A Study on the Status of Health care waste management and infection control practices - Anekal Taluk, Bengalore District.
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- Title
- A Study on the Status of Health care waste management and infection control practices - Anekal Taluk, Bengalore District.
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Why I Joined CHLP Fellowship
£Á£ÀÄ ªÀÄÆ®PÀ UÀÄ®âUÁð f¯ÉèUÉ ¸ÉÃjzÀÄÝ CzÀÄ PÀ£ÁðlPÀzÀ »AzÀĽzÀ & zÀħ𮠪ÀåªÀ¸ÉÜ EgÀĪÀ
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w½zÀÄPÉƼÀÄîªÀÅzÀÄ eÉÆvÉUÉ £À£ÀߣÀÄß ¸ÀªÀiÁd ¸ÉêÉAiÀÄvÀÛ £ÀqÉAiÀÄĪÀAvÉ ªÀiÁrvÀÄÛ.
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DgÉÆÃUÀå ¥Á®£É EzÀÄ AiÀiÁªÀÅzÀgÀ §UÉÎAiÀÄÆ £À£ÀUÉ CµÀÄÖ w½zÀj°®è.
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CA±ÀUÀ¼À£ÀÄß ºÉÆA¢gÀÄvÀÛzÉ, CzÀgÀ°ègÀĪÀ vÉÆAzÀgÉUÀ¼À£ÀÄß w½zÀÄPÉÆAqÀÄ AiÀiÁªÀ jÃw¬ÄAzÀ
¥ÀjºÀj¸À§ºÀÄzÀÄ ªÀÄvÀÄÛ ¸ÀªÀÄÄzÁAiÀÄ DgÉÆÃUÀåzÀ°è d£ÀgÀ ¥ÁvÀæ K£ÁVgÀÄvÀÛzÉ JAzÀÄ
w½zÀÄPÉƼÀî®Ä £À£Àß°è D¸ÀQÛ¬ÄzÀÝ PÁgÀt ¸ÀªÀÄÄzÁAiÀÄ DgÉÆÃUÀå PÀ°PÉAiÀÄ PÁAiÀÄðzÀ°è
vÉÆqÀV¹PÉÆAqÉ.
Learning Objectives
£Á£ÀÄ ¥Àj¸ÀgÀ §UÉÎ D¸ÀQÛ¬ÄzÀÝ PÁgÀt ¥Àj¸ÀgÀ «eÁÕ£ÀzÀ°è ¸ÁßvÀPÉÆÃvÀÛgÀ ¥ÀzÀ«AiÀÄ£ÀÄß
¥ÀqÉzÀÄPÉÆAqÀ PÁgÀt £À£ÀUÉ ¥Àj¸ÀgÀPÉÌ ¸ÀA§AzsÀ¥ÀlÖ PÁAiÀÄðUÀ¼À£ÀÄß ªÀiÁqÀ®Ä £À£ÀUÉ RĶPÉÆqÀÄwvÀÄÛ.
¥Àj¸ÀgÀPÉÌ ¸ÀA§AzsÀ¥ÀlÖ «µÀAiÀÄUÀ¼À£ÀÄß w½zÀÄPÉÆAqÀÄ CªÀUÀ¼À£ÀÄß ¸ÀjqÀ¥Àr¸ÀĪÀÅzÀÄ.
¸ÁªÀAiÀĪÀ PÀȶ ªÀÄvÀÄÛ ¸ÀªÀÄvÉÆî£ÀvÉAiÀÄ C©üªÀÈ¢ÞAiÀÄ£ÀÄß w½zÀÄPÉƼÀÄîªÀÅzÀÄ.
¸ÀªÀÄÄzÁAiÀÄ ªÀÄvÀÄÛ ¸ÀªÀÄÄzÁAiÀÄ DgÉÆÃUÀåzÀ ¸ÀªÀĸÉåUÀ¼À£ÀÄß w½zÀÄPÉƼÀÄîªÀÅzÀÄ.
¸ÀA±ÉÆÃzsÀ£Á PÉëÃvÀæzÀ°è £À£ÀߣÀÄß D¼ÀªÁV vÉÆqÀV¹PÉƼÀÄîªÀÅzÀÄ.
Introduction
DgÉÆÃUÀåzÀ §UÉÎ £À£Àß zÀȶÖPÉÆãÀ
F ªÉÆzÀ®Ä CAzÀgÉ ¸ÀªÀÄÄzÁAiÀÄ DgÉÆÃUÀå PÀ°PÉAiÀÄ PÁAiÀÄðPÀæªÀĪÀ£ÀÄß ¸ÉÃgÀĪÀ ªÉÆzÀ®Ä £À£ÀUÉ
AiÀiÁªÀÅzÉà jÃwAiÀiÁzÀ ªÀÄvÀÄÛ DgÉÆÃUÀå ªÀiÁ»wUÀ¼À §UÉÎ w½¢gÀ°®è, DgÉÆÃUÀå CAzÀgÉ
1
D¸ÀàvÉæAiÀÄzÁjvÀ aQvÉì ¥ÀzÀÝw MgÉvÀÄ AiÀiÁªÀÅzÉà ªÀÄÄ£ÀÆìZÀ£É PÀæªÀÄUÀ¼À£ÀÄß C£ÀĸÀj¸ÀĪÀÅzÀÄ
w½¢gÀ°®è.
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£ÀªÀÄä PÀ®à£É, M§â ¸ÀªÀiÁd ¸ÉêÀPÀ£ÀÄß PÀÆqÁ DgÉÆÃUÀåzÀ ªÀiÁ»wAiÀÄ£ÀÄß w½zÀÄPÉÆAqÀÄ vÀ£Àß°è
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DgÉÆÃUÀåªÀ£ÀÄß ºÀ®ªÁgÀÄ ªÉÊzÀåQÃAiÀÄ zÀȶÖPÉÆãÀ¢AzÀ £ÉÆÃqÀzÉà ºÀ®ªÁgÀÄ zÀȶÖPÉÆãÀ¢AzÀ
C½§ºÀÄzÁVzÉ.
GzÁ:¸ÁªÀiÁfPÀªÁV,
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©ÃgÀĪÀ CA±ÀUÀ¼ÁVªÉ.
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«ZÁgÀ, ¸ÀA¸ÀÌøw, »£ÀßvÉAiÀÄ£ÀÄß ºÉÆA¢gÀÄvÀÛzÉ.DgÉÆÃUÀåPÀgÀ ¸ÀªÀÄzÁAiÀĪÀ£ÀÄß ¸ÀȶָÀ®Ä ºÀ®ªÁgÀÄ
CA±ÀUÀ¼ÀÄ M¼ÀUÉÆArgÀÄvÀÛzÉ. CzÀgÀ°è ªÀÄÄRåªÁV d£ÀgÀ fêÀ£À ±ÉÊ°, PÀÄrAiÀÄĪÀ ¤ÃgÀÄ,
¥Àj¸ÀgÀ, vÀgÀ¨ÉÃwUÀ¼ÀÄ, ªÀ¸Àw, ªÀiÁ£À¹PÀ DgÉÆÃUÀå, zsÀƪÀÄ¥Á£À ªÀÄvÀÄÛ vÀA¨ÁPÀÄ
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D®ä DmÁ ºÉÆA¢gÀĪÀ DgÉÆÃUÀå CA±ÀUÀ¼ÁzÀ ¸ÀªÀÄvÉ, ¥ÁæxÀ«ÄPÀ DgÉÆÃUÀå CjªÀÅ, ¸ÁªÀiÁfPÀ
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J¯Áè CA±ÀUÀ¼À£ÀÄß ¸ÀgÀªÁV w½zÀÄPÉƼÀî®Ä ¸ÀºÁAiÀÄPÀªÁVgÀÄvÀÛzÉ.
Learning from collective Sessions
£Á£ÀÄ ¸ÁªÀÄÆ»vÀ PÀ°PÁ CªÀ¢üAiÀÄ°è £ÀqÉzÀ vÀgÀUÀwUÀ¼ÀÄ ¢£À ¢£À¢AzÀ £ÀªÀÄä°è D¸ÀQÛAiÀÄ£ÀÄß
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PÁAiÀÄðªÉÊRjUÀ¼À£ÀÄß w½zÀÄPÉƼÀî®Ä ¸ÀºÁAiÀĪÁ¬ÄvÀÄ.
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PÀ°PÉAiÀÄ°è ªÀÄvÀÄÛ ºÀ®ªÁgÀÄ «µÀAiÀÄUÀ¼À ZÀZÉð £ÀqÉAiÀÄÄwÛzÀݪÀÅ CªÀgÀ°è J®ègÀÆ
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2
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ºÉÆA¢zÀÝgÀÄ.
¸ÁªÀÄÆ»PÀ PÀ°AiÀÄ CªÀ¢üAiÀÄ ºÀ®ªÁgÀÄ «µÀAiÀÄUÀ¼ÀÄ ZÉZÉðAiÀiÁUÀÄwÛzÀݪÀÅ DzÀÝjAzÀ ºÀ®ªÁgÀÄ
«µÀAiÀÄUÀ¼À£ÀÄß w½AiÀÄĪÀAvÉ ªÀiÁrvÀÄ.
CªÀÅUÀ¼À°è ªÀÄÄRåªÁV, D±Á ¸ÀªÀiÁd¸ÉêÀQAiÀÄgÀ ¥ÁvÀ,æ ªÀAiÀĸÀÌgÀ ¸ÀªÀĸÉåUÀ¼ÀÄ, ¥Ë¶ÖPÁA±ÀzÀ
PÉÆgÉvÉ, ºÀ®ªÁgÀÄ «µÀAiÀÄUÀ¼ÀÄ w½zÀÄPÉƼÀÄî ¸ÀºÁAiÀĪÁVvÀÄÛ.
¸ÁªÀÄÆ»PÀ PÀ°PÉAiÀÄ CªÀ¢üAiÀÄ°è «±ÉõÀªÁzÀ zÀȱÁåªÀ½UÀ¼À £ÉÊd avÀæt
zÀȱÁåªÀ½UÀ¼À £ÉÊd avÀætUÀ¼À PÀ°PÉAiÀÄÄ ºÀ®ªÁgÀÄ ¸ÀªÀĸÉåUÀ¼À ¸ÀAUÀªÀĪÁVvÀÄÛ CªÀÅUÀ¼À°è
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«µÀAiÀÄUÀ½ÃAzÀ ºÉtÂÚ£À ªÉÄïÁUÀĪÀ zËdð£Àå ªÀÄvÀÄÛ £ÀªÀÄä ¸ÀÄvÀÛªÀÄÄvÀÛ°£À PÀvÀÛ°£À ¨sÁUÀªÁVvÀÄÛ
JAzÀÄ ºÉüÀ§ºÀÄzÀÄ.
“gÁªÀÄPÀÌ PÀxɬÄAzÀ” MAzÀÄ HjUÉ D¸ÀàvÉæAiÀÄ JµÀÄÖ ªÀÄÄRå §qÀªÀjUÉ AiÀiÁªÀ jÃwAiÀÄ aQvÁì
¥ÀzÀÝwAiÀÄÄ zÉÆgÉAiÀÄÄwÛzÉ JAzÀÄ w½zÀħAzÀ ¸ÀAUÀwAiÀiÁVvÀÄÛ.
Universal Health Coverage
F MAzÀÄ zÀȱÀåªÀ½AiÀÄÄ ºÀ®ªÁgÀÄ zÉñÀUÀ¼À DgÉÆÃUÀåzÀ AiÉÆÃd£ÉUÀ¼ÀÄ, RZÀÄð ªÉZÀÑUÀ¼À, d£ÀgÀ
fêÀ£À DgÉÆÃUÀåUÀ¼À w½zÀÄPÉƼÀî¯Á¬ÄvÀÄÛ.
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M§â ªÀåQÛAiÀÄÄ vÀ£Àß fêÀ£ÀzÀ°è DzÀ PÉ®ªÉÇAzÀÄ WÀl£ÉUÀ½AzsÀ vÀ£Àß ªÀÄ£À¹ì£À¯ÁèUÀĪÀ
§zÀ¯ÁªÀuÉUÀ¼ÀÄ fêÀ£ÀzÀ°è ºÀ®ªÁgÀÄ wgÀĪÀÅUÀ¼À£ÀÄß ¥ÀqÉzÀÄPÉƼÀÄîvÀÛªÉ. CzÀÝjAzÀ AiÀiÁªÀ
jÃwAiÀiÁV ºÉÆgÀ§AzÀÄ ¸ÀªÀiÁdPÉÌ ªÀiÁzÀjAiÀiÁzÀ «µÀAiÀĪÀÅ ¤dPÀÆÌ PÀÄvÀƺÀ®PÁjAiÀiÁVvÀÄÛ.
