Harriet Sathyavathi : To Analyze the exisisting Helth Systems in the Community
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- Title
- Harriet Sathyavathi : To Analyze the exisisting Helth Systems in the Community
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Report
On
THE
Fellowship
Programme
In
Community health
cell
Harriet Sathyavathi
2006
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ACKNOWLEDGEMENT
I thank the community health cell for giving me the opportunity to be apart of the
Fellowship scheme.
I sincerely acknowledge the support of DR Thelma and Ravi for there support and
inspiration to work in the field of community health.
No amount of words can couch the gratitude to the CHC team for their
Constant support and guidance.
I would like to thank the NGOS in helping me to conduct the training
programme
And for their support
I would be failing in my duty if I forget to express my gratitude to my friend
And my fellow friends for there support
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Contents
1) introduction
2) orientation report
3) learning objectives
4) description of the pulicat lake
5) report on palaverkkadu
6) report on the training programme
7) health system in palaverkkaadu
8) conclusion
9) experiences of kargilnagar
10) experiences of kanaginagar
11) experiences of srinivasapuram
12) conclusion
Introduction
Life’s experiences have had implications in my life to choose a career in social work and
purpose to work for the vulnerable. Coming from a warm, conducive family, which was
also a source of inspirations for a social growth in self. There were small triggers that
made me to think to work for the vulnerable in the society, but it was a path undefined to
me. in acquiring degree in BA (industrial relations), I acquired the skill to face a
competitive world that was growing rapidly and challenge, but amidst these, the trigger
led me also to work for the poorest in a small way of gesture visiting them in slums
hospitals, homes etc .
This experiences were I stated drawing my focus to work in the field of social work.
There was a strong inclination that grew, in me to work for the vulnerable. With many
confrontations within self, reflections and opinion from different people, I choose to
acquire my MSW to precede the path to unknown realities.
FOUNDATION
During my two years in MSW, was a Revelation to a lot of issues, and knowing the
extent of severity of the problems in the society. The experience gained during the 2 years
was that of learning and exploring. I was never specific to the kind of work, I always
wanted to work for all section of the people, thus this helped me to specialize in
community development, learning the whole development scenario of the community,
and the power the community had. It was a holistic learning, giving a broader view of the
entire structure of the community. At the End of 2 years I had my path defined. After the
completion during my break of 3 month, I was looking for opportunities ,during this time
is when I heard about community health cell through a friend of mine ,health was a
very generalized topic for me, for me working for people in the community health was
one main aspect I need to learn. my enthusiasm to learn more in this field led me to be a
part of the fellowship programme that was organized by community health cell. The
orientation programme gave me an aril view of the health status and issues of concerning
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the health in the development process. Helping me to shift my focus and need for a career
launch in health.
Orientation programme
Fellowship programme duration: six months
No of sessions: 15
Topic covered:
Concepts on public health
Issues related in health as a human right
Cartelism
Implications of policies on health
Nutrition
Topics on social issues
Women’s health
Issues in patents to drugs
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•
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lecture
group discussion
interactive sessions
case presentations
presentations by fellows
Methodology:
Enchaining sessions
During the Fellowship Training, it was a starting point to my explorining area in the
field of health, specific to public health. Human population has always, lived with disease
and sickness. Though society evolved its own ways of dealing with this reality for
centuries, .the development and growth of modern medicine gave society to intervene in
the disease process but access in still a question.
There were a lot of questions in my mind and not able to understand the, link to the entire
process of policies, poverty, access ,buget, drugs, and other socials issues.
Why don’t people in rural areas have the access to health services?
If exploitations are the cause of poverty, why do we let it continue?
How do modern medicine justify in equality among people in the society?
if we improve primary health care can we improve health of the
people/health for all ?
Who do the health sectors involve?
Imprecations of the other issues in improvising health
The topics covered durning the orientation was a mile stone for a search for
understanding of the issues of centre to community heath .the sessions that were taken
were data based and literatures from different project,programmes,policy
implementations that were studied.
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Some of the concepts were clarified for better understanding, debates add to the interests
in knowing the issues.
The experiences that was shared by every fellow from there past experiences were also
help ful for butter understanding. Difficulties and conflicts were also the process of
learning. Perspectives from alma Ata to models, rights perspective, from social change
transformations and collective vision was an adventures learning.
