Health for the Millions, Vol. 5, Oct. 1979

Item

Title
Health for the Millions, Vol. 5, Oct. 1979
extracted text
The Nation's Voice
On Health and Medical Education
National Health and Medical
Education Conference turns health
eduation towards the needs of the
people.
There were 270 participants.
Present were Central and State
Health Ministers, Directors of
Health Services, Directors of Medi­
cal Education, heads of various
systems of medicine such as Homeo­
pathy, Ayurved, Unani, Siddhi and
Naturopathy.

The Conference was held in new
Delhi from August 27th to August
30th. A delegate from VHAI was
invited and attended.
The Minister of Health, Shri,
Rabi Ray, was Chairman of all the
working general sessions. He is a
delightful person, sociable, patient,
kind and competent. However hot
the debate, he would always diffuse
tension by some relaxed or humor­
ous comment.
Three Year Medical Course

The most debated topic was the
controversial three year medical
course, to be begun after the ten
plus two, or the equivalent educa­
tional level.

While the nation’s oratorical fes­
tival was debating whether such
schools should be opened or not,
the quiet effective lady Health
Minister, Dr. Tople, of Maharashtra
took the stage to announce that
Maharashtra had long ago decided
to open five such schools, and they
would be receiving students almost
immediately. The schools are to be
in: Ratnagiri, Nander, Kolhapur,
Akola and Dhulia.

There were many vehement
speeches against the plan, but the
sense of the house was in favour.
So we may say that the idea has
been approved and recommended.
Health Sciences University

Another topic of unusual interest
was the feasibility of a health educa­
tion university for each State, espe­
cially the more developed States.
The sentiment in favour was that
the ordinary universities are not
sufficiently conscious of the health
needs of the country to plan and
organize health1 education. The
subject is so vast, varied and com­
plex that a separate university is
needed for it.

The nurses expressed fear that
most of the resources of such a
university would go to doctors, and
the nursing profession would be con­
sidered a step-child. This possibility
was discussed frankly, and the
recommendation was made that the
university should not be called a
Medical University, but Health
Sciences University, or some equiva­
lent name, to indicate equal open­
ness to all the health related pro­
fessions .
Health Education Commission

The proposal of a Health Education
Commission received strong sup­
port. The idea arises from the model
of the University Grants Commis­
sion. The latter, due to insufficient
funds, has not been able to assist
health education to any notable
degree.

The universal concept would be
had in the many different kinds of
courses that would be offered,
ordinary medicine plus the special­
The purpose of the Commission
ties, nursing, pharmacy and all the would
be to plan and ensure balan­
para-medical branches. There would
development of all health related
be courses in all the systems of ced
medicine and the history of medi­ disciplines, medicine, nursing, den­
pharmacy, administration,
cine. Then humanities, sociology, tistry,
anthropology and psychology as etc.
these relate to health education.
It should have financial resources
There would also be courses in how
to teach. Some speakers pointed to implement its recommendations.
out that the teachers in medical
The existing national Councils
colleges rarely have as much as a would
be retained as advisory
diploma in teaching. They often
bodies. But the general idea is that
lack the art of communicating.
all systems of medicine, all cate­
It would be left to each State to gories of and for registration and
decide whether the university would ethical standards, learning, and all
be a rcsidedtial teaching university Councils would be brought under
or an affiliating university. The the common umbrella of the Medi­
suggestion that seemed most accep­ cal and Health Education Council.
table was that one of the medical
Continuing Education
colleges in the State could be chosen
as the State Health Sciences Univer­
The need of continuing education
sity and the other medical colleges merited long discussion. All were
in the State would be affiliated to it. in favour of it. The debate was on

HEALTH FOR THE MILLIONS/OCTOBER 1979

1

how it could be carried out. Every­
body agreed that every professional
person today must up date him/her­
self by reading and discussions, and
more formally about every five
years. The reason is the rapid
advance of knowledge, sometimes
called the knowledge explosion. If
we try to make do with what we
learned in our degree obtaining
years, we quickly become out of
date, and this light defect will lead
towards irrelevance.
The whole gamut of seminars and
short courses was recommended.
Of interest for VHAI, correspon­
dence courses were also recommen­
ded.

Mother

Teresa

The Saint of the Gutters

Research

The trend of the discussion on
research was that the major portion
of it should be applied research
relevant to the needs of the people
of this country. The whole ethos of
research, states the draft national
plan, should be based on simple,
low cost, health technology, the
results of which are replicable in
routinized settings. The need of
continuing research for cures or
vaccines for leprosy, malaria, etc.,
was urged, as well as in matters
related to human reproduction and
population control.
Medium of Instruction

Whether and to what extent the
medium of instruction in medical
colleges should be in the regional
language attracted serious dis­
cussion. The cons pointed out the
scarcity of books in these languages,
and especially of journals. The pros
urged the experience of reality that
many of the first year medical
students cannot understand what
the lecturer is saying.

The conclusion of the discussion
was that our decision must be in the
direction of preparing ourselves to
teach in the regional languages, as
Israel, Japan, and many other coun­
tries do.
The trend of thinking in the
Conference was to energise the
health services of the country, and
make them more easily available
among our millions of neglected and
underserved people.
2

The Nobel Peace Prize coming to
Mother Teresa is symbolic of the
World's attention to the children of
the poor. The prize committee said
that it had “expressed its recognition
of Mother Teresa's work in bringing
help to the suffering humanity.”
“This year the World has turned its
attention to the plight of children
and refugees, and these are precisely
the categories for whom Mdther
Teresa has for many years worked
so selflessly.”

Mother Teresa and her Mission­
aries of Charity have been bringing
love, hope and relief to hundreds of
beggers, lepers, the blind, the crip­
pled, the dying and the unwanted of
the Calcutta slums. For decades she
has been providing the poor medical
care, schooling, a bowl of gruel, a
slice of bread or just a clean place
to die.
“The poor give us so much more
than we give them”, said Mother
Teresa in an interview in 1977.
“They are such strong people, living
day to day with no food and they
never curse, never complain. We
don’t have to give them pity or
sympathy. We have so much to
learn from them.”
Mother Teresa was bom on
August 27, 1910 in Skopje, Yugo­
slavia and her original name was
Agnes Gonxha Bojaxhiu. She came
to India when she was 18 as a novi­
tiate from Ireland where she had
entered Loreto Congregation. She

taught for 20 years culminating in
her being made the Principal of St.
Anne’s High School, Calcutta. It
was then in 1947, she received “the
call” to dvote the rest of her life
serving the poorest of the poor, the
sick, the dying and the unwanted.”
Mother Teresa applied for decloisteration from the Pope in 1948,
which she got for a year. She began
organising schools and dispensaries
for the poor. Realising the extent of
her work and her total dedication,
the Church granted special per­
mission to from the Order of the
Missionaries of Charity in 1950.

