbal
medicines, atleast for common ailments. Therefore we prepared
a list of some common ailments, and our experts spent considera-ble time in finalising some simple herbal preparations for the
tribals in M.P.
6.
-6-
As a programme we train village level traditional practitioners
in preparing 15 herbal medicines. Several training programmes
were conducted.
Then we decided to train the trainers in 8 tribal district of
the state. So far 20 trainers were trained and juore these
trainers conduct training programmes in their respective areas.
2. Assistance in identification and use of local medicinal plants;
The second problem of the tribal is related to the identifica
tion of medicinal plants. They felt that even though there are
several medicinal plants in their forests, they know only
few of them and also their knowledge regarding its use is very
limited.
There-fore, in a second phase of the programme MP VHA included
identification and use of the medicinal plants. Training prog
rammes on this aspect are being organised in different parts
of the state.
During the programme,local traditional practitioners and MPVHA
experts conduct a tour programme of the local forests.' They
collect all possible medicinal plants from forest. The plants
are then brought to one place. After a proper classification
of all the plants, each plant is taken up for study. The plant
is exhibited before all the participants. They share their
knowledge regarding the use of the plant. Experts also share
their knowledge regarding the plant. Then after a due discu
ssion all the information regarding the plant is well documented
and is properly attached with herbarium of those medicinal
plants. The information is then made available to anyone.
Last year,it was decided that experts would prepare a list of
only 25-30 medicinal plants of prime importance, and future
orientation programmes would be focused mainly on identification
of these medicinal plants.
Follow-up;
There is a systematic follow-up of the programme. Villagers
write letters to MP VHA regarding the usefulness of herbal
preparations, they identify the problems. The problems are
then referred to the consultants on traditional medicine.
Alongwith the Voluntary Agencies, Government forest department
has shown keen interest in the programme and several programmes
are being held in collaboration with the forest department.
7.
-7Orientation programmes on health planning;
As per the resolution of the last AGM, MP VHA office was assigned
a responsibility of making the Government and Voluntary Health
Agencies aware of MP VHA approach,and the health planning based
on the approach.. In a response this office made some efforts of
organising the orientation programmes for the health agencies at
various levels.
Orientation for the Government Agencies;
We felt that it was necessary to make the highest Government
Health functionaries aware of the alternative approach recommended
by MP VHA. Therefore MP VHA Executive Secretary presented the appro
ach before the Government health functionaries in lectures at
Bhopal during ' March and April 1993. The lectures were held at the
Academy of Administration and were arranged by the Government
agency. The health secretary, Joint Director of health services
and other high level officials were present during the lectures.
We also focused our attention on the voluntary agencies and
organised a three days orientation programme for the voluntary
agencies of Bilaspur region. Nearly 40 representatives of
different voluntary agencies were present during the programme.
CKFAM regional Director Mr.Anil Shidore and representatives of
other donor agencies like CASA and World Vision were also present
during the meeting.
However the presence of the regional Director of UNICEF Dr.Kulkarni
during the meeting was very fruitful. In his lecture he endorsed
the efforts of MP VHA and admitted that new health care approach
'
Unicef cdn be the on^ possible alternative strategy of health care.
’has^planned The meeting established closer contacts of voluntary agencies with Unito v
/conduct four regional meetings for the voluntary agencies in the
state in collaboration with Federation of Voluntary agencies.
Senior consultant of the Planning Commission of India Dr.Mathur
came from Delhi to participate in the orientation programme. In
his presentation Dr.Mathur described it as the health care approach
which is qpnsistant with the new economic policy of India. He
assured the support of planning commission in promoting the new
appraoch in the state.
A similar orientation programme was organised for .the voluntary
agencies of Chhindwara District of MP. Nearly 30-35 participants
of some grass root level organisations were present during the
meeting. As a follow-up of the programme some local agencies of
Chhindwara District have already initiated health care efforts on
the approach.
.,..8.
-8A three days orientation programme for Catholic Priests was held
at Catholic Seminary at Ashta near Bhopal, Nearly 100 priests
participated in the orientation programme. The programme was cond-ucted by MP VHA Secretary Fr.Pradeep Cherian and Executive Secretary
Mr.Raj Bhujbal, During the programme Fr.Cherian presented the
approach as a process of humanisation.
Some other programmes on the subject were also held at
different places in the State,
Health Care model on new approach;
Recently MP VHA, in collaboration with the District Administration
of Indore launched^a health care project covering 20,000 rural
population of Indore District.
Eventhough the programme was started only in May 1993, it gained
wide publicity through news papers. The leading news papers desc
ribed the attempt as entirely new approach. In a public meeting
Deputy Director of Panchayat explained it as a “Health Care System
of Panchayati Raj" and the District Collector of Indore saw it
as the reversal of the former system. He said that "in this
system the entire responsibility of health promotion is with
village leaders i.e. Panchayat^and the role of Government Health
Agency is only to provide necessary assistance to the villagers
in their efforts," The Chief Editor of national level news
paper Hindustan Times visited the project . villages. He
encouraged the village leaders for their efforts and suggested
that the approach should not be only confined to the health care
but should also be extended to all other aspects of development.
Now the Government is making efforts to apply the same health
care approach in urban areas. Overseas Development Authority
selected several slums of Indore for the experient. The programme
is now launched. O.D.A. requested MP VHA guidance in their efforts.
The other major Government Agency,Narmada Valley DevelopmentNVDA)
is also planning development of the oustees of sardar Sarovar Dam
on the same approach.
Models of Unifocused Programme:
i. Eye care Project: .
MP VHA has also launched a District level eye care programme as
a model of unifocused programme based on the new approach. The
programme is basically implemented by the Indore District
Administration while the planning is controlled from MP VHA
office.
9
-9The project will cover nearly 8 lac rural and 10 lac urban popula
tion of the District. The Government appointed three persons for
the project. At present they work in MP VHA office but soon the
office will be shifted.
As per the plan Panchayat Department sent circulars to all Panchayats
for selecting one volunteer per 1000 population. We are expecting
a list of 1800 volunteers from villages. These volunteers will be
trained to identify referral cases and then the referred cases will
be examined by the Government Cpthelmic Assistants and Opthelmologists
Further planning of the eye care programme will depend on the over
all assessement of eye problems.
Each District of the state has sufficient funds for District Eye Care
programme and therefore it is possible to initiate such efforts in
all Districts of MP.
ii. School Health Programme;
A District level School Health Programme covering a nearly
3,50,000 students is launched by the District Administration
in collaboration with MP VHA. Health education and medical
check-up of students are two major aspects of the programme.
For this we are planning to train nearly 8,000 school teachers.
The teachers will be trained to give health education and also
to identify students with health problems and refer therj for
medical check-up.
Initial planning of the programme was completed during the
month of May and June 1992.
Our school health programmes are also going on in Bilaspur,
Jabalpur, Seoni and Dewas Districts. These programmes cover
more than 200 schools of the area.
ADMINISTRATION
•
Two more programme officers were appointed during the last year.
Dr.Sohani is looking after the promotion of Traditional Medicine
and Miss Lata Pillai is responsible for the programmes like health
planning and production of health education material.
Finances;
Christian Aid is our major donor agency, and we are greatful to
them for their continuing support to our efforts. We also get
some financial assistance from UNICEF, Government of India and DOM CC
10.
-10However it must be noted it was not possible for us to undertake
all these activities within the limits of direct financial
assistance to us by above mentioned donars, because'our actual
expenses are far more than the financial assistance we get. It
was possible only because voluntary and government agencies shared
the expenses of our programmes without giving finances to us.
Governing Body:
We are specially gratefull to the members of Governing Body for
their active participation in MP VHA activities. Sane of the
members demonstrated MP VHA approach in their respective
programmes and also
conducted several programmes.
Office Staff:
A sudden increase in MP VHA activities put an extra worklpad on
small staff of this office, yet the staff fullfilled the Work
to the satisfaction of this office and therefore we express our
deep sense of gratitude for their immense contribution.
With best wishes,
Raj Bhujbal,
Executive Secretary.
aj/-
Programme from May 1992 to June 1993
S.NO.
Place
Date
Workshop on
No .of Participents
1.
Jeevan Jyoti
•Jun
30
25
Orientation Programmeon the approach of
people's Participatio
2.
Harda Dist.
Hoshangabad
July 27-29
50
Nutrition Education
Poona
Aug.1 2-4
3.
Meeting vath the
principal of Ujjain
Biblical Seminary.
4.’
Indore
August
30
Community Health
training through
National open School.
5.>
Catholic Seminary
Aug. 8-10
Ashta
40
Workshop on approach
6.
Jabalpur
Sppt. 10-12
37
School health.1
7.1
Jabalpur
Sept. 13-15
48
Communication.1
8.'
Village Barwani
Vikas Khand Rahtgaon
Distt. Hoshangabad
9.'
70
Village covered
3Q
Identification of
Herbal Plants.1
Pushpakunja Hospital
Kasturba gram, Indore
Oct.1 19-:23
60
Village covered
School health and
communication
// 2//
S.NO.
Place
10•'
Sewa- Kendra
Panigaon
Distt. Dewas
11.’
No. of Participents
Oct. 28-31
32
Nov. 4-7
41
Nov.’ 4-7
24
Village covered 30
Workshop
Fif teen
medicine
preparation.
Block-Pali
Distt.Bila spur
12.
Date
School Health
P.O.Pali
Distt.Bilaspur
18
Preparation
Herbal Medici
13.
Distt.Bilaspur
Nov.' -1-8
Visits to
Rizda,
BlL.Home
Champa
Jairam Nagar.
14.'
P.O.Pohri
Di stt.Gwalior
Nov.- 22-24
40
10
Preparation
Herbal
medicine.-
15.
P.O.Mohana
Distt Gwalior
Dec. 15-17
14
Preparation
Herbal Medi
cine.
1993
16.'
Bila spur
Het el Chandrika
Jan. 6-8
65
Participation
of people's
Programme.
...3/-
M 3 //
S.NO.
Place
17.'
Mission Hospital
Date
Nolof
participent
village>
covered1
workshop
55
33
Preparation of
Jan-11-13
H.l Medicine.!
Compound CHHAPRA
Distt.< Seoni
$
18 .<
Jhabua
J an-16.18
19.’
Helhi
Feb. 1-4
25
women's Health.'
Executive Secratc
visit to vmi
20.1
R.K.U.M.S. Akaltara
Distt.Bilaspur
Feb-4-6
21.
Mandies war
West- Nimar
Feb- 10
22.<
Sewa Kendra
Feb- 15-17
55
8College
Preparation of
3Schools
Herbal Medicine.
X
Visit.
Exhibition
40
Panigaon
23.1
Delhi
Delhi Visit by
Feb.' 22-26
Executive Sec.
Feb- 23-25
24.<
Jasalpur
25.'
Govt.Vivekanand
College Manindergarh
Feb.23-25
Kasturbagram
35
8
Preparation of
H. medicine.
Distt. Surguja
26.
School health
35
March 1-4
Women's Health.’ ,
Indore.'
....4/-
// 4 //
S.NO.
Place
27.
Mandi eswar
Date
No .of
Village
covered
March 7
Work Shop
Meeting with
Jan Chetna Mu.:
West - Nimar
(Dr. Sohni)
28.
Sewa Kendra
Panigaon
March 15-17
45
Information a;
Documentation.
Di st. Dewas
29.
Datta Mandir
March 15-17
33
15
Trainer’s
training
Mandieswar
West- Nimar
30.
Bhopal
torch 27-29
31.
Panchyat Bhavan
March 26-28
Meeting on
alternative
health progra:
attended by
Executive Sec,
28
15
Prepa ration
Health medicir
Farkanara Distt.'
1
Raigarh
32.
M.P.V.H.A.Indore
Meeting with
March 29-31
Dr. Manjnnath
and Dr. Kha re
33.5
Sendhwa
April 3-5
34.
Gwalior
April 7
35.
Bhopal
April 8
36.
I S S R D
Shahpur DistiBetul
April 12-14
Plan on
Arunima.'
45
Khoj meeting
Danida meeting
24
10
Preparation of
H.medicine
5/-
// 5 //
S.NO.
37.1
38 .»
Place
Date
Noof Parti
cipents
Parad Singha
XJ&XXXX3XO
U4X
Distt.Chhindwara
April 15-18
65
Rest House Manpur
April 28-30
15
Village
covered
Health planing for
chhindwara.
idea 1 xkx wuscJiEXa®.
7
Forest Dept.Manpur
Preparation of
Herbal medicine.*
Range, Indore.’
39.
Rest House Choral
April 28-30
10
7
Preparation of H.
medicine.
Forest Dept.Choral
Range- Indore.'
40.
Gramonati Sansthan
Orientation workshop ’
May 3-7
on Health education.
Mahoba Dist.Hamirpur
U.P:
41
Annpurna Asharain
May 16-19
37
18
42.'
Tarun Sanskar
Preparation of Herba
medicine.*
Padaria Dist.Jabalpur
Meeting by UNICH1.
May 16-18
Dist..Jabalpur
43.1
Forest Dept.i
May 12-14
30
4
Preparation of
Herbal medicine
Daulatpur Distt.*
Dewas.
44,
Agriculture Dept.
May
15
7
Udainagar Distt.i
Dewas.
45.’
Catholic Church
Parsahi Distt.
Bila spur.
Preparation of
Health medicine
June 13-15
65
17
Preparation of
Health medicine.’
M.P. VHA Policy
&
Programnes for the year 1992 - 93
I. Policy:
1. A resolution:
The association should make all possible efforts to
promote human development approach based on the strategy
of "participation in people's programmes." This was resolved
during the Annual General Body Meeting of the Association
held at Pachmarhi on June 6,1992. The body prepared a list
of the following recommendations which now constitutes the
policy of the association in improving the health status of
people as its specific, and overall human development as it’s
general goal.
In the view of the above resolution, the board also directed
this office to plan the programmes in accordance with the
policy and recommendations of the Annual General Body.
2. Assumptions;
Basically the association believes that there are two appro
aches of human development. The first, or the present approac’
ire-supposes that the basic problems of man i.e. hunger,
diseases, lack of adequate shelter and clothing etc. can be
solved by empowering people through economic growth and tech
nological progress. In the process, the government and
voluntary agencies planned and initiated several developmen
tal programmes on all fronts-in health, education, agriculture,
environment protection etc.
However, despite of sincere commitments and modern scientific
strategies, the government and the voluntary agencies failed
to secure people's participation, and this led to the overall
failure of the programmes.
Moreover whatever economic growth and technological progress was
achieved even without people's participation has now become a major
cause of our concern. The so-called development is now leading us
to a path of self destruction; irresponsible industrial growth
created problems of pollution, migration of villagers to cities,
electrification and other technological progress enabled man to
exploit valuable natural resources like water, huge darns are being
constructed at the cost & mass scale deforstation and mercyless
evacuation of people, and the advancement in medical technology
flooded our markets with non-essential and hazardous drugs. It
also enabled people selective killings of female fetus in mother's
womb.
