Aravindan. R : Socio-economically Backward Patients have Inadequate Health Care

Item

Title: Aravindan. R : Socio-economically Backward Patients have Inadequate Health Care
extracted text: Community Health Learning Programme - 2021-22

Report by Aravindan R

Society for Community Health Awareness, Research and Action

SOPHEA - SOCHARA CHLP 2021-22

Introduction

About me:
I’m Aravindan, co-founder of DoctorNet India, a non-profit organization started to make
healthcare accessible to socio-economically backward people. I live in Coimbatore with my
wife Abirami, two daughters and my mother. I’ve completed Masters in Computer
Applications (1995) and Masters in Social Work (2005). I was volunteering with the
Association for India’s Development (AID), Bay area, California chapter and the Bangalore
chapter for several years. I’ve been working in the software industry since 1996. Primarily
with Oracle Corporation, California, USA and Oracle software India Limited. As of Nov
2021, I work part time for Oracle India.
About DoctorNet India
Socio-economically backward patients have inadequate health care options and are
constrained by the lack of knowledge, money and communication skills to get reliable
medical advice and treatment. To make healthcare accessible to such patients, we act as a
bridge between empathetic doctors and needy patients from rural/remote areas. We associate
with grassroots organizations who do meaningful interventions for the under-privileged
people in rural/tribal areas.When they come across patients in need of curative health
advice/treatment they refer to us. We interface with the doctors and help them to get the right
advice/treatment and more importantly provide emotional support throughout the treatment.
Curative health guidance was the primary focus in the initial two years. Till Feb 2022, we’ve
guided 1100+ socio-economically backwards patients from remote areas - for whom
healthcare would have been inaccessible. In the past two years (before joining CHLP), we
were working on mental health guidance, preventive health and health awareness aspects.
After CHLP, started working on community health intervention
Why did I join the fellowship?
I’ve experientially understood that health is a complete physical, social and mental wellbeing and not merely absence of disease. Being from a non-medical background, it was
essential for me to broaden my understanding of health to do more meaningful work.

What were my learning objectives and were they met?
My objective was to get a 360 degree understanding of health - with a focus on community
health. The program certainly met my objective.
Reflections on use of the LMS, videos and participation in live online sessions
The Learning Management System served its purpose very well. It is very valuable to have
not just the recorded videos but also additional learning materials. They are serving as useful
reference materials for each topic. I wish we will continue to have all the materials beyond
the course.
I attended all the live sessions. The insights and experiences of the wonderful learning
facilitators were very valuable in addition to understanding their field of expertise.

Learning from modules and how I applied the learning in my work?
The broader understanding of health that I got is helping to review the mission and vision and
reassess the direction of DoctorNet India. For this, the modules ‘Right to health’, ‘Equity,
Health movements’, ‘social movements and social change’, ‘Climate change and health’,
‘Globalization and health’ and ‘Universal health coverage’ provided the right insights.
To improve the way with which we do the curative healthcare guidance, below modules were
helpful: ‘Mental health’, ‘Communicable disease’, ‘Health systems in India’, ‘Palliative
care’, ‘Non communicable disease’,‘Social determinants of health’ and ‘Voluntary health
sector’.
With the confidence instilled by CHLP, midway into the program, we started a community
health intervention in a disadvantaged community in Coimbatore. It has around 700 families,
primarily dalits. Below modules provided the right perspectives and direction to do
community health work: ‘Social determinants of health’, ‘Community health’ ‘Women and
child health’, ‘Comprehensive primary health care’, ‘Food and nutrition’, ‘Community
Water Sanitation and Hygiene’, ‘Urban health and occupational health’ and ‘Health
communication’.
How was the balance between work, life and the CHLP maintained?
For about 30% of the course duration, we were actively working on COVID related guidance,
awareness programs, tele consulting coordination etc. For about 70% of the course, I was
working full time in Oracle and then moved to a part time role.
Finding time for CHLP was a challenge. However, because of the value we get (personally
and for DoctorNet) from the wonderful learning facilitators, I made it a point to attend all the
live sessions and watch the video lessons. This is of significant value to us.
Mentorship process and reflections
Assigning 1-1 mentors is of significant value. I am fortunate to have Dr. Mohan Isaac as my
mentor. He will be a valuable advisor beyond the CHLP duration on the directions of
DoctorNet India.