Reflection:
The various topics that were organized gave clarity to my thought in reality situation,
Misconceptions clarified, and present scenario of the statues of health in the
developmental process, my understanding during the orientation was more in terms of
reflection and looking towards working for the worsening conditions of health in many
parts of the world. The various topics covered moved from getting social approach to
public health to the right based issues of the public health, Interlink the analysis one needs
to do on policy level. Overwhelmingly and, reaffirming the continuing importance of
health for all. The orientation also rose awareness’ on policies, policy process issue
enabling them in ,addressing health equity issues, and helping to advocate for it
revitalization. The orientation also gave a space on the right to health in the context of
gender. An experience of in cooperation key issues such as the struggle against trade
agreements and the funding organization input on the
commission or the social
determinants of health, health movement and impact of globalization on health.
The orientation was an intercultural group giving an opportunity to be a part of the
diverse culture where each one had gained a lot of experience in the struggle .the
programme also helped to build up contacts,confrount ideas, raising issues, clarifying
and above all learning different strategies. I underestimated the problem and responded
very less to this issue of health, now knowing the aspects and struggle for comprehensive
primary health care and sustainability; I will indeed work in my own way in helping the
health systems.
My colleagues who were with me in the orientation programme were voices working
towards the deliberation for health for all, here is were I learnt that a uniform approach is
need to work for a issue. I realized being passive will leads us no were but a determined
work needs to be done, with the community tapping community resource collectively
working towards the health for all. a need for a ground level action focusing for along
term involment of people and out going efforts in monitoring the health setup in the
community and helping to rehabilitating the health systems. The orientation was a source
of pumping knowledge and constantly equipping me.
Originations visited
Vimochana
Hss
Nimhans
Tvs project
Women’s voice
Suggestions
Need to include topics on environment health
Need to have more time to discuss issues
Need to have more time to visit Ngos
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Need to include health law
LEARING OBJECTIVES
1} To analyze the existing health systems in the community and the changes
required.
2} To understand the various issues concerning women and health problem.
3} To study the existing government programmers in relation to women’s health
and
its implementation in the community.
4} To study the knowledge and perspective about, health systems function for
women
In the community.
5} To understand the impact of disaster in women’s health.
Experiences of palaverkkadu
A DISCRUIPATION OF THE PULICAT LAKE THE RICH RESOURSE OF
THE STATE
08-Mar-2005, The Times Of India,
Hyderabad.
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The second largest backwater lake in India - Pulicat - has become almost dry.
Tsunami and other abrupt climate changes led to the sand bar's growth at the mouth of
Plicate Lake. These changes have also prevented water from Bay of Bengal entering the
lake. This has had a telling effect on aqua fauna and forced migratory birds to leave the
picturesque lake.
As there is not much water left
into the lake, the migratory birds like shovellers, pintails common teals, curlews, plovers,
godwits, shanks, bareheaded geese are taking shelter
in less known wetlands like nearby Kudiricheruvu. Even smaller birds like waders have
also shifted to Kudiricheruvu.
The study revealed that pollution due to pesticide residues, sewage, and agricultural
chemicals and industrial effluents has become a major threat to Pulicat Lake. Arani and
Kalangi rivers, which drain into the lake, are bringing the fertilizers and pesticides with
runoff from the agricultural fields. The rapid industrialization and the consequent
problems of environmental degradation and loss of employment to thousands of local
inhabitants of the Pulicat lake require the intervention of the ecologists, environmentalists
and educators for evolving a sustainable community based environmental resource
management strategy. The environmentally sensitive and ecologically delicate region is
threatened with the impending danger of losing its wetland forests, rare species of flora,
fauna. The livelihood of the local community of fishermen, local tribal and agricultural
workers are in danger due to massive unemployment, object poverty and the Ultimate
displacement from their place of residence.
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The harmful effluent disposal by the industries at the mouth of the Ennore Creek,
emission of
fly ash from the thermal power station located in the Ennore region, release of polluting
cooling water into the Buckingham Canal and dredging operations undertook by the
Ennore Port, are the major developmental threats causing incalculable damage
to the Pulicat Lake's environment. Added to this man made disasters, the natural disaster
in the form of Tsunami stuck the shore adjoining to the Pulical lake on 26th December
2004 causing damage and destruction.