The development approach which is based on the strategy of
"participation in people's programmes" ensure economic grcwch and
technological progress but this is necessarily associated with
....2.
-2-
elivation of human values in societyi
In fact# in this approach
economic growth and technological progress is not possible without
elivating human values in society, because in this approach people
are forced to feel their problems, to think rationally about the
problems, prepare plans, and then to implement it according to those
plans. Thus people prepare their own programmes and the' role of
the government and voluntary agencies is to assist them in‘their
programmes at all levels i.e. in feeling, thinking and actions.
In this sence the process of participation in people’s programme
is a process of humanisation.
M.P. VHA PROGRAMMES
Objectives:
I. Awareness;
1. To make voluntary agencies aware of the shortcomings of
the present programme oriented approach.
2. To make the voluntary agencies aware of the alternative
development approach based on the strategy of "participation
in people's programme."
II.
Assistance:
1. To provide necessary assistance to the agencies which will
make efforts of initiating the programmes based on the new
approach. This assistance can be given in the following
various ways:
i.
ii.
iii.
assistance in planning
assistance in manpower training
assistance in resource material and resource persons.
Programmes:
I. Awareness Programmes:
Voluntary agencies in the state can be made aware of the new
approach in various ways, but it can be done more effectively by
i. visiting the member organisations.
ii . circulating publications on the approach.
iii. organising orientation programmes for different types
of voluntary agencies in the state.
iv. establishing some model programmes on the approach.
.. .3.
-3-
Assistance programmes;
The voluntary agencies willing to initiate their programmes will
require assistance in the following areas;
i.
assistance in planning the programmes.
ii.
assistance in manpower training.
iii.
assistance in resource material and resource persons.
*
Programme strategy;
1. Classification of the voluntary agencies;
Madhya Pradesh is a vast state and there are several types of
organisations in different parts of the state.
Though all the
organisations are ultimately making efforts of human development,
there are differences in their socio-cultural, and religious back
grounds, their ideologies, concerns and areas of emphasis are
different.
In order to give due respect to the identify of all the organisa
tions, this association will have to make a careful catagorisation
of the organisations and develop a strategy of awareness and
assistance progranrnes relevant to all the different organisations
in the state. For example, our programme strategies for catholic
organisations will have to be different than the strategies for
social action groups. For this, it is necessary to make cata
gorisation in the agencies operating in Madhya Pradesh.
Broadly speaking, the agencies in the state can be classified in
the following manner;
i.
T^e agencies in the state can be classified in the following
major categories;
VCLUCT.XRY AGENCIES IN THE STATE
Social A^ion groups
Cathol^ Organisations
1. Issues based
1. Resource centres
organisations
like Narmada,
2. Hospitals in urban
Bhopal gas tragedy.
areas.
3. Hospitals in rural
areas.
2. Demand generation.
■ groups.
Protestant^Organisations
1. Hospitals
1. Resource Centres
2. Hospitals with
Community health
Centre.
2. Hospitals
4. Resource organisa
tions.
5. Community health
centres with dispen
saries.
5. Centres with uni
focused activities
like leprosy, eye etc.
6. Social action groups.
3. Hospitals with community
health centres.
3. Community health
centres.
4. Hospitals with
community health
centres.
7. Centres with unifo
cused activities like
leprosy, eye problems
et.
Other organisations
4. Centres for develop
ment activities.
PROGRAMMES CF MP VHA UPTO DECEMBER 1992.
I.
Awareness Programme:
1. Preparation of distribution material:
We can plan to prepare the distribution material on the
approach before December 1992. This will include:
i. Basic principles of the approach.
ii.
iii.
Methodology of its implementation.
Case studies of some model programmes.
,
iv.
Techniques of undertaking specific interventions
related to health.
2. Orientation Programmes:
Some orientation programmes on the approach were held since
last two months. We intend to organise two workshops on
the approach before December 1992.
i. A workshop for social action groups.
ii.
A workshop for the organisations involved in community
health work.
-0-
Programme from August to December
1. August 24 - 26
: Proposed dates for nutition workshop
with ODA (ANMs).
2. September 9-15
: Workshop on low cost communication aid
and school health workshop with
government teachers at Jabalpur.
3. September 21-23
: Harda - Workshop on identification of
herbal plants.
4. September 26-20
: Proposed dates for school health
workshop with government teachers at
Dewas district.
5. October 7-8
: Proposed dates for Damoh visit.
6. October 15-17
: Proposed dates for school health workshop
with government teachers at Jhabua Dist.
7. November 16-22
; 1. School Health Workshop with government
teachers at Bilaspur.
2. Workshop on preparation of herbal
medicines for old government teachers
at Bilaspur.
3. Follow-up meeting with old governmentteachers.
8. December 1-4
-
: 1. School health workshop at Lakhnadon.
2. Preparation ofi herbal medicines,
follcw-up meeting with government
teachers.
3 'B.S.M. Training programme before Becember,
CASE STUDIES CF EXPERIMENTS
IN
DEVELOPMENT THROUGH
•'PARTICIPATION IN PEOPLE’S PROGRAMME
BY
Raj Bhujbal
Executive Secretary
MP Voluntary Health Association
Indore.
CONTENTS
I. MP VHA's efforts in promoting health through
"Participation in People's Programme."
i. Village level treatment of minor ailments
through herbal medicines.
ii. Improving health status through
nutrition education.
iii.
II.
Introduction of eye testing at village level,
Two programmes of Bilaspur Experiments by
"Gramin Seva Sanstha."
i. People's effort in Goitre Control.
ii. People's effort in Horticulture development.
III.
An overview of comprehensive development at
Panigaon by "Seva Kendra."
IV.
An Experiment by the Forest Department at Harda.
MP VHA's EFFORTS IN PROMOTING HEALTH
THROUGH
PARTICIPATION-IN PEOPLE *3 PROGRAMME.
1 • Visage level treatment of minor ailments through herbal medicines
Two years ago we called a state level meeting of some 75
traditional practitioners of herbal medicines.
Five national
level experts on traditional system of medicine were also
present as the resource persons.
The purpose of the meeting was not to promote traditional
system of medicines, it would have misled us and would have
kept us engaged in developing different methods of popularising
traditional systems of medicines.
Our purpose was simply to
prepare some common action plan for providing relief ,to people
as our minute contribution in elivating their health status.
In the beginning, all the participants prepared a list of the
health problems of their respective areas. Finally, the
list of nearly 32 health problems was prepared. There is
nothing new in it. Even the traditional approach begins with
the assessment of the health needs of people.
The real difference between the traditional and the new approach
begins after assessment of the health problems.
Traditionally,
after the assessment we should have gone into the process
of identifying the causes of the problems, its solutions,
interventions, the detail strategies of undertaking these
interventions, and so on. Finally we would have ended in
preparing one of those massive community health programmes.
We avoided that temptation. For us, those tribals are not
only machines with some technical faults, they are also
humanbeings involved in the process of solving their health
problems. So our further discussion was centred on their
efforts in solving.the health problems. This is the uniqueness
of the new approach.
..2.
-2They informed that of all those 32 health problems they were
unable to do anything for nearly 13-15 health problems. However,
they were confident that herbal treatment was possible for the
rest. But they were facing several problems in preparing
medicines for those 15-17 minor ailments.
Then we confined our discussion only to the treatment of those
15-17 minor ailments, and our experts decidediprovide necessary
assistance to them in preparations of those herbal medicines.
Thus, they prepared a guideline for the preparations of 15
herbal medicines.
All the participants agreed that those 15
herbal medicines were useful at village level.
Then according to the plan prepared at the meeting, we conducted
several training programmes in the state and trained over 200
villagers in preparing those medicines. Later these trained
*
people conducted training programmes in nearby villages. We
received information of some such programmes.
It is our estimate
that today there are atleast 300 villages in the state where
villagers avail a facility of treatment of minor ailments through
herbal medicines.
The second step in this programme was to strengthen these trained
villagers in identifying local medicinal plants.
The programmes
of identification of medicinal plants were also organised at
some places.
One of such a programme was organised at Panigaon of Dewas Dist.
This is a tribal belt of the district. The programme was organised
for those people who were already trained in preparing herbal
medicines.
During the training, the experts on traditional medicine, and the
villagers went into the nearby forest and identified several
medicinal plants. There was a discussion on all the plants. The
information was well documented. The villagers also prepared a
herbarium of the medicinal plants and the herbarium alongwith the
information of each plant, is permanently displayed at Panigaon.
....3.
New it. is left upto the experts on traditional medicines to
innovate more interventions for further strengthening of villagers
in the field of herbal medicines.
This may not be an easy process.
It requires a careful translation of modern knowledge and technology
into simple information and easy techniques.
-0-
11•
IMPROVING HEALTH STATUS
THROUGH
NUTRITION EDUCATION
A Workshop on nutrition education:
During January 1992, MP VHA had called a four day workshop for
Primary School Teachers of Pali block of Bilaspur District.
The purpose of the workshop was to prepare plans to improve
health status of villagers through interventions related to
nutrition education.
the workshop.
Nearly 142 teachers were present during
In the beginning it was made clear to all the teachers that
eventhough the workshop was organised with the permission of
education department, they were participating only as educated
representatives of villages, and not as teachers. This means
that whatever they would doing during or after the workshop,
will be in their capacity as responsible representatives of
village community. Therefore the participation in the workshop
was their own choice and we had also assured them that the
education department would not take any action against them
if bhey would choose not to participate' in the workshop. It
is against this background that we began the workshop.
Communication Strategy;
We did not have to make any efforts to make our presentation
interesting - no colourful flash cards or posters, no puppets
S'
shows, dramas or story telling.
Yet when we concluded the work
shop at 5.30 p.m. on the first day, the participants insisted
to have an additional session at night and so we continued the
programme till midnight.
We did organise some independent entertainment sessions, but
the purpose was not to make our presentation interesting.
2.
-2The Goal:
Daring the very first session of the workshop one tribal teacher
stood up and boldly said "Sir nutrition education is not our
major concern in villages. The majority of our villagers are
leading good healthy life without your modern nutrition edu
cation, without knowing the names of those vitamins."
"Our major concern", he said, "is the diseases in villages.
We want to reduce these diseases, want to reduce disabilities
and deaths due to diseases.
Instead of wasting your time and
our time in that nutrition education, why not do something
about the real sufferings of our villagers?"
There was much truth in this suggestion of that tribal teacher.
Villagers are neither interested in our nutrition education
nor they are willing to do anything about its promotion in their
villages.
In short, it is not their programme.
This is the problem; if we claim to do health promotion through
participation in people's programme, how can we give nutrition
education when it is not people's programme ?
It is true that nutrition education is not a people's programme
but improving the health status of their families and their
village communities is certainly a people's programme. Whenever
people clean their homes and its surrounding, make efforts for
safe drinking water, brush their teeth, take bath, treat people
with home remedies, or take them to the hospitals, they are
involved in the programme of improving their health status.
It is in this people's programme
that nutrition education has
a special place as a necessary intervention, and people are
not aware of it.
Therefore primarily our goal was not to give nutrition education
to people but to make them realise the significance of nutrition
education in their programme of improving health status, and
then give nutrition education as a necessary follow up.
-3-
Objectives:
In the light of the above mentioned goal we had set the
following objectives for the workshop:
1.
To make people aware of the significance of nutrition
education in their programme of improving health status.
2.
To give nutrition education in a manner in which i.
ii.
3.
4.
They would realise their own responsibilities.
They would realise the assistance they require from
Government and from voluntary agencies.
To give guidelines for planning the programme.
To allow the participants to prepare their own action
plans in which -
i.
v
firstly they would prepare a plan of their own
initiatives in the view of their own resources,
abilities and potentials.
ii. secondly they would prepare a plan of a systematic
assistance to their initiatives.
The workshop was conducted to fullfill the above mentioned
objectives. The following is a brief description of our
presentation.
Definition of health status:
First of all it is important to know what we mean by the health
status. If we say village Rampur is healthier than village
Sitapur then obviously we mean that at Rampur there are less
diseases, deaths and disabilities than at Sitapur.
Without
going into any further details we can say that diseases, deaths
and dissabilities are the three major parameters of measuring
the health status of apy village.
4.
Causes of Diseases; External and Internal;
We can measure the health status by diseases, deaths, and
disabilities but we know that deaths and disabilities are
caused by diseases. So if we decrease diseases we will be
able to improve the health status of people.
For this, it
is necessary to examine the causes of diseases.
Most of us are aware of so many causes of diseases ... polluted
air, contaminated water and food, mosquito bites, unhygenic
life style etc. But it is very important to know that we do
not necessarily suffer from malaria after a bite by an infected
mosquito. If this was the case, then by this time all the
population of India would have been wiped out. Also all these
who drink contaminated watejS do not necessarily fall sick.
This means that apart from the external causative agents of
*
diseases, there are some internal factors, which influence efhealth.
And one of them is the nutritional status of person.
If a person is weak then there are more chances of him falling
sick than a healthy person. Also the effects of sickness on
a weak child are often more than on a healthy child. However
this should only be taken as a norm and not as a rule.
The Importance of Nutrition Education;
For improving the health status of vour village, it is very
important that the village environment should be clean, they
should get safe drinking water, etc. Since health is also
related to educational and economic status, attempt should be
made to elivate educational and economic status of villagers.
But it will take several years,should then our children suffer
untill we convert
present villages into those ideal villages ?
What we can do at present in the given situation ?
In comming few years we may not be able to create ideal healthy
environment in our village, we may not be able to improve educa
tional and economic status of villagers, but atleast we can
identify those weak children and take a special care of those
children. This is certainly possible at any village with little
training, devotion and efforts.
-5The tasks before the villagers?
In the light cf all the above discussion we can conclude that
primarily villagers will have to perform the following tasks:
1.
To identify weak children.
2.
To take care of those weak children at village level.
3.
To refer some extremely weak children to hospitals
in time.
4.
To educate villagers for improving nutritional status
of expecting mothers and under five children*
The Role of Government or Voluntary Health Agencies;
1.
To enlighten the villagers regarding the importanceof
nutrition in their efforts to elivate the health status of
their village, and also to make them aware of the expected
tasks in it.
2.
»"
If the villagers are willing to perform those tasks at village
level then the government and voluntary agencies should assist
villagers in training some selected villagers in performing
those tasks. The objectives of such a training is to equip
villagers with knowledge and skills related to nutrition.
This means that :
i. Villagers should have some knowledge of balanced diet,
different nutritional deficiences, special care related
to those nutritional deficiences.
ii. The villagers should be skilled in identifying different
types of nutritional deficiences, they should also be
skilled in identifying those cases of nutritional
deficiences, which require special hospital care.
iii.
The villagers should be skilled in.giving nutrition
education in- community. They will have to be trained
to use their own methods of communication in giving
nutrition education.
6.
-6-
3.
4.
The government and the voluntary agencies should be
equipped to take a medical care of the patients refered
by the villagers.
The Government and the voluntary agencies should keep a
proper record of nutritional deficiencies and keep
villagers informed about the causes of the nutritional
deficiencies in their respective villages.