ªÀiÁ£ï¸ÀÆ£ï UÉêÀiï
ªÀiÁ£ï¸ÀÆ£ï UÉêÀiï F MAzÀÄ DlªÀÅ PÀ°AiÀÄ ¨sÁUÀªÁVzÀÄÝ, gÉÊvÀgÀ fêÀ£ÀzÀ°è «¢üAiÀÄÄ
AiÀiÁªÀ jÃwAiÀÄ ªÀvÀð£É vÉÆÃgÀÄvÀÛzÉ DzÀÝjAzÀ F gÉÊvÀ£À fêÀ£À ¸ÀªÀĸÉåUÀ¼ÀÄ, C£ÀÆPÀÆ®vÉUÀ¼ÀÄ,
C£Á£ÀÆPÀÆ®vÉUÀ¼ÀÄ JA§ CA±ÀªÀÅ DlzÀ ªÀÄÄRå ¸ÀAzÉñÀªÁVvÀÄÛ.
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gÁdgÁªÀiï gÀªÀgÀ ¸ÀÈd£À²Ã®vÉ PÀ°AiÀÄÄ J®ègÀ°ègÀĪÀ ¥Àæw¨sÉÃAiÀÄ£ÀÄß ºÉÆgÀºÁRĪÀ ªÉâPÉAiÀiÁV
¥ÀjªÀvÀð£ÉAiÀiÁ¬ÄvÀÄÛ JAzÀÄ ºÉüÀ§ºÀÄzÀÄ £ÀªÀÄä°è ºÀ®ªÁgÀÄ jÃwAiÀÄ ¥Àæw¨sÉAiÀÄ£ÀÄß, £ÁªÀÅ
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C¨sÁå¸À gÀƦ¹PÉƼÀÄîªÀAvÉ ªÀiÁrvÀÄÛ.
Learning from Filed Visits
PÉëÃvÀæ ¨sÉÃnUÀ½AzÀ ºÀ®ªÁgÀÄ ¸ÀªÀĸÉåUÀ¼À £ÉÊd avÀætUÀ¼ÀÄ £ÀªÀÄä ªÀÄ£À¸Àì£ÀÄß PÀ®PÀĪÀAvÉ
ªÀiÁrvÀÄÛ. F MAzÀÄ PÀ°PÉAiÀÄ CªÀ¢üAiÀÄ°è ºÀ®ªÁgÀÄ PÉëÃvÀæUÀ½UÉ ¨sÉÃn ¤ÃrzÁUÀ £ÀªÀÄä°è
K£ÀÆ PÉ®ªÉÇAzÀÄ ¨sÁjà ªÀiË£À DªÀj¸ÀĪÀAvÉ ªÀÄvÀÄÛ PÉ®ªÉÇAzÀÄ PÉëÃvÀæ ¨sÉÃnUÀ¼ÀÄ £ÀªÀÄä §qÉzÀÄ
J©â¸ÀĪÀAvɪÀiÁqÀÄwÛzÀݪÀÅ, CªÀÅUÀ¼À°è ªÀÄÄRåªÁV...
1. Green Foundation, Bangalore.
F PÉëÃvÀæ ¨sÉÃnAiÀÄ°è ¸ÀéAiÀÄA ¸ÀAWÀ¢AzÀ PÀȶAiÀÄ°è ºÀ®ªÁgÀÄ §®zÁªÀuÉUÀ¼ÀÄ §A¢zÀÄÝ,
¸ÁªÀAiÀĪÀ PÀȶ, ªÀÄtÂÚ£À ¥sÀªÀvÀvÉÛ, gÁ¸ÁAiÀĤPÀ UÉƧâgÀUÀ½AzÁUÀĪÁ £ÀµÀÖUÀ¼ÀÄ, ¸ÀªÀÄvÉÆî£ÉAiÀÄ
C©üªÀÈ¢ÞUÀ¼À CA±ÀUÀ¼À£ÀÄß w½zÀÄPÉƼÀî¯Á¬ÄvÀÄÛ.
2. Basic Needs India
J®èjUÀÆ w½¢gÀĪÀAvÉ ©.J£ï.L ªÀiÁ£À¹PÀ DgÉÆÃUÀåzÀ §UÉÎ, PÉ®¸À ªÀiÁqÀÄvÁÛ ¸ÀªÀÄÄzÁAiÀÄzÀ°è
vÉÆqÀV¹PÉÆArzÉ. ©.J£ï,L £ÀªÀÄä£ÀÄß £ÉÃgÀªÁV ªÀiÁ£À¹PÀ C¹ÜgÀ ªÀåQÛAiÀÄ°è DUÀĪÀ vÁvÁÌ°PÀ
§zÀ¯ÁªÀuÉÃUÀ¼ÀÄ, fêÀ£À ±ÉÊ°, ¸ÀªÀĸÉåUÀ¼ÀÄ, ¸ÀªÀiÁdzÀ°è CªÀgÀÄ AiÀiÁªÀ jÃwAiÀÄ »A¸ÉUÉ
M¼ÀUÁUÀÄwÛzÁÝgÉ.
D ªÀåQÛAiÀÄ£ÀÄß AiÀiÁªÀ jÃw¬ÄAzsÀ £ÉÆÃrPÉƼÀî¨ÉÃPÀÄ, PÀÄlÄA§zÀªÀgÀÄ AiÀiÁªÀ jÃw¬ÄAzÀ
¸ÀªÀiÁdzÀ°è CªÀgÀ ¹ÜwUÀwUÀ¼ÀÄ EgÀÄvÀÛzÉ JAzÀÄ w½zÀ ¸ÀAUÀwUÀ¼ÁVzÀݪÀÅ.
3. FRLHT, Bangalore.
FRLHT AiÀÄÄ MAzÀÄ «±ÉõÀ PÉëÃvÀæ ¨sÉÃn JAzÀÄ ºÉüÀ§ºÀÄzÀÄ.¸ÀA¸ÀÌøw¬ÄAzÀ ªÉÊzÀå ±Á¸ÀÛç
ºÀÄnÖzÀÄÝ ºÀ®ªÁgÀÄ OµÀ¢üPÀgÀtzÀ UÀÄtªÀżÀî JµÀÄÖ VqÀªÀÄÆ°PÉUÀ¼ÀÄ £ÀªÀÄä ¥Àj¸ÀgÀ £ÀªÀÄUÉ
ªÀgÀªÁVzÉ, F ¥ÀgÀA¥ÁjPÀ ªÉÊzÀå±Á¸ÀÛçUÀ¼ÁzÀ, DAiÀÄÄðªÉÃzÀ, AiÉÆÃUÀ AiÀÄÄ£Á¤, ºÉÆëÄAiÉÆÃ¥Àw
aQvÉì ¥ÀzÀÞwUÀ¼ÀÄ ¨ÉÃgÉ ¨ÉÃgÉAiÀiÁVzÀÄÝ J®zÀègÀ ªÀÄÆ® DgÉÆÃUÀå ¸ÀÄzsÁgÀuÉ MAzÉÃ
CA±ÀªÁVvÀÄÛ.
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4. Association of People with Disability
F MAzÀÄ PÉëÃvÀæ CªÀ¢üAiÀÄÄ CAUÀ«PÀ®vÉ MAzÀÄ ±Á¥ÀªÉÇÃ! ªÀgÀªÉÇÃ!JA§ «ZÁgÀªÀ£ÀÄß
w½AiÀÄĪÀAvÉ ªÀiÁrvÀÄ, CAUÀ«PÀvÉAiÀÄĪÀÅ ¸ÀªÀĸÉå JAzÀÄ PÉÆAqÀgÉ CAzÀÄ PÉÆ£ÉAiÀĪÀgÉUÀÆ
¸ÀªÀĸÉåAiÀiÁV G½zÀÄ ºÉÆÃUÀĪÀÅzÀÄ EAvÀºÀ CAUÀ«PÀ®vÉAiÀÄ£ÀÄß ªÉÄnÖ ºÀ®ªÁgÀÄ ¸ÁzsÀ£ÉUÀ¼ÀÄ
ªÀiÁqÀ§ºÀÄzÀÄ, ºÁUÀÆ E£ÉÆߧâ CAUÀ«PÀ®jUÉ CAzÀÄ ªÀiÁUÀðzÀ±Àð£ÀªÁUÀĪÀÅzÀÄ JAzÀÄ
w½zÀÄPÉƼÀî¯Á¬ÄvÀÄÛ.
5. ¸ÉúÁßzsÀ£À (People Living with HIV/AIDS)
¸ÉúÁßzsÀ£À £À£Àß ¥ÀæPÁgÀ EAzÀÄ MAzÀÄ «©ü£Àß ¨sÉÃn, JAzÀÄ ºÉüÀ§ºÀÄzÀÄ KPÉAzsÀgÉ
£Á£ÀÄ M§â ºÉZï.L.« EzÀÝ ªÀåQÛAiÀÄ£ÁßUÀ°è UÀªÀĤ¸ÀgÀ°®è, ¸ÉúÁßzsÀ£À ¸ÀA¸ÉÜAiÀÄÄ ºÀ®ªÁgÀÄ
ºÉZï.L.«AiÀÄļÀî gÉÆÃVUÀ¼À ¸ÀàA¢¸ÀĪÀ PÁAiÀÄðzÀ°è vÉÆqÀVzÀÄÝ ºÀ®ªÁgÀÄ ºÉZï.L.«AiÀÄļÀî
ªÀÄPÀ̼À£ÀÄß £ÉÆÃrzÁUÀ AiÀiÁªÀ ¥Á¥ÀªÀiÁqÀzÉà ¨sÀÆ«ÄUÉ §AzÀ ªÀÄPÀ̽UÉ ªÀÄ£É JAzÀÄ
ºÉüÀ§ºÀÄzÀÄ.
6. PÀgÀÄuÁ®AiÀÄ ªÀAiÀĸÀÌgÀ ªÀÄ£É
PÀgÀÄuÁ®AiÀÄPÉÌ MAzÀÄ ¢£ÀzÀ ¨sÉÃn ªÀiÁrzÁUÀ £Á£ÀÄ E°èAiÀĪÀgÉUÀÆ JµÀÄÖ C£ÁxÀ
ªÀÄPÀ̼À §UÉÎ PÉýzÀÄÝ ¸ÁªÀiÁ£ÀåªÁVvÀÄÛ, DzÀgÉ F PÉëÃvÀæ ¨sÉÃnAiÀÄ°è JµÀÄÖ vÀAzÉ vÁ¬ÄUÀ¼ÀÄ
ªÀÄPÀ̽zÀÄÝ, C£ÁxÀgÁVzÁÝgÉ F zÀȱÀå £À£ÀߣÀÄß ªÀAiÀĸÀÌgÀ DgÉÆÃUÀåzÀ DyðPÀ ªÀÄvÀÄÛ ¸ÁªÀiÁfPÀ
¸ÀªÀĸÉåUÀ¼ÀÄ w½zÀÄPÉƼÀÄîªÀAvÉ ¥ÉæÃgÀuÉ ¤ÃrvÀÄÛ.
PÉÆ£ÉAiÀÄzÁV EAvÀºÀ ºÀ®ªÁgÀÄ PÉëÃvÀæ ¨sÉÃnUÀ¼ÀÄ £ÀªÀÄä°è CAzÀgÉ £ÀªÀÄä ¸ÀªÀiÁdzÀ°ègÀĪÁ
¸ÁªÀiÁfPÀ vÉÆAzÀgÉUÀ¼ÀÄ PÀqÉUÉ UÀªÀÄ£ÀºÀj¸ÀĪÀAvÉ ªÀiÁrvÀÄÛ, £ÀªÀÄä£ÀÄß D ªÀiÁUÀðzÉqÉUÉ
£ÀqsÉAiÀÄĪÀAvÉ ªÀiÁUÀðzÀ±Àð£À ¤ÃrvÀÄÛ.