Landless agricultural workers and unemployed fishermen are the victims of the mega
projects implemented and they are in search of alternate earnings. Under such
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circumstances, it is feared that the members of the local community may be forced to
turn towards resource extractive and anti-social activities such as illegal sand mining,
illicit brewing and indiscriminate exploitation of coastal and environmental resources,
to surmount the problem of poverty and to survive.
PALAVREKAD
The community is located around 30km from the Chennai city, Pulicat lake is
environmentally, ecologically and socially important It is the second largest
stretch of brackish water in India.1/3 lies in Tamilnadu and rest in Andhra
Pradesh ( 14 kuppams earn livelihood by fishing in the lake ) so both share
rights in the lake. Majority depend on lake fishing and rest on marine fishing.
Issue of fishing rights is very historically significant. The train was the best
transport to reach the place .during the journeys to the palverkkadu interesting
incidences stories, latest up dates such things picked through conversations;
much more to this lot of learning’s took place.
It is one of the best communities, which one can learn the community dynamic
Politics, potential resources life of fishing community, unity ………much
more.
As I entered the community I was in a puzzle what to do, it was like a desert
Unknown to me, almost a month I spent in visiting the community, the
various
Hamlet and rapport building with the community and the NGO staffs in
getting to
Know the community. During the few visits to the community lot of things, I
Had observed a few that were explicit about the community.
The corporation of the community
The social responsibility that the community carries
The wide-ranging of dynamic occupation of the fishing community
The solidarity and social justice of the community
The human resource of the community
Unified equality
Secularism
Dynamics of the community
Extinguished culture difference
Life style
Diverse groups
The time was insufficient to study the community ,as I had come with my objectives I
started to look in what way I could contribute as well learn from the community .one of
my learning objectives was to study the health problems related to women very
specifically in relation to the community. I decided to organize training programme for
the women in the community.
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The training programme was a participatory. I had decided to conduct the training for the
women on the strip of island , as there were more vulnerable to the health conditions, and
access was a difficulty for that community. Initially I went to visited the community and
organized the community meeting with the women SHGS in the hamlets to get their
opinion in conducting the meeting it was their request that hey felt the need for the
training programme on health also they suggested that it would be nice if the whole
community could be benefited.
The next step was to contact the NGOS working there. I met a few ngos who were
working in that strip of island and discussed about the feasibility of the programme.the
NGOS also felt the need for the training for the community some straggles was discussed
how to go about the programme the NGOS gave full support in organizing the training
programme.
Stergiers for the training programme.
The concentration was more to the people living in the island .the island consists of 13
villages .after looking at the health system their, training program was planned for women
in collaboration with the Ngo’S Worked with the women in palawekadu,to study their
health status.
As the community was big and it was difficult to organize the community training in all
the hamlets so I decided to organize the training by getting representatives from the each
community for the training .since there were 13 villages they were divided to 3 groups.
6- Hamlets in first group
5- Hamlets in second group
2-Hamlets in third group
The group was divided according to the distances of the community for accessing the
place of the training .the group constituted around 30 members ie 5 from each village
along with 2 representatives from the ngo.The training had followed some criteria for the
members participating –
Only for women
Above the age of 20ys
Married women only
Women who are literate
Women belonging to the community
Women who have good rapport with the community
Women who have an inclination to know about health
Women who can contribute the learning ti the community
Training programme
Title –coping with health
Goal- to create health awareness by addressing community health, public health and
development problems related to women.
Objectives-
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to identify health problems related to women .their family, and the community
to conduct training programmes with a focus on prevention at their level
to help them develop their social skill
Session 1 - Brain stormining session
TITLE –streaming heath
About the training session
The need for the training
Introducing self and group
Deciding on the strategies for the training
Evolving the topic of interest
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Methodology
Interactive sessions
Group discussion
This session was an interactive sessions, keeping in mind the group and their interests the
session took place in the community surrounding, There was a maximum participation of
30 members from different villages escorting with their field staffs. Two representatives
from each ngo were present .the session started with an intro of all the members followed
by a discussion of the training programme. There was a brain stromining of the topics
linking to the daily problems faced by them special focus to the health of women. The
topic were eaqaqaqz3discussed by discussions of personal encounters faced by every
individual. Interesting facts were reviled about their health problems, such as lack of
services, accessibility, and incidences from the villages ,much more all the members
interacted and participated .The discussion long-drawn-out for an hour and the next
meeting was also fixed it was an understanding that every, Tuesday the meeting will be
held, in the community. which will be organized by the women and will gather at
2pm,.keepining the flex ability of the members the timing was fixed the session ended
with a lot of response of and participation of the group a head to make the training
thriving
Session -2
Topic-determinants of health
The training was organized in the community the representatives from different villages
were present. Health being a very immense topic, as time was a factor. I restricted to
giving a brief description of the concept. The training started with a game to get the group
to action for the session.