In this respect they should also provide guidance to the
villagers regarding the necessary steps that the villagers
should take in dealing with their local nutritional problem;
Nutrition Education:
After clearly explaining the importance of nutrition education,
the role of villagers and the role of voluntary agencies the
*
participants made a demand for nutrition education and for the
skills in identifying cases of nutritional deficiencies.
As per their demand the nutrition education was given to the
participants in the following order of presentation.
Here this
order of presentation is very important because every step is
a participation in their priorities:
1. Different types 6f nutritional disorders and diseases.
2. Signs and symptoms of each type of nutritional disorders.
3. Signs and symptoms of cases to be referred to hespital.
Special care of children in each case of nutritional
deficiency.
5. Concept of balanced diet and how to plan balanced diet
in available food items.
4.
Village Level Planning:
After all the presentation on nutrition education and the skills
associated with it we reminded the villagers and following
expected tasks to be performed in each village:
1. Identification of the cases of nutritional deficiencies
2.
3.
4.
Special care of the identified cases.
Identification of cases to be referred to hospitals.
Nutritional awareness at village level.
-7We catagorically informed the participants that explaining the
task was our limit. It was not possible for us to give guidance
to them on planning village level activities to fullfill those
tasks. For example, it was not possible for us as to which
procedure they should adopt to identify children. Should it be
done by some formal survey, or should it be done by a casual
home visits?
Would the identification be done by different
persons in different parts of village? or should it be done by
only one person in all village.
The participants agreed with us that it would not be possible
for us to plan activities in their villages. They also agreed
that since socio-cultural structure and leadership pattern in
each village is different, village level planning would have
to be done by the villages seperately.
>
V
The participants then prepared their own action plans. Since
those plans were prepared by the persons who were going to
implement the plans, it was not possible for us to question the
feasibility of those plans. However this does not mean that
the plans prepared by them were perfect, it only means that
they were convinced about the feasibility of those plans. These
plans certainly require some modification during actual implemen
tation.
Follow-up of the workshopi
1. A news lettert
While the participants are in the workshop they feel inspired
to do something at village level. This enthusiasm is often
temperory because it is product of the social environment
created at the workshop. When the participants return to
their respective villages, they face an adverse environment.
It is the environment in which no one is interested in doing
anything for the health promotion of village. In such situation
a participant feels lonly and his lonliness may lead to
non-action.
...8.
-8-
With the consideration of the above situation, we had requested
the participants to send a detail news of their efforts to us.
So we received several letters from the participants of the
workshop regarding their activities and plans.
those activities in the news letter.
We publish
The news letter is in Hindi and looks like a small news paper.
This
is deliberate, because the villagers give a great
importance to the news published in the news paper.
This news paper is a great help to these village level volunteer.
The news paper establishes his identify as a part of- large state
level group involved in health promotion at village level.
Assistance by the local Voluntary Organisations:
In some way this has been our draw back.
So far the voluntary
*
agencies had always adopted a policy of seeking people's assista
nces in their progranmes but they are not aware of the strategy
when people seek their assistance.
However it is encouraging that some of our member organisation
are providing systematic assistance to the initiatives taken by
the village level volunteers.
Personal visits and letterst
Some of these village level volunteers seek assistance through
the letters. In most cases their demands are related to health
education material. For this purpose we have established an
information cell in the office and send necessary information to
them. If the large number of volunteers demand same information
then we publish such information in our news letters and in
•health mirrors.'
Sometimes we also visit our village level volunteers in their
respective villages. Such visits are not always possible for
us but the representatives of lotfal voluntary organisations
visit them often.
9.
-9iv.
'Follow-up Workshop;
We have planned to conduct a follow-up workshop for these
volunteers in September 1992. The purpose of the workshop
is to evaluate the work done so far, to provide more in
formation, to help them to plan their activities
more
systematically, and to help them to organise resources
from outside i.e. from Government and voluntary agencies.
Such workshops were held at Kundum block of Jabalpur,
at Chappara block of Seoni and at Panigaon of Dewas District.
III.
INTRODUCTION OF EYE TESTING AT VILLAGE LEVEL.
Cne of the most important aspect in'primary eye care at village
level is a timely referral of the cases.
This is important
in all age groups but specially more important in young school
going children. A neglegence at early stage may result in
some permanent deformity.
Translation of Technoloqy;
This timely referral is possible only when some village level
workers will develop skills for it. But in the light of modern
o 'P h.t'hool m oi «.«H
highly sophisticated knowledge of opthelrnology is not a simple
process; It requires a translation of modern opthelmic knowledge
and techniques in simple village level knowledge and techniques
possible at village level, and therefore can only be dene by
a well qualified opthalmologist, who is also aware of village
level limitations.
For MP VHA this responsibility was undertaken by Dr.Sudhir
Mahashabde.
He is also a board member of the association.
Dr.Mahashabde deviced a simple technique by which any literate
villager can easily identify problems of vision and also can
distinguish between cases of refractive errors, and the cases
to non-refractive errors. The technique enables a village
level worker for a proper feferral; He can refer the cases of
refractive errors to optometrist, but he will refer the cases
of vision problems with non-referactive errors to a qualified
opthelmologist.
All this appears very difficult but it is our experience that
any literate or illiterate village person can learn the test
in less than 30 minutes. The kit for the test is also not
cost
very expensive. It/only Rs. 15/-, and can be permanently used.
Dr.Mahashabde also developed some simple flash cards by which
a village worker can identify referral cases of different eye
problems. It requires only 2 hours training and the cost of
these cards is Rs. 10/- .
2
-2-
Dr.Mahashabde's efforts in developing village level techniques
in Primary eye care is a unique effort, and certainly we are
grateful to him for it, but this process translation of medical
technology into village level simple techniques is not new in
other fields of primary health care.
ORS and kits for village
level birth attendeqts is good example of it.
An intervention as Participation in People's Programme;
The difference between the traditional and the new approach lies
not in the techniques but the manner in which it is used in the
process of delivering health care.
When we speak of participation in peoples programme in this
contest of primary eye care, we want them to identify the
referral cases at their own initiatives. It is people's respon
sibility to select a person for training, it is their responsibi
lity to identify the referral cases and it is their responsibility
to seek assistance for the treatment of the referral cases. Unlike
the traditional approach, there will no paid worker visiting
each home and fullfilling the target of primary eye tests.
It is with this above approach in mind that we have recently
introduced primary eye testing at villages through the village
level volunteers.
Some international agencies involved in eye care programme
have already given us an assurance that they will make necessary
arrangements for the medical examinations of the referral cases
identified at village level.
Primary eye care involves several other interventions. We shall
depend on the advise of the experts in identifying those various
necessary interventions. We shall then introduced those inter
ventions in already exisiting infrastructures based on the
approach of participation in people's programme.
—x—
V.
X. -
wo PROGRAMMES CF BILASPUR experiment
ogle's Effort in Goitre Control-;
Several eastern districts of MP are declared as Goitre prone
and Bilaspur is one of them.
Mr.Vijay Tiwari undertook the
task of Goitre control in Pali Block of Bilaspur District
through his organisation called Gramin Seva Sanstha.
The
p rogramme which was started with the initiatives of MP VHA
is a good example of the approach.
In the beginning Mr.Tiwari spent a considerable time in collect
ing information regarding Goitre problem in that area; He examined
iodised salt samples from several villages Pali block and found
that those samples did not contain iodine.
He also made a survey
of Government Efforts in solving Goitre problem and learnt that
almost nothing was being done.
He then called a large scale meeting of village leaders and
placed all the information before them.
Naturally, the villagers
were annoyed and wanted that Mr.Tiwari should do something
about the problem.
They assured full ao-operation to him in
these efforts.
A just cause and massive support of people, .... a perfectly
ideal situation for any social action group to organise an
impressive show. As a social activist Mr.Tiwari should have
exploited the situation. He should have organised few demonst
rations in front of the office of District Administration, shouted
slogans against inefficiency of the government, and he should
have managed to get in prison for a coupIt of days.
All these actions would have put Mr.Tiwari and his organisation
in the category of those “grass root level freedom fighter§“
and his programme would have been one of those rare models where
the voluntary agencies manage to secure people*s participation.
2
-2Here it is very important to note that Mr.Tiwari and his organic
sation did not organise any demonstration. Neither he, nor the
workers of his organisation were put behind bars. He did not
accept people's offer to support him on this important issue.
"Goitre is not my problem, there is no reason why I should take
initiative in solving the problem,'and then seek your assistance.
Mr.Tiwari informed this categorically to the people present at
the meeting. He said that he was not their elected representative
who should present their demands before the government. He made
it absolutly clear that Goitre was their problem, and if they
were interested la solving that problem they would have to take
initiatives.
The role of his organisation^was only to provide
necessary assistance on demand.
He also wanted people to
understand that his organisation had limited resource and any
assistance to them would be only within the limited resources of
his organisation.
Therefore they should not have any over
expectations from him or from his organisation.
As a result of this strategy, people took initiatives in solving
the problem and GSS provided the necessary assistance within
the limits of their resources. Eventhough the process is going
on today, we will just take a glimpse of some of people's
achievements in solving the problem.
First of all village' leaders organised a meeting of District
Collector and people in one small village of the block.
The
District Collector promptly ensured the participation.several
other government functionaries in the meeting,
in this, Gramin
Seva Sanstha only helped them in establishing their contact
with the Government.
During the meeting the District Collector Mr.Indrajit Dani and
the Government health functionaries were made aware of the
problem. Several salt sample were tested on the spot, and it
was found that the iodine content in most samples was far less
than the required norm.
3.
-3-
The district administration and people together worked out
a systematic plan of action. This included the warming to all
the traders regarding the sale of non iodised salt, some
curative measures at the government health centres, a constant
mechanism of checking the salt at the level of stock and also
at the level of distribution centres etc.
At the request of
the people, the district administration also checked salt which
was in several vagan at Bilaspur Railway station. The vagans
were sealed by the Government when they found that iodine content
in that salt was too less. The vagans are still on the railway
Station. . w
,
...
,
-.-.t administration and peen >■» t.ooeth->’- worked
-
Certainly this is just a beginning and much more has to be done.
But whatever is done, was possible only through the approach
of participation in people’s programme.
-x-
II.
,
People's Effot in Horticulture;
Here is one more example of a development intervention which
was basically intended for the economic development but also
resulted in the health promotion.
There■are about 12-13 small villages around the catchment area
Khuntayhat dam in Pali blick of Bilaspur district. Majority
of the villagers are tribals and the villagers are resettlements of
oustees of the dam.
About 7 years ago Mr.Vijay Tiwari initated development work in
these villages through his organisation called “Gremin Seva Sanstha."
When the organisation began the work in those villages, 90% people
were landless agricultural labourers, they were also involved in
seasonal migration to towns for their livelyhood. The percentage of
literacy was certainly as law as in any other tribal part of MP.
The villages were also not linked by roads. Where there is a com
bination of unemployment, poverty and illiteracy, one does not
have to say toomuch regarding the health status of such conrnuni y
4.
In this situation, it was obvious that Gramin Seva Sanstha should
have introduced some employment generation schemes, develop an
infrastructure for primary health care delivery with atleast a
small hospital, initiated some literacy programmes in all the
villages, organise communities to form Mahila Mandals or youth
clubs, and finally, to make everthing appear progressive, he
should have arranged some public awareness progranmes and organise
few demonstrations before the local administration.
This would
have put Mr.Tiwari and his organisation in the category of
those ideal development projects.
Today, after 6-7 years of efforts, those landless malnurished
labourers sell around two truck loads of fresh vegitables daily
in nearby town. Most.of them have atleast one and half acres
of land. The people who used to go to towns in search of jobs
are new in search of labourers to increase the output of their *
farms.
Such economic prosperity is often associated with'its own evils,
individualistic self dependent, arogant society and a gradual
down fall of human values.
Something that is taking place in
our urban economically developed societies.
You will observe an exactly contrary trend in these villages.
The village^ communities here are getting more and more organised.
Instead of being individualistic and self centred these villages
are now engaged in the plans of collective benefits of villages.
They are in the process of formation of co-operatives, making
efforts for raising their educational status and village
panchayats are getting to control any possible social evils
in their communities. This does not mean that there is a kingdom
of heaven on earth. It simply means there is a positive direction
of change,
, '
Mr.Tiwari says that success or the failure of all our development .
efforts depend on what do we think of those villagers lifeless
machines? ... useless animals ? ..or responsible human beings?
If we will treat them as machines or animals, then we will not
....5.
-5-
give them any opportunity’to solve their problems, instead »e
we will determine their problems with' our perspective. We will
also not permit them participate in the process of planning. All
the planning will be done in our offices because we will have
no faith in the thinking process of those illiterate, ignorant
villagers.
The efforts of Gramin Seva Sanstha deserves a careful study
because what they did is catagorically different than what our
modern social scientist would do. He would identify the problems
and then would prepare a systematic strategy for solving those
problem. It is somewhat like a mechanic would do to repair a
machine. Often he does not care to aSk what people are doing
to solve the problems.
This is a question which no one asks to
a machine and.it is this..question which differentiates between
a mechanical and human approach of development.
,
So Gramin Seva Sanstha's members developed personal relationship
with the rillagers, revealed themselves to people and then tried
to understand
their life process.
Being farmers, villagers natural inclination w^s towards farming.
Every year, they were employed as labourers in the fields in
the catchment area of the dam.
As per the rules, the land in the catchment area is auctioned
ever/ year. Some rich businessman used to the land on lease
and then employ these villagers as labourers in that land.
Af;er examining the situation Mr.Tiwari and his associate learnte
t>at the villagers could easily take the land on lease collective!
;nd then work in it as the owners of land.
.•
k.-.
'.c-
■■
He informed this to the villagers.
. '
- '
■
■ ec
The villagers then launched
a struggle for the land and it took them nearly
2 years to
win that battle. And as result, today each family has around
one and half acres of very productive land.
.. .6.
-6I
-
...
The second step was to ina:ke efforts for increasing the productivity
of the land.
Gramin seva Sans'tha helped the villagers in establish
ing contacts with the horticulture department. Unfortunately the
horticulture department was engaged in fullfilling the targets of
the sen ernes given to them by their higher authorities.
people's assistance in fullfilling the schemes.
They wanted
But the situation
in the village was not in conformity with the conditions of these
schemes.
Any way people were also interested in those schemes.They -
simply wanted the assistance of the experts of horticulture depart
ment in increasing the productivity of land.
After some discussions with the villagers, the government functionari<
realised the irrationality of their efforts of promoting government
schemes.
They admitted that basically their responsibility was to
assist people in their efforts to increase productivity.
And they
fullfilled the responsibility with dedication.
*
The villagers then began to produce so much vegetables that there
was a problem of transporting it to a good market. That problem
is also solved, and two trucks are engaged in transporting vegetables
to the market.
Yet there is still a problem of surplus. Because unless there is a
provision of storing vegetables, the farmers have to sell it in
throwgh'away price. In. .order to solve this problem, the farmers
are now in the process of constructing a cold storage through their
co-operative.