Field Placement in Sarvodaya in Gulbarga District
¸ÀªÉÇÃzÀAiÀÄ JA§ ¸ÀA¸ÉÜAiÀÄÄ UÀÄ®âUÁð f¯ÉèAiÀÄ C¼ÀAzÀ vÁ®ÆèQ£À°è PÁAiÀÄð
¤ªÀð»¸ÀÄwÛzÀÄÝ ºÀ®ªÁgÀÄ ¸ÁªÀiÁfPÀ ¸ÀªÀĸÉåUÀ½UÉ ¸ÀàA¢ü¸ÀĪÀ°è AiÀıÀé¹AiÀiÁVzÉ. F MAzÀÄ
¸ÀA¸ÉÜAiÀÄ ªÀÄPÀ̼À ²PÀët, ¥Ë¶×PÁA±ÀzÀ PÉÆgÀvÉ, vÁ¬ÄAzÀgÀ ¸ÀªÀĸÉåUÀ½UÉ ¸ÀàA¢¸ÀĪÁ ¸À¨sÉ,
¥Àj¸ÀgÀ ¸ÀéZÀÒvÉAiÀÄ §UÉÎ ªÀÄPÀ̼À£ÀÄß EvÀAºÀ ZÀlĪÀnPÉUÀ¼À°è vÉÆqÀV¹PÉÆAqÀÄ PÉ®¸À
ªÀiÁqÀÄwÛzÉ, ¹¸ÀÖgï nãÁ CªÀgÀÄ ¸ÀªÀÄÄzÁAiÀÄ vÀ¼ÀºÀ¢AiÀÄ ¸ÀªÀĸÉåUÀ½UɸÀàA¢ü¸ÀĪÁ CªÀgÀÄ
PÉ®¸À ¤dPÀÆÌ ºÉªÉÄäAiÀÄ «µÀAiÀĪÁVzÉ.
£Á£ÀÄ ¸ÀªÉÇÃðzÀAiÀÄ JA§ ¸ÀA¸ÉÜAiÀÄÄ PÉëÃvÀæ CzsÀåAiÀÄ£ÀPÁÌV ºÉÆÃzÁUÀ ºÀ®ªÁgÀÄ jÃw¬ÄAzÁ
¸ÀªÀÄÄzÁAiÀÄzÀ
ZÀ®£À
ªÀ®£ÀUÀ¼À
¸ÀA¥ÀÆtð
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w½zÀÄPÉƼÀÄîªÀ°è
¸ÀºÁAiÀÄPÀªÁ¬ÄvÀÄÛ,CzÀgÀ°è °AUÀvÁgÀvÀåªÀÄ, UÁæ«ÄÃt fêÀ£À ±ÉÊ°, CªÀgÀ°ègÀĪÀ
ªÀÄÆqÀ£ÀA©PÉUÀ¼À ¤UÀÆqsÀvÉ, gÉÊvÀgÀ fêÀ£ÀzÀ¯ÁèUÀĪÀ KgÀÄ¥ÉÃgÀÄUÀ¼ÀÄ FºÀ®ªÁgÀÄ ¸ÁªÀiÁfPÀ
PÁgÀtUÀ½AzsÀ ¸ÀªÀÄÄzÁAiÀÄzÀ DgÉÆÃUÀåªÀ£ÀÄß ¤zsÀðj¸ÀĪÀ ¤zsÁðgÀPÀUÀ¼À §UÉÎ §AzÀÄ ¥ÀQë£ÉÆÃl
£À£ÀßzÁVvÀÄÛ.
5
ªÀÄAwæ ªÀÄAqÀ®zÀ ªÀÄÆ®PÀ ªÀÄPÀ̼À UÀÄA¥ÀÄUÀ¼À ªÀiÁr ºÀ®ªÁgÀÄ ¸ÁªÀiÁfPÀ
¸ÀªÀĸÉåUÀ½UÉ ¸ÀàA¢¸ÀĪÀÅzÀÄ ¹¸ÀÖgï nãÁgÀªÀgÀ ªÀÄÄRå GzÉÝñÀªÁVvÀÄÛ.CzÀÄ C®èzÉ F
ªÀÄAvÀæ ªÀÄAqÀ®ªÀ£ÀÄß G¥ÀAiÉÆÃV¹PÉÆAqÀÄ ¨Á®PÁ«ÄðPÀ ªÀÄvÀÄÛ fÃvÀ ¥ÀzÀÝw
vÉUÉzÀĺÁPÀĪÀÅzÁVvÀÄÛ.
F MAzÀÄ UÁæªÀĪÀÅ ºÀ®ªÁgÀÄ ¸ÀªÀĸÉåUÀ½AzÀ PÀÆrzÀÄÝ CzÀgÀ°è PÀÄrAiÀÄĪÀ ¤Ãj£À ¸ÀªÀĸÉå,
±ËZÁ®AiÀÄ, «zÀÄåvï, gÀ¸ÉÛUÀ¼À ªÀÄvÀÄÛ ¸ÁªÀðd¤PÀ ªÁºÀ£ÀUÀ¼À F J¯Áè ¸ÀªÀĸÉåUÀ¼À £ÀqÀĪÀ°è
§zÀÄPÀÄ ¸ÁV¸ÀĪÁ fêÀ£À CªÀgÀzÁVvÀÄÛ.
DgÉÆÃUÀå ¥Á®£Á vÁådå
£À£Àß CzsÀåAiÀÄ£ÀzÀ «µÀAiÀĪÁzÀ DgÉÆÃUÀå ¥Á®£Á vÁdåzÀ §UÉÎAiÀÄÆ ºÀ®ªÁgÀÄ «µÀAiÀÄUÀ¼À£ÀÄß
E°è w½zÀÄPÉƼÀî¯Á¬ÄvÀÄ. §¸ÀªÉñÀégÀ ªÀÄvÀÄÛ ¸ÀPÁðj D¸ÀàvÉæUÀ½UÉ ¨sÉÃn ¤ÃrzÁUÀ DgÉÆÃUÀå
¥Á®£Á vÁådåªÀÅ ¤ªÀðºÀuɪÀÅ ¸ÀjAiÀiÁV £ÀqÉAiÀÄzÉà EgÀĪÀÅzÀÄ w½zÀħAvÀÄ, UÀÄ®âUÁð
f¯ÉèAiÀÄ°è ºÀ®ªÁgÀÄ ¥ÁæxÀ«ÄPÀ DgÉÆÃUÀå PÉÃAzÀæUÀ½UÉ ¨ÉÃn ¤ÃrzÁUÀ £Á£ÀÄ vÀgÀUÀwUÀ¼À°è
w½zÀÄPÉÆAqÀÄ ºÀ®ªÁgÀÄ «µÀAiÀÄUÀ¼À §UÉÎ ªÉÊzÀågÀ eÉÆvÉUÉ ZÀZÉð ªÀiÁqÀ®Ä
¸ÀºÁAiÀÄPÀªÁ¬ÄvÀÄÛ.
Healthcare WasteManagement Workshop in Gulbarga
DgÉÆÃUÀå ¥Á®£Á vÁådåzÀ PÁAiÀÄðUÁgÀzÀ°è £Á£ÀÄ ¨sÁUÀªÀ»¸À®Ä ªÀÄÄRå PÁgÀt £À£Àß D¸ÀQÛ
ªÀÄvÀÄÛ qÁ||gÁªÀÄPÀȵÀÚ UËqÀ JAzÀÄ ºÉüÀ§ºÀzÀÄ.
F
MAzÀÄ
vÀgÀ¨sÉÃwAiÀÄ
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¥ÀjZÀAiÀĪÁ¬ÄvÀÄÛ.CzÀÄ C®èzÉà DgÉÆÃUÀå ¥Á®£Á ¤ªÀðºÀuɬÄAzÁUÀĪÀ ¥Àj¸ÀgÀ ªÀiÁ°£Àå,
¸ÀªÀÄÄzÁAiÀÄzÀ°è AiÀiÁªÀ jÃw¬ÄAzÁV ºÁ¤PÁgÀªÁVzÉ CzÀÄ AiÀiÁgÀÄ AiÀiÁjUÉ AiÀiÁªÀÅzÀgÁ
ªÀÄÆ®PÁ ºÉÃUÉ ºÀgÀqÀÄvÀÛzÉ.¥ÁzÀgÀ¸ÀzÀ ¤ªÀðºÀuÉ, DgÉÆÃUÀå ¥Á®£Á vÁådå ¤ªÀðºÀuÉ
ªÀiÁqÀĪÀ ªÀÄÄRå GzÉÝñÀUÀ¼ÀÄ, w½zÀÄPÉƼÀî¯Á¬ÄvÀÄÛ.
D±Á
¸ÀªÀÄÄzÁAiÀÄzÀ°è M§â ¤¸ÁéxÀð ªÀÄ£ÉÆèsÁªÀ£ÉAiÀÄļÀî ºÉtÂÚ£À ¸ÀºÁAiÀÄ ªÀiÁqÀĪÀ ¸ÉêÀQAiÀÄgÀ
§UÉÎ «ªÀgÀªÁzÀ w½zÀÄPÉƼÀî¯Á¬ÄvÀÄÛ.CªÀgÀÄ ºÀ®ªÁgÀÄ dªÀ¨ÁÝjUÀ½zÀÝgÀÄ, ¸ÀªÀÄÄzÁAiÀÄzÀ°è
K°UÉUÁV PÁAiÀÄ𠤪Àð»¸ÀĪÀ ªÀåQÛUÀ¼ÁVzÀÄÝ, ¸ÀªÀÄÄzÁAiÀÄ ¸ÀÄzsÁgÀuÉAiÀÄ°è CªÀgÀ ¥ÁvÀæ
ªÀÄÄRåªÉAzÀÄ w¼ÀzÀÄPÉƼÀî®Ä ¸ÀºÁAiÀĪÁ¬ÄvÀÄÛ.
G¥À¸ÀAºÁgÀ
F MAzÀÄ PÉëÃvÀæ CªÀ¢üAiÀÄ°è
UÁæ«Ät fêÀ£À £ÉÊd zÀȱÀåUÀ¼ÀÄ £À£Àß ªÀÄ£À¸Àì°è
¸ÉgÉ»qÀĪÀAvÉ ªÀiÁrvÀÄÛ, ¸ÀªÀÄÄzÁAiÀÄ, ¸ÀªÀÄÄzÁAiÀÄ DgÉÆÃUÀå, D±Á ¸ÀªÀiÁd¸ÉêÀQ, ¥ÁæxÀ«ÄPÀ
DgÉÆÃUÀå PÉÃAzÀæ , CAUÀ£ÀªÁr PÉÃAzÀæ, ªÀÄPÀ̼À ²PÀët PÉÆgÀvÉ, ªÀAiÀĸÀÌgÀ fêÀ£À±ÉÊ°,
6
ªÀiÁ£À¹PÀ DgÉÆÃUÀå, F J¯Áè vÀgÀUÀwUÀ¼À°è w½zÀÄPÉÆAqÀÄ §AzÀ £ÀAvÀgÀ PÉëÃvÀæ ¨sÉÃnUÀ¼À°è
£ÀªÀÄUÉ ¸ÀºÁAiÀĪÁ¬ÄvÀÄÛ.
¸ÀªÀÄÄzÁAiÀÄ JAzÀgÉ K£ÀÄ, ¸ÀªÀÄÄzÁAiÀÄzÀ°ègÀĪÀ ¸ÀªÀĸÉåUÀ¼ÀÄ, CªÀÅUÀ¼À … d£ÀgÀÄ ºÉÃUÉ
¸ÀàA¢¸ÀÄvÁÛgÉ ºÁUÀÆ ¹¸ÀÖgï nãÁgÀªÀgÀ ¸ÀªÀÄÄzÁAiÀÄzÉÆA¢UÉ EgÀĪÀ ¸ÀA§AzsÀªÀ£ÀÄß £À£ÀߣÀÄß
¸ÀªÀÄÄzÁAiÀÄ PÀqÉUÉ ¸É¼ÉAiÀÄĪÀAvÉ ªÀiÁrvÀÄÛ.