She continued her work in
Calcutta and founded Nirmal Hriday
for the dying destitutes and Nirmal
Shishu Bhavan for destitute children.
Over the years her work spread all
over India and in many other coun­
tries, Today there are 158 branches
of this Order in 14 countries all over
the World and in India alone there
are 98.
Fighting poverty with love and
faith her band of sisters carry on
the work never worrying about
resources. “God provides” says
Mother Teresa and some how or
the other the money pours in She
has received land from the Govern­
ment in many places. Besides the
honour
the prize
money of
SI90,000 means that “more can now
be done for the poorest of the
poor”.

HEALTH FOR THE MILLIONS/OCTOBER 1979

SR. CAROL HUSS

In Pursuit of Wholeness
Modern medicine is a wonderful
thing, but there are two problems:
people expect too much of it,' and
too little of themselves. Modern
medicine is good, invaluable and
worthy of our highest regard. But
it is not the same as health. Health
is a state of wellness including
physical, emotional and mental
factors plus harmony within oneself,
with one’s neighbours, with the
universe and with God. It is pri­
marily a matter of self responsibi­
lity. But the modern medicine
system generates a value system
that does not hold the patient
responsible for his state of health.
On the other hand it legitimizes his
state and makes him look for help
externally.

purpose in life: to find opportuni­
ties for the expression of uniqueness
and a place of dignity among
others. A holistic approach pro­
motes the interrelationship and
unity of body, mind and spirit. It
encourages healthy, enjoyable acti­
vity on all these levels of existence.
□ Attention to lifestyle and
environment offers the most
rewarding paths to improved
levels of health.
□ Wellness initiatives in one
area of your life will reinforce
health enhancing behaviour in
other areas, e.g., jogging,
exercises, yoga, meditation.
□ It is even possible to be “well”
in the midst of illness and
dying. You can learn to inter­
pret illness as a message from
within—a signal that some area
of yourself deserves attention
and reform. Similarly you
can learn to accept the even­
tuality of your own mortality,
and experience
the dying
process as another human
reality.
□ A state of high level wellness
is within reach of all.

Then there are other problems of
modem medicine. It is too expen­
sive for any one but the top 10%
of the population to afford. It is
not available to the rural masses.
Many drugs cause more problems
than they solve. There is not suffi­
cient protection to the public related
to the knowledge, availability and
use of medicines. Doctors have a
tendency to over medicate and often
fail to maintain the necessary vigil­
lance over patients who continue to
take potent drugs long past the time
when their benefit is indicated.
For tins reason people are search­
ing for new ways of maintaining
wellness. One of these is the holistic
health approach.

How do you go about it?

A wellness lifestyle cannot be
made in a day. It is hard work to
live well. An integrated lifestyle
requires emphasis on each of five
dimensions.

What is Holistic Health?

Holistic health emphasizes what
is within your power and self res­
ponsibility for health and well
being. It is an alternative to doctors,
drugs and disease, because a life
style that is consistent with wellness
will help you avoid diseases, and
you will need doctors and drugs far
less than you probably do right
now.

To be well a person must find
personal satisfaction and a sense of

1.
2.
3.
4.
5.

selfresponsibility
nutritional awareness
physical fitness
stress management
environmental sensivity.

Each of these is expanded below.
Self Responsibility

The biggest factor accounting for
insufficient self-responsibility in our
society is probably the lack of
effective health education.

Self Responsibility Principles

I. You are in charge of your own
life.
2. You are different from every­
body else.
3. You are motivated by a desire
for happiness.
4. You need a sense of purpose.
5. You are ok, and on your way
to being even better.
6. At times you might prefer
illness to health.
7. Stop, examine and choose.
8. Go for positive happiness,
wellness style.
9. Great decision are seldom
made under distress.

Part of self-responsibility is know­
ing how to use the medical system
effectively, as well as learning to
create a lifestyle that enables you to
stay healthy and out of the medical
system to the extent possible.
Nutritional Awareness

Five out of the ten leading causes
of death are diet related. They are:

1. diseases of the heart
2. cerebrovascular diseases
3. diabetes milletus
4. arteriosclerosis
5. cirrhosis of the liver
Nutritonal Awareness Principles

1. Go out of your way for natu­
ral “live” foods, curd, garlic,
soyabean, sprouts, fresh fruits,
raw vegetables, honey, apple
cider vinegar, bran, sunflower
seeds, wheat germs, nutri­
tional yeast.
2. Vary your diet.
3. Avoid dangerous foods and
food additives.
4. Boycott refined, processed
foods.
5. Learn to dislike the refined
carbohydrates.

HEALTH FOR THE MILLIONS/OCTOBER 1979

3

6. Keep it simple and take your
time.
7. Eliminate coffee, tea, alcohol,
and other addictive drugs.
8. Concentrate on quality in pro­
teins.
9. Enjoy fresh fruit and un­
cooked vegetables every day,
if you can.
10. Try to get high-fiber roughage
every day.
Physical Fitness

Inactivity is a serious health haz­
ard that has been convincingly link­
ed to hypertension, chronic fatigue,
physiological inefficiency, premature
aging, poor musculature, and inade­
quate flexibility. These conditions,
in turn, are major causes of lower
back pain, injury, tension, obesity,
and coronary health disease. No
matter how attentive you may be to
your nutrition, however much you
control and channel stress, and
regardless of how much you prac­
tice self-responsibility and environ­
mental sensitivity, you cannot be
healthy if you are not reasonably
fit.

As if all this were not bad
enough, you might as well recognize
that lack of exercise leads to pre­
mature bodily aging, or pathologi­
cal old age.

Stress Management

Mental stress is taking a fairly
heavy toll of our health in modern
times. Again it is in this region
modern medicine with its headache
pills and sleeping pills has done
more harm than good. Proper stress
management requires understanding
of our physical and psychological
responses under stress conditions
and regulating them in such a way
that our health is not damaged.
Stress management principles are:

1. Take stock of your own
power.
2. Make up your own guidelines.
3. Take it easy.
4. Try ways to quiet yourself.
5. Enjoy what you do to manage
stress.
6. Design an environment for
quieting.
7. Set your sights on inner peace.
8. Plan your response to stress.
9. Work on being open and poli­
tely assertive.
10. Consider changing parts of
your life.
11. Consider changing parts of
your life that bring chronic
stress.
Environmental Sensitivity

In discussing this dimension of
wellness, I would like you to think
of the environment as having three
1. Make physical fitness a part aspects: the physical, the social,
of your life.
and the personal. The first two
2. Don’t think of fitness as a components are rather familiar and
crash programme.
self-evident. They refer to the ex­
3. Exercise is fun, so don’t cheat tent to which all aspects of air,
yourself by taking an activity water, land mass, and other physical
configurations combine with social
too seriously.
conditions (economic, governmen­
4. Learn to distract yourself.
5. Get in touch with Mother tal, culture, etc.) to act upon the
individual and enhance or limit
Nature — and yourself.
health and well being. The personal
6. A little activity goes a long component of environment refers to
way.
the extent to which your immediate
7. Set modest expectations.
surroundings either affirm or deny,
8. like wine, you can get better or facilitate or inhibit, your efforts
to pursue high level wellness.
with age.
9. Get involved in your activity.
Another way to think of the per­
10. Learn how to breathe!
sonal component of this dimension
11. Supplement your favorite fit­ is to talk of a “space” or spaces,
ness activity.
which I define as all the stimuli or
12. Express your fitness objectives forces acting upon a person at any
in a contract.
point in time. To the extent that
you learn to design and shape the
13. Be sensible.
Physical Fitness Principles

4

spaces under your control, you are
planning your personal environment
and making it easier to enjoy the
pursuit and experience of high level
wellness.