This is not the end.of thp story.
,This approach of participating
in people's programmes has it several positive side effects.
The
villagers who have now developed a habit of solving their problems
through their efforts are seriously thinking about other aspects
of their development which includes health and education.
"Economic growth and technological progress of villages is not our
final goal," says Mr.Tiwari,
of our approach.
it is only a necessary by product
Our major concern is to let the people lead a
life of human diginity in any given situation."
O/ERVIbW CF
COMPREHENSIVE DEVELOPMENT PROGRAMME
AT
PANIGA ON
An introduction;
In September 1987, a Catholic Priest, Fr.Pradeep Cherian went to
Panigaon of Dewas district to initiate some development activities
in that area.
Panigaon is around 70 kms from Indore on Indore-Harda-Nagpur road,
and is a village with a population of around 1500. It is surrounded
by several tribal villages in the forest. Panigaon is a main
shopping centre for all the tribals in that area.
There is an interesting.history of these tribals; Most of them are
not the local residents but were emigrated to this area from East &
West Nimar district of MP nearly 20 years ago. The emigration
took place because the local resident tribals left the area due
to a constant disturbances from wild animals.
When the tribals
in Nimar district Received a news that the land at Panigaon was
available at almost a threw away price, they came to Panigaon,
purchased the land, took up the challenge of facing wild animals
and settled in those villages around Panigaon.
Fr.Cherian went to Panigaon and instead of constructing a Catholic
Centre, he stayed in one rented house. He insists that this should
not be seen gs act of sacrifice, or identification with the poor.
The purpose vas only to allow people to knew him and to know the
people, and the best way to it was to say with people. Even in
that rented house he tried to make his life little more luxurious
than the rest of the villagers.
Rising expectations;
As he began his stay in the village, being a Catholic Priest, there
was some opposition to him on religious ground, but neither it
lasted for a long time, nor he was too much worried about it.
Fr.Cherian was more concerned about rising expectation of the
villagers due to his presence.
They expected that he will certainly
open an Erglish Medium School, construct hospital, distribute grains
and in th? process probably he would convert some tribals.
' I
...2.
-2A message of hope:
After few months'‘personal interaction people came to know that
Fr.Cherian was not an object which could be used for school,
hospital or wheat, but he was a living person, a human being with
whom they could interact personally, a person who shares his '
problems with them and a person with whom they could share their
joy or sorrow.
But this person was something different than whom they had met
earlier. He was a person with a message of hope. It was a hope
that they could improve themselves with their own efforts and he
was willing to assist them in their efforts. This was a process
of participating in people's programme. It is this message of
hope that latter became a basis of all his activities at Panigaon.
While commenting on the work at Panigaon, one tribal leader said
“Fr.Cherian did not make us beggers but by being with him we learnt
how to lead a life with human diginity."
Programme of School Education;
During some discussions the villagers decided to do something
about the education of their children. So they decided to examine
the present available facilities for primary education in their
villages.
It was found out that the villagers were not willing to send
their children to the government schools because the teachers
remained absent most of the time and were not taking interest in
teaching. The teachers on the other hand complained that instead
of sending children to schools, the villagers were using them in
some house hold jobs, or were sending them for cattle grazing.
However without going too much into the process o£ finding faults,
the villagers, alongwith Fr.Cherian, decided that a seperate
teacher would be appointed.
The villagers would partially take
up the responsibility of the payment of his salary, and will also
be responsible for sending children to that school,
Fr.Cherian
agreed to supervise'the education in those schools.
...3.
-3Though it appears as a parallel structure of education system, in
reality, it was only a temporary extention of the government
primary schools.
All the students who'attend such schools are
also enrolled in the government primary schools and the examina
tions are conducted by the teachers of government school.
The programme began with a school in one village and then gradually
spread in 20 villages.
This arrangement also encouraged the
teachers of the government school, and they began to be more syste
matic and regular in their work.
As expected, in some villages
the villagers gradually began to send their children directly to
the government schools.
In such villages these Mextention,‘ schools
were not needed and therefore were closed down. At present there
are three villages in which such schools are closed down.
As the villagers are realising the importance of education, they
are making a community level efforts to send more children to scheol.
At a village Tamtek, the villagers appointed two three persons to
look after all their cattles. The community provides them necessary
wages in different ways. How they do it is their business, but
it is important to note that this decision enabled more students to
go to school.
As the urge for education is increasing people are not just satis
fied with the primary schools. One of those-villages planned to
have a middle school^ They sought guidance from Fr.Cherian. He
then guided the villagers to approach Government.
After few repea
ted visit to the education office in the Secretariat at Bhopal,
the government agreed to open middle school in the village on the
condition that the villagers would contribute Rs.50,000/- for the
construction of building. Surprisingly, the villagers collected
Rs. 50,000/- in less than a week and submitted the amount to the
government. Every family in the village was asked to contribute
something. No amount was fixed. Even one rupee was accepted as
a valuable contribution.
The villagers also realise the problems of teachers and try to help
them in solving their problems. At one village there a minor clash
between the government teacher and some villagers.
The village
cotnaunity called a meeting and after realising that some villagers
were at fault, they gave warning to them.
...4.
There is one high school at Panigaon.
at the high school did not join.
Some teachers who are postek|
This is ay( usual practice in many
rural schools and often no one takes notice of permanent absence of
teachers. But the students took a serious note of it and discussed
it with some village leaders. Knowing that they themselves will
have to do something, they straight went to the office of district
collector of Dewas, informed aboutuM?n the office. For the Govern
ment officials, it was a strange
experience. Earlier, no student
had ever visited their office with a request for an appointment
of a teacher. The district administration promptly responded and
the teacher was appointed in the school.
Economic Development through a Co-operative:
During the early months of the year 1991, the discussions on poverty
began in the village level meetings. Certainly some villagers
waste their money in drinking and that is one of the cause of th&ir
poverty.
But the major cause was their habit of taking loans for
seeds and fertilizers from local money lenders on very high interest
rate.
They were often not in a position to repay those loans and
always remained trapped in it.
The villagers suggested that Fr.Cherian should give them loans at
a lower interest rate and this could be a good option for the
present situation. Fr.Cherian agreed, but he wanted villagers
to think wither this could be a permanent arrangement. The villa
gers themselves did not agree that the loans from Fr.Cherian could
be a permanent solution. So after long discussions the village
committees prepared a following plan of action as a permanent
solution for the problem. Now the same is being implemented
since July 1991.
1.
The village committees decided that each earning member of
village would contribute Rs. 20/- per month in village fund,
and the collection would be deposited in local bank in the
name of three persons.
Of these two person would be the
village leaders and'the third would be a worker of Fr.Cherian’^
organisation.
...5.
-5-
2.
Since one year's collection would not be sufficient for advancing
loans, it was decided that the process of depositing money would
continue for three years without any utilisation of those deposits
3.
As an interium arrangement Fr.Cherian would make a provision
of some funds for loans.
4.
In any case, loans would not be given to any farmer but only
to the village committees and village committees would be
responsible for proper distribution and collection of loans.
Each village committee would find its own way of dealing with
the defaulters.
5.
The loans would never be given in the form of cash, but there
would be a collective purchasing of seeds, pesticides, and ferti
lisers.
This would be alloted to each village according to
its collective demand. Proper distribution of all these items
would entirely be a responsibility of village level committee.
At present the programme is going on in 15 villages and people
have stopped taking loans from the local money lenders. As per
the plan, the villagers have already deposited over Rs, 50,000/in their fund. That amount is now also transferred in yearly
fixed deposit.
As an interium arrangement for three years, Fr.Cherian advanced
some money for the purchase of seeds, fertilisers and pesticides
in July 1991. So far there was 90% recovery of the loan. Fr.
Cherian is certainly concerned about the rest 10% loan, but he
is not worried about it. The loan was given to village committees
and it will be a duty of the village committees to find some way
of refunding the loan.
Meanwhile the village conmittees examined the cases of defaulters.
According to them all the remaining cases of default are due to
some genuine causes, and.therefore they are given sufficient time
for the repayment of their loans.
For village committees, the collection of deposit is also not an
easy process.
In one village, they did not have sufficient money
...6.
-6for depositing the necessary amount.
The problem was solved in
rather strange way; one villager had an extra bullock.
simply means that he-could do without it.
Extra
The village comnittee
then requested him to sell that bullock and deposit the amount
in the bank on behalf of the villagers. This was done and villa
gers are now gradually repaying the amount.
All the above activities should have resulted in clash between
the local money lenders and Fr.Cherian. But it did not happen
because of the attitude of Fr.Cherian and associates towards the
money lenders.
"It is against our principles,“ says Fr.Cherian,
"to put people in a rigid category of exploiters and exploited.
For us, all of them are created in the image of God and therefore
deserve human level dignified treatment. To the best of our
ability, we assure that treatment to the money lenders. Many times
we require their assistance in programmes of community development,
and sometimes they too require our assistance in their programmes."
New the plans are being prepared to give education to the farmers
on careful and proper use of pesticides and fertilisers.
Other Development Activities;
The villagers around Panigaon are now involved in several develop
ment activities. These include; health education through school
children, malaria control, preparation of herbal medicines at
village level, agriculture development, afforstation, water resource
management, development of the folk media etc. etc.
The guiding principle in all these programmes is the same. Let
people reflect on their cwn difficulties, let them plan their
own programnes in the light of the knowledge given to them, and
finally assist them in their efforts.
Most of the above mentioned programmes were’ started with the ini
tial assistance from Fr.Cherian and his associates. Today some
programmes like literacy are totally being run by the villagers.
....7.
-1-
The institution:
All the activities at Panigaon are being carried out through an
institutional base.
This institution, called “Seva Kendra” means
a centre for care, and is a unique example of an institution
required for carrying out the development programmes through the
approach of participating in people's programme.
While the villagers and Pr.Cherian were planning the programme
in that rented house at Panigaop, people strongly felt a need of
some permanent base. So the villagers collected Rs. 8,500/- and
handed it over to Pr.Cherian for purchasing land. But in the view
of the future needs of the institution Pr.Cherian added some more
money, purchased some more land, and constructed 3 small buildings.
These buildings surrounded by a beautiful garden is a pride of
the village. In the evenings, without taking permission' from any
one, the villagers open the gate, walk inside, take stroll in the
garden and return.
There neither any dogs to prevent their entry
into the premises, nor any watchman to question their presence.
Seva Kendra is not only a home for tribals.
The businessmen, money
lenders, politicians, police officers and other local government
officers also make it a point to visit Seva Kendra.
'Tribals' or
'Harijans' are not our “target groups," says Pr.Cherian, and "in
fact we do not believe in this kind of target oriented approach
which gives rise to casticism or communal disparity. We love all
of them irrespective of their caste, creed, religion or economic
status." Pr.Cherian and his associate do not proclaim this message
verbally, but the social environment in the premises makes it
clear to all.
A huge specious varanda, with a permanent sitting arrangement for
several people, dominates the building in which Pr.Cherian has his
office.
The office room is just near the front gate of the building.
Strongly the office is in the bed room of Pr.Cherian, which leaves
almost no gap between his private and public life. “This", Pr.Cherian
argues, “does not mean that I have no respect for privacy in indivi
duals's life, I am only against a split personality. That is a
sickness."
8,
-8-
Eventhpugh there is so much talk about participation in people's
programme, the structure of buildings, and inbuilt luxuries in it,
do not indicate that there was even an attempt to identify with
the
lives of poor villagers.
Fr.Cherian.
‘'This is not a contradition" argues
■
"To me participation means two things; firstly it
means that I should reveal my true self to people, and secondly
I expect people to reveal their true self to me in response."
He makes it clear that people must know that Fr.Cherian is not
Mahatma Gandhi, or Vinoba Bave, they must know that he is a
person who loves basic comforts of life. He accepts villagers
as they are, and expects that the villagers should accept him
as he is. This is essential for a personal relationship on equal
terms.
They neither celebrate the establishment day of the institution,
nor there is any one who swears in the name of institution.
Institution is not their master, it is only a means.
The insti- *
tution does not govern people but people govern the institution.
They strongly believe that "man is not made for the laws, but
laws are made for man."
This is reflected in the entire function
ing of the institutions.
There is always a content review of the
laws and the regulations of the institution.
The laws and regula
tions are changed if it become an obsbicle in their human deve
lopment
programnes.
Primarity the workers at Seva Kendra are not giveh details of
their job description, but are given responsibilities based on
their liking, attitudes, abilities, potential etc. Then it is
their duty to prepare detail descriptions of their jobs in the
light of their responsibilities. The higher level fumetionaries
do provide them all the necessary assistance in preparing systematic
job analysis. For example the head of the institution did not set
fixed duty hours for a gardner. He is given a responsibility of
looking after the garden.
How he should look after the garden
is the decided by him alongwith the higher authorities.
...9.
I
-9Here the workers are not free to do anything they would like
to do.
This will result in a chaos.
The workers freedom is
restricted by their specific responsibilities and by the plans
they prepare for fullfilling those assigned responsibilities.
There is a balance between the freedom and the farm in which a
worker fullfills his responsibilities.
In this approach a worker does not become a cog in machine,
rather he gets an opportunity for a full expression of his
personality. It is a human process which necessarily results
in job satisfaction and therefore, in a joyful accomplishment
of given responsibilities.
-0-
IV.
AN EXPERIMENT BY THE FOREST DEPARTMENT AT HARDA:
A development approach through participation in people’s programme
requires a considerable degree of flexibility in the institutional •
structure and therefore it is not possible to adopt the approach
unless we change the structure of the institution through which
we wish to operate.
"This", District Forest Officer Mr.B.M.S.Rathod, "is not
necessarily true.
We adopted the approach without making any
major revolutionary changes in the present structure of the
forest department." This is a unique contribution by Mr.Rathod.
He proved that the approach can be adopted by any government
department without any major reforms in its present structure.
Only after few years of service this young IPS officer realised
that no achievements were possible without true participation by*
people and there was no way of securing people's participation.
Therefore instead of trying to secure peoples participation
in the programmes of the department, he changed thd role of the
department, and the department began to participate people's
struggle for survival.
But this was not a deviation from his duties as a forest officer.
In the process he made them to realise the significance of . forest
protection in their struggle of survival. Today hundreds of
village level volunteers protest the forest in his jurisdiction,
and the work is continously being monitored by village level
forest protection committees alongwith the forest guard. This
is something which was not possible by those handful paid
functionaries of the forest department.
Alternative housing:
Housing is one major problem of the tribal villages. For centuries
they accustomed to houses of wooden structures. Today, with
all the restriction by the Government, it is not easy to get
sufficient wood from forest. Yet with a great struggle, they
manage to get that wood and construct their huts.
....2.
One of the way of dealing with
forcement of the law.
. s problem is by a strict en
In practice suqh action only increases
corruption in the department, but assuming that it is possible,
Will it be a human way of dealing with those tribals ? We must
remember that the tribals always consider themselves as the
owners of forest.
Forest is their home.
It is only in the
recent years that we have made them realise that they were
strangers in their home-land.
