Abirami Aravindian : Need for Intervention in Serious Health Issues, and Providing Curative Healthcare Guidance for Socio-Economically Backward Patients.

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Title: Abirami Aravindian : Need for Intervention in Serious Health Issues, and Providing Curative Healthcare Guidance for Socio-Economically Backward Patients.
extracted text: COMMUNITY
HEALTH
LEARNING
PROGRAM
2021-2022

REPORT BY

ABIRAMI ARAVINDAN

ORGANISED BY SOCHARA

Abstract
What is health?
I have been searching for an answer to this question without even realizing it, ever
since I co-founded my healthcare non-profit in 2017. And these past five years have
been an illuminating journey of finding those answers through various field visits,
hospital visits, and patients, social workers and doctors. Initially I was overwhelmed
with the need for intervention in serious health issues, and providing curative health
care guidance for socio-economically backward patients. Only later did I start to
question whether this was all there was to healthcare. Slowly we started working with
preventive health and health awareness. But something was still missing. It was in a
search for this that I joined SOCHARA’s Community Health Learning Program.
Learning about the importance of mental health and community health intervention has
broadened my perspective, and I'm looking forward to incorporating my learning in the
field. The learning facilitators brought their rich experiences and expertise, to deliver
insightful and meaningful sessions. And it gave me a whole new perspective on the
field I thought I was beginning to understand.
This course helped me to view health not as a disease to be treated, but as a
fundamental right that should be holistically addressed.

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Introduction
My name is Abirami Aravindan, co-founder of DoctorNet India, a non-profit
organization that makes curative healthcare accessible to socio-economically backward
patients. I live in Coimbatore with my husband and two daughters.
I completed B.Sc. Biotechnology/Biochemistry in the year 1999, but I found my true
calling when I started volunteering in 2012 with a healthcare non-profit in Coimbatore
where I worked with fundraising for poor patients. During that time, I realized how
hard it was for underprivileged patients, especially from remote communities, to access
empathetic and affordable healthcare. I learnt the importance of empathetic doctors
who explained the patient's condition to them, to dispel the fear of the unknown that is
half the problem. I realized I didn’t want to work with fundraising as much as I wanted
to help these patients get guidance to affordable, empathetic and patient centric
healthcare. With this background and my husband’s volunteering experience and a
drive to help those in need, we started DoctorNet India in 2017.

Why I joined CHLP
Over the years, we established a solid base in providing curative health guidance for the
needy. But I wanted to explore other aspects of health in order to provide holistic
treatment for the communities we worked with. For us to be able to transition our work
from curative health guidance to holistic well being, I need to get a better
understanding of the importance of community health from the experts. The CHLP
program perfectly fitted my requirements.
Through this program, I wanted to learn about community based health intervention. I
was also keen on learning about the importance of mental health well being, as it is a
highly stigmatized and neglected area in healthcare. Another area that is often
overlooked, is health rights for the patients. I wanted to learn about it, in order to be
aware and fully informed so that I can implement it in my work. The course has met all
my expectations, and taught me more, and it has been valuable in implementation for
my work.

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My learning and application
LMS was easy to use. The availability of recorded videos is very useful. Live sessions
from experienced facilitators were very insightful. I attended all sessions except one.
Mostly there wasn’t any difficulty in managing the course along with my other
commitments. I was prepared and looking forward to each session.
As we were learning, we started doing community health intervention a few months ago
in a neighboring underprivileged community. Somewhere in the back of my head it had
always bothered me that we were doing so much for people across Tamilnadu, but so
little for the community literally next to us, where the maids and securities came from.
CHLP gave me the opportunity and the push to start working on it instead of just
leaving it as a thought. Right from the basic principles to the rich experiences shared by
the learning facilitators in the modules and live session, it was all very useful for me to
start working impactfully and responsibly in the community.
One example of how the learnings from this session have been valuable is how we
started working with the community. With what I’ve heard from some of the apartment
staff who live in that community, my first instinct would have been to naturally assume
that alcoholism was the biggest problem they face, and started working towards it. But
my learnings from CHLP made us initiate a gathering with the people instead and ask
them what their biggest issues are. To our surprise, alcoholism -while definitely a
troubling issue- was not the biggest one. We were shocked to hear that there was
prevalent drug usage starting right from 10 year old boys. In this way my learnings for
CHLP were valuable because we are now able to work better with the community, by
conversing with the people itself instead of assuming things as an uninvolved third
party.
We have now built trust in the community. Understood their priorities and started
working towards meeting community objectives, by enabling and empowering them to
fight for their own issues and needs.
Our understanding of mental health from the course has improved our sensitivity while
interacting with patients and caregivers. I think this is very critical for our work.