The air you breathe, the city or
town in which you live, the quality
of your home, and the attractions
or shortcomings of your neigh­
bourgood are alf examples ot physi­
cal and social environments. The
manner in which you organize your
bedroom or work space, the kinds
of friendship networks you create
and sustain, and the nature of the
feedback about yourself which you
invite by your actions, are all exam­
ples of the personal environment, or
spaces you consciously or unknow­
ingly set up for yourself.
Most of us are relatively insensi­
tive to our physical and social en­
vironments, and are even less
attuned to the personal spaces
around us which vastly affect our
health and well-being. If you com­
mit yourself to a lifestyle of high
level wellness, you will have to cul­
tivate an awareness of the physical
and social components of the envi­
ronment. You will also deliberately
design your personal environment.

There are severe limits to what
most of us can do to change the
physical and social aspects of our
large environments The problems
of population expansion, air pollu­
tion and other forms of pollution,
atomic waste, urban blight, infla­
tion, and all forms of social disso­
lution are beyond the province of
the individual. But, while it is diffi­
cult to change, affect, shape, order,
and design your relationship to these
overeaching physical and social en­
vironments, it is both easy and
enjoyable to design the personal
component of your environment.
The first step in doing so is to
increase your sensitivity to all the
stimuli that touch upon your sense
at any point in time. These may be
physical, mental, chemical or any­
thing else. You create a great deal
of your physical, social, and perso­
nal environments by your choice of
place, career, job, friends, and life
style. In turn, these environments,
or spaces affect all aspects of your
life. There are many reasons why it

HEALTH FOR THE MILLIONS/OCTOBER 1979

pays to learn to shape a space. A
positive environment will help you
stay healthy and move toward high
level wellness, whereas a negative
environment will block your growth
toward well-being and all manner of
positive expression.

RURAL DEVELOPMENT

Principles of Pbysical/Social Envi­
ronmental Sensitivity

1. Do yourself and the world a
favour — live lightly on the
earth.

Rayalseema Development Trust

2. If you smoke, try extra hard to
quit; if you do not, assert your­
self around those who do.

The Rayalaseema Development
Trust, with headquarters at Anantapur, operates a fabulous rural deve­
3. Eat lower on the food chain.
lopment project. Its founder and
director is Mr Vincent Ferrer.
4. Living wisely is your best Closely associated with him is Anne,
his charming English wife. She
revenge.
assists the Director in the health
5. Consider participating in an en­ service.
vironmentally oriented oiganiThis year 75,000 trees have been
sation.
planted. That is symbolic of the
work volume of the project. There
6. Have fewer children or more are
above 400 employees. The ser­
of someone else’s.
vices are designed almost entirely
for tribals and harijans.

They have trained seventy vil­
lage health workers. This is an as­
tounding number for one project.
1. Catalog the impact of your Each of them is assigned a popula­
tion of about one thousand. That
personal environment.
totals seventy thousand people. The
officers tell us that concerning
2. Upgrade your needs to pre­ health they have learned much and
ferences.
been inspired by the VHAI com­
munity health seminars they have
3. Arrange your personal environ­ attended. Anne is taking our health
care administration correspondence
ment.
course. Interestingly, their village
health workers are nearly all village
4. Match your values and spaces. dais (traditional birth attendants).
They have found them especially
5. Don’t stay bored or unhappy suitable because their maternal and
child experience disposes them to
with your life.
be sensitive to health care needs.
6. Stay current with yourself on These carefully selected ladies are
eager to leam. As interesting events,
the basic questions.
one of the VHWs has gained
enough of reputation that she was
7. Learn to recognize a poor invited to deliver the wife of one of
space fit.
the doctors. Another lady patient
had retained, urine, and needed a
8. Do more for your future than catheter. She was unwilling to have
a man doctor. So, with the doctor’s
hang around waiting for it.

Principles of Personal Environmental
‘ Sensitivity

HEALTH FOR THE MILLIONS/OCTOBER

1979

direction, it was done successfully
by one of the VHWs.
There are five doctors in the pro­
ject. One of them is supervisor for
the whole health system of educa­
tion and practice. One is Ayurvedic
and one a homeopath. They all have
equal status and participate as a
group in the planning and evalua­
tion. Between the doctors and the
village health workers are a few
nurses, and several health guides
trained for two years at Oddenchatram.
There is maximum community
participation. Every village in the
project area has a community deve­
lopment committee. All the acti­
vities are first discussed with them
and their support is obtained. This
includes the health activities.
Prominent among the faming
activities has been irrigation. Tube
wells, open wells and ponds have
been made throughout the project
area. Assistance also is given con­
cerning improved seeds, effective
rotation of crops, and fertilizers.
People are assisted with introduc­
tions to get bank loans, and guid­
ance in fulfilling the related obliga­
tions.

In one village, co-operative farm­
ing has been undertaken on a trial
basis. So far it is working satisfac­
torily. With guidance from the pro­
ject, the villagers who own land
decide on the fields to be planted.
Their work is distributed and recor­
ded. The harvest is shared equally
among all the participants. They
have irrigation. The growing crops
are thriving.
5

T. VIJAYENDRA

COVER STORY

New Hope for Rurai Amputees
“Read this paper. My name is
written here’*, said Kishan Bhau
Darekar proudly giving me a press
clipping from a Marathi newspaper.
Darekar, an erstwhile contract
labourer in a sugar mill in Auranga­
bad, Maharashtra, lost his right leg
in an accident. Being poor, all his
meagre belongings went to meet
hospital expenses. In those terrible
months his wife and two children
died of starvation.

Darekar is typical of patients at
the Rehabilitation Research Centre
of the S M.S. College, Jaipur. Poor
amputees, rejected from society, and
even from their own family, have
heard about this centre. They have
heard that you just have to reach
Jaipur some how, and then you get
free lodge, board, a free artificial
leg, and the fare to return home
too!