The game was to let the group to stand on a scale that will express there state of health
,for the day and the scale ranged from healthy to sick and the members standing on the
scale will state the reason for being healthy or sick. Various reasons were said i.e. healthy
,tired ,sick, ……….due to reasons like work stress, lack of money, no medication,
happy,…………….many more. We spoke about the complex interaction in the
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community between the factors like food, water, sanitation, employment economic and
social factors that has much to do with health.
After the excise the discussion proceeded explain the determinants of health, we spoke
about the inter relation of the socio economic, implications to health. How every indicator
to the survival has the implication in changing the health scene, its not only the possibility
or the solution to reduce the incidences life losses due to health reasons apart from
revitalizing the quality of health care, we also look into the individuals responsibility to
his/her health
status.
Session-3
Topic-demystification of anatomy
MethodologyDiagrammatic representation
Interactive Group discussions
This session was to introduce the basic knowledge of the body and its functioning, this
was to help the women to know about the self before giving them the knowledge of
diseases and illness as they should be able to link the causes of illness in relation to body
and health.
This session was handled by arun who is also a fellow of CHC, who had come to visit the
community. The session was very interactive the parts of the body and its functioning was
covered it was a new experience for the women and they enjoyed the session lot of
clarifications that they had was discussed the women found the session very interesting
and helpful. The women were ignorant about this topic but session helped the women
understanding the other sessions.
Session -4-6
Topic –basic illness
The topic covered under this session was many this was organized by discussions, every
member shared about the illness that is prevailing in the community lot of examples were
shared. The session covered topics like:
Basis ailment
infections
Dhiarror management
Anemia
Child care
Water sanitation and health
Traditional and healing practices
The group with there interaction spoke about prevention of the above diseases and how
the community could partake in prevention of the above diseases.
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Session -7-10
Topic-women’s health
This was the most interesting sessions the women in the start of the session were very
introvert as the issues were personal to them but the women spoke trough examples which
was intesting topics that were covered were
Nutrition and women’s health
Reproductive health
Contraception’s
Reproductive track infection
Hiv/Aids
Reaching out –community health
Key observations
The group was cohesive, during the process of the training programme I found that the
women were able to converse what they actually wanted to know. The group enjoyed the
training.
During the sessions, one issue that was of constant concern to the group was alcoholism
The women know better prevention methods, which were not followed.
HEALTH SYSTEM IN PALAVERKKADU
With a rapid advament made in technology .and at the pace at which things are taking
place in the medical field, hear is a field with a population so extensive, there is only one
general hospital, a PHC catering to the whole community. The situation is pathetic to see
were primary health care given less importance. During the observations, I found some
facts about the condition of the general hospital. It was only in the year 2000 that the
hospital was changed from PHC to GH.
The condition of the GH is still like the PHC with its facilities
Hospital infrastructure
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Medical wing.
Labour room.
Out patient department.
Ward
Sidha wing
STAFF STRUCTURE
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1-Doctor
1-Senior nurse
1-Sidhe prationer
1-ANM
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•
1-Assitant
FACILITIES IN THE HOSPITAL
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5-6 Beds
Drug storage
No weighting scale
No BP apparatus
No lab facilities
No water facilities
Poor electricity available
Improper ventilation
The above facility is what is available in the hospital; it has been a constant struggle
for the people in palavrkkadu in getting their right to health care. Road blokes, strikes,
memos to the government are in process, but the government has made no efforts for
the change. The struggle has made no change, so we need to find alternate methods of
improving the system. Individually as a institution one cannot find solutions we need
to work with the community in solving the issues.