Second Placement visit in Bangalore
F MAzÀÄ PÉëÃvÀæ CzsÀåAiÀÄ£ÀzÀ°è DgÉÆÃUÀå ¥Á®£Á vÁådPÉÌ ¸ÀA§AzsÀ¥ÀlÖAvÉ PÉ®¸À
ªÀiÁqÀ¯Á¬ÄvÀÄ.JgÀqÀ£Éà PÉëÃvÀæ CªÀ¢üAiÀÄ°è £À£Àß PÀ°PÉ CvÀåvÀÛªÀĪÁV ¸ÁVvÀÄÛ.
qÁ|| ¥ÀÈyé±ïgÀªÀgÀ£ÀÄß ¨sÉÃn ªÀiÁrzÀ £ÀAvÀgÀ £À£Àß ¸ÀA±ÉÆÃzsÀ£Á CzsÀåAiÀÄ£ÉÌPÀ ¸ÀA§A¢ü¹zÀAvÉ
¥Àæ±ÉÆßÃvÀÛgÀUÀ¼À£ÀÄß vÀAiÀiÁj¹PÉÆAqÀÄ CzsÀåAiÀÄ£À ¥ÁægÀA©ü¹zÉ CzÀÄ DzÀ £ÀAvÀgÀ D£ÉÃPÀ¯ï
PÉëÃvÀæzÀ°è §gÀĪÀ ¸ÁªÀðd¤PÀ ªÀÄvÀÄÛ SÁ¸ÀVà D¸ÀàvÉæUÀ½UÉ ¨sÉÃn ¤Ãr DgÉÆÃUÀå vÁdå
¤ªÀðºÀuÉAiÀÄ §UÉÎ ¸ÀA¥ÀÆtð w½zÀÄPÉƼÀî¯Á¬ÄvÀÄÛ.
F MAzÀÄ PÉëÃvÀæ CzsÀåAiÀÄ£ÀzÀ°è £Á£ÀÄ ºÀ®ªÁgÀÄ DgÉÆÃUÀå ¥Á®£Á PÉ®¸ÀUÁgÀgÉÆA¢UÉ
ZÀað¹ DgÉÆÃUÀå ¥Á®£Á vÁådåzÀ ªÀiÁ»wAiÀÄ£ÀÄß ¸ÀAUÀæºÀuÉ ªÀiÁrPÉÆAqÀÄ CzÀ£ÀÄß
PÀA¥ÀÆålgï£À°è zÁR¯É ªÀiÁrPÉÆAqÀÄ CzÀ£ÀÄß ¥Àj²Ã®£É ªÀiÁqÀ¯Á¬ÄvÀÄÛ.
F MAzÀÄ CªÀ¢üAiÀÄ°è ºÀ®ªÁgÀÄ ¸ÀPÁðj ªÀÄvÀÄÛ SÁ¸ÀV PÀbÉÃjUÀ½UÉ ¨sÉÃn ¤ÃqÀ¯Á¬ÄvÀÄÛ.
Taluk Family and Social Welfare office Anekal, Bangalore (U).
District Plan Management Office, Bangalore.
District Family and Social Welfare Office, Bangalore
Dr.Pruthiush, M.S.R Medical Hospital, Bangalore.
Anekal Taluk PHC’s and Private Hospital.
Karumalaya Old Aged Home, Bangalore.
Snehadhan (Lliving with HIV/AIDS).
Institute of Ayurveda and integrative medicine low-cost copper
device for Microbial purification of drinking water in household
a field visit.
1. FRU Hospital Anekal Taluk
F DgÉÆÃUÀå ¥Á®£Á vÁådPÉÌ «µÀAiÀÄPÉÌ ¸ÀA§A¢ü¹zÀAvÉ F D¸ÀàvÉæUÉ ¨sÉÃn¤ÃrzÁUÀ ªÀÄvÀÄÛ
C°è EgÀĪÀ PÉ®¸ÀUÁgÀgÉÆA¢UÉ ªÀiÁvÁ£ÁrzÁUÀ DgÉÆÃUÀå ¥Á®£Á vÁådå ¤ªÀðºÀuÉAiÀÄ §UÉÎ
¸ÀjAiÀiÁzÀ ªÀiÁ»w ¤ÃqÀĪÀÅzÀgÀ eÉÆvÉUÉ M¼ÉîAiÀÄ ¤ªÀðºÀuÉ ªÀiÁqÀĪÀÅzÀÄ w½zÀħAvÀÄ.
2. District Health Care District Nodal Officer
7
District Health Care District Nodel Officer¨sÁUÀåªÀAwAiÀĪÀgÀ£ÀÄß
¨sÉÃnªÀiÁrzÁUÀ £À£Àß ¸ÀA±ÉÆÃzsÀ£Á CzsÀåAiÀÄ£À §UÉÎ CªÀjUÉ w½¹zÁUÀ £À£Àß CzsÀåAiÀÄ£ÀPÀÌ
C£ÀÆPÀÆ®ªÁªÀŪÀAvÉ D£ÉÃPÀ¯ï vÁ®ÆèQ£À°ègÀĪÁ, D¸ÀàvÉæUÀ¼À zÁR¯Áw ¤ÃrzÀÝgÀÄ EzÀÝjAzÀ
£À£Àß ¸ÀA±ÉÆÃzsÀ£Á PÁAiÀÄðPÉÌ ¸ÀÄ®¨sÀªÁ¬ÄvÀÄÛ.
3. Taluk Family and Social Welfare Office, Anekal.
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8
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Waste ManagementJA§ ªÀÄÄ¢æPÉÌAiÀÄ°è ªÀÄÄ¢æ£À¸À¯Á¬ÄvÀÄÛ.
Field Placement in Gurukula Botanical Sanctuary in Kerala
The Gurukula Botanical Sanctuary and Garden in Peria, in the Wayanad
district of Kerala. To reach it, you have to travel along an unpaved road from
Peria for a couple of kilometers through a jungle. The moment you enter the
Gurukula you experience the tranquility of nature. There are evergreen forests
on all sides. You can see numerous types of butterflies and birds, like the
winged parakeet and Mountain Imperial Pigeon. There is the Niligiri Langur,
the sambar deer and the necked mongoose. It is home to nearly 3,000 species
of plants from the Western Ghats and is rich in fauna and flora. But there is a
whiff of danger too. There are more than 20 varieties of snakes, of which
seven are very poisonous.
In GBS, there is organic farming, animal husbandry, and alternate
energy mechanisms, rain water harvesting vegetable garden. They have a
programme called, „School in the Forest‟ where schoolchildren and adults
live and work in the sanctuary. A five-month programme costs Rs 50,000,
which includes food, accommodation, instruction and travel.
Wolfgang Theuerkauf is a German, who came here 40 years ago, fell in
love with the place and stayed on. “His travels to different parts of the world,
his came to India and ended up in the Western Ghats, he says “He bought a
patch of land and started the Gurukula in 1981. As this area was encircled by
forests, no one was willing to look after it, so. I decided to do so. In 1981 he
received Indian nationality and married a Malayali, Leelama, who is from
Periya.
9
Suprabha Seshan, a Tamilian, has been assisting Theuerkauf for the past
20 years. Now, as Director of the sanctuary, Suprabha gives classes on the
conservation of forests.
Their work has received international recognition. The International
Union for the Conservation of Nature has labeled the Gurukulam as one of the
25 centers of bio-diversity in the world.
In 2006 it won the „Whitley‟ award, the biggest environment award
from Great Britain for the most effective conservation efforts around the
world. So a German living in India is doing his best to preserve eco systems in
one corner of this vast country.
The Sanctuary is a patch of 50 acres of forest land of which some 40
acres are left largely alone for natural succession. About 5 acres is
meticulously tended and doubles as a showcase for visitors to visit, explore,
interrogate and comprehend. The Gurukula tends its forests on the principles
of restoration ecology with careful, conscious human interference. Form the
mosses, liverworts, ferns, orchids, lichens to the massive angiosperms, each
one is documented, catalogued, tended and known by nature, place,origin, age
and stage.
A small group of six individuals live and work at the sanctuary and are
collectively responsible for the place. It has grown into an informal centre for
botanical research, forest department's collaborative centre for conservation
efforts and a space for children to gleam into the mysteries of what constitutes
the living earth.
Objectives of GBS
The GBS aim is to conserve the nature and preserve the disappearing
flora and fauna. They grow the plants seen everywhere to make people aware
that these are the plants they neglect also they grow fishes.
Objectives of School in the Forest
GBS educational programme „The School in the Forest‟ is now 12 years
old. It works with schools, individuals and NGOs at local, regional, national
and international levels.
The concern is to bring about a shift in attitude and alliance within
human society with respect to the natural world.
10
GBS encourage long and intensive exposure to the tropical forest
environment, to open up different sensibilities and dimensions in children.
They are urging a collective reflection of environmental and global
issues in order to bring about effective and meaningful action.
They suggest that the severance between humanity and nature has
complex roots. A far deeper awareness is needed to address this.
“My experience in school in the forest”
On December 26th morning I left for wayanad and reaching Gurukula
Botanical Sanctuary (GBS) I stay couple days in GBS guest house.
School in the forest was unexpected wonderful Opportunity when I first went to GBS
I‟ve no specific ideas about School in the forest I was concerned with to
understanding about nature conservation, Climate of wayanad, Cultural of tribal
people, later when I interact with the people GBS I slowly understood the School in
the forest program along with objectives and specific ideas agreed to its rules and
regulation.
Construction house in the forest
This is a new experience for me. It is the first time are I and loranzo
construction house. It is a totally different exposure. Shelter and food are basic
needs for human beings wherever you go, whatever you do these are very
important.
House took four to five days to complete. I had carried to down from the
sanctuary. This activity was. some time boring and sometimes I‟m thinking where
I have come, what I‟m doing, what my interest, and I‟m not clear my ic
objectives.
11
Setting up tent
I also tent a on preparing my own. Daily I was asking about setting up of
tent to loranzo, finally one day I got to do it. I did not sleep even one day in the
tent because I scared about elephants.
Work on Sanitation
Sanitation is very important work because it indicates of clean
environment and their reason. Alternative sanitation constructed In the forest a.
While working on sanitation I remembered Mr. Prahlad IMwho is working on
water and sanitation. One of the unexpected activities that I enjoyed
Shopping weekly once in Mananthavady
I went for shopping in Mananthavady with Subbi, Loranzo, Isa, we
purchased materials and things for school in the forest.
Coffee picking
Coffee harvesting was another activity in
which I was interested and daily I was involved
in picking up coffee from 10 to11.30 am.
Path clearing in forest
12
Path clearing is also a part of the program while working on path
clearing; Idid not know how to use the spade initially but slowly I understood
the method and developed using a spade.
Cooking also part of program
Another experience was of cooking, and I learned to cook, how much
quantity is required for four persons, daily menu and all members cooked
nicely and it was a helpful to understand each other.
Forest walk
I wake up in the between morning 6.30 and 7 am I used to go for forest
walk daily for 1 hour between 7 and 8. In the walk I observe many things are
which a very different experience was for me. There are many different variety
of species of plants, different shaped leaves, colorful butterflies, different types
of bird‟s, spiders, mosses, Ferns, orchids, and also learnt relation between
plant to one other, some time I saw snakes, and insects. It created a complete
different world around me, sometimes I forget myself while enjoying nature.
River walk
13
River walk is another enjoyable activity in the forest
Visiting Garden with Suma
I went to around garden with suma, who is specialist in plants , suma
explained about elephant leaves( Begonia family) Orchids, impatiens plant,
first plat on earth, herbivorous, carnivores, plants, trees , scrubs, wood trees,
woodless trees, exotic trees, re plantation and rare plants, she is suggested me
read to biological plant book.
Yoga and physical exercise
Loranzo was teaching us yoga daily in the morning. Some physical
activity, like running, roof climbing and so on.
Working in site
In the forest I selected my own site
for identification of plants, in my site I
collected different types of flowers,
leaves, grass, and seeds then went to the
library to discuss with Suprabha Seshan.
14
The site I selected near to water
spring it is rich in plants I collected so
many things I discuss taxonomy of about
roots, leaf, flowers structure, ecology,
habitat etc…
About Loranzo
Loranzo is a one of my best friend, teacher, a good person and a hard
worker; he inspired me a lot, thank you, Loranzo.
Some of the trip we had in this program were Visit of Maradam farm
School and herbal park Tiruvnamalai in Tamilnadu, Solitude Organic cafe.