And so they have reached. Dil
Bahadur from Manipur, Shyamnath of Bhojpur and Ranjan a boy
of 12 from Calcutta sent by Mother
Teresa. Polio victim Nirakar Pattanayak is so deformed that he
looks like a wobbly ball. On the
other hand, Ayub from M.P. is a
cheerful and brilliant chess player.
Some have their legs cut below the
knee, some above, some have lost
one leg, some both legs. Phalahari
Mahto from Dhanbad lost both his
legs and an arm. But all of them
have on thing in common. All of
them come from poor, mainly rural
families. The mark of suffering and
humiliation is written large on their
faces.

Actually, they get much more
than they have anticipated. There
is no formality. You just give your
name and address and you are ad­
mitted. The organisers say: “We
can’t humiliate people by asking
them to prove that they arc poor
and that they have lost their leg.
We can see it ourselves”. The
whole process takes less than half
an hour. And then each one gets a
towel, a soap, a mug and a plate.
6

The Jaipur Foot

The ward is very informal. There
is no hospital white paint that ter­
rorises poor people. Instead there
are simple cots on a veranda over­
looking a court yard where all these
rural people arc sitting, talking,
singing, smoking. There are no
visiting hours and visitors, social
worker, nurses and other workers
move about freely.
The Voluntary Agency

The voluntary agency involved is
“Sri Bhagwan Mahavir Society for
Physically handicapped”. It was set
up on March 30, 1975 during the
celebration of 2500 years of the
Nirvana of Lord Mahavir. This
society works in co-operation with
the Government in a unique fashion.
The government hospital provides

the salaries of the su rgcon and the
craftsmen of the centre, and the
food for the patients. The ward is
housed in a few abandoned garages.
The society has not created a large
establishment of its own. Instead
it provides crucial inputs, which are
difficult for a government organisa­
tion. The entire money is spent on:
(a) purchase of raw material,
(b) payment for appliances to
the poor,
(c) safeties to two part time
employees — an accountant
and storekeeper,
(d) transport and maintainciicc
cost of the patients,
(e) hiring additional personnel
to meet the increasing work
load.

HEALTH FOR THE MILLIONS/OCTOBER

1979

Some enthusiastic members of the
society come regularly and supervise
the work, talk to the patients and
assist with their difficulties. One
woman social worker comes daily
and helps to schedule the amputees’
treatment. For example, some one
who comes with only one leg ampu­
tated below the knee, can be fitted
within a day and requires only a
few days walking practice. On the
other hand a Syme’s amputee will
require about 40 days stay. The
volunteer social worker also writes
case history of each patient.
Recently a few girls of the local
college have begun coming under
the NSS Programme to initiate
educational programmes among the
patients, run a literacy class and so
on.
Appropriate Technology

Medical rehabilitation work has
a history of over twenty years at
the S.M.S. Hospital, Jaipur. Besides
simpler appliances such as braces
and callipers, they were also making
artificial limbs.

As is customary in most medical
establishments in our country, the
designs of these limbs were borrowed
from the West. Often, it was not
realised that such designs may not

necessarily suit Indian patients.
Soon, however, because it is easy to
observe an amputee moving around
on crutches, a number of patients
were spotted who had earlier been
fitted with an artificial limb and
who had returned to crutches. This
led to a close questioning of the
reasons which led to a rejection of
the limb by these amputees.
It then became apparent that the
designs borrowed from a different
culture may not necessarily suit the
life style of our people. A western
limb, for instance, has a foot piece
which, because of its appearance
and fragility, needs to be hidden
and protected by a shoe. Shoes are
normally not worn by the majority
of our villagers.

Shoes raise materially the cost of
a limb and the frequent breakdown
especially in the rugged landscape
of our villages pose problems of a
recurring expenditure.
Further,
western limbs were designed for
walking on level, paved surfaces.
When used in the uneven, rugged
terrain of a village, their deficiencies
in respect of adaptability to the
ground are readily revealed. Our
cultural habits involve squatting or
sitting cross-legged on the floor. It
is obvious that these postures require
a range of movement in the foot

piece which the “chair-sitting”
western amputee never needs.
As this feed-back became avail­
able, it became increasingly clear
that alternative designs were called
for. Some intensive work led to the
evolution of what is now interna­
tionally known as the “Jaipur Foot.”
Briefly, its design is a complete
breakaway from conventional de­
signs. The structural unit, containing
an exteremely simple, but effective
and virtually indestructible sponge
rubber universal joint, is enclosed in
rayon cord (used in tyres) and the
external surface is a layer of vulca­
nised rubber, moulded in a die
which reproduces the shape of a
normal foot. The foot is made of a
sturdy and waterproof exterior
which so closely mimics a normal
foot that even experienced orthopae­
dic surgeons sometimes fail to reco­
gnise the amputated side. Shoes can
be dispensed with. Over 1500 ampu­
tees, mostly villagers, have been
fitted with this foot. Follow-up
studies have been gratifying. Many
amputees are now regularly work­
ing on their farms, moving in mud
and water, for 3 to 4 years without
a breakdown. When this foot was
tested in the laboratories of the Uni­
versity of Strathclydeat, Glasgow
on a Scottish amputee, he refused
to part with it at the end of the
study; he felt it was admirable for
hiking in the Scottish Highlands!
Patients can now squat and sit crosslegged on the floor. Women can
work in traditional kitchens. Sadhus
can enter temples without taking off
their limbs.
Involvement of Local Craftsman

Another interesting feature of
this centre is that workers in the
workshop are not trained in a
technical training institute. They
are local craftsman. The history of
their involvement is interesting.

Local Craftsman at Work
HEALTH FOR THE MILLIONS/OCTOBER 1979

At the centre they had a Craft
Instructor to help rehabilitate
spinal injury patients by teaching
some crafts. It was purely fortuitous
that this craft instructor Worked in
the close vicinity of the limb shop.
Watching the crude fumbling while
trying to give a practical shape to
theoretical concepts of a new design
for the foot, he became extremely
interested. While the minds of for­
7

mally trained limb makers would
refuse to get out of the grooves of
their training, this craftsman felt
absolutely free to think of novel
solutions, utilizing local materials
and his own skill. The dependence
on imported materials ceased. He
made the first die for the foot, using
ancient sand casting methods. When
no major rubber manufacturers
came forward to help in preparing
the vulcanized rubber foot, an
ordinary way side retreading shop
owner was approached. He vulcani­
sed these feet and subsequently
taught the workers at the centre to
do it themselves. It is important to
note that this poor man never
charged anything for this work. He
just got emotionally involved in the
problems of the physically handicap­
ped and even now, comes and
spends all his spare time sitting in
the Centre and watching patients
walking away happily on the foot
made possible due to his invention.