Health care services issues
Lack of emergency services
No cesarean session
No blood transfusion facility
no anesthesia
Limited services in the night
Lack of staffs
No emergency services
Referral services –poor follow up
It is very necessary for the NGOS to take up the issue of health as there are no
NGOS who emphasize on the issue of health in there agenda. we also need to
work on the process to help in the stranded of the GH in palaverkkadu.
Issues related to the medical physicians
Poor communication skills that is required to the adjustment to the community
Less time spent with the patient
Improper introspection
Poor maintenances of health records
Increase staffs
Need for more general practice
Distance of the GH
The above were some of the issuer raised by the medical stalls of the GH,working
towards health for all means we need to have a bottom up approach and also need to
look into the health sector ,only when proper facility is available will we have proper
care givers and will maintain high stranded of care.
Training session organized for the NGO staffs
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At the end of the training organized for the women I found that it was insufficient
information, so with a discussions held with NGO staffs ,I decided to organize a two
day training programme for the NGO staffs ,topics for the training was given by the
staffs according to their need.
Agenda
To integrate all the ngos
To introduce community health
To discriminate knowledge on health
Topics covered were
Introduction to health
Determinants of health
Health rights
Women’s health
Substance abuse
Health rights
Ngo that participated
MSSS
BHUMI
JEEVA JOTHI
SIGA
Resource persons
Amir (chc staff)
Asha (chc fellow)
Sathya(chc fellow)
Four VHNS from the community (PHC)
Out come
The training helped the staffs in adding on the knowledge on health, and concerning
issues, it provided space for clarification of doubts and better understanding of health
issues. The session was very interactive and also helped in sharpening the skills of
training
Conclusion
The experience in palverkadu was a memorable one as it had helped me to understand
many issues; it also helped me to identify and analyze stressful situations in the
community
Mid term review
On jan 23-25 there was a reflection, were the whole group met again to share there
experiences in the three months. Each one in the group went in diverse journey areas
to gain experience and see the relation in the fields. It was and an exciting phase in
terms of learning.
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There were group sharing and discussions regarding fellowship experience and
learning points each of the fellow were given equal time to share and clarify there
confusions and dilemmas apart from this there were input sessions on the over view of
community health workers and related issues and time was slotted to clarify the un
finished topics
Durining the meet it was a opportunity to attend the MFC annual meet 2006 on the
topic quality and coats of health care in the context of the goal of universal access.
Durining this time friend ship and meeting new people from various back grounds
collectively working on various issues aiming at a common goal Health for All
at this meet it was an opportunity to hear from different professionals about their work
,it was also an eye opining to the various issues. Policies issues ,government
programmers and which way to go ?the meet focused at right based framework in a
larger historical context .arguments limiting to right based perspective and also a
detailed discussions on the right to health care.
Experiences of kargilnagar
The Kargilnagar , situated in Ernavur in Thirvallur district – Chennai site was visited
after the post effects of tsunami the people were just shifted to Semi-permanent
shelters were build and by an organization. That was allotted by the government
through the co-ordination of the CNCC which worked all through for the people
affected by tsunami to rehabilitate the affected families. The incitation of the Ngo and
the government should be appreciated in rehabilitating the people; The community
first lived in tar courted houses. which located in a low line area, and the people in the
area also found difficulty in living , there were no facilities available there and there
were lot of community clashes so the people were Relocated the people near celcrete
factory- 18.6acres- given by government situations of people in semi permanents.
The area had around 2000 temporary shelter built .the Ngo had taken all
efforts to build the shelter CNCC had a greater role to play in this project. When the
project was on the proposed state the government wanted to dispense the shelter to the
people because of the crisis around it was incomplete as the people occupied in this
condition there was a lot of chaos. Only few families occupied as allotted the Ngo
that was working took all efforts to finish the work that was undone .but this did not
last long as the rains had the adverse affect on the existing living condition of the
people in Ernavoor.
OBSAVATIONS FROM THE SITE
As the condition was, in chaos it was difficult to work but this site had given a lot of
learning from the field. Some of the observations during the visits
Issues related to the shelter that was of most concern to the people
HOUSIINIG
Incomplete constructions
Poor standers of construction??
Irregular progress of work during Floods.