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COMMUNITY INTERVENTION

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About the community:
I started my work in an underprivileged community with 700 plus households. People
living there were predominantly from scheduled castes. Most of the men work as
construction laborers and painters. The women work in municipality corporations as
sweepers, or in households as home helpers.
Around 80% of the people use public toilets or do open defecation.Most of the children
go to government schools for primary and secondary education.There is an Urban PHC
very close to this community. People use this for basic medical needs.
We started our work in the community during covid 2nd wave. We went to the local
Urban PHC, understood the facilities available there and supported them with the needs
during covid. We referred the people in the community with covid to free tertiary care
hospitals and also helped them with teleconsultation and provided mental support.
During the Pandemic many children in the community lost their education and were
getting spoiled due to loss of regular routine like going to school, meeting their friends
and regular play.
A 22 years old volunteer from the same community arranged for an evening tuition
center for these children. This was our opening to start community work here, and we
had our first interaction with the community through him.

Objective:
I have been working in curative health for the past 5 years. During this journey I
understood the importance of working in preventive health and health education.
Community based health intervention was new to me and I was keen on learning it.
Whatever was thought or discussed, I had an opportunity to apply and learn through
experimentation in the community.
This community is our neighboring community. We wanted to work in this community
to help/enable them to overcome their problems, especially health problems like
alcoholism, drug addiction, and struggles from heavy interest loans.

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Log of meetings till date:
1st meeting- 20/11/21 with 10 attendees.
Spoke with the women, understood their priorities and needs.
2nd meeting- 2/12/21 with 12 attendees.
A yoga trainer came and spoke with women about self care and the importance of
breathing exercise and Yoga for well being.Many felt it to be useful and started
practicing. Introduced some simple healthy refreshments like Herbal tea.
3rd- 8/12/21 with 20 attendees.
Covid 3rd wave was about to start and a general physician came and spoke about covid
precautions and commonly seen winter disease and preventive methods. Apart from
health awareness we started discussing the commonly seen problems such as heavy
debt loans during unexpected and expected times..
Slowly introduced simple cost effective refreshments like multi millet health drinks.
4th meeting-15/12/21 with 25 attendees.
An obstetrician and gynecologist came from a local private medical college and spoke
with women on menstrual health and cleared their doubts.After the doctor left we spoke
with them about individuals interest/ talent and one special thing about them. This
interaction was like an icebreaker session and women started becoming more
comfortable with one another.
Refreshment was some healthy vegetable soup.
5th meeting- 23/12/21 with 17 attendees.
A women physiotherapist came and spoke about the importance of self care. Some
basic exercises were taught for working women. Cleared most of their pain related
doubts.
Second half of the session, a video was played about selfcare done by our CHLP fellow
friend Dr. Shilpa. This was well observed by the women.
6th meeting happened on 30/12/21 with 18 attendees.
Selfcare session continued. Women realized the importance of self care and individual
well being. Few of them opened up their thoughts. Since it was a day before the new
year we discussed the next year plan.