My Leanings
This program in I learnt many thing like discovering the
nature, Simple living, Work experience, my personal skills are
developed, Discovered the other culture and language, the beauty of
the tribal people, the beauty of physical hard work, challenges of
wild life, Interactions with people of different nationality, Feeling of
humanity as one, idea developed on organic farming.
Paper presentation in Lucknow, UP.
13th Annual Conference of Indian Society of Hospital Waste
Management Lucknow, Uttar Pradesh.
Loranzo And Poul
Suprabha, Pradeep, Nadeem
15
Bhim, Govinda, Lorazo
A Study on the status of health care waste management of Infection
Control practices in health care settings of Anekal Talk, Bangalore Urban
District.
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PÁgÀtªÁ¬ÄvÀÄÛ JAzÀÄ ºÉüÀ§ºÀÄzÀÄ.
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ªÀÄÄRåªÁVvÀÄÛ DªÀgÀ°è ªÀÄÄRåªÁV qÁ||¥ÀÈyé±ï, qÁ||AiÀÄĪÀgÁd, qÁ||D¢vÀå, qÁ||gÁºÀįï
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Reading books in CHC library
Down to earth
National health policy
Biomedical waste and the law
Naimarlya & Aryogya (kannada)
Hosatu (Kannada)
Environmental impact assessment
Essential Of Public Healthcare
Compulsory Liencin for Public Health
Bio medical waste law
Rapidex English course
Hospital waste management and Monitoring
Safe management of healthcare management information & learning
from community
Pesticides in India
Setting environment standards
CHLP Reports
Community Health Monitoring Plan
Chinese Acupuncture
Elements of NHP
Health for All
Report on national Health policy Work shop
Health and national manual
Public health nutrition
Research for development
16
Methods for community development
Participation research and evolution
Community development
How to measure and evaluation
Community monitoring planning
NRHM in the eleventh five years plan
Primary health care
Yoga foe diabetes
Ayurveda
Homeopathy
Science and technology
Ten steps towards organic farming
Green tropism
Ministry of Wayanad
Abstract
A study on the status of health care waste management and
infection control practices in health care settings of Anekal Taluk,
Bangalore Urban district
Introduction
Health care waste (HCW) is a potential source of infectious diseases and
may also root to environmental pollution. This hazardous impact on human
and environment can be minimised by implementation and execution of
standard systematic Health Care Waste Management (HCWM) procedure. The
study was accomplished to observe and describe HCWM and infection control
(IC) practices in health care settings (HCS).
Materials and Method
A cross sectional study was conducted in Anekal taluk, Bangalore
Urban district of Karnataka state by visiting 37 HCS during August and
September, 2013. Data was collected using a standard check list for HCWM
and IC related practices (segregation, storage, collection, transportation and
disposal). Descriptive analysis was done using Microsoft Excel and SPSS
version 20.
17
Result
Sharp waste containment was satisfactory in 51.4% and sharp waste
disinfection/treatment in 45.9% (n=17) of HCS. Infected plastic waste was
being disinfected 48.6% (n=18) HCS. Appropriate final disposal of sharp
waste was carried out in 89.2% (n=33), infected plastic waste in 64.9% (n=24)
and soiled waste in 83.8% (n=31) HCS. Sharp waste disfigurement was done
at 75.7% (n=28) HCS and infected plastic waste disfigurement in 56.8%
(n=20) HCS.
Conclusion
The study on the status of HCWM and IC practices illustrates that all the
guidelines are not being followed at all the HCS and there is a need to
strengthen the HCWM for better enforcement of guidelines to ensure the
human health and environmental protection.
Keywords: Healthcare, Waste Management, Waste Disposal,
Segregation, Containment, Disinfection
Introduction
Health care sector is one of the fastest growing sectors in India
especially in the urban areas with an estimated growth rate of 12% per annum1.
With increasing number of health care settings (HCS) the health care waste
generated is also increasing. An estimated 0.33 million tonnes of hospital
waste is generated annually in India; the average waste generated per bed per
day ranges between 0.5kg and 2 kg 2. WHO estimates that between 75% and
90% of hospital waste generated is non-hazardous and the remaining 10-25%
is hazardous waste which has potential to affect human health 3.
Healthcare waste is a source of environmental pollution and infectious
diseases, and is made up of toxic chemicals, infective materials, plastic waste,
sharps and general waste for which appropriate disposal is essential. Health
care waste is dependable source for infectious diseases like gastroenteric
infections, respiratory infections, ocular infections, tetanus, skin infections,
HIV/AIDS and hepatitis3. Health care waste presents a threat not only to
patients and their visitors but also to health care workers4. Appropriate
management of these wastes is important to protect human and environmental
18
health and is a responsibility of all health care workers and facilities.3
Guidelines have been established for segregation, containment, colour coding,
transportation and final disposal of healthcare waste. Studies conducted in
different parts of the country have shown poor adherence to biomedical waste
management rules prescribed by the Ministry of Environment and Forests as
per the Bio-Medical Waste (Management and Handling) Rules, 19985,6,7.
In this context the present study was conducted to observe and assess
healthcare waste management (HCWM) and infection control (IC) practices in
HCS located in Anekal taluk of Bangalore urban district which has seen a
recent spurt in urbanisation and increase in number of healthcare centres.
Materials and Method
Study Area:HCS located in Anekal taluk of Bangalore urban district
which has seen a recent spurt in urbanisation and increase in number of
healthcare centres.
http://wgbis.ces.iisc.ernet.in/energy/water/paper/wetland_restoration/studyarea.htm
Study Design: A descriptive cross sectional was conducted to assess the
existing health care waste management practices in 37 HCS including Primary
19
Health Centres (PHC), First Referral Unit (FRU), private hospitals, nursing
homes, clinics, diagnostic centres.
Study Period: The study was conducted between August and
September 2013 in Anekal taluk of Bangalore urban district
Sampling: A total of PHC-09, FRU-01, Clinics-13, Private hospital-11,
Diagnostic centres-2, were selected through convenient sampling.
Study Population: Population for the study comprised of health
workers (Doctors, Nurses, lab technicians, ward boys, ayah and helpers).
Inclusion criteria: Health care facilities with consent and permission
were included in study. Within each centre, staff members (indicated above)
who knew Kannada or English and willing to participate were included in the
study.
Data collection: Data was collected using a modified version of a
previously tested checklist which covers the HCWM topics of segregation,
containment, colour coding, disfigurement, transportation, final dispose of
waste and, availability of guidelines and infrastructure for waste disposal,
personal protective measures/equipment (PPE) and vaccination status of at-risk
workers.
Analysis: Data was entered in SPSS version 20. Basic analysis was
performed using Microsoft Excel and the results were stratified and compared.
Results
The final sample for analysis conducted out of total 37 HCS in the
study, Table 1 shows information of the various centres surveyed. Of the
surveyed centres, 43.2% had in-patient services besides OPD services (56.25%
were private hospitals and 31.25% were PHC‟s). FRU had the most number of
beds per centre, in-patient admissions, out-patient visits, followed by private
hospitals. (Table 1)
Table 1: Details about healthcare settings surveyed
Type of
HCS
Only OPD
N
%
OPD+IP
n
%
Avg.
Beds
Avg.
Avg.
Avg.
admission/ deliveries/ OP
month
month
visits
PHC (n=9)
4 44.4
5 55.6
4.8
14
12.7
805.6
FRU (n=1)
0
1
100
80
140
22500
0
100
20
Clinics
(n=14)
Diagnostic
centres
(n=2)
Private
Hospital
(n=11)
Total (n=37)
13 92.9
1
7.1
2
0
0
100
0.4
0
0
698.6
0
0
0
0
2 18.2
9 81.8
24.5
36.4
17.4
1790.9
21 56.8
16 43.2
11.3
16.4
12
1600.8
Avg.- Average, OPD- Outpatient Department, IPD- Inpatient Department
Sharp management practices were observed and assessed at HCS
surveyed. Colour coded dustbins were present only at 66.7% of PHC‟s, 7.1%
of clinics, 50% of diagnostic centres and 54.5% of private hospitals surveyed.
While appropriate sharp waste segregation was being done only at 77.8% of
PHC‟s and 78.6% of clinics, all diagnostic centres and private hospitals were
following appropriate segregation. Containment of sharp waste was being
carried out only at 66.7% of PHC‟s, 35.7% of clinics, 50% of diagnostic
centres and 66.7% of private hospitals included in the study. Sharp waste
disfigurement was being done at majority or all of the different types of HCS
surveyed except for in clinics. Other than clinics, majority of the other HCS
undertook safe transportation of sharp wastes. Appropriate sharp waste
disposal was being carried out at majority of the HCS surveyed. (Table 2)
Table 2: Sharp waste management practices being followed at
healthcare settings surveyed
Type of
HCS
PHC
(n=9)
FRU
(n=1)
Clinics
(n=14)
Diagno
Presence Appropri
of colour
ate
coded
segregati
dustbins
on
N
%
N
%
6 66.7
7 77.8
0
0
0
0
1
7.1
11 78.6
1
50
2
100
Appropria
te
Safe
Appropri
Contain disfigure transportat
ate
ment
ment
ion
disposal
N
%
N
%
N
%
N
%
6 66.7
9 100
8 88.9 8 88.9
0
0
100
1
100
1
100
5 35.7
6 42.9
6
42.9 11
78.6
1
2
2 100.0
50
21
1
100
2
100
stic
centres
(n=2)
6 54.5 11 100
7 63.6
Private
Hospita
l (n=11)
N=Number of centres adhering to guidelines
10 90.9
8
72.7 11
100
Comparing government and private HCS with regards to sharp waste
management shows that for all sharp waste management practices except
appropriate segregation, government HCS were performing better than private
HCS. (Figure 1)
Figure 1: Comparison of sharp waste management practices
between government and private healthcare settings surveyed
Infected plastic waste management practices were studied at HCS
surveyed. Colour coded dustbins for disposal of infected plastic waste were
present only at 55.6% PHC‟s, 14.3% of clinics, 50% of diagnostic centres, and
45.5% of private hospitals and at the single FRU surveyed. Except for clinics
appropriate segregation of infected plastic wasted was being carried out at all
other HCS. While only at 77.8% PHC‟s, 35.7% clinics, 54.5% private
disfigurement of infected plastic waste was being carried, at the FRU and all
diagnostic centres such practice was being followed. Disinfection of infected
plastic waste was being carried out at 55.6% PHC‟s, 35.7% clinics, 63.6%
private clinics, the FRU and none of the diagnostic centres respectively. With
22
regards to appropriate disposal of infected plastic wasted it was being done at
77.8% PHC‟s, 50% clinics, 63.6% private hospitals, the FRU and all the
diagnostic centres. (Table 3)
Table 3: Infected plastic waste management practices being
followed at healthcare settings surveyed
Type of
HCS
PHC
(n=9)
FRU
(n=1)
Clinics
(n=14)
Diagno
stic
centres
(n=2)
Private
Hospita
l (n=11)
Presence Appropria Contai Approp Infected
Safe
Appro
of colour
te
nment
riate
Plastics transpo priate
coded
segregatio
disfigur Disinfec rtation disposa
dustbins
n
ement
tion
l
N
%
N
% N % N % N % N % N %
5 55.6
9 100 7 77.
7 77.
5 55.
5 55. 7 77.
8
8
6
6
8
1 100
1 100 1 10
1 10
1 10
1 10 1 100
0
0
0
0
2 14.3
11 78.6 5 35.
5 35.
5 35.
6 42. 7 50
7
7
7
9
1
50
2 100 1 50
2 10
0
0
1 50 2 100
0
5 45.5
11
100
6 54.
5
6 54.
5
7 63.
6
6 54.
5
7
63.
6
N=Number of settings adhering to guidelines
While comparing government and private HCS with regards to their
infected plastic waste disposal it is seen that the former have better waste
management practices than the latter in terms of proportion of HCS following
a practice. (Figure 2)
23
Figure 2: Comparison of infected plastic waste management practices between
government and private healthcare settings surveyed
Table 4 provides information on the facilities available and methods
used for disposal of healthcare wastes at various settings. Incinerator was not
available at any of the HCS surveyed. Autoclave, burial pit and sharp pit were
being used present all the PHC‟s. In contrary to guidelines two PHC‟s reported
that plastic waste was being burnt. Autoclave was present at 21.4% of the
clinics and 45.5% of the private hospitals. The FRU, clinics, private hospitals
and diagnostics centres out sourced their HCWM to a private agency for final
disposal and hence had no need for burial and sharp pit.