Slight variation between proposed structure and erected structure.
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Involment of the people in the project is not significant.
Shelter built in Low line area.
Quick allotment of shelter settlement of people after Tsunami.
Provided employment-cash for work during constructions.
.
During the visits the above problems were found, in the last visits the conditions of
the shelter were better, the corrections in the shelter were made and the condition of
the people also improved. Rectifications were makeover the time.
OCCUPATION
This was one of the major concerns of the people in the community, apart from the
depressions that they underwent; coping with day-to-day life was still a major struggle
to the community. the problems that were encounter were Away from sea.
No transportation facilities.
No accessibility to go to work in early hours.
Decline in lively hood earnings.
Forced to move to activate jobs.
Increased number of people in idleness
Increase people in gambling
Apart from the above problems, there were othere issues that were of major concerns
and needed attentionPROBLEMS FACED BY PEOPLE OF THERE
Dynamics of conflicts among defect group in community.
Lack of basic drinking water and electricity
No proper sanitation conditions wide open practice of defecation.
Water logging.
Non-working condition of street light.
Lack of safety and security.
Distance in availing the health facilities.
No emergency services.
Health conditions in the community
The health condition of the people in the community were also worse, some of the
problems that existed in the community were• No health post.
• Health camp.
• Poor hygiene and no sanitation
• Unhygienic surroundings
• Increased number of women with health problems
• Alcoholism is being rampant
• Portable water is still a problem
• Water stagnation still exists
• Increase number of children sick
Increase cases of fever and Derrière
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Kargilnagar was a very challenging area to work; it was a interesting experience in
visiting the community as changes were in constant process. An experience in the
rehabilitation phase was also a process of learning.
Report on the allied areas visited
KannagiNagar
Kannagi nagar was also another tsunami affected area .but the time factor restricted to
work only in one are to have better learning from the community. this was a
rehabilitation area for the tsunami affected communities .people from different
communities settled hear .During the visits some of the observations and reality that
existed in the community wereFIELD REALITY AT KANNAGI NAGAR
The tsunami affected people were provided with temporary tents, tin sheet shelters
at two different locations in chennai city.
• One on the north coastal region off the city limits and other on the south east end
in old mahabalipuram road at okkium thoraipakkam , 5 km from the IT corridor
called Kannagi Nagar .
• It is a place well known as resettlement area consisting of 15000 govt built
housing units.
• Kannagi nagar hosted people who were mainly living in the banks of adyar river
including Srinivasapuram.
• The health and sanitary conditions in the location was poor.
• The CNCC had a separate committee with six major organisations called kannagi
nagar coordination committee to look into the peoples need.
Oxfam, PAM, Udavi proposed to build houses for the people
•
Srinivasapuram
Srinivasapuram also another tsunami affected area which was visited, much time was
also not spent hear. it was a opportunity to visit different areas .hear was an
opportunity to visit and observe the whole area and also time was spent with the
people in the community and understanding their state of mind after the disaster.
Field reality in Srinivasapuram slum
• Very popular urban slum within the heart of the city, on the shore, also
surrounded by the adyar river on one side
• Thickly populated area.
• People live in tenements made by the slum clearance board and also in
hutments along the adyar river.
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• Poor sanitary conditions, consequences - grave health problems.
• Majority of them belong to dalit community.
• Fishermen turned auto rickshaw drivers. Women work as housemaids.
• Only a couple of NGOs were working prior to tsunami, now increased
considerably.
• Environmental issues are very dominant, owing to polluted waterway
running along the slum area.
• It acts as a garbage dumping yard by the slum-dwellers.
• Recent floods affected the households.
• At times of disaster there is limited scope for evacuation due to the
river.
• The surrounding lands are owned by a very prominent business person
who indirectly controls the slum dwellers.
• There are incidences of forceful eviction by setting fire and
threatening the people to occupy the prime location of the slum.
• Close to the slum on the opposite side of the bank , stands a hi-tech
business center owned by this firm.
• There is widespread talk that people in srinivasapuram own tenements
but claim to live in hutments for want of new shelters.