As this interaction between pro­
fessional doctors and traditional
craftsmen, highly skilled but unlet­
tered, started displaying pay-offs,
this strategy was adopted as an
institutional one, and now the
centre is always on the lookout for
such skilled craftsmen who under­
stand local materials and who are
creative. Over a period of time
the centre has acquired a wide
assortment of such people.

Handicapped Children

In India over thirty lakhs children
suffer from some kind of handicap
or the other. The breakdown is:
Mentally retarded
Blind
Orthopaedically handi­
capped
*
Deaf

20 lakhs
8 lakhs

5 lakhs
2 lakhs

Training and Rehabilitation of
these children are so inadequate
that they cater to the needs of only
4% of the physically handicapped,
2% blind and 2% of the deaf!

— “A Small Voice”
UNICEF, March 1979

3

T. VIJAYENDRA

Women Health Workers
A new kind of change agents are
appearing in rural India—the
women health workers. This was
the predominant feeling I gathered
in my visits to the community
health projects in Madhya Pradesh.

and the small dispensary serves as
a centre for the community health
programme. There are 9 VHWs
in this programme 7 of which arc
Bhils, one from the Bhilala tribe
and the other from Patelia.

The organising Secretary of the
M.P.V.H.A. Miss Marjorie Hill
spoke highly of the innovative
teaching methods in training illite­
rates tribal health workers. Many
students of the M.I.B.E. Graduate
School of Nursing, Indore go for
their field training in these commu­
nity health projects.

The other outstanding feature of
the programme is the innovative
method in teaching these illiterate
Bhil women. All the teaching is
done by lectures using picture book.
The daily report is written by put­
ting tick marks against pictures.
Similar pictures are put in the
medicine bottles.

JOBAT AND MENDHA

The VHWs are paid Rs. 40/- per
month. After an initil training of
10 days they come once a week to
the centre for further education.
This involves weekly reports, help­
ing and studying at the centre and
bringing referral cases. On one
another day in the week they come
with the mothers of the children
suffering from malnutrition. The
mothers also receive some educa­
tion at the centre.

Jobat is a small little town in
Jhabua district in South West M.P.
The Christian Hospital has been
serving the community for over 50
years. Over the years they realised
that unless the health work reaches
the village homes the health status
of the people will not improve.

For the poor tribals do not reach
the hospital unless it is very serious.
What is needed is that diseases are
prevented by early detection, im­
proved nutrition, immunization and
health education. For such a com­
munity health project to succeed it
is essential that the VHWs should
be effectively trained.
The Training of the VHWs

One major reason for the suc­
cess of the programme is that all
the personnel involved are from the
Bhil tribe. Thus the man at the
top—Dr. Daniel is Bhil and so is
Dr. Tezlo. The community health
personnel—Mrs. Rufus and Mrs.
Ingrid Paul are also Bhils. And so
are the 11 Bhil VHWs.

So is the case in the Mendha
Community Health Centre. The
person in charge is Suzane Tezlo,
who is a Bhil and so are her colle­
agues. Mendha is a small village

Change in the Status

There is a dramatic change in the
life of these women. Majority of
them used to work on the sub­
sistence family farm. Today they
have risen in the status. They can
give immediate relief in many
children’s diseases, give medicine
for scabies, assure safe delivery of
babies by bringing pregnant women
for checking. The villagers envy
them because they move about con­
fidently in buses, in the town,
talk to doctors and administrative
officers and even with foreigners!
They also dress better and look
cleaner.
Many of them have a high moti­
vation for going forward and lear­
ning more. For instance they are
not happy with putting tick marks
on their reports. They want to
write. Unfortunately the literacy

HEALTH FOR THE MILLIONS/OCTOBER

1979

programme is not succeeding,
mainly because they do not have
any person familiar with methods
of functional literacy. Still all of
them can write their names.

They also are very much aware of
the larger problems because they
are from the villages. Thus every
one is concerned about the drought
problem. During drought the male
population goes to distance places
and the cattle is stolen. They want
irrigation works to be implemented
in their area, providing job and
soling the local problem.
A Measure of Success

The figures of the nutritonal
status of the children give us an
idea of the extent of the problem
and what has been achieevd.
Children under Target
Six
Area

Non Tar­
get Area

On the Road to
Health
35%
1° Malnutrition
36%
11° Malnutrition 21%
111° Malnutrition 8%
Pictorial Daily Report of VHWs

MANDLESHWAR

Mandleshwar is a small little
town on the banks of the river Nar­
mada in West Nimar District. The
•community health programme is
similar to Jobat and the two pro­
grammes are linked.

However Mandleshwar has its own
local problems. Miss Doreen Mor­
rison, in charge of the programme,
is very modest about the achieve­
ment of the programme and is
frank about the shortcomings.
One of the problems is, she said,
is the bad tradition of doles. It
makes people dependent and then
it becomes difficult to convince
them that they should become self
reliant and support the VHWs who
are doing a service and should be
paid.

Secondly, unlike Jobat, where
every one is from the same com­
munity. Mandleshwar is a caste
society and the village politics is
very complex and changes with the
.fortunes of the political parties.
HEALTH FOR

The Programme
However the programme has been
largely successful and has many
interesting features. Miss Morrison
is very self critical about the inade­
quacy of the teachers. “Zn many
ways the VHWS whom we are
teaching are brighter and more keen
in their work than the nursing team.
They are more assertive and aggres­
sive , have more energy and interest
because they work among their own
people."

And this was borne out in my
meeting with these health workers
and moving with them in their vil­
lages. They move about confidently,
asking questions, joking and even
scolding some of the men.
They are respected in the village
and are offered tea or nuts in most

the MILL1ONS/OCTOBER 1979

homes. Only a few months ago
they were agricultural labourers and
a visit would normally have resulted
in being ordered about to do some
household chores.

There is a change in the caste
prejudices too The VHWs eat with
each other and even food cooked
by harijans. All of them said that
they want to learn more, learn to
read and write, handle delivery
cases independently etc. They are
very critical of the village Dais and
sometime teach them.

These low caste and tribal women
carrying the knowledge and con­
fidence of modern science are
posing a great threat to the spirits
of obscurantism and will prove an
important vehicle of progress and
change in coming years.
9

INTERNATIONAL

Voluntary Health Movement
The awareness about community
health in the world's poor countries
is increasing rapidly. A large num­
ber of such projects are operating
in many countries. Inevitably along
with this growth the need is felt to
bring together, support and stren­
gthen the voluntary health move­
ment at a national level.

It is therefore, not surprising that
organizations like VHAI are coming
up in other countries too. Below we
carry reports about two such organi­
zations.
BANGLADESH

The Voluntary Health Service
Society (VHSS) was set up in March
1978 to support the many voluntary
health projects up and down the
country through the running of tra­
ining courses, exchange of informa­
tion, liaison with the government
and the procurement and distribu­
tion of medical supplies.