Table 4: Facilities available and methods used for final disposal of healthcare
waste in the healthcare settings surveyed
Burning
Autoclave
Burial Pit
Yes
%
2 22.2
0 100
0
0
0
0
Yes
9
1
3
0
%
100
100
21.4
0
Yes
9
0
0
0
%
100
0
0
0
5
45.5
0
0
Type of HCS
PHC (n=9)
FRU (n=1)
Clinics (n=14)
Diagnostic centres
(n=2)
Private Hospital
(n=11)
0
0
24
Waste Sharps
Pit
Yes
%
9
100
0
100
0
0
0
0
0
0
Expect for one private hospital there was satisfactory usage of gloves by
ward boy at other HCS with ward boys. With regards to vaccination status of
ward boy except for private hospital rest of the HCS with ward boys had
vaccinated them. Of the HCS with ayah‟s on roll not at all PHC‟s and private
hospitals there was satisfactory usage of gloves and except for ayah‟s in PHC
in all other HCS they were vaccinated. In all HCS with helpers there was
satisfactory usage of gloves by them and also all of them were vaccinated.
(Table 5)
Table 5: Occupational safety measures for healthcare workers at
healthcare settings surveyed
Type
of
HCS
PHC
(n=9)
FRU
(n=1)
Clinic
s
(n=14)
Diagn
ostic
centre
s
(n=2)
Privat
e
Hospit
al
Gloves
usage
Ward
Boy
Satis
facto
C
ry
W usag
W
e
B (%)
5 100
Vaccinatio
n status of
Ward Boy
C
W Vacci
W nated
B
(%)
5
100
Gloves
Vaccinatio Gloves Vaccinatio
usage
n status of
usage
n Status of
Ayah
Ayah
Helper
Helper
Satis
Satis
facto
facto
ry
ry
C usag C Vacci C usag C Vacci
W
e
W nated W
e
W nated
A (%) A
(%)
H (%) H
(%)
4
75
4
75
1 100
1
100
1
100
1
100
1
100
1
100
1
100
1
100
2
100
2
100
1
0
1
100
1
100
1
100
1
100
1
100
0
0
0
0
0
100
0
100
5
80
5
80
3
67
3
100
3
100
3
100
25
(n=11)
CWWB = Centres with ward boys, CWA = Centres with ayah CWH = Centres with
helpers
District Nodal Officer for healthcare waste management has visited all
the HCS surveyed for purpose of monitoring. Majority of the HCS had
obtained authorization from Karnataka Pollution Control Board for healthcare
waste generation and consequent management. There was lack of system for
recording of illness/ injuries/ accidents resulting from healthcare waste
handling limited to healthcare workers in majority of the HCS. Similarly there
was lack of a monitoring mechanism for healthcare waste management system
in majority of the HCS. Staff training was also found to be lacking in majority
of the HCS. Accident register was available only at two PHC‟s and the FRU.
While the FRU had all the required monitoring and regulatory systems in
place, the diagnostic centers were seen to be lacking in all such systems expect
for obtaining authorization from Karnataka Pollution Control Board. (Table 6)
Table 6: Compliance with monitoring and regulatory systems for
healthcare waste management at healthcare settings surveyed
Type of
HCS
PHC
(n=9)
FRU
(n=1)
Clinics
(n=14)
Diagnostic
centres
(n=2)
Private
Hospital
(n=11)
Authorization
from
Pollution
Control
Board
obtained
Yes
%
8 88.9
System of
recording of
illness/
injuries/
accidents
Yes
4
%
44.4
Yes
5
%
55.6
1
100
1
100
1
100
1
100
1
100
13
92.9
1
7.1
1
7.1
4 28.6
0
0
2
100
0
0
0
0
0
0
0
0
10
90.9
4
36.4
3
27.3
3 27.3
1
9.1
26
Monitoring Training/ Accident
of waste
retraining register
management
to the
system
staff
provided
Yes
% Yes
%
4 44.4
2 22.2
Discussion
The present study was aimed at assessing the practice of Health Care
Waste Management indicates that HCWM guidelines were not being adhered
at all HCS. The situation in government HCS being better compared to private
HCS as per this study. Two health centers studied were burning plastic wastes,
a source of dioxins which have adverse health effects 8. The importance of
segregation is to separate infectious and non infectious waste and to avoid
potential hazards which may occur as a result of mixing the waste produced.
Similar to the present study, studies conducted in Lucknow, Uttar Pradesh;
Pulwama, Jammu and Kashmir have shown that colour coding for containment
of wastes was not being practiced at HCS which led to poor segregation
practices; however a study conducted in rural India have shown that the HCS
was following colour coding of wastes6,7,9,. Similar to our findings, a study
conducted in Pune, Maharashtra showed that segregation of sharps and
infected plastic waste was being adhered in majority of HCS 6,10.
Disfigurement of sharps which is important in order to prevent injuries
and also to prevent transmission of communicable diseases like Hepatitis B,
HIV/AIDS, is not being followed at some HCS according to the present study
and also studies conducted in Pune, Kathmandu and Nepal10,11. Similar to the
findings of the present study health care workers in Pune were provided with
personal protective equipment and were in practice; however, a study
conducted in Agra showed poor usage of personal protective equipment10,12.
Thus it can be seen that all the HCS are not adhere to HCWM guidelines. The
strengths of the study is that both government and private HCS including
diagnostics centres of Anekal taluk were included and tested study tool was
used for data collection. However, due to time constraint, only few hospitals
could be visited. Due to inability to obtain permission from some of the private
HCS for this study, the sample size was reduced furthermore.
Conclusion:
The study conducted in HCS located in Anekal taluk of Bangalore urban
district shows that, most of the HCS are following HCWM rules prescribed by
the Ministry of Environments and Forests, Government of India. There is a
need to address on some of the issues like following the colour coded bins,
disfigurement, disinfection and safe transportation in private HCS compare to
public HCS. Enabling the knowledge and practicing skills among healthcare
personnel‟s at HCS may lead for positive outcome. There is a need to tackle
these issues with hand holding trainings, capacity building to practice and
27
disseminate knowledge about HCWM. Continues monitoring and evaluation
could help to sustain the HCWM and practice at all levels of HCS.
References
1. Ghura AS, Kutty CS. Bio Medical Waste A Corporate Responsibility Dilemma in
India.
Available
from:
http://www.gnims.com/images/articles/bio_medical_waste.pdf
2. Patil AD, Shekdar AV. Health-care waste management in India. J Environ
Manage. 2001;63(2):211–20.
3. Prüss A, Giroult E, Rushbrook P. Teacher‟s Guide: Management of Wastes from
Health-care Activities. World Health Organization; 1999
4. Shareefdeen ZM. Medical Waste Management and Control. J Environ Prot.
2012;3(12):1265–8.
5. Sharma S, Chauhan SVS. Assessment of bio-medical waste management in three
apex Government hospitals of Agra. J Environ Biol. 2008;29(2):159.
6. Gupta S, Ram B, Kumar DA .Environmental Education for Healthcare
Professionals with Reference to Biomedical Waste Management -A Case Study of a
Hospital in Lucknow, India. Int Res J Environ Sci. 2012 Dec;1(5):69–75.
7. Bhat MA, Khan IA, Ahanger MA, Bhat SA. Biomedical waste management and
handling of district Pulwama. Int J Recent Sci Res. 2013;4(7):946–8.
8. Bulucea CAV, Bulucea AV, Popescu MC, Patrascu A. Assessment of Biomedical
Waste Situation in Hospitals of Dolj District. Int J Biol Biomed Eng. 2008;(1):19–28.
9. D.S.Vyas, Urvij B. Dave. The Safe Disposal of Bio-Medical Waste (Case study of
a Rural Medical Hospital). National Conference on Recent Trends in Engineering &
Technology. Anand,Gujarat,India; 2011.
10. Rao SKM, Ranyal RK, Bhatia SS, Sharma VR. Biomedical waste management:
an infrastructural survey of hospitals. Med J Armed Forces India. 2004;60(4):379–
82.
11. Rijal K, Deshpande A. Critical Evaluation of Biomedical Waste Management
Practices in Kathmandu Valley. Proc Int Conf Sustain Solid Waste Manag [Internet].
2007 [cited 2013 Nov 19]. p. 5–7. Available from:
http://www.swlf.ait.ac.th/IntlConf/Data/ICSSWM%20web/FullPaper/Session%20IV/
4_02%20_Kedarrijal_.pdf
12. Lakshmi BS, Kumar MP. Awareness about Bio-Medical Waste Management
among Health Care Personnel of Some Important Medical Centers in Agra. Int J Eng.
28
2012;1(7)
Available
from:
http://www.ijert.org/browse/september-2012edition?download=1139%3Aawareness-about-bio-medical-waste-managementamong-health-care-personnel-of-some-important-medical-centers-in-agra&start=200
Volume – 12 Issue – 01
September 2013
President’s page
Editor’s page
Household medical waste management
Mercury – chronicles ;
Assessment of atmospheric Mercury
Safe management of Health care waste – Philosophy
Vermicomposting
Letters to editor
Instruction to authors
Volume – 12 Issue – 01
29
September 2013
JOURNAL OF THE
INDIAN SOCIETY OF
HOSPITAL WASTE MANAGEMENT
30
JOURNAL OF THE
Indian Society of Hospital Waste ManagemenvÀ
For Private Circulation only
General,
Air HQs (RKP), New Delhi
EDITORIAL BOARD
Honorary Chief Editor
Editorial Support:
Dr. S. Pruthvish
Professor &Former Head of
Community Medicine,
MSRMC and Chairperson – HCWM
Cell
Dr. S. P. Suryanarayana
Professor and Head of Community
Medicine
MSRMC, Bangalore
Dr. K. Pushpanjali
Professor and Head, Community
Dentistry
Dr. K. Lalitha
Co-ordinator, HCWM Cell
Dr. G. Suman
Co-ordinator, HCWM Cell
Dr. GautamSukumar
Assistant Professor, Dept. of
Epidemiology,
NIMHANS, Bangalore
Dr. Shalini C. Nooyi
Members
Dr. D. Gopinath
Professor of Community Medicine
MSRMC, Bangalore and Former
Chairperson, HCWM Cell
Dr. N. Girish
Additional
Professor
–
Epidemiology
NIMHANS and Member – HCWM
Cell
Professor of Community Medicine
Dr. Shalini S
Dr. T. Hemanth
Professor of Community Medicine
MSRMC and Director, HCWM Cell
Associate Professor of Community
Medicine
Dr. Dinesh Rajaram
Dr. V. Narendranath
Chief Administrative Officer,
M.S.Ramaiah Medical Teaching
Hospital
Bangalore
Associate Professor of Community
Medicine
DrArjunan Isaac
Group Captain (Dr) Ashutosh
Sharma
DMS (O&P) Medical Directorate
Dr. B. S. Nandakumar
Associate Professor of Community
Medicine
Associate Professor of Community
Medicine
31
And Head – Division of Research &
Patents, GEF
Dr. Saraswathi. G. Rao
Special Officer,
M.S.Ramaiah Academy of Health
Sciences
Dr. Riyaz Basha
Associate Professor in Community
Medicine
BMCRI, Bangalore
Advisor – Biostatistics:
Dr. A. C. Ashok
Principal & Dean,
M.S.Ramaiah Medical
Bangalore
Dr. N. S. Murthy
Research Co-ordinator
MSRMC, Bangalore
Mr. Shivaraj N. S.