Does participation in people's programme here means helping
people to collect wood from forest? Obviously Mr.Rathod did
not adopt this method, but he did participate in people's struggle
for constructing huts. He constructed some model huts of mud
as alternative to those huts of wooden structure. Today many
villagers are seeking guidance of the forest department in
constructing those model huts.
When asked about their target for mode-hut-acceptors, one forest *
guard said "why should we set a target ? If our model is a viable
alternative then people will accept it.
If they doh't then we
will have to work for better model which people will be willing
to accept.
We don't want to get involved in propoganda for
forcing our model on them.
Therefore we shall not give any
incentives to the acceptors."
Almost a similar attempt is being done in case "chulhas".
The
villagers are exposed to several types of chulhas and solar heaters.
Village Forest Protection Committees:
The forest department made various efforts of participating in
people's struggle for survived.
These efforts created.a need
for village level organisation.
So the villagers, with the
assistance of the functionaries of forest department formed
village protection committees.
Till last years, there were
142 village committees.
...3.
-3One member of each family is a member of the comnittee and the forest
guard of the area works as a recording secretary.
taken by the committee as a whole.
The decisions are
Basically the role of the committee is to consider the problems of
villagers, find collective solutions of the problems, activate village
community to take necessary actions to solve the problems, seek assist
ance of the government and voluntary agencies, and finally the committ
also monitors the efforts by the villagers and by the government in
solving their problems.
The forest guard keeps a systematic record of the village committee
meetings.
He helps the villagers in establishing contacts with the
concerned Government Departments, voluntary agencies, and even resourc
persons. This is now possible for him because the district collector
has made the Forest Department as a nodel agency for rural development
!
Recently they also formed block level committees.
This committee
constitutes the representatives of all the village committees of the
block and considers the problems of the villages collectively.
responsibility of the block level committee is only to.provide
necessary assistance to the village level committees.
The
Health Programmes by the Village Level Committees;
As one of their major responsibility, several village committees
decided to improve health status of their villages.
They began the job by enabling people to take care of their minor
ailments at village level. Accordingly, MP VHA trained several
village representatives in preparing 15 herbal medicines for minor
ailments. These trained persons are new in position to train others
and therefore they do not require any more outside assistance in train
As a second step, MP VHA resource persons will be conducting a work
shop for training villagers in identification and use of the local
medicinal plants.
The forest department has planned to help them
in planting herbal gardens.
.. .4.
However, their efforts of health promotion are not only confined
to the herbal medicines, at their request MP VHA also organised a
nutrition education workshop for them.
In the beginning this will
atleast enable the villagers to identify malnurished children
and to take care of them at village level, or to. refer them to
hospitals in time.
During the same workshop, the villagers are also trained to iden
tify referral cases with eye proHems in time. The forest
department will help the villagers in getting necessary assistance
for the treatment of referred cases.
The process will go on, and many more health related interventions
can gradually be introduced at village level.
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_ —_ _____ __ _ -
ECCNQMIC GRCWTH MCDEL - A DISILLUSICN:
"After nearly four decades of optimisdism and hope that
economic growth and transfer of technology from rich to
the poor countries will lead to the development of the
latter." says an Indian development expert Walter Femades,
"most analysts are convinced that the assumptions of the
1950s have been belied and that alternative development
models have to be found."
But before we begin a search for those alternative models,
it is essential to understand; what is the nature of this
economic growth model ?
What were the assumptions of 1950s
on which the model was based ? and finally what is so wrong
with the model that new we have been asked to look for an
alternative ?
In 1950s, the economic grewth model was introduced by the
first Prime Minister Jawaharlal Nehru.
Deeply influenced
by the Western culture and educational system, Nehru had a
vision of converting India into Western scientific technolo
gical society.
With the exceptions of some minor reforms,
Nehru's model remained basically unchanged throughout last
40 years and as a result of these efforts we witnessed massive
development programmes on all fronts; in education, health,
science, technology, agriculture, and so on.
But,what is the ultimate result of this development? Does
our gigantic police force with all its modern sophisticated
weapons assure us security? Do the increasing number of
courts and judges guarantee us human justice? Is the urban
"development" society more civilised than the "under developed
village community? and finally, are the literate and educated
are more humane in their behaviour than those ignorant rural
masses?
2
-2The answers to all these questions are obvious. CUr develop
ment efforts have failed to satisfy a common man.
He is so
much disillusioned by these development activities that he
has almost lost a hope in the entire government system.
In
fact he is now rebelling against the government and in some
parts of the country this rebellion is taking a violent turn.
All this situation calls for a critical examination and this
requires a criteria for a value judgement.
Therefore in this
presentation I shall make an attempt to define human develop
ment, evaluate the economic growth model in the light of the
definitions and finally present an alternative model of deve
lopment.
DEFINITIONS CF HUMAN DEVELOPMENT
Human development is defined in two ways; firstly it is
defined in terms of what a man “has", and secondly in terms
of tthat a man "is'*.
These two types of definitions give rise
to two different types of development approaches.
When human development is defined in terms of what a man "has"
e.
i.
T.V., car, knowledge, skills, institutions, organisations
satalites, and even atom bombs, then economic growth and
technological progress becomes an ultimate goal of the deve
lopment efforts. This is a development model of economic
growth which is adopted in India since 1950, and it is a
process of elivating man’s struggle for existence.
The other definition of human development is based on what
a man "is."
Here it is assumed that man behaves or relate
with others on different levels of existence.
Sometimes man
behaves, or treat others as if human feelings, human thinking
and human actions are meaningless.
of mans existence.
This is a material level
Sometimes he behaves like a cog in machine
This is a mechanical level of man’s existence.
an animal level of existence.
The third is
Here man’s life is conditional
by instincts, rewards and punishments.
But the fourth,and
...3.
-3the highest is a human level, and is catagorically different
At this level man exhibits
than the other sub-human levels.
and strives for freedom i. e. freedom of feeling,' freedom of
thinking and freedom of actions.
In this concept of develop
ment the efforts are made to elivate man from a lower level
of existence to a human level of existence.
a process of humanisation.
This can be called
After a brief overview of these two concepts i.e. development
as a process of elivating man's struggle for existence, and
development as a process of humanisation, we shall go into
more detail discussions of each of these development approaches
Firstly we shall consider basic principles of development
as a "process of humanisation."
teria for a value judgement.
This will provide us a cri
Secondly, we will try to under
stand the present development model of economic growth and
attempt its evaluation, and lastly, we shall explore a conc
rete methodology of elivating man's struggle for existence
through a process of humanisation.
BASIC PRINCIPLES CF THE PRCCESS CF HUMANISTIC!-!
After spending much of his life on careful analysis of modern
technological society a famous Christian Philosopher hr.Francis
A Schaeffer said that the final test of human development in
any society or culture is this: "How humanly the people of
that society or culture treat each other?" He said that this
was the way in which all generations judged its precedeors
and this the way in which coming generations will judge us.
Certainly there are several levels on which people behave or
treat each other, but we can put most,of them in the following
four major catagories:
i. Material level
ii.
iii.
iv.
Mechanical level
Animal level
Human level.
4
-4At a material level people treat others just as a
of
flesh and give no consideration to their feelings, thinking
or actions. This is the lowest level on which people can
treat each other.
Dowery death is common example of material level treatment.
They consider woman as a lifeless object, something they
used for economic gains and then destroyed when found use
less.
Also consider the '..'ay in which Family Planning
promoters behave with village women.
By giving all the
promises of canforts the promoters bring those women in
health centres and when the operations are over, promoters
and their promises disappear.
This happens because in Family Planning Programme people
are Ufeless targets and they become useless if they cease
to be the targets.
Material level treatment is new a part
of everyday life.
You can experience it almost anywhere
in government offices, courts, police stations etc.
Mechanical level:
Mechanical level of human existence is mostly confined to
urban life, and is a by product of our technological society.
In this society machine is a final source of dependence almost a God.
In the precess of workshiping these machines,
man's entire life style becomes mechanical.
Describing this mechanical level of man's existence, Eugen
Weber, in his book "Paths to the Present11 writes "the world
no longer belongs to men - it belongs to 'process' to the
'machine' that has taken over. Men are ciphers, their fates
inscribed in advance on the punch cards of a gigantic IBM
machine.
It is 'theprocrustean world' of Aldous Huxley, made
up by scientists - if mankind does not fit, too bad for mankind.
Animal Level:
Conditioning, indoctrination, manupulation etc are the different
words for man's interaction with others at animal level. When
...5.
-5people treat others as animals the efforts are made to change
their behaviour by rewards and punishments.
The animal level
treatment is clearly reflected in the present propogand'a techni
ques applied in advertisements, politics and even in develop
ment programmes.
Human level:
Human level of man’s existence is categorically different than
all the other three levels of his existence.
This is the level
in which man strives for, freedom of feeling, freedom of think
ing and freedom of action.
When people treat others at human
level they give due respect to their feelings, thinking and act
ions.
At this level mans feelings, thinking and actions are
not conditioned by the external forces.
According to Mahatma Gandhi, this is a level at which man gives
a response to his "inner voice."
Acharya Rajneesh describes
it as an awakened stage of man and in Christianity it is a
stage of walking in "light."
Man in the image of God:
In fact a man at all levels of existence thinks, feels and
acts.
But at a sub-human there is a lack of co-ordination
between these three qualities.
Sometimes a man is so much
controlled by his emotions that he does not care about rational
thinking and his actions are governed only by his emotions.
At the level of institutions we find that there is no room
for feelings, they make highly technical plans without any
concern for the sufferings of the people. At the institution-al level sometimes we also find that the programmes of the
institutions are designed in such a way that the staff totally
gets involved in the mechanical activities without feelings
or thinking.
At the human level we experience a co-ordination between feelings
thinking and action.
Mahatma Gandhi's freedom struggle is a good
example of man's existence at a human level.
Even when several
freedom fighters were shot dead, they were not taken over by
their emotions.
Mahatma Gandhi did not allcw people to react,
or to behave at animal level.
They continued their routine
prayers in all situations, their thinking was rational and
their actions were in harmony
with their feelings and thinking.
British could have suppressed India's freedom struggle at all x
sub-human levels, but Gandhi chose to fight for freedom at human
level, and naturally even the citizens of Great Britain supported
the struggle.
Human level of existence is characterised by a harmony between
man’s Reeling, thinking and actions and therefore is an express
ion of beatuy, it is hard to find the explanation of this level
man’s existence in the given universe of facts. It is therefore
attributed to the spiritual jvorld__and is often termed as the
image of God in man.
The wholiestic concept of man:
When we consider man in totality of his existence, we have to
take into consideration all the four levels of man's existence.
This is the wholiestic concept of man.
At the lowest level man is a matter, he is flesh and bones
made up of atoms and molecule.
Access of deficiency of matter
in man can affect his entire personality.
At a mechanical level
man is a machine .... a macnine that pumps blood into all parts
of human body, a machine that keeps body temperature at certain
level, a machine that can calculate or store information, etc.
It is very important that this machine should operate properly.
At an animal level man is a fully organised living unit with
different systems like respiratory system, digestive system,
urinary system, nervous system ecc operating in harmony with
each other.
In addition to all this, man also contain in himself a higher
level existence.
This is a human level.
It is at this level
he distringuishes himself from animals and makes effort to form
his own identity through his own free feelings, thinking and
action.
A CRITICAL ANALYSIS CF ECONOMIC GROWTH MODEL
If ’economic growth model’ cf development was simply a process
of increasing man’s educational standard, economic status, and
technological potentials, then there is no need to subject
this model to critical analysis. No one can deny the importance
of economic growth and technological progress in man’s develop
ment.
But the economic growth model a fall system, it is almost a
religion with its own article of faith;
Here we shall consider
the following two major basic pres-uppositions of the system:
1. Man's all problems can fully be explained in terms of what
a man "has".
If he has less than what he should have i.e.
inadequate water, food, shelter, knowledge, technological
facilities etc then he suffers.
his sufferings by -
Man can be delivered from
- providing "more" to him (a charity approach)
- enabling him to get"more"(a developmental approach)
- awakening him to demand "more" (a. social action approach)
2. The model presupposes that the process of development
should be purely scientific.
All the aspect of the process
should be within the frame work of science i.e. within the
frame work of "cause and effect." Anything beyond it must be
discarded as irrational. However if people still want to ding
to their religions then the religions and its beliefs should
be confined to the four walls of worship centres.
Religions
should be always kept away from socio-eccnomic and political
aspects of human life.
A moral vacuum;
Let us now examine the consequences of these two basic pre
suppositions on our society The first pre-suppositions gives us a criteria of measuring
the status of man, society or a culture.
According to-this,
development of man should be measured in terms of what a man
"has" - his knowledge, education, certificates, institutions,
organisations, police force, judicial system, health care sy
stem, satalites and atom bombs.
lebelled "developed.’’
Those who have more of it are
That is why Wester affluent countries
-2-
are called "developed" nations, and the poor nations, despite
of all their cultural heritage are looked down as "under
developed."
No one seems to question this terminology because
economic growth and technological progress is now universally
accepted parameter of development.
If this is the final criteria of development, then why
should the Western countries, which are so much concerned
about the development of poor nations, worry about the atomic
power stations in India?
If development means only empowering
people or nations then why should they impose sanctions when
India develops technology for launching satalites?
The development model can not even operate in moral vacuum.
Our former Prime Minister Rajiv Gandhi frankly admitted that
not even 15% benefits of the economic development programmes
ever reach to the poor. The present Prime Minister Mr.Narsimharao said "things are even worse."
He infact expressed
willingness to hand over all the developmental activities to
the voluntary agencies.
A cult of science:
In their second presupposition the advocates of the model claim
to be scientific and reject anything beyond the framework of
"cause and effect" as unscientific and irrational.
There are two major consequences of this belief. Firstly it
gave rise to a major cult, a cult of science called "scientism"
and secondly the development process in the model became
mechanical.
Let us first examine this cult of science. The cult is based
on a faith that all that is beyond "cause and effect" frame
work of science should be discarded as irrational. If this is
true then the basic presupposition of science that "the world
is real and that the laws are stamped in the structure of
universe", is a matter of faith and can never be proved, or
explained within the cause and effect framework of science,
should it then be rejected as unscientific and irrational?
-3-
True science operates in all humility.
It begins with a faith
in natural order in the universe and then goes on to discover
that order, or those laws. It also realises that scientific
laws are only statements of probabilities, and they are not
absolutes.
If fact science only deals with probabilities and
not with absolutes.
The arrogant proclamation that all that can not be explained
in the "cause and effect" framework of science should be dis
carded as irrational, did not come from the scientists.
It
came from people who converted science in% God and advised
us' to worship industries and machines.
s</cience called "scientism."
This is a cult of
This cult of science is probably
one of the most unscientific development in our technological
society.
Now most of the planning process of our development programmes
is in the hands of the follwers of scientism.
They formulate
plans on the basis of scientism in which man is treated only
upto the level of animal because in scientism there is no place
for a human level existence of man.
As a result the planning
process becomes mechanical and indoctrination, manipulation,etc
become essential parts of the implementation process.