By June 19 8 it had 47 mem­
bers. It has an executive board who
belong to different projects. From
July ‘78 Dr Razia Laila Akbar has
been its Director. Dr Akbar has
recently visited India. She spent
some time with VHAI Delhi office
and later she visited health projects
in India.

Dr Akbar has a distinguished
career in the medical profession.
She has worked and taught in
the field of public health, mater­
nity and child care and family
planning both in Bangladesh and in
the United States. Before joining
VHSS she was Deputy Director,
Maternity and Child Welfare Ser­
vices of Bangladesh government.

main theme — like Health worker,
Tube wells, Incentive and steriliza­
tion, Drugs — uses and abuses, Nurs­
ing in Bangladesh etc. It also carries
reports about health project in
Bangladesh. In Touch is sent free to
interested people.

Editor: Dr Razia Laila Akbar,
No: 4, Road No. 16 (old 72)
Dhanmondi Residential Area,
Dacca — 1
Bangladesh.
GUATEMALA

Tne Guatemala Association of
Community
Health
Services
(ASECSA) was founded in February
1978, in order to meet the recognis­
ed needs of dispersed groups work­
ing in rural Guatemala in primary
health care and promotion.
The Philosophy of ASECSA

Noting the ineffectiveness of the
existing health systems, the solution
to health problems, it is visualised,
ought to come from techniques and
resources that permit a greater,
more efficient coverage. The pri­
mary objective of ASECSA, there­
fore, is to improve the coverage
of health services and foster the
utilization of resources that promote
primary health care. To achieve
this objective it is necessary to
improve the existing community
health services, and become more
accessible to them.

The instruments
and means
to provide these services and to
study new alternatives that permit
an improvement in primary health
care.
Organisation

In Touch

“In Touch” is the official organ
of Voluntary Health Service Society
of Bangladesh. It is a monthly news
bulletin. Many of its issues had one
10

The ASECSA functions through a
board of directors that has been
elected by the General Assembly.
The General Assembly is made up
of one voting member of each of

the member organization. However
more than one member of the con­
stituent organizations can attend
the meeting.

The five board members include
a microbiologist working in appro­
priate technology, a director of a
rural health and development pro­
gramme, a hospital administrator, a
rural health promoter and a rural
clinic nurse! It is heartening to see
that people working at the grass
root level have an equal status in
decision making along with the
experts.
Activities and Achievements

The ASESCSA works through
three commissions: administrative,
therapeutic and education com­
mission. Within the short period
of one year they have made signifi­
cant progress.
Administrative Commission

It is mainly responsible for help­
ing the board of directors to run
the organization. Its activities in­
clude recruting personnel and evolv­
ing personnel policy, accounts,
planning and evaluation, relation
with other institutions, coordinate
with other commissions, building,
office etc.
Therapeutic Commission

This commission has taken up an
extremely interesting and challeng­
ing work. It has made a survey of
the needs of members regarding cer­
tain medicines, their purchase price,
supply, quantity etc. It established
a norm for the acquisition and dis­
tribution of essential drugs. It has
begun this work since March 1979
and some members saved up to
117% of their expenses on drugs. It
is also going to publish information
sheets in simple language on indica­
tions, counter indications and utili­
zation of medicine.

HEALTH FOR THE MILLIONS/OCTOBER 1979

Educational Commission

It began its work with a survey
of available educational material
and needs of the members. The majo­
rity of the member organizations
are of rural peasant origin and have
programs of environmental sani­
tation.

It is also setting up an Informa­
tion Centre. It is publishing a
monthly magazine “El Informador”
for the promotion of rural health.
It is taking up a comprehensive pro­
gramme of publishing health educa­
tional material beginning with a
graphic pamphlet about immuni­
zation.

Looking Ahead

In the years to come ASECSA is
sure to contribute in a major way
in the field of rural health care and
health education It will provide
inspiration to many other countries
in the third world to have similar
organizations. O

HEALTH EDUCATION

BLA1—A World Link
The British Life Assurance Trust
for Health Education, was founded
in 1966. To a large extent the Trust
represents the common ground that
lies between medicine and insur­
ance, and which exists because both
have an interest in promoting the
further education of the medical
profession, and public generally, in
the fields of preventive medicine
and health.
Working mainly
through the medium of educational
technology, defined in the broadest
terms, BLAT seeks to promote this
further education by encouraging
individuals and institutions to intro­
duce new ideas and materials into
their reaching. Over the years the
work of BLAT has been assisted
greatly by the support of the
Nuffield Foundation and the World
Health Organization. Nuffield, with
a grant of £ 36,000 in 1972, made
possible the development of a
Centre for the production of indi­
vidual learning materials in medical
education, and it has also financed
a number of research projects.
WHO designated BLAT a Colla­
borating Centre for Educational
Technology so that it functions at
an international level, especially in
the developing countries.

As far as it is known no other
profession has such an organization
and this degree of uniqueness arises
from five features. Firstly the fact
that BLAT docs not possess an area
of interest in which it is the sole
operator. Secondly, it is indepen­
dent of any of the institutions, such
HEALTH FOR THE MILLIONS/OCTOBER

as universities, colleges, and socie­
ties, which do have their own areas
of interest, and it can thus colla­
borate with any of them or bring
about collaboration between them.
Thirdly it is not a grant giving body
and thus collaboration takes the
form of a commitment of staff and
resources. Fourthly the fact that the
activities of BLAT cut right across
the traditional boundaries of pre­
school, primary, secondary, higher,
further and general education.
Finally it can offer a wide range of
expertise and facilities including
research, graphic design, electro­
nics, printing, teaching and the
provision of information.

BLAT staff can be grouped in
five sections, information library,
administration, film library, audio­
visual and research and develop­
ment, all of which provide an infor­
mation service.

A bi-monthly abstracting journal
“Information” gives details of pub­
lication, current research work,
educational software and hardware,
and general news. The journal is
edited by the information library
which offers advice on the avail­
ability, whereabouts etc. of mater­
ials and organizations concerned
with health or medical education.
The library has a reference section
open to visitors and holds a large
stock of academic papers.

The BMA/BLAT Film Library
publishes a catalogue of its 700

plus titles, all of which have been
appraised by a panel of specialists
before inclusion in the library. The
films are available for hire at a
nominal charge. The libraiy also
acts as the distributor of World
Health Organization films in the
U.K. and in collaboration with the
Graves Medical Audiovisual library,
it has started to operate a small
videocassette library. The BLAT
Certificate of Educational Com­
mendation is awarded to films of
educational content and technical
merit. The annual BLAT Trophy
competition attracts a world wide
entry and films of outstanding
merit can achieve gold, silver or
bronze awards unner the BMA
Film Competition scheme.
The audio-visual
section has
facilities and expertise in audio-tape
recording and duplicating, graphic
design, photography and printing
all of which are available to out­
side educational organizations and
individuals.
The research and development
activities of BLAT have resulted in
a large number of publications in
the form of books, journal articles,
conference papers and learning
materials. The learning materials
cover wide range of media includ­
ing audio-tape and booklet, a
medium for which BLAT has been
the main pioneer in the U.K. The
main emphasis has been placed
upon assisting teachers to develop
methds and materials which pro­
mote individual learning.