Assistant Professor,
Medicine
MSRMC, Bangalore
College,
Mr. A. K. Sengupta
Formerly with WHO – India
Community
Mr. Alexander Von Hildebrand
WHO - PAHO
Ms. Radhika K
Lecturer Cum Statistician
MSRMC, Bangalore
Ms. Payden, WHO - SEARO
Dr. K. S. Baghotia
Hon Secretary – ISHWM
EDITORIAL ADVISERS
Reviewers:
Dr. A. K. Agarwal
President – ISHWM
Dr. Arvind. BA
Assistant Professor of Community
Medicine
Air MshlLalji K Verma, AVSM
(Retd)
President, ISHWM
Dr. Bhanu M
Assistant Professor of Community
Medicine
Surg R Adm P Sivadas, AVSM
(Retd)
Immediate Past President, ISHWM
Dr. R. K. Goud
Addl. Professor
Community Medicine
SJMC, Bangalore
Dr. C. Shivaram
Founder Chairman,
HCWM Cell, Bangalore
Dr. S. Kumar
President – Medical Education
Gokula Eduction Foundation
32
JOURNAL OF THE
INDIAN SOCIETY OF HOSPITAL WASTE MANAGEMENT
Volume – 12 Issue – 01
September 2013
CONTENTS
PRESIDENTS PAGE
EDITOR’S PAGE
ORIGINAL ARTICLES
1. Managing Bio Medical Waste Generated at Households – An
Unaddressed Public Health Problem in India – Goud R et al
2. Existing Practices of Bio-Medical Waste Management in Primary
Health Centres of Udupi Taluk, Karnataka–Lobo E, et al
3. Plastics Bags – A Vehicle of Microbe Transmission – Banu A and
Yadav R D
4. Assessment of Atmospheric Mercury Levels By Indigenously
Developed Equipment In Dental Health Care Settings In
Bangalore- Kumar et al.
5. A Scenario of Healthcare Waste
Chikkaballapura, Karnataka-Singh J et al
Management
in
6. A Study on the Status of Health Care Waste Management and
Infection Control Practices in Health care settings of Anekal
Taluk, Bangalore Urban District– Surpur B et al
7. Mercury – The Rouge Element - Sharma A et al
8. Safe Management of Health Care Waste: Concept And
Philosophy - GoudR et al
9. Water Pasteurization as a means of disinfecting biomedical
liquid waste – Ramesha Chandrappa
10.Vermicomposting: -Prospects at a tertiary care centre of
Lucknow- Singh A et al
RESOURCES AND INFORMATION
IGNOU Certificate course details
Details of Indian Society of Hospital Waste Management.
ISHWM Conference 2012 – Brief report
Letter to editor.
Guidelines for authors.
PRESIDENT'S MESSAGE
The UN Basel Convention has identified health care waste as
the second most hazardous waste after radioactive waste. There
are not very many countries which have made significant
contributions in this field. India is one of them, especially in south East Asia.
India was the first country to have legislation on bio-medical waste in 1998.The
Indian Society of Hospital Waste Management (ISHWM) was formed soon
after, in the year 2000. Air Marshal (retd) L K Verma as founder President
ISHWM nurtured it for long time and made sincere efforts to bring it to a centre
stage. Today, ISHWM has distinguished membership spread across the country.
The ISHWM and its members have been on Board of National and International
agencies, namely, Government of India, WHO, UNDP, UNIDO and others.
ISHWM contributed in the planning and development of IGNOU's six month
duration Certificate Programme in Health Care Waste Management (CHCWM)
through distance learning.
It is heartening to note that WHO, SEARO has recently signed an Agreement
for Performance of Work (APW) with ISHWM to undertake a multicentric
research study "On Linkage between Hospital Associated Infections and Health
Care Waste”. Further, as many of you are aware that the 2nd Edition of the
WHO HQ Geneva's famous Blue Book "Safe Management of Waste from
Health Care Activities”, January 2013 has been published. It is like a global
Bible on HCWM. The President ISHWM has authored Chapter 13 in the Blue
Book.http://www.healthcarewaste.
org.I would recommend that you should download it and read at your
convenience.
The ISHWM has a great repository of experts and talent across in HCWM the
country. The last ISHWMCON 2012 at Yenepoya Medical University,
Mangalore was a great success. I am grateful to KGMU, Lucknow to take a
laudable initiative to host ISHWMCON 2013.I am also grateful to WHO,
SEARO specially Mrs Payden to support our conferences and take initiative to
invite delegates from number of SEA countries.
I am sure the delegates and students will be immensely benefited by way of rich
scientific deliberations, presentations and interactions during this conference
and through this coveted Journal which will be ejournal from this issue.
Wish you all Merry X-Mas and Happy New Year.
Prof Ashok K Agarwal MD, DNB, DHSA (UK)
Quality Assurance and Accreditation Expert
European Union and GOI ITS Project
NIHFW, New Delhi. 110067
Mobile: +91 9810423788 +91 9810423788 Email: akrekha4547@yahoo.com
EDITORS PAGE
Esteemed readers and members of ISHWM!
It brings immense pleasure to the editorial board to bring out this
issue of the Journal of ISHWM (Vol 12 No1 September 2013).
Interesting experiential articles are the highlight of current issue.
Situation of Health Care Waste Management in Primary Health Care
setting portrayed in three articles – from Chikkaballapur District, Anekal Taluk,
Udupi Taluk in Karnataka is probably representative of picture in Primary Health
care system in Karnataka and rest of India. It is good to see research articles from
Government Health system. Proposal to consider pasteurization of water is an
attempt towards innovation by Dr Ramesh of Karnataka Pollution Control Board. Dr
Arpana traces chronicles of mercury. There are articles on mercury and plastic
management from MS Ramaiah Dental College and Bangalore Medical College. Dr
Ramakrishna Goud takes us through grey areas of health care waste management.
Dr S Kumar, President, Medical Education, Gokula Education Foundation,
Bangalore makes silent contribution through inspiring quotations across the Journal.
From this issue, the Journal of ISHWM will be an e- Journal and will be hosted in
website from second week of Dec 2013. The editorial board seeks support of all
readers to help in designing, developing, updating an email directory of all ISHWM
members and readers who subscribe to the Journal. The editorial board invites
research articles, useful information on trainings, conferences, resource materials
and educational materials, documentation of innovations made from across the
South East Asia Region. Please help us develop the Journal, further.
Indeed it has been a tough job to bring out the journal on time. The Governing
Council of ISHWM and Faculty and Post graduate students of the Dept. of
Community Medicine, and friends of Health Care Waste Management Cell, MS
Ramaiah Medical College have extended their support to make it possible to bring
out this issue, as in the past.
We thank the readers for their continued support and participation through the forum
created by ISHWM.
Merry Christmas and Happy New Year!With warm regards
Dr Sreekantaiah Pruthvish
Hon Chief Editor, Journal of Indian Society of Hospital Waste
management
Chairperson – HCWM Cell, Professor of Community Medicine, MS
Ramaiah Medical College, Bangalore 560 054, Mobile: 0091 9901042731,
Email: psreekantaiah@yahoo.com
ORIGINAL ARTICLE
A STUDY ON THE STATUS OF HEALTH CARE WASTE MANAGEMENT AND
INFECTION CONTROL PRACTICES IN HEALTHCARE SETTINGS OF ANEKAL
TALUK, BANGALORE URBAN DISTRICT
*Bhimraj Surpur1, Pruthvish S.2, Adithya Pradyumna3, Prahlad I.M3, Hemanth
Thapsey4, Rahul ASGR 5, Yuvaraj B.Y.1
1
Fellow, Community Health Learning Program, 1Program Officer, SOCHARA
Bangalore, 2,4Professor, Community Medicine, M S Ramaiah Medical College,
Bangalore, 3Research Associate, SOCHARA, Bangalore. 5Fellow, Community
Health Learning Program.
INTRODUCTION: Health care waste (HCW) is a potential source of infectious
diseases and may also root to environmental pollution. This hazardous
impact on human and environment can be minimized by implementation and
execution of standard systematic Health Care Waste Management (HCWM)
procedure. The study was accomplished to observe and describe HCWM and
infection control (IC) practices in health care settings (HCS).
MATERIALS AND METHOD: A cross sectional study was conducted in
Anekaltaluk, Bangalore Urban district of Karnataka state by visiting 37 HCS
during August and September, 2013. Data was collected using a standard
check list for HCWM and IC related practices (segregation, storage,
collection, transportation and disposal). Descriptive analysis was done using
Microsoft Excel and SPSS version 20.
RESULT: Sharp waste containment was satisfactory in 51.4% and sharp waste
disinfection/treatment in 45.9% (n=17) of HCS. Infected plastic waste was
being disinfected 48.6% (n=18) HCS. Appropriate final disposal of sharp waste
was carried out in 89.2% (n=33), infected plastic waste in 64.9% (n=24) and
soiled waste in 83.8% (n=31) HCS. Sharp waste disfigurement was done at
75.7% (n=28) HCS and infected plastic waste disfigurement in 56.8% (n=20)
HCS.
CONCLUSION: The study on the status of HCWM and IC practices illustrates
that all the guidelines are not being followed at all the HCS and there is a
need to strengthen the HCWM for better enforcement of guidelines to ensure
the human health and environmental protection.
Keywords: Healthcare, Waste Management, Waste Disposal, Segregation,
Containment, Disinfection
INTRODUCTION
Health care sector is one of the
fastest growing sectors in India
especially in the urban areas with an
estimated growth rate of 12% per
annum1. With increasing number of
health care settings (HCS) the health
care waste generated is also
increasing. An estimated 0.33
million tonnes of hospital waste is
generated annually in India; the
average waste generated per bed per
day ranges between 0.5kg and 2 kg
2
. WHO estimates that between 75%
and 90% of hospital waste generated
is non-hazardous and the remaining
10-25% is hazardous waste which
has potential to affect human
health3.
Healthcare waste is a source of
environmental
pollution
and
infectious diseases, and is made up
of toxic chemicals, infective
materials, plastic waste, sharps and
general waste for which appropriate
disposal is essential. Health care
waste is dependable source for
infectious diseases like gastroenteric
infections, respiratory infections,
ocular infections, tetanus, skin
infections, HIV/AIDS and hepatitis3.
Health care waste presents a threat
not only to patients and their visitors
but also to health care workers4.
Appropriate management of these
wastes is important to protect human
and environmental health and is a
responsibility of all health care
workers and facilities.3 Guidelines
have
been
established
for
segregation, containment, colour
coding, transportation and final
disposal of healthcare waste. Studies
conducted in different parts of the
country have shown poor adherence
to biomedical waste management
rules prescribed by the Ministry of
Environment and Forests as per the
Bio-Medical Waste (Management
and Handling) Rules, 19985,6,7.
In this context the present study was
conducted to observe and assess
healthcare
waste
management
(HCWM) and infection control (IC)
practices in HCS located in
Anekaltaluk of Bangalore urban
district which has seen a recent spurt
in urbanisation and increase in
number of healthcare centres.
MATERIALS AND METHODS
Study Design: A descriptive cross
sectional was conducted to assess
the existing health care waste
management practices in 37 HCS
including Primary Health Centres
(PHC), First Referral Unit (FRU),
private hospitals, nursing homes,
clinics, diagnostic centres.
Study Period and Population: The
study was conducted between
August and September 2013 in
Anekaltaluk of Bangalore urban
district. Population for the study
comprised of health workers
(Doctors, Nurses, lab technicians,
ward boys, ayah and helpers).
Sampling: A total of PHC-09, FRU01, Clinics-13, Private hospital-11,
Diagnostic centres-2, were selected
through convenient sampling.
knew Kannada or English and
willing to participate.
Data collection and analysis: Data
was collected using a modified
version of a previously tested
checklist which covers the HCWM
topics of segregation, containment,
colour
coding,
disfigurement,
transportation, final dispose of waste
and, availability of guidelines and
infrastructure for waste disposal,
personal
protective
measures/equipment (PPE) and
vaccination
status
of
at-risk
workers.Data was entered in SPSS
version 20. Basic analysis was
performed using Microsoft Excel
and the results were stratified and
compared.
RESULTS
The final sample for analysis
conducted out of total 37 HCS in the
study, Table 1 shows information of
the various centres surveyed. Of the
surveyed centres, 43.2% had inpatient services besides OPD
services (56.25% were private
hospitals and 31.25% were PHC‟s).
FRU had the most number of beds
per centre, in-patient admissions,
out-patient visits, followed by
private
hospitals.
(Table
1)
Inclusion criteria: Health care
facilities
with
consent
and
permission were included. Within
each centre, staff members who
Table 3: Details about healthcare settings surveyed
Type of
Only OPD OPD+IP
Avg.
Avg.
Avg.
Avg.