The planning process in economic growth model appears to be
scientific because they use scientific techniques, and there
are several institutions which are totally involved in deve
loping those scientific techniques. Their contribution is very
valuable, it should never be undermined.
Unfortunately their contribution remains unutilised because
the planning process is based on the basic presupposition of
"scientism" and not of science.
It is the "scientism", and
not science which forces our planners to treat people only at
material, mechanical and animal level.
This planning process
almost neglects human level of existence.
The programmes then
become mechanical and they heavily depend on sub-human level
techniques like conditioning and indoctrination for the achieve4.
ments of their goals and targets.
People refuse sub-human
level treatment, they refuse react to the manipulation tech
niques, and then our planners have to manage their development
programmes without people's participation.
Mechanical approach and the problem of people's participation:
While we deeply involved in seeking people's participation in
our development programme, it is very important to note that
most of our development programmes run with almost none, or/"very
little participation of people. The fact that programmes can
run without people's participation is one of the basic chara
cteristics of the programmes in economic development model.
This characteristic requires a critical examination before we
blame people for their non-participation.
For the purpose
of this critical examination, we shall take an overview of
the primary health care management system, which is a part
of economic growth model.
In- 3
Commuiiiiy Heaiih Ceii
From:
To:
Cc:
Scr«l:
Attach:
Subject:
"Shanker Lar' <s-ial@dfid.gov.uk>
<chc@sochara.org>; <phmovement@touchtelindia.com>
<secretariat@phmovement.org>
Monday. March 22, 2004 5:08 PM
TOR-MP-Heaith.doc; Pro forma for Commercial Proposal doc
Temporary Health Consultant: Madhya Pradesh State Team
DFID India invites your commercial proposal for above assignment in the format attached herewi
Yon can mail your reply latest bv 25'03/2004. The Terms of Reference for the assignment is aiso
attached herewith. Also, kindly send your latest CV for our record purpose.
T *31
Deputy Head
Contracts and Procurement Advice Section - CaPAS
driv inuia, ±>ntxSii niSui v^oiiiniission
B-28, Tara Crescent. Qutab Institutional Area
Hi -
0 016 Zi2.dia
Direct Number: 91-11-5279 3364
Tel: 91-11-2652 9123 extn: 3364
Fax:91-11-2652 9299
E-Mail: S-lal®dfid sov uk
W ebsitei wwvv. dlicL gov. vik.
This e-mail has been scanned for all viruses by Star Internet. The
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3/23/04
terms of reference
Temporary Health Consultant: Madhya Pradesh State team
DFID, INDIA
1.
Background
a)
The Department of International Development is committed to taking forward
its Country Assistance Plan in India. This Involves working with four state
governments as well as the Government of India to enable the priorities
highlighted in DFiD's ‘Better health for poor people’ to be taken forward in
India. DFID India is currently spending approximately £20 million pounds per
year in the health sector. It is working at a strategic level with all four state
governments as the emerging DFID state strategies to support poverty
eradication are developed. At the national level, DFID is expanding its support
io the National Aids Control Programme, the Reproductive and Child Health
programme, and continues to be the largest donor supporting the national
effort to eradicate Polio.
b)
Within the four states, DFID support to better health outcomes is at different
stages of development. However, in ail cases we are seeking to define
broader and more comprehensive programmes of sectoral support, built on the
foundation of a State led and owned strategy for the health sector.
2.
Overall Obisctiv©
s)
Ths Health Consultant will provide technical advice to the DFID Madhya
Pradesh State Team and will be the principal source of health advice. The
main priority will be to take forward the recently approved District Health
Management and Sector Reform Programme, in doing so. the Consultant wiii
work closely with the Programme Manager, and a multi-disciplinary team of
Advisers and prccrarnme sta>>.
b)
The Consultant will also work closely with the State Representative in
contributing to the strategic direction and development of the Health Strategy
in Madhva Pradesh.
3.
oCupc ui wwOiiC
As a member of a multi-disciplinary State team, the Health Consultant wiii fulfil roles
that have been classified as follows:
a)
District Health Management and Sector Reform programme (£17.Gm)
The main and most immediate priority will be to:
o
Provide technical health inputs for this recently approved project.
•
in addition, lead on processes identified in Annex 3 of the project document,
and any other that may arise, in effective and timely delivery of the programme
•
Regularly review progress and maintain a strategic view of impact and
effectiveness of the Health project
«
*
b)
»
*
Work closely with the Project Officer to ensure adherence to DFID's
mandatory project management procedures.
Effectively consult with, and draw on inputs from the Madhya Pradesh
multidisciplinary team.
Health Strategy
With overall strategic guidance of DFIDI's Human Development Adviser, and
close liaison with the State Representative, provide the following support:
With the State Representative, liaise on discussions on health issues with
State government, technical agencies and multilateral partners in Madhya
Pradesh in influencing the development and implementation of the state health
policy (DANiDA led) and strategy (DFID led).
Keep well informed of key health policy and issues in Madhya Pradesh, and
remain adequately informed of concerns of key stakeholders and other
contextual issues through regular field visits.
c)
Contribution io Madhya Pradesh State Programme
•
Provide quality health advice to colleagues within the State team, drawing as
appropriate on knowledge and expertise across DFID, and taking part in the
review of other Madhva Pradesh programmes as required
Contribute to the development of appropriate DFID health and poverty
elimination strategies for the Madhya Pradesh State Assistance Plan
Identify where specialist knowledge can inform issues and facilitate provision
accordingly (including: recruiting consultants, assisting in the drafting of terms
of reference, briefing and de-briefing and monitoring performance)
•
•
4.
Reporting and Administrative Arrangements
a)
The Health Consultant will work for the DFID Madhya Pradesh Stale Team
and be based in Bhopai or Deihi. S/he will report io the Madhya Pradesh
Programme Manager. S/he will be required to work for upto 10 days a month
based on an agreed monthly workplan with the Programme Manager.
Frequent travel to Madhya Pradesh will be required, provisionally constituting
30% of time.
5.
Timing and duration of post:
a)
The appointed candidate will need to be able to start as soon as possible, but
no later than 1st April 2004. The posting will be for 4 months.
6.
Skills and Competencies
The Health Consultant:
a)
wili be expected to act as a source of professional advice to DFID in both India
and UK on issues relating to health, human development and their relationship
to poverty. In particular the Health Consultant will need good strategic skills
and technical Knowledge relating to health systems development and reform,
reproductive health (including safe motherhood) and priority health conditions
which affect the poor. In addition the Health Consultant should understand
ootn macro-level and household influences and determinants upon health
particularly, within the context of decentralisation in Madhya Pradesh.
should ideally have 5 years experience in international health development
work.
understand the broad range of development issues, including the aims and
practices of the UK's and others’ development assistance, and the policy and
institutional environment affecting development outcomes.
should be personally effective, with a strong ability to communicate.
ID India
Pro forma for Commercial Proposal
1.
■; NAME
STAFF INPUTS AND FEE RATES
DESCRIPTION
KU rsf
DAILY FEE
COST
j
DAYS
RATE Rs.
in Rs.
:i
1
I
1
I
L
i
2.. rTGjvCtGva flGi.iiwtjrScstiiG COSiS
Projected reimbursable costs should be shown separately in the format set
out below using separate sheets to provide full details under each heading.
Unit prices should be quoted for such items as air fares (stating the class of
fare envisaged), subsistence, property rents and local transport (where this is
to be provided by the Proposers).
CLASS
NO
COST
RATE
l|
1
Economy
; FARES Domestic
1
1
j Other travel costs (specify)
;!
; Vehicle Reniai for Locai i ravel
I On
Qnh "Fryrol
-UDIOta‘
'
1 SUBSISTENCE person/days
1 2.2
Sub Total
I__
ii ACCOMMODATION person/dsys City 1
!
1 2.3
I1
I
I
•
Cny z (speciry) i
Sub Total
1
S COMMUNICATION
including
telephones
■
1
11
1
■ 11
1
1
9
■1
1
1!
1i
i
i
8
i
i
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i
1_____ 11________ Iin
1
____
1 DOCUMENTATION
AND
REDORTiNG
3 . ,
b including computing expenses
I
§ Any OTHER (Specify)
II
11
!
d
1
;
i
! TOTAL PROJECTED REIMBURSABLE COSTS: (B) Rs.
! TOTAL PROJECTED CONTRACT COST: /Af + (B) Rs.
I------------------------------------------------------------- —---- —_____________ _- ■
i
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!
!
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WATSAN . LOOKING TO THE FUTURE
UNICEF will address the Year 2000 goals through four major strategies—Bisparity
Reduction (including Gender), Decentralization, Sustainability ; and Integration
at Community Level with other Social Inputs.
Activities for Rural Communities will focus on
Sustainable Drinking Water Supply through community management of drinking
CHILD SURVIVAL & DEVELOPMENT
water sources.
Protection of Drinking Water through correct well construction and adequate
drainage around water points: and at household
Environmental Protection and
Management by monitoring degradation of
gtounc water sources and through promotion of watershed management.
Alternate Delivery System for Sanitation by phasing out from direct subsidy
and by encouraging n- vate initiative to construct sanitary facilities.
Hygiene Education
THE
level, through effective
communication and motivation strategies
peoplf. to bring about behavioral changes, through
development of communication strategies
Involvement of Schools and Anganwadis by using them as channels of
communication for creating awarenesss tn the parents and the community.
Working through Panchayat Institutions for awareness generation, community
mobilization and motivation.
Mainstreaming Gender Issues into the programme through greater participation
of women in planning and decision making and through transfer of skills.
WATSAN 2000 GOALS
1996 is UNICEF's 50th year of service to the children
of this world. During this year, UNICEF recommits itself
' to the promises made to the children during the World
Summit held in 1990.
The World Summit for Children identified a set of global
■ goals for radically improving the lives of children, women
and families by the year 2000. India, a signatory to
the Summit Declaration, reaffirmed her commitment to
the cause of children in the country' by laying down a
set of goals to be reached by the year 2000. These
goals form a part of India s National Plan of Action
A COMMITMENT TO THE CHILD.
Gunieaworm surveillance by monitoring the case containment strategy so as to
secure zero guineawarm cases by 1997.
unicef
; The Water and Sanitation goals for India -are
a
Universal access to safe drinking water and improved
access to sanitary means of excreta disposal.
United Nations Children's FundWater & Environmental Sanitation Section
INDIA COUNTRY OFFICE
73 Lodi Estate, Now Delhi-1’0 003
® Eradication of guineaworm disease.
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•
Safe water, personal hygiene^
latrine use and environmental
sanitation lead to healthier life.
Butterfly symbolises joy, beauty
and quest for cleaner surroundings.
Rajiv Gandhi National Drinking Water Mission
Ministry of Rural Areas & Employment, Government of India
SCIENCE CENTRE (GWALIOR)
MADHYA PRADESH
(A voluntary action for science communication)
WRH HTTR
7>T
HTJH H-TT (nnfeiqt)
(’ft wrc pjmnTrpj)
OFFICE
HIG-12, Darpan Colony, Gwalior - 474 011,
Phone : 341027, 341395
SCIENCE
CENTRE
Science Centre Gwalior is a voluntary or
ganization registered under the society registra
tion act of 1860 (M.P. Society registration act 76).
Science Centre is devoted for promotion of scien
tific temper among the people and to popularize
the understanding of science for uplift of common
man.
A JOURNEY FROM BJVJ -1987
Soon after the pioneering and massive
science communication experiment the Bharat
Jan Vigyan jatha of 1987, a will of voluntarism
sensitized and activated during BJVJ -87 as LOG
Gwalior, was keen and eager to join hands with
National science communication and science
popularization activities created by NCST. This
will of voluntarism has created the science centre
Gwalior.
The science centre (Gwalior) M.P. a
voluntary organization devoted to science
popularization and people’s science movement,
started work in 1987 but was formally established
in 1988.
In a short span of seven years science
centre organized a science popularization mA
ment in the most backward areas of Madhya
Pradesh and provided it a meaningful direction.
The science centre has a well knit com
positions consisting of thousands of children,
teachers, activists, scientists and villagers of Mad
hya Pradesh. Science centre has established Bal
Vigyan Parishads in schools and mohallas for
school going children with a view in taking science
to the people including development of scientific
thinking among children, promoting scientific ac
tivities, helping people to free themselves from
blind faiths and traditions and arousing self con
fidence.
The achievement of this organization in
the past have been significant. The various
programmes undertaken, reached lakhs of
peoples directly through the medium of science
rallies, science- songs, science-plays, scienceA seminars and surveys explaining miracles
activities, science-yatras etc.
The science centre has also organized a
large number of training programmes for activists
of other sister organisations in the country and
helped hitherto small or infant organisations in
neighbouring states to come up and grow.
Activities
Bal Vigyan Parishad
Children science Congress
Bal Vigyan Parishad has been set up by
science centre as its activity for children age-group
of 5 to 17 years. Approximately 20,000 children
are working in Bal Vigyan Parishad activities in
M.P. Major Science activity of Bal Vigyan Parishad
is to organise the state children science congress
in M.P. Now nationally they are starting to get
affiliations with NACHISCA clubs of NCSTC Net
work.
j
State & National training workshops have
been arranged for children science congress ac
tivities.
^:ience popularization through folk arts and
NIDAN
origamy
NIDAN has been setup as an activity of
the NCSTC Network and is the National Institute
for demystification and research in anti-scientific
notions. NlDAN’s Central India regional centre is
being operated by Science centre Gwalior.
Science centre has arranged trainings in
the field of origamy, science through folk arts etc.
in various parts of Madhya Pradesh and Uttar
Pradesh.
Training Programmes
Children's science congress
To help children in developing a scientific
temperament and more frequent use of the
“Method of Science", a children science congress
was organized first in 1989 at Gwalior. The basic
idea is to demonstrate on a large scale that it is
possible to turn the learning of science into an
^^yable and creative pursuit (i.e., joy of learn
ing) , that even within the frame work of the existing
system of education itself, it is possible to en
courage children to learn science by doing it. by
making use of their own hands and head and by
treating their environs as a big open and endless
laboratory. Since 1993 it has been adopted by
NCSTC Network to organize on the National level.
Science Communication and
Explaining Miracles
Science centre Gwalior has conducted
training programme in scientific explanation of
miracles for the NGOS, teachers and Nehru Yuva
Kendra Youth Co-ordinators on the invitation of
state Govts, and NGO’s in states of Assart^
Nagaland, Tripura, Delhi, Rajasthan, Bihar, U.FW
Karnataka, A.P., Himachal Pradesh, Gujrat,
Jammu and Kashmir, Manipur, Orrissa, Pondichery, and BJGVJ-92 state organising commit
tees. Special Trainings have been arranged for
500 district youth co-ordinators of NYKS.
Science centre has conducted training for
district literacy committes of Durg, Gwalior,
Khandwa, Shajapur of M.P.
Science writing for News papers/Radio
Science writing training programmes has
been organized by science centre at Gwalior,
Raipur and Bilaspur.