COMMUNITY HEALTH CELL
326, V Main, I Block
Koramangala
Bangalore-560034

II

News from the States
MADHYA PRADESH
RAHA, the Raigarh Ambikapur
Health Association will be holding
its General meeting on November
5, 1979 at the Holy Cross Hospital,
Kunkuri. On this occassion they will
be hosting a workshop on Physical
Assessment (Nov 6 to Nov 12). The
workshop is sponsored by M.P.
VHA and will be conducted by Dr
Ron Seaton of VHAI.

* Anesthesia workshop for Nurses
in Anesthesia was held at Padhar
Hospital, Dist. Betul from August
13 to 27, 1979. The workshop was
organised by VHAI and was direc­
ted and coordinated by Mary Me
Nabb and Daniel Singh.

MAHARASHTRA
Unusual excitement introduced
the ANNUAL CONVENTION OF
THE CATHOLIC
HOSPITAL
ASSOCIATION, Nagpur. Medical
students staged a public demons­
tration against Dr Pramila Tople,
Minister of Health and Family Wel­
fare, Government of Maharashtra,
when she arrived as chief guest of
the convention. The students were
expressing their disagreement with
the plan of the Maharashtra Gov­
ernment to open five medical
schools with a three year course, to
train rural youth for health care in
the village.

In honour of the year of the
child the theme of the conven­
tion was: CHA AND CHILD DEV­
ELOPMENT.

The Chairman was Archbishop
Eugene D’Souza. He gave a beauti­
ful address contrasting the idealism
of conventions with the sad reality
of the hunger, illness and neglect
which is the lot of millions of our
children.
An outstanding address was given
by Dr M.V. Joseph. He described
the now famous school health pro­
gramme operated by the Christian
Hospital, Kangazha, Kerala, in an
12

VAH1 Workshop on Anesthesia for Nurses held at Padhar Hospital
Aug. 13-27 1979
area extending several kilometres
around the hospital. As people’s par­
ticipation, a few selected teachers
and students are trained to assist
with the health care of the students.

Dr G. M. Carstairs, a Scotch
psychiatrist, spoke learnedly on the
Social Health of the Child. Remark­
able among his counsels was the
supreme delicate and gentle care that
should be given to the baby in the
process of being bom and during
the first moments after birth. Any
rough treatment, he said, would
harm it emotionally, and have seri­
ous consequences that might appear
in its later life.
Dr S. N. Mukherjee held the
attention of all with his account of
the community health extension
programme of the Mure Memorial
Hospital, Nagpur. In the villages
selected for health care, there was in
the first years frustration, because
health was not a priority for the
people. Then they began with eco­
nomic development projects. Imme­
diately enthusiasm rose, and after
that a successful health programme
was established. It includes village

health workers, and considerable
people participation.
The discussion sessions of the
convention were especially interest­
ing. Numerous • valuable experience
were presented and suggestions
made. They are worthy of being
preserved in some published form.
The
Maharashtra
Voluntary
Health Association (MVHA) is try­
ing to find out what its role ought
to be. They have circulated a ballot
with 60 ideas for seminars and pro­
grams asking people to assign
priority to them. These 60 ideas
themselves tell us what a lot can be
attempted!

* The Hastimal Sancheti Memorial
Trust is doing important work in
rehabilitating orthopaedically handi­
capped children. It has held 39
camps in 16 districts of Mahara­
shtra and examined 14, 740 chil­
dren, of which 11, 737, have been
diagnosed as defective — 3870
needing operations, 2445 needing
caliprs and 5023 needing physio­
therapy. Some 2352 children have
been operated free at Sancheti hos-

HEALTH FOR THE MILLIONS/OCTOBER 1979

pita!. Calipers are provided at sub­
sidized rates.
In a survey of 22 villages they
found 7 out of every 1000 to be
orthopaedically defective.
Recently the trust has received a
donation of Rs 15 lakhs from a busi­
nessman from Pune.
Our HOME at Nagpur (esta­
blished in 1890) is a home for the
physically handicapped children and
adults. It has a full fledged Reha­
bilitation centre. It provides a home
for some 125 children who are
physically handicapped with polio
and cerebral palsy, 50 handicapped
adults and 100 aged and infirm men
and women. It helps them with
artificial appliances which are
manufactured by them, and provides
education and vocational training.
They have appealed for donations.
Address:
OUR HOME
Untkhana,
Medical College Road,
Nagpur 440 009.
* The Wanless Hospital, Miraj has
set up an independent department
of Nutrition Development Pro­
gramme — NDP — headed by Mrs
Maryonna S. Cassdy. NDP is to
provide medical men materials,
messages, communicatin skills, nut­
rition and sanitation education to
prescribe nutrition and sanitation
INSTEAD of medicine if possible
or if not, in addition to medicines.

health and development, manage­
ment and T.A. principles. The
faculty also visits participants at
least once during the course.
Mr.
George
Ninan
VHAI
Southern Region, Mr K.M. George,
KVHS and Mr D. Rayanna APVHA
arc the resource persons for the
training programme.

KERALA
The Kerala Voluntary Health
Services (KVHS) conducted a half
day workshop on labour legislations
such as payment of bonus, payment
of gratuity and Kerala tax on em­
ployment acts. Most of the hospi­
tals in Kerala have already received
notices from the All Kerala Private
Hospital Employees Association
demanding minimum wages and
bonus.

GUJARAT
* GVHA cosponsored with COMFORD (Communications for Deve­
lopment) and conducted a seminar
on Writers for Children on Health
topics.
The annual Convention of GVHA
will be held on November 17 and
18th. The topic chosen for the con­

vention is “Problems of Rural
Development”.
* The minimum wages Act has been
made applicable to all Hospitals,
and Nursing Homes in Gujarat from
31st August 1979. ft is enough to
have one bed to fall under the Act.
The Act stipulates minimum wages
as Rs 7.70 per day in cities and
Rs 6.90 per day in other places.

WEST BENGAL
The West Bengal Voluntary
Health Association (WBVHA) will
be arranging a seminar in November
1979 at Durgapur on community
health and development with the
workers of 4 districts nearby such as
Purulia, Bankura, Burdwan and
Midnapur.
* Young doctors of Calcutta plan to
start a magazine on health and
society. It is going to be a quarterly
bilinguial (English and Bengali)
magazine and will focus on a critique
of the health sjstem and search for
alternative approaches. Contact:
Manan Ganguli,
CNMC Main Hostel,
59 A-D Beniapukur Road,
Calcutta 700 014.