Take away from CHLP and Looking Ahead -Where do I go from here?
The primary highlight of CHLP is the expertise and experience of the learning facilitators.
SOCHARA was able to get who is who of the experts in each topic. It is made possible only
because of the decades of connections and goodwill of SOCHARA.
I was able to imbibe the ethics and values of the facilitators during the interaction - in
addition to the technical content. Inspiration is more important than information.
DoctorNet India was started as a curative health guidance platform. The learning is helping to
shape and refine the organization’s direction - by establishing linkages between the
theoretical knowledge and our field work. The understanding and the contacts will help

towards doing community health, health promotion, prevention and education intervention in
the long term.
___________________________________________________________________________

Project
Background
CHLP project was suggested to be done in a span of 3 months. Being part of
DoctorNet India, I wanted to kickstart a project that is aligned to our organization’s
objectives and then continue as a long term project beyond the CHLP duration. My
mentor Dr. Mohan Isaac was okay with this approach.
The community health action project was appropriate to be done by Abirami, cofellow of CHLP and co-founder of DoctorNet. The details are available in her report. I
chose the below project knowing well that it is a long term project.
Objective
The objectives of my project are to 1) create a comprehensive life skills education
content and to 2) create a model delivery methodology that is replicable.
Motivation
Majority of adults in the disadvantaged communities today
1. Lack basic health and fitness; they get intimidated by health problems due to
lack of knowledge.
2. Do not treat people of opposite gender with dignity
3. Vote without understanding the importance of democracy and basic rights.
Spew religion/caste based hatred with increased polarization being the norm.
4. Do not value healthy food/environment and treat the earth as if it is owned
only by them and not other species.
One of the reasons is that the conventional school system does not have space to
discuss these basic, but essential aspects.
Many factors are related to the social determinants of health (SDH), the non-medical
factors that influence health outcomes.

Execution
A) Content

-

Create content in the 4 areas mentioned in the Motivation section above.
1. Care for self
2. Care for the opposite gender.
3. Care for the country
4. Care for the world

-

To be targeted to the disadvantaged children in the age group 8 to 16.
After interacting with many people who do school health education, we found
that there is no high quality content that is standardized and public. The
intention is to create content in text form in English (referred to as “common
core” in this document) and then to translate to other languages as needed.
This is to be in the WikiBooks form https://en.wikibooks.org/ . This will be
applicable to communities and schools from various socio-economic-politicallinguistic contexts. Once the standard content is created, the people who
deliver the content can tailor-made to their local context.
To be copyright free.
To collaborate with experts in each area and reuse their existing content, best
practices as much as possible (example, for health education - kcpphc.org
and for democracy arappor.org etc.)

-

Tasks done
- Discussed with development pediatricians in CMC Vellore. They have agreed
to create content related to newborn care - as a pilot
- Working with an informal group of physicians, community health workers,
CHLP 2021-22 fellows and SOCHARA on creating common core content.

B) Pilot Delivery
In DoctorNet India, we are doing community health intervention in a disadvantaged
community in Coimbatore. This has around 700 households, with the majority being
dalits. https://youtu.be/q_rq7QZY0_Q
In this community, I am working in a neighbourhood learning center with 40 children
in the age group 8-15. I have established good relationships by guiding the local
volunteers, teaching 10th grade students, organizing awareness programs, parents
meetings, nutritious snacks and enabling local volunteers to address social issues
etc.

Tasks done
- Established good working relation in a disadvantaged community for the
model content delivery so that it becomes replicable
- Working with SOCHARA on technical infrastructure to deliver content as
audio lessons (preferably as an assisted delivery mechanism by health
animators in the community or teachers in the school).
Going forward
- Complete the common core content in text form for all the modules and
publish online in WikiBooks format.
- Choose one text module and convert to audio or video based on the local
community needs
- Deliver in the pilot community
- Get feedback and refine
- Document best practices
- Create documentation for the assisted delivery (for health animators in the
community or teachers in the school)
- Explore collaborating with AID India to convert the text content to video and
deliver in their evening learning centers across Tamil nadu - as they already
have the technical and human resources to deliver on a large scale.
Constraints
The pace of the project was slower than I anticipated because of reasons like
multiple concurrent priorities in DoctorNet India and my office work. However, the
good news is that it is in the right direction to be completed as envisaged.

Acknowledgements
1. All the CHLP organizers, facilitators and co-fellows for rekindling our energy and
enthusiasm to continue to work in DoctorNet.
2. Special gratitude and respect to Dr. Ravi, Dr. Mohan and Dr. Denis for taking their
time to listen to DoctorNet's story, its current functioning methodology and providing
valuable suggestions to improve DoctorNet services.
3. The community volunteers where we work on the community health and in the
children learning center.
4. Guru, the secretary of SOCHARA, for continuously engaging with DoctorNet,
ranging from the mental health guidance work to the school health education work.

Media: Aravindan.pdf

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