Jan Vigyan Yatra
Science centre has organized chambal
Jan Vigyan Yatra in 1989, covering chambal and
Gwalior division, BundelKhand Jan Vigyan Yatrya
covering Sagar, Tikamgarh, Jhansi, Datia, Shivpuri, Guna etc., Dr. B.R. Amedkar Jan Vigyan
Yatra Covering tribal areas of Madhya Bharat and
Bundelkhand, Delhi Jan Vigyan Yatra on invitation
of NCSTC Delhi, Pani jeevan dani jatha etc. to
^mote the scientific temper among masses.
Seminars and Symposium
Science centre has arranged various
seminars/workshops/symposium on environmen
tal problems of chambal ravines, impacts of
science and technology on Indian Literature,
watershed management in rural areas, manage
ment of tendu patta, problems of science
popularization movements etc.
CHILDREN’S CAMPS
Awards
Science centre Gwalior has arranged
various children camps at Gwalior, Sagar, Tikamgarh for children of Madhya Pradesh and Delhi,
Science centre awards teachers and
children for best efforts in science popularization
in schools every year.
Drinking water survey
Software
Science centre has conducted survey and
published its report on quality of drinking water of
Gwalior, Tikamgarh, Indore and Bhopal. Survey
has conducted by water testing mediul(|
(i)
^i)
developed by DRDE scientists
People science festival
Every year science centre organizes a
science festival activities in various parts of M.P.
among masses to popularize science and technol
ogy. Lakhs of people participated in the activities.
Geet) for NCSTC Network.
Regular kit for demonstrating and explain
ing miracles marketed by NCSTC Network
Delhi.
Clean-up Gwalior schools
A mass campaign has been organized by
science centre to clean Gwalior based school with
the help of Bal Vigyan Parishads. Thousands of
school children and teachers have been par
ticipated in the programme.
Audio cassettes of science songs (Vigyan
Geet) and science folk songs (Vigyan folk
(iii)
(iv)
Slide Shows on chambal ravines and Bhopal
Gas trazedy, video film on Chambal ravines.
Bal Vigyan and Vigyan Literacy kits for
children and neo- litrates
Publications
(i)
Technical Reports on problem of Chambal
ravines (Hindi)
(ii)
Explanation of Miracles (Hindi)
(iii)
Technical Report of National Institute on
Environmental Activities
Mustard and Rapseed (English)
Science centre Gwalior has organize^^
movement
chambal
Ghati
Bachao
in
Bhind/Morena districts, various children and
teachers camps/competitions has been organized
to educate the issues related to environment.
Vigyan Geet and Lokgeet (Hindi)
(v)
Science plays (Hindi)
Toys/Games
Various Scientific games for children.
Health Activities
Recognition
Science centre has organized various
health activities for women and children in
Gwalior, Tikamgarh & Shajapur districts.
Science center’s activities are well ap
preciated by various state Govts, and NGOs na
tionally. It is recognised by NCSTC (DST) Govt, of
India by awarding its top award of science
populatization to the period of 1987-91 to science
centre Gwalior.
Secretary of science centre acted as na
tional convenor for NCSTC- Network 1991-93. He
is also nominated as state convenor to BJGVJ- 92
while Dr. K.K. Tiwari was nominated as state
president to BJVJ-92.
Management
Science Centre is managed and run by
elected Governing Board headed by President.
President -
Dr. K.K. Tiwari Ex V.C.
Jiwaji, University, Gwalior.
Working President -
Prof. Shivkumar Shrivastava
VC. Dr. Harising Gaur
University, Sagar.
Vice President -
Kamal Dixit
Reader
Makhan Lal Chaturvedi
Patrakarita, Vishwavidyala,
Bhopal.
Secretary -
Arun Bhargava
Project coordinator - B.M. Gupta (Delhi)
Co-ordinatorsDr. Uma Shankar Dwivedi
(Gwalior) O*
Smt. Santosh Chaudhary
(Gwalior)
Shri. Ashutosh Mishra
(Balaghat)
Shri Madhu Silakari
(Sagar)
Smt. Kavita Soni
(Raipur)
Printed by: Surya Offset Printers. Gwalior. Phone :341096
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UP-TO-DATE LIST CF MEMBER ORGANISATIONS
APRIL 1993.
1.
Betul
District
SpNOo
Bastar
1.
Jyoti Niwas,
Kothagaon, P.O.Korar,
Via.Kanker, Bastar - 494 670.
2.
Karunalaya Health Centre,
PO Karitagaon, Asna,Via.,
Bastar - 494 221.MP.
3«
Nav Jyoti Dispensary,Potnar,
C/o Pushpa Niwas,
Jagdalpur PO, Bastar - 494 001.
4.
Santwanalaya Dispensary,
PO Konta,
Bastar-MP.
5.
Jai Mata Convent/Carmel Shanti <
Bhavan,
Catholic Ashram,
PO Govindpur, Kanker Via.,
Bastar-MP.
6.
Vimala Hospital,
PO Bijapur, Bastar-MP.
7«
Social Welfare Centre,
C/o Catholic Church,
Jagdalpur, Lalbagh,
B as tar-MP.
8.
Assissi Shanti Bhavan,
PO Narayanpur,
Bastar - 494 661-MP.
49.
Dr.Iswar Ramani,
Manjulapara, Kanker,
Bastar-MP.
10.
Yeshudeva Ashram,
PO Bhiregaon; Bastar-MP.
11.
Nazareth Bhavan,
PO Chindagarh, Bastar-MP.494113
12.
Padhar Hospital,
PO Padhar, P.B.No.20,
Betul-460 001.MP.
13.
Institute For Social Service &
Rural Development,
Mothidhana, Shahpur,
Betul-M.P'.
Name & Address of Orqns.
2,
-2-
3.
4.
• 14.
Bhopal
Bilaspur
UP-
Dr.S.K.Vasishta,
Indian Red Cross Society,
Shivaji Nagar, Bhopal-MP.
15.
Bhopal Eye Hospital,
29,Rajdeo Colony, Berasia Road.
Bhopal - 462 018.
16.
Chandukuri Leprosy Hospital,
PO Baitalpur,
Bilaspur - 495 222-MP.
17.
Christian Hospital,
PO Champa,
Bilaspur-495 671.MP.
18.
Christian Hospital,
PO Mungeli,
Bilaspur - 495 334.MP.
19.
Maria Sahaya Kendra Dispensary,
C/d Susamati Niwas,
Link Road, PO Tarabahar Naka,
Bilaspur - 495 004.MP.
20.
Nav Jyoti Dispensary,
Parsahi, PO Akaltara,
Bilaspur - 495 552-MP.
21.
Weidner Memorial Hospital,
C/o Catholic Ashrarn,
PO Risda, Via.Masturi,
Bilaspur-495 553.MP.
22.
Sneh Swasthya Kendra,
Hasdeo Project,
Korba, Bilaspur-MP.
23.
St.Francis Dispensary,
P.B.no.7, Gandhi Nagar,
Bilaspur - 495 001.
24.
Gramin Vikas Karyakram,
Barchapara, PO Champa,
Bilaspur-MP.
25.
Lakhan Singh,
MP Vigyan Sabha,
27,Kholi, Vikas Nagar,
Bilaspur - 495 001.MP.
26.
Mr. Vi jay Tiwari,
Nehru Nagar,
Behind Jabal & Sons,
Bilaspur—MP.
27.
Gramin Seva Sanstha,
Post Pali, (Khatgoraj)
Bilaspur-MP.
-3-
Bilaspur Contd...
5.
Chhatarpur
6.
6.
7.
8.
Chhindwara
Damoh
Dewas
28.
Fr.A.Thainese, Principal,
St.Joseph's Higher Secondary School, i
PO Jairamnagar,
Bilaspur-495 550-MP.
29.
Samarthan Samaj Seva Sanstha,
Main Road, Lormi,
Hatri Chouk,
Bilaspur-MP.
30.
Christian Hospital,
Po & Dist.Chhatarpur,
471 001.MP.
31.
Gandhi Centenary Memorial Dispensary,
Bunglow No. 16, New Gong PO,
Chhatarpur-rMP.
32.
Sukri Mission Hospital,
PO Junnardeo,
Chhindwara - 480 551.MP.
33.
Opthelmic Services,
Mid-India Christian Mission,
PO & Dist.Damoh - 470 661. MP.
34.
Central India Christian Mission,
Damoh - 470 661,
3 5.
Christian Hospital,
Hatpiplia PO,
Dewas-MP.
36.
Divia Sadan,
PO Sonkach,
Dewas-MP.
37.
Khrist Seva Kendra,
PO Kshipra,
Dewas-MP.
Panigaon Swasthya Seva Kendra,
PO Panigaon,
Dewas - 455 308.MP.
9.
Dhat
39.
Anand Nagar Leprosy Rehabi
litation Project,
Anand Nagar,
Dhar - 454 001.MP.
40.
Christian Hospital,
Dhar - MP.
41.
Catholic Hospital,
PO Dhani,
Dhar - 454
MP.
42.
Maria Niwas Health Programme,
PO Dathigaon, Rajgarh,
Dhar-MP.
10.
Dhar Contd...............
43.
Rajgarh Social Service Centre,
PO Rajgarh,
Dist.Dhar-MP. 454 116.
Durg
44.
Bishop Weidner Hospital,
Aradhana Niwas,
PO Nandini Nagar,
45.
Karuna Hospital,
Nandini Road, Khursipur,
Bhilai, Durg - 490 002.MP.
46.
Pushpa Hospital,
P0 Dalli-Rajha'ra,
Durg - 491 228.MP.
Durg - 490 036.MP.
47.
Mrs.M.E.Patlia,
College of Nursing,
B.S.P.Hospital,Bhilai,
Durg-MP.
i
11.
Gwalior
48.
Dr.S.K.Singh,
19,New Vivekanand Colony,
R.K.Puri, Gwalior-11,MP.
49.
Sambhav Social Service,
19,New Vivekanand Colony,
R.K.Puri, Gwalior-11, MP.
50.
MP REALS,
19,New Vivekanand Colony,
R.K.Puri, Gwalior- 11.MP.
12.
Hoshangabad
51.
13.
Indore
51.
Christian Hospital,
Sanyogitaganj,
Indore-452 001.MP.
52.
St.Francis Dispensary,
Robert Nursing Home,
Near Red Chruch,
Indore-MP.
53.
Red Cross Maternity Hospital,
Mhow, Indore - 453 .441.MP.
54.
Social Welfare Centre,
Nanda Nagar, Road No.12,
Indore - 452 003.MP.
55.
Dr.Arun Mathur,
13/2,Pars! Mohalla,
Indore - MP.
56.
Indore Eye Hospital Society,
MOG Lines, Dhar Road,
Indore - 452 001.
57.
Pushpkunj Hospital,
PO Kasturbagram,
Indore - 452 020.MP.
...
58.
Saraswati Mohata Dispensary,
Bhagirathpura,
Mohta Nagar,Indore-MP.
59.
I.D.S.S.S.,
P.B.No.168,
60.
Mrs.F.Jacob,
15,Chainsingh Ka Bagh,
Indore-MP.
(New PalasiaJ
61.
Dr.Savita Inamdar,
22/10,Yeshwant Niwas Road,
Indore - 452 003.MP.
62.
Snehalaya,
P.B.No.19, Kasturbagram,
Indore - 452 020.MP.
63.
Mr.Carlton,
Choithram Hospital,
Bishop's House,
Indore - 452 001.
Manik Bagh Road,
Indore-MP.
64.
Shradha Samudayik Vikas Yojana,
47,Vandana Nagar,
Indore-MP.
65.
Dr.D.P.Shinde,
C/H-30, Junior HIG,
Shukliya,
Pt.Deen Dayal Upadhayay Naggp,
Indore-MP.
66.
St.Mary's Dispensary,
Mhow, Indore.MP.
67.
Dr.B.M.Shrivastav,
24-E,Nawlakha Complex,
Navlakha, Indore-MP.
68.
Dr.Vijay Natu,
8/A/4, South Tukcganj,
Ganga Janina Apartments,
Indore- MP.
69.
Pushpkunj FHP,
PO Kasturbagram,
Indore - 452 020-MP.
70.
Sat Prakashan Sanchar Kendra,
Bhavarkuwan,
Indore - MP.
71.
Mr.David G.Singh,
Christian Hospital,
Banycgitaganj,
Indore - MP.
....6.
-6-
72.
Bharatiya Gramin Mahila Sangh,
313,Jawahar Marg,
Indore - 452 002.
73.
Cancer Care Trust & Res.Ftin.,
3/1,Race Cource Road,
Indore - 452 003.
Asha Niketan,
52-B,Vandana Nagar,
Indore-MP.
74.
14.
Jabalpur
PL.„ „
frc5
15.
'v'C<iv
Jhabua
'
75.
Christa Panthi Ashram Hospital,
PC Darsani, Via.Sihore,
Jabalpur-MP.
76.
Mahila Jagran Samiti,
E.Ghamapur,
Jabalpur - 482 001.MP.
77 o
Tarun Sanskar,
1784,Ranjhi, Jabalpur-MP.
78.
Nav Rachna Samaj Sevi Sanstha,
Mohla, PO Dhangaon,
Tah.Sihcre, Jabalpur-MP.
79.
Pushpa Kalyan Kendra,
Dungripada, PO Thandla,
Jhabua - 457 777 MP.
80.
St.Theresa's Hospital,
Panchkuhi, PO Meghnagar,
Jhabua-MP.
81 •
St.Joseph's Dispensary,
Unnai, PO Kodli,
Via.Petlawad, Jhabua - 457 773.
82.
Christian Hospital,
jobat, Jhabua-MP.
83.
Holy Family Dispensary,
C/o Catholic Church,
Jhabua - 457 661-MP.
84.
Hission Hospital,
PO Thandla, Jhabua - 457 777.
85.
St.Michael's Health Centre,
Japadara, C/o Mission Hospital,
Thandla, Jhabua-MP.
86.
Jeevan Jyoti Hospital,
Meghnagar, Jhabua - 457 779-MP.
87.
Ish Nilaya,Antonpura,
C/o Catholic Chruch, Jhabua-MP.
88.
pr,Joseph Thayil,
Jeevan Jyoti Hospital,
Meghnagar, Jhabua-MP.
.... 7.
16.
Handla
89.
90.
Little Flower Dispensary,
Buhwa Bichiya, PO Kurela,
Mandla-481 995-MP.
Jeeva Dharo-Health Centre,
1'0 Duhanbi,
Shahpura,
Mandla-MP.
17.Morena
18. Nimar - East
Bl.
Katra Hospital,
PO Katra, Mandla - 481 661.MP.
92.
Nirmala Dispensary &
Maternity Home,
C/o Nirmala Convent,
Lalipur, Mandla-MP.
93.
St.Norbert's Dispensary,
PO Junwani, Samnapur Via.,
Mandla-MP. 481 880.
94.
St.Gertrude’s Dispensary,
PO Dullopur, Mandla-481 880.MP.
95.
Assisi Sachidanand Dispensary,
PO Chabi, Mandla-481 672.MP.