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Log of meetings till date:
Due to 3rd wave of corona there was a break for a month.
7th meeting- 25/1/22 with16 attendees.
Dr. Menaka, who is a dentist and drama teacher by profession came and sat with the
women in the community and spoke about our addiction to social media and its severity
on health.
8th meeting- 3/2/22 with 16 attendees.
Dr. Anand Bharathan (Liver transplant surgeon) came and sat one among them and
started to speak to them about the less consumption of sugar and oil which plays a
major role in one’s health. Gave several simple steps to reduce its consumption. He also
spoke shortly about the alcohol's effect on the body, especially the liver. People greatly
appreciated his awareness and started following it in a small way.
9th meeting- 10/2/22 with 22 attendees.
This meeting was initiated to prioritize their community needs and talk about it. One of
the community volunteers wrote it as a letter. Local body election happened that
following week so they wanted to present it to contestants.
10th meeting- 22/2/22 with 16 attendees.
Myself and Aravind spoke to the women about mental health through whatever we
learnt in CHLP and from the orientation that we experienced on mental health from the
Psychiatrist and social workers in CMC hospital, Vellore.
Started a few surveys with the women on their mental health.
11th meeting- 10/3/22 with 15 participants.
Women’s day celebration was celebrated with a few games and icebreaker sessions.
Women thoroughly enjoyed it. Healthy and tasty snacks like ragi vada, fresh fruits and
buttermilk were distributed to the attendees.
12th meeting- 22/2/22 with 18 participants.
Dr. Neethirajan, Orthopedician by profession spoke with the people on healthy living
through physical well being like nutritious food, exercise and mental well being
through keeping mind healthy through positive thoughts.

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How I started working:
First we understood the education needs of the children and arranged extra volunteers
to teach those children and also provided sports material for physical and mental fitness
and entertainment.
Through the evening tuition center I started the community work. I spoke with their
parents through informal meetings and understood the needs of the community.From
what I saw in the community, I felt the need of creating a women's wellness group for
women in the community because most of the women who were bread winners of the
family hardly have time for selfcare.
I identified a few local volunteers and during the first session, we had to go door to
door to invite the women to participate in the women wellness meeting. Collected their
phone numbers and created a whatsapp group to update about the meeting date, timing
and facilitator of each session.
We started the first meeting by knowing each other, to understand their priorities and
needs.
Most of them spoke about drug addiction and alcoholism in the community, sanitation,
clean toilets, waste management and troubles created by dogs in the community.
We had a weekly one hour meeting planned with an awareness session on health
followed by a few minutes discussion on community problems each time. Healthy
refreshments were introduced in these meetings. It started with around 10 women
attending and now 25 members attend these meetings regularly and find it to be
informative and useful.

Impact on the community
In most of the sessions, discussions were on healthy living lifestyle. People were
amazed on how doctors spoke on health awareness and not about disease. Many women
started practicing it in day to day life and found it to be effective. Women started to
feel close and started sharing their problems and mental stresses. Their physical illness
was addressed through reference to an empathetic doctor and cost effective treatment.
Mental problems were addressed through counseling and reference to psychologist and
psychiatrist depending on the need, and a few were referred to deaddiction centers.

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My learning
Through my community health intervention I understood various social determinants on
health.
I could see the gender inequalities faced by women and the need for community
involvement for their well being. I saw how much of an effect simply creating a park or
playground in the community could possibly have on the physical and mental well
being of all age groups.
I learnt that there was so many things that played a role in the wellbeing of a
community, and this journey was just the beginning.

Going forward
I am practically learning that working on community health is not just about physical
and mental well being. It's about working on a range of social problems starting from
sanitation to social justice.
My key takeaways have been these. Learning about the importance of community based
health intervention, and understanding mental health. Being supportive to differently
abled and caregivers, and realizing the importance of health animators from the
community. Learning about the gender based health inequalities , the social
determinants of health, comprehensive primary healthcare, health communication.
Overall, this journey has been an invaluable experience for me as a social worker, and
as a person.

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Acknowledgements
I sincerely thank SOCHARA for providing me such a wonderful learning opportunity.
Special thanks to
All learning facilitators for the insightful sessions.
Dr. Denis for making all live sessions more interactive and lively.
My mentor Mr. Ameer for all the guidance on health rights based intervention in
the community.
Volunteers Jeeva ,Aravind, Kanchana and Visalakshi for helping me to build the
community.
All the doctors, physiotherapist and yoga teacher for their valuable time.
My family for being the pillar of strength.

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