A WIDER PERSPECTIVE BEYOND ILLINESS
The experience that I had gained were informative and educative and it gave a cursory
glance of the of different communities .during the learning process I went through the
process of participatory, problem solving behavior- modification teambuilding and
other formal approaches that encouraged experiential learning. Community health has
evolved ways in integrating othere development activities. it has helped in evolving
dynamic process ,it has helped in meeting challenges and helping ‘learn to learn’.
When I left to the field to explore the field, the field was too wast to be specific to the
objectives but efforts were made to
CONCLUSION
Durining the training in community cell I have gained broad and strong perspectives
on community health. The six months was time for me to reflect and sharpen the
existing capacity I had. Though I framed my objectives before I left, I was only able
to focus on few objectives .health was not my interest area to work but after the
fellowship, I started to develop the interest in community health.
I had gained a balloonist view of community health and my interest has been growing
stronger in this field ,every day in the field was a new experience new to explore .the
over all training programme also helped to build my personal self. at the end of the
fellow ship I realized that we need to start with the people ,live with them, start with
what they know, build with what they have and help them to accomplish the task.
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Durining my experience I found that the health system need to function, need to
improve infrastructure, service at there need should be provided. the process is long
we need to bring in the community development concept to enable people to exercise
collective responsibility to their own health and demand right to health
Women have been the most vulnerable in the community were importance to them are
never given they have always been neglecting their health, and given the least
importance
.we need to train women in medical education to help them selves, in terms of crisis
helping to change the empowering process training them .simultaneity de-stressing
the health centers, rejuvenation of hospitals and evolving a focus on comprehensive
wellness centers for the poor .
Annexure
SWOT analysis of palaverkkadu
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Strengths
• GOOD LEVELS OF COMMUNITY PARTICIPATION
• ADEQUATE KNOWLEDGE ABOUT CSO’S EXISTENCE AND
FUNCTIONING
• UNITY AMONG DIFFERENT PANCHAYATS
• GOOD NUMBER OF EDUCATED YOUTHS
• DIVERSE CULTURE AND SECTIONS OF PEOPLE
• RICH EXPERIENCE IN FISHING AND RELATED ACTIVITIES
FOR MANY YEARS
• WELL-KNOWN AREA FOR PRAWN CATCH AND EXPORTS
• OUTGOING PEOPLE
• PRESENCE OF MANY NGOS
• WELL INFORMED COMMUNITY
• TOURIST ATTRACTION GEOGRAPHICALLY BEAUTIFUL
ISLAND
Weakness
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•
•
•
•
•
•
•
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GEOGRAPHICAL LOCATION- ON THE BORDER VILLAGE
NEGLECTED AREA SINCE LONG TIME
POVERTY STRICKEN COMMUNITY
DENIED ACCESSIBILITY DUE TO REMOTE LOCATION
DISTANCE FROM ALL THE FACILITIES- MEDICAL,
EDUCATION
MINIMAL KNOWLEDGE OF ALTERNATE EMPLOYMENT
INADEQUATE OPPORTUNITIES FOR GROWTH
NO PRACTICE OF SAVINGS AMONG PEOPLE
DECLINE IN PRAWN CATCH OVER THE RECENT TIMES
ENVIRONMENTAL DEGRADATION IS SIGNIFICANT
SEASONAL, CYCLIC OCCUPATION
COMMUNITY DYNAMICS & CLASHES
Opportunities
• FORMING FISHING CO-OPERATIVES
• INVOLVING WOMEN IN PANCHAYAT
• INVOLVING PANCHAYAT IN HEALTH AND OTHER ISSUES
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•
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IMPROVING FISH LANDING AND STORAGE UNITS
ENHANCING FISHING TECHNOLOGY
PRACTICING ALTERNATE JOB DURING OFF SEASON
INVOLVING EDUCATED YOUTH IN DEVELOPMENTAL
ACTIVITIES
• CHANNELISING UNITY TOWARDS PROGRESS OF THE
COMMUNITY
Threats
• ENVIRONMENTAL DEGRADATION / DISASTER PRONE
• CASTE RELATED CONFLICTS
• DECLINE IN SCOPE FOR EMPLOYMENT
• UNEMPLOYMENT AMONG EDUCATED YOUTHS
• INCREASE IN FISHERMEN AND DECREASE IN CATCH
• INCREASED DEPENDENCE ON NGOS
• INDEBTNESS
• CONFLICTS OVER FISHING RIGHTS
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