HCS
N
%
n
% Beds admission/ deliveries/ OP
month
month
visits
14
12.7 805.6
80
140 22500
0
0 698.6
PHC (n=9)
4 44.4
5 55.6
4.8
FRU (n=1)
0
0
1 100
100
Clinics
13 92.9
1 7.1
0.4
(n=14)
Diagnostic
2 100
0
0
0
0
0
0
centres
(n=2)
Private
2 18.2
9 81.8
24.5
36.4
17.4 1790.9
Hospital
(n=11)
Total
21 56.8 16 43.2
11.3
16.4
12 1600.8
(n=37)
Avg.- Average, OPD- Outpatient Department, IPD- Inpatient Department
Sharp management practices were
observed and assessed at HCS
surveyed. Colour coded dustbins
were present only at 66.7% of
PHC’s, 7.1% of clinics, 50% of
diagnostic centres and 54.5% of
private hospitals surveyed. While
appropriate
sharp
waste
segregation was being done only at
77.8% of PHC’s and 78.6% of clinics,
all diagnostic centres and private
hospitals
were
following
appropriate
segregation.
Containment of sharp waste was
being carried out only at 66.7% of
PHC’s, 35.7% of clinics, 50% of
diagnostic centres and 66.7% of
private hospitals included in the
study. Sharp waste disfigurement
was being done at majority or all of
the different types of HCS surveyed
except for in clinics. Other than
clinics, majority of the other HCS
undertook safe transportation of
sharp wastes. Appropriate sharp
waste disposal was being carried
out at majority of the HCS surveyed.
(Table
2)
Table 4: Sharp waste management practices being followed
Presence Appropri Contain Appropria
Safe
Type of of colour
ate
ment
te
transportat
HCS
coded segregati
disfigure
ion
dustbins
on
ment
N
%
N
%
N
%
N
%
N
%
Appropri
ate
disposal
N
%
PHC
6 66.7
7 77.
6 66.
9 100
(n=9)
8
7
FRU
0
0
0
0
0
0
1 100
(n=1)
Clinics
1 7.1 11 78.
5 35.
6 42.
(n=14)
6
7
9
Diagno
1
50
2 100
1
50
2 100
stic
centres
(n=2)
Private
6 54.5 11 100
7 63.
10 90.
Hospit
6
9
al
(n=11)
N=Number of centres adhering to guidelines
8
88.9
8
88.9
1
100
1
100
6
42.9
78.6
2
100.
0
1
1
2
8
72.7
1
1
100
100
Figure 1: Sharp waste management practices in government and private
settings
Comparing government and private
HCS with regards to sharp waste
management shows that for all sharp
waste management practices except
appropriate segregation, government
HCS were performing better than
private HCS. (Figure 1)
Infected plastic waste management
practices were studied at HCS
surveyed. Colour coded dustbins for
disposal of infected plastic waste
were present only at 55.6% PHC‟s,
practice was being followed.
14.3% of clinics, 50% of diagnostic
Disinfection of infected plastic
centres, 45.5% of private hospitals
waste was being carried out at
and at the single FRU surveyed.
55.6% PHC‟s, 35.7% clinics, 63.6%
Except for clinics appropriate
private clinics, the FRU and none of
segregation of infected plastic
the diagnostic centres respectively.
wasted was being carried out at all
With regards to appropriate disposal
other HCS. While only at 77.8%
of infected plastic wasted it was
PHC‟s, 35.7% clinics, 54.5% private
being done at 77.8% PHC‟s, 50%
disfigurement of infected plastic
clinics, 63.6% private hospitals, the
waste was being carried, at the FRU
FRU and all the diagnostic centres.
and all diagnostic centres such
(Table 3)
Table 3: Infected plastic waste management practices being followed at
healthcare settings surveyed
Type of Presence Appropria Contai Approp Infecte
Safe
Appro
HCS
of colour
te
nment
riate
d
transpo priate
coded segregatio
disfigur Plastics rtation dispos
dustbins
n
ement Disinfec
al
tion
N
%
N
% N % N % N % N % N %
PHC
5 55.
9 100 7 77
7 77
5 55
5 55 7 77.
(n=9)
6
.8
.8
.6
.6
8
FRU
1 100
1 100 1 10
1 10
1 10
1 10 1 10
(n=1)
0
0
0
0
0
Clinics
2 14. 11 78. 5 35
5 35
5 35
6 42 7 50
(n=14)
3
6
.7
.7
.7
.9
Diagno
1
50
2 100 1 50
2 10
0
0
1 50 2 10
stic
0
0
centres
(n=2)
Private
5 45. 11 100 6 54
6 54
7 63
6 54 7 63.
Hospit
5
.5
.5
.6
.5
6
al
(n=11)
N=Number of settings adhering to guidelines
Figure 2: Comparison of infected plastic waste management practices
between government and private healthcare settings surveyed
While comparing government and
private HCS with regards to their
infected plastic waste disposal it is
seen that the former have better
waste management practices than
the latter in terms of proportion of
HCS following a practice. (Figure 2)
surveyed. Autoclave, burial pit and
sharp pit were being used present all
the PHC‟s. In contrary to guidelines
two PHC‟s reported that plastic
waste was being burnt. Autoclave
was present at 21.4% of the clinics
and 45.5% of the private hospitals.
The FRU, clinics, private hospitals
and diagnostics centres out sourced
their HCWM to a private agency for
final disposal and hence had no need
for burial and sharp pit.
Table 4 provides information on the
facilities available and methods used
for disposal of healthcare wastes at
various settings. Incinerator was not
available at any of the HCS
Table 4: Facilities available and methods used for final disposal of
healthcare waste in the healthcare settings surveyed
Waste Sharps
Type of HCS
Burning
Autoclave
Burial Pit
Pit
Yes
%
Yes
%
Yes
%
Yes
%
PHC (n=9)
2 22.2
9
100
9
100
9
100
FRU (n=1)
0
0
1
100
0
0
0
0
Clinics (n=14)
0
0
3
21.4
0
0
0
0
Diagnostic centres
(n=2)
0
0
0
0
0
0
0
0
Private Hospital
(n=11)
0
0
5
45.5
0
0
0
0
Table 5: Occupational safety measures for healthcare workers at
healthcare settings
Type
Gloves Vaccinatio
Gloves
Vaccinatio Gloves Vaccinatio
of
usage
n status of
usage
n status of
usage
n Status of
HCS
Ward
Ward Boy
Ayah
Ayah
Helper
Helper
Boy
C Satis C Vacci C Satis C Vacci C Satis C Vacci
W fact W nated W fact W nated W fact W nated
W ory W (%)
A ory A
(%)
H ory H
(%)
B usag B
usag
usag
e
e
e
(%)
(%)
(%)
PHC
5 100 5
100
4
75 4
75 1 100 1
100
(n=9)
FRU
1 100 1
100
1 100 1
100 1 100 1
100
(n=1)
Clinics 2 100 2
100
1
0 1
100 1 100 1
100
(n=14
)
Diagn
1 100 1
100
0
0 0
0 0
0 0
0
ostic
centr
es
(n=2)
Privat
5
80 5
80
3
67 3
100 3 100 3
100
e
Hospi
tal
(n=11
)
CWWB = Centres with ward boys, CWA = Centres with ayah CWH = Centres
with helpers
Table 6: Compliance with monitoring and regulatory systems for
healthcare waste management at healthcare settings surveyed
Type of
Authorisation System of
Monitoring Training/ Accident
HCS
from
recording
of waste
retraining register
Pollution
of illness/ management
to the
Control
injuries/
system
staff
Board
accidents
provided
obtained
Yes
%
Yes
%
Yes
% Yes
% Yes
%
PHC (n=9)
8 88.9
4 44.4
5 55.6
4 44.4
2 22.2
FRU (n=1)
1 100
1 100
1
100
1 100
1 100
Clinics
13 92.9
1 7.1
1
7.1
4 28.6
0
0
(n=14)
Diagnostic
2 100
0
0
0
0
0
0
0
0
centres
(n=2)
Private
10 90.9
4 36.4
3 27.3
3 27.3
1 9.1
Hospital
(n=11)
Expect for one private hospital
with helpers there was satisfactory
there was satisfactory usage of
usage of gloves by them and also all
gloves by ward boy at other HCS
of them were vaccinated. (Table 5)
with ward boys. With regards to
District Nodal Officer for healthcare
vaccination status of ward boy
waste management has visited all
except for private hospital rest of
the HCS surveyed for purpose of
the HCS with ward boys had
monitoring. Majority of the HCS had
vaccinated them. Of the HCS with
obtained
authorisation
from
ayah’s on roll not at all PHC’s and
Karnataka Pollution Control Board
private hospitals there
was
for healthcare waste generation and
satisfactory usage of gloves and
consequent management. There
except for ayah’s in PHC in all other
was lack of system for recording of
HCS they were vaccinated. In all HCS
illness/ injuries/ accidents resulting
from healthcare waste handling
limited to healthcare workers in
majority of the HCS.
Similarly there was lack of a
monitoring mechanism for healthcare
waste management system in
majority of the HCS. Staff training
was also found to be lacking in
majority of the HCS. Accident
register was available only at two
PHC‟s and the FRU. While the FRU
had all the required monitoring and
regulatory systems in place, the
diagnostic centres were seen to be
lacking in all such systems expect for
obtaining
authorisation
from
Karnataka Pollution Control Board.
(Table 6)
DISCUSSION
The present study was aimed at
assessing the practice of Health
Care Waste Management indicates
that HCWM guidelines were not
being adhered at all HCS. The
situation in government HCS being
better compared to private HCS as
per this study. Two health centres
studied were burning plastic wastes,
a source of dioxins which have
adverse health effects8. The
importance of segregation is to
separate infectious and non
infectious waste and to avoid
potential hazards which may occur
as a result of mixing the waste
produced. Similar to the present
study, studies conducted in
Lucknow, Uttar Pradesh; Pulwama,
Jammu and Kashmir have shown
that colour coding for containment
of wastes was not being practiced at
HCS which led to poor segregation
practices;
however
a
study
conducted in rural India have shown
that the HCS was following colour
coding of wastes6,7,9,. Similar to our
findings, a study conducted in Pune,
Maharashtra
showed
that
segregation of sharps and infected
plastic waste was being adhered in
majority of HCS 6,10.
Disfigurement of sharps which is
important in order to prevent
injuries and also to prevent
transmission of communicable
diseases like Hepatitis B, HIV/AIDS,
is not being followed at some HCS
according to the present study and
also studies conducted in Pune,
Kathmandu and Nepal10,11. Similar
to the findings of the present study
health care workers in Pune were
provided with personal protective
equipment and were in practice;
however, a study conducted in Agra
showed poor usage of personal
protective equipment10,12. Thus it
can be seen that all the HCS are not
adhere to HCWM guidelines. The
strengths of the study is that both
government and private HCS
including diagnostics centres of
Anekaltaluk were included and
tested study tool was used for data
collection. However, due to time
constraint, only few hospitals could
be visited. Due to inability to obtain
permission from some of the
private HCS for this study, the
sample
size
was
reduced
furthermore.
CONCLUSION:
The study conducted in HCS located
in Anekaltaluk of Bangalore urban
district shows that, most of the HCS
are
following
HCWM
rules
prescribed by the Ministry of
Environments
and
Forests,
Government of India. There is a
need to address on some of the
issues like following the colour
coded
bins,
disfigurement,
disinfection and safe transportation
in private HCS compare to public
HCS. Enabling the knowledge and
practicing skills among healthcare
personnel‟s at HCS may lead for
positive outcome. There is a need to
tackle these issues with hand
holding trainings, capacity building
to
practice
and
disseminate
knowledge
about
HCWM.
Continues
monitoring
and
evaluation could help to sustain the
HCWM and practice at all levels of
HCS.
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ACKNOWLEDGEMENT:
We thank the Department of Health and Family Welfare, Government of
Karnataka especially Dr. Rajani District Health and Family Welfare Officer, Dr.
Sunil Kumar, Taluk Health and Family Welfare Officer and his team, Healthcare
Waste Management Officer for providing permission and their cooperation. We
thank Dr Ramakrishna Goud (St. John‟s Medical College, Bangalore) for
providing us with the checklist prepared by him, which we have modified for the
purpose of this study. I also thank Dr. Ravi Narayan, Dr.Thelma Narayan, As
Mohamed and team SOPHEA for their support and helping facilitate this process.
“You will never reach your destination if you
Stop and throw stones at Every dog that barks”
--Winston Churchill
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