96.
Dr.A.D„Haque,
Grace Health Education &
Technical Development Societ
Near New Masjeed,
Kostha Mohalla,
Mandla-MP. 481 661.
97.
Manav Vikas Samiti,
Ganeshpura,
Morena - 476 001.MP.
98.
St.Mary's Convent Dispensary,
PO Khandwa, East Nimar - MP.
99.
Vandna Bhavan Health Centre,
Bhagwanpura, Khar kala,
Khandwa - MP.
100.
St,Luke's Dispensary,
Pavitra Atma Ashram,
PO Aulia, Pandhana,
East Nimar - MP.
101.
Ashirvad Health Centre,
PO Dhulkhot, Via.Burhanpur,
Khandwa - 450 333.
102.
St.Joseph's Dispensary,
PO Deolikala, Khar Via.,
Khandwa - 450 331.
Sr.Khati Hauzer,
Mahila Vidhya Sram Vihar,
Catholic Church Compound,
Khandwa - 450 001.
103.
.. .8.
'
-8-
Khandwa Contd...
19. Nimar West
20. Neemuch
21o
Rajnandagaon
104.
Jeeva Dhara Health Centre,
Chanera, PO Dongergaon,
Khandwa - MP.
105.
Shanti Niketan Health Centre,
Karpur PO, Jaswali,
Khandwa-MP.
106.
Nav Jycti Sadan Dispensary,Dongalia
C/o St.Joseph’s Convent,
PO Deoli-kala, Via.Khar Kala,
Khandwa -MP.
107.
St.Mary's Health Centre,
Near Dalik, Aurangapura,
PO D Dist.Khargon - MP.
108.
Ehristian Hospital,
Mandlwashwar,
West Nimar-MP.
109.
Karuna Hospital,
PO Sendhwa, West Nimar-MP.
110.
Pushpa Niwas Health Centre,
Pandarnia, PO Warla,
Sendhwa, West Nimar-MP.
111.
Maria Bhavan Health Centre,
PO Barwani,
West Nimar -MP.
112.
Maria Bhawan,
PO Bhikangaon, West Nimar-MP.
113.
Dr.Manish Joshi,
Usha Clinic, Phawara Chouk,
Neemuch - 458 441.MP.
114.
Christian Fellowship Hospital,
Diwan Para,
Rajanandagaon-491 441.MP.
115.
Nav Jivan Dispensary,
Kaurinbhatta,
Rajanandagacn-MP.
116.
St.Xavior Dispensary,
sarangarh, Raigarh-MP.
117.
Holy Cross Dispensary,
PO Gholeng, Raigarh-496 338.
118.
Holy Cross Hospital,
PO Kunkuri, Raigarh-MP.
119.
Morning Star Hospital,
Beladula, Raigarh-MP.
120.
St.Mary's Dispensary,
PO Duldula, aashpur,
Raigarh - 496 334.MP
S-T-
22.
Raigarh
..... 9
-9Raigarh Contd..........
23.
Raipur
' 121.
Devia vandana Dispensary,
PO Jokhbahala, Raigarh-MP.
122.
Holy Family Dispensary,
PO Musgutri, Kansabel,
Raigarh-MP.
123.
St.Anne’s Dispensary,
PO Pathalgacn,
Raigarh-MP.
124.
St.Anne’s Health Centre,
Porthenga, Via.Jaspur,
Raigarh-MP.
125.
RAHA, C/o Bishop's House,
Kunkuri PO, Raigarh-MP.
126.
St.A.nne’s Health Centre,
PO Saraitoli, Raigarh-MP.
127.
St.Anne's Health Centre,)
Ambakcna, PO Asta,
Raigarh-MP.
128.
St.Anne's Health Centre,
PO Ghaghra, Via. Jashpur,
Raigarh-MP.
129.
St./lnn's Health Centre, PO Lureg
Raigarh-MP.
130-
St.Anne's Health Centre,
PO Birsinga, Raigarh-MP.
131.
St.Anne's Health Centre,
PO Gharghoda,
Raigarh-MP.
132.
Lahar Samaj Seva Sanstha,
PO Madanpur, Via.Kharsia,
Raigarh-MP.
133.
Christ Sahaya Kendra Dispensary,
PO Kapa, (Asha Niketan
Raipur - 492 005.MP.
134.
Shantipur Leprosy Hospital,
PO Dhamtari, P.B.No. 64,
Raipur-MP.
135.
St.Joseph's Dispensary,
Catholic Church,
PO Bagbahara, Raipur-MP.
...10.
-10-
Raipur contd....
24.
25.
26.
Raisan
Ratlam
Rewa
13 6.
Evangelical Mission Hospital,
PO Tilda-Neora,
Raipur-MP.
137.
Mukti Prakash Ashram,
Banjari, PO Bhatagaon,
Raipur-MP. 493 559.
138.
Our Lady of Providence Hospital,
PO Basna, Raipur - 493 554.
139.
Praycg,
PO Tilda-Neora, Raipur-493 773.
140.
Chhatisgarh Mahila Jagrti Sangatan,
A-38,Shankar Nagar,
Housing Board Colony,
Raipur-MP.
141.
Asha Bhavan Health Centre,
Samerikalan, Sultanpur, '
Raisen - 464 986.MP.
142.
Pushpa Dispensary,
Pushpa Complex, PO Silwani,
Raisen - 464 986.MP.
143.
Sneha Bhavan Hospital,
Begumganj, Raisen-MP.’
144.
Christian Hospital,
Ratlam - 457 001.MP.
145.
New Life Centre,
P.B.No.206, Alkapuri,
Ratlam-MP.
146.
St.Thersa's Hospital,
Dewra, PO Bhamara,
Rewa-486 445.MP.
147.
Dr.K.N.Pandey,
C/o Dr.L.D.Jat, Nehru Colony,
Gurh Road, Rewa-MP.
27.
Sagar
148.
Sweedish Mission Hospital,
PO Khurai, Sagar - 470 117.MP.
28.
Sehore^
149.
Pushpa Kalyan Kendra,
PO Ashra, Sehore - 4-66 116.
150.
Preeti Kunj Swasthya Kendra,
PO & Dist.Sehore - 466 001.MP.
Nirmal Mata Clinic, Kailaspur,
PO Pindra, Satna-MP.485 331.
29.
Satna
151.
152.
Sr.Lucy,
S.H.Convent, Pateri,
Mahadeva PO, Jawaharnagar Via.,
Satna-485 002.MP.
11
-11-
Satna Contd. ...
153o
Alphonsa Dispensary,
PO Jhand, Kund,
Satna-MP.
Seoni
154.
Lakhnadon Christian Hospital,
PO Lakhnadon, Seoni- 480 886.
155.
Chapara Christian Health Centre,
PO Chhapara, Seoni - 480 884.MP.
156.
Christian Hospital,
burhar Road, Shahdol - 484 001.
157.
Mr.S.B.Namra,
Ankur Farm, Jamudi,
Anuppur, Shahdol-MP.
158.
Giri Jyogi Clinic,
PO Gijwar, Madwas,
Sidhi- 486 669.MP.
159.
Karima Dispens ary,
PO Odagady, Waidhan,
Sidhi - 486 886-MP.
160.
Christ Niwas Dispensary,
PO Singrauli Colliery,
Sidhi - 486 661.MP.
161.
Uday Diespnsary,
Udayagiri, Karimatti,
PO Chauoh’al, Sidhi - 486 661.
162.
Holy Cross Hospital,.
PO Ambikapur, Surguja-MP.
163.
Ursuline Charitable Dispensary,
Bankheta, PO Pratappur,
Surguja- 497 223.
164.
Nitya S^hayak Mata Health Centre
PO Wadraf Nagar,
Surguja- 497 225.MP.
165.
St.Joseph's Health Centre,
PO Baikantpur,
Surguja-MP. 497 335.
166.
Catholic Ashram, Ambikapur,
PO Phunduldihari,
Surguja- 497 001.MP.
167.
Ursuline Health Centre,
Kodaura, PO Danwra,
Balrampur, Surguja- 497 119.
$68.
•St.Joseph's Dispensary,
PO Balrampur,
Surguja - 497 073.
30.
31.
32.
33.
Shahdol
Sighi
Surguj a
,
*
12
-12-
169.
Suryapara Christian Hostel,
Mission Compound,
Surguja-497 111.MP.
170.
Nirmala Health Centre,
Jhingo PO, Raj pur,
Surguja - 497 118.MP.
171.
Carmel Health Centre,
Puranpani,Dumberkholi PO,
Samari, Surguja-497 222.MP.
172.
Santoshi Health Centre, Patora
PO Patora, Surguja-MP.
173.
Prabhat Tara Dispensary,
PO Bhargwan,
Surguja - 497 001.MP.
174.
St.Ursuline Swasthya Kendra,
Jagannathpur, (Mahadevpara),
PO Dharampur, Surguja-497 223.
34. Ujjain
175.
Pushpa Hospital,
Dewas Road,
Ujjain - 456 000. MP.
35.
176.
Catholi Mission,Garratola,
PO Manegaon, Baihar,
Balaghat-481 111.
177.
Good Shepherd Sisters,
C/o Catholic Church,
Sindhi Sadan Path,
Ward No.13,
Balaghat - 481 001.
Surguja Contd.......
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[nartnada] FW: appeal lo prevent.
Subject: jnarmatlaj FW: appeal to prevent the enactment of the "MP. Special Areas Sec urity Bill"
Date: Wed, 17 Jan 2001 12:01:04 -f 0530
From: Nilanjana Biswas <nilanjanab@synectics.soft.net>
To: alforum@mahiti.org, atvhrci@vsnl.com, narmada@egroups.com. das@iiap.emet.in
Dear friends,
Forwarding this mail from Madhya Pradesh Jana Sangathana.
Please respond as organisations/individuais asap.
With regards,
Nilanjana Biswas
10 January, 2001
Dear Friends,
The Madhya Pradesh Jan Sangathans (peoples' organisations) have sent an appeal to prevent the
enactment of the "MP. Special Areas Security Bill", which will adversely affect any group raising
their voice against human rights violations.
Please respond urgently.
Seema Misra
Targeting peoples' organisation in th® name of Naxalism
Dear Friends,
On 27th November 2000, the Madhya Pradesh Legislative Assembly without any significant debate
and discussion passed the "M. P. Special Areas Security Bill 2000”. It is now awaiting the
President's assent. This went largely unnoticed by the public. It was publicised as a law to curb
illegal activities of certain people’s organisations and naxalites.
The main features of the Bill are:
1.
Any organisation or group of the people can be banned if their activities are declared illegal.
2.
Organisations and groups ranging from an informal group of people to trade unions can be
banned. Organisations need not be registered to come under the purview of this proposed
law.
3.
The lists of activities defined as illegal are very general, for example, activities that disturb
the' law and order or peace or have the tendency to create obstacles in the maintenance of
public order, etc.
4.
The government is not bound to divulge the reasons for the ban.
5.
It does not give any opportunity to the organisations/groups to represent their case before the
declaration of ban.
6.
This law when enacted would not only be applicable to the members of the
organisations/groups who are banned but also to persons who support such
organisations/groups in any form.
7.
Members of banned organisations and their supporters are liable to imprisonment for a term
up to 3 years and fine.
8.
There is a provision for forfeiture all the movable and immovable properties and assets of the
banned organisations/groups.
9.
Unlimited powers have been granted to the District Collectors and the Superintendents of the
Police.
10.
An appeal against the ban must be filed within the fifteen days of the declaration of ban to the
Advisory Board.
11.
Besides the above appeal no suits, petitions, revisions or injunctions are allowed in any court
against any order of the Government under this Bill. A person can go io the High Court and
Supreme Court under Articles 226 and 32 (respectively) of the Constitution.
This law when enacted would have wide reaching powers and is intended to suppress all kind of
peoples' resistance and movements in M. P. This is clear from the object and reasons for the Bill
which states that danger from illegal activities of some peoples’ (janta) and naxalite organisation
necessitates this. But it would be used against those who are working to protect the basic human
rights of common people.
Out of the six activities that have been defined as ill- legal activities only one can be said to relate
to naxalite activities. That is using violent and terrorist means to create fear in the minds of the
public or using arms and explosives. The other activities that are defined as illegal are very general
and unclear and can be used against any peoples' organisation, such as disturbing the public
order; disturbing the peace; hindering or obstructing the working of the rule of law, it's institutions
and functionaries or has a tendency to do so., etc. These are not extremist acts and any
organisation trying to highlight peoples' problems using non-violent or democratic means would fail
under the purview of this proposed law.
Such repressive laws are going to be enacted in all the states very soon in the wake of
globalisation, liberalisation and privatisation. Andhra Pradesh already has such a law in existence.
The objects and reasons for the Bill states that AP has also prohibited the illegal activities of
peoples and naxalite organisation in its efforts .to curb naxalites.
For the peoples' organisations, groups, trades unions, peoples’ fronts in M. P. and other states,
this proposed Act is a warning. This is time to wake up and be ready! All of us must come together
io fight against such anti-people Bill!
Please write protest letters to the following persons to prevent the enactment of this Bill. : -
1.
The President of India, Rashtrapati Bhawan, New Delhi.
1/24/01 5:26 PM
[nannada] F\V; appeal to prevent the ena... the "MP. Special Areas Sec urity Bill''
Fax No: 011-301 7290 / 7824/7077
2.
The Governor, Madhya Pradesh, Rajyapal Bhawan, Bhopal, Madhya Pradesh
Fax No. 0755-363 3272
The Chairman, National Human Rights Commission, Sardar Patel Bhawan, Parliament
Street, New Delhi -110001. Fax No: 011-334 0016
4.
The Chief Minister, Madhya Pradesh, Shyamal Rills, Bhopal, Madhya Pradesh
3.
Fax No. 0755-540501. Email: cm@valibh.rnp.nic.in
5.
The President, Ali India Congress Committee, (Congress I), 20 Janapath, New Delhi-110001.
Fax No. 011-301 8651
On behalf of
Madhya Pradesh Jana Sangathan
Kisan Adivasi Sangathan, Hoshangabad
Shramik Adivasi Sangathan, Betul
Narmada Bachao Andolan, Bedwani
Ekta Parishad. Bhopal
Khedyut Mazdoor Chatna Sangathan, Jhabua
Adivasi Mukti Sangathan, Bedwani
Bargi Bandh Visthapit Avam Prabhavit Sangh, Jabalpur
Bhopal Gas Pidit Mahila Udyog Sangathan. Bhopal
Yogesh Deewan, Hoshangabad
Note: Please send a copy of the protest letters at the following address:
Raghvendra / Sharnim
Shramik Adivasi Sangathan, Shahpur:
[najtnada] FW: appeal to prevent the cm., the "MP. Special .Areas Sec urity Bill"
A copy of the Bill in Hindi is available with the Shramik Adivasi Sangathan or at the South Asia Human Rights
Defenders' Consultant office: G-13 Hauz Khas, New Delhi-110016.
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Subject: jaarmada: AC HON ALERT: Dewas Killings
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