ANDHRA
♦A seminar on Human Relations
and Communications was held at
Hyderabad. Dr. Carol Huss from
VHAI conducted the seminar. Some
18 members attended the seminar
and learnt Transactional Analysis
and related insights for better human
relations and communications.
*The Regional Training Programme
(six plus one) has been organised for
the health centres of Cuddapah
district. The6-f-l training method
is a method of experience based
learning where six learners from
nearby health centres come to one
base centre or hospital. The first
meeting is about 2 days and there­
after the participants meet every
one/two months for 2 days to dis­
cuss a predetermined subject. The
course usually lasts one year. The
topics included will be community

Participants at the Workshop for Nurses in Anaesthesia held at C.F.
Hospital, Oddanchatram, Madurai Dt.. Tamilnadu, 30th July through
4th August 1979.

HEALTH FOR THE MILLIONS/OCTOBER 1979

13

OPPORTUNITIES

AND ELSEWHERE
Middie Management Seminar

VHAI OFFERS
Community Health Course at
Jamkhed

Duration: January 7th to mid
February 1980
Fees
: including board, lodge
and tution Rs. 600'Faculty : Raj and Mabelle Arole
and VHAI staff.
This introductory course at the
Comprehensive Rural Health Pro­
ject, Jamkhed, Ahmednagar pt,
Maharashtra is aimed at giving
highly motivated people an oppor­
tunity to learn the concepts of com­
munity health and development
through academic and practical
work experience and observation.

Contact:
Co-ordinator,
Cemmunity Health & Develop­
ment,

VHAI, C-14, Community Centre,
S D.A,, New Delhi 110 016.

Community Health and Development
Residency Programme

The one year residency pro­
gramme in community health and
development is designed for young
men and women who wish to work
in such programmes in organising
capacities. The course offers theorical inputs as well as practical
train.ng in ongoing programmes,
under selected preceptors. Spon­
sored candidates with BA, RNRM,
MSW, MBBS, MBA are accepted.
Individual institutes as well as
VHAI can be sponsors. For pro­
spectus write to:

Mr Ron Seaton,
Coordinator,
Voluntary Health Association of
India,

C-14, Community Centre,
Safdarjang Development Area
New Delhi 110 016.
Nurse Anaesthesia Course

The aim of this course is to pro­

14

Dated: 3rd to
1979
vide anaesthesia service to small
and remote hospitals through train­
ing nursing personnel with a theore­
tical and practical course in anae­
sthesia. At present sponsored grade
‘A’ nurses are accepted for a 15
months course outside the sponso­
ring hospital. A certificate is awar­
ded after a further one year practice
in the sponsoring hospital. Two
courses start every year — in Jan­
uary in North India and in Septem­
ber in the South. The medium of
instruction is English.

For prospectus write to:
Ms Mary McNabb
Volunlary Health Association of
India,
C-14. Community Centre,
Safdarjang Development Area,
New Delhi 110 016.
Workshop on Personnel Manage­
ment in Hospitals

The aim of this workship is to
discuss the role of a personnel
Manager in a hospital, what is ex­
pected of him from the hospital and
what should he know/leam to be
effective in’his job.
Date

: January 7 to January
13, 1980

: Navjyoli
Nike tan,
Patna 8'. 0 001
(Bihar).
Last date: December 20, 1979
Registration
fee: Rs 150/-

Venue

Contact:
S. Srinivasan,
Health Care Administration
Voluntary Health Association of
India,
C-14, Community Centre,
Safdarjang Development Area,
New Delhi 110 016.

8 th December

Venue: Jeevan Jyothy, Hyderabad

Contact:
D. Rayanna,
Executive Secretary, AP VHA.
10-311/7/2, Vijayanagar Colony,
Andhra Pradesh.
Hospital Management

A 5-day workshop in Hospital
Management will be held at some
Central place in Madhya Pradesh
from January 8 to January 12
1980.

Contact:
Marjorie Hill
M.P Voluntary Health Associa­
tion PO Box 170
Indore 452 001
M.P.

Training Programmes at The
Philadelphia Leprosy Hospital,
Salur.

1. Six weeks doctors course in
leprosy (VHth batch).

From: 17th January 1980 To: 28th
February 1980
2. Paramedical workers training
course in leprosy (6 months
duration). (Xth batch).
From: 14th February 1980 To: 13th
August 1980.

NB: For all the above courses spon­
sored candidates only will be
taken. All the above courses
are recognised by the Govern­
ment of Andhra Pradesh and
the Government of India and
recognised certificates will be
issued. The medium of instru­
ction for all the above courses
is ENGLISH.
Dr Alexander Thomas, MD
Superintendent,
Philadelphia Leprosy Hospital,
Salur (Vizianagaram Dt.)
Andhra Pradesh 532 591.

HEALTH FOR THE MILLIONS/OCTOBER

1979

SITUATIONS
Wanted

Nurse

For a rapidly expanding Christian
Hospital, with community outreach
and Nurses’ Training school.
1. General Physician with MD
or equivalent.
2. Obstretrician/Gynaecologist
with MD or DGB.
Individuals with initiative and
leadership qualities will be prefer­
red. A married couple will be
acceptable.
Applp to:
The Administrator.
Evangeline Both Hospital.
(The Salvation Army)
Nidubrolu
Dist. Guntur, Andhra Pradesh.
522123

A nurse for a nursing home in
Goa. Salary Rs 240/- per month
and free quarters. Apply to:
K.S. Rao,
Personnel Officer,
Cosme Matias Menezes Memorial
Trust,
Rua De Ourem,
Panjim, GOA.
Woman
Health

Job:

Community

Worker

in

To work among tribal
women in Belul district
M P. The job involves

health work coupled with
literacy and development
work.
Qualification: Any woman ANM/
Graduate Nurse/
Degree in Home
Science with apti­
tude for the work,
preferably knowing
Marathi.
Contact:
Dr. D.K. Sharma,
Director,
Satpura Integrated Rural Deve­
lopment Institution (SIRDI)
E 6/65 Arera Colony,
Bhopal, 462014 Madhya Pradesh.
that these 3000 people stop dirnking.

LETTERS
FROM A FIELD WORKER
I am a Community Health Nurse.
I want some advice from you. At
present I am going to the people of
five villages for giving help. One of
them is called Pode and the biggest
problem there was drinking. They
talked with me and then the Mukhia and the Panch of the village
made the following rules:
(1) Any one who comes to the
village drunk will pay a fine
of Rs 25/- next day.
(2) He will feed all the 500 peo­
ple of the village with his
own money.

The result of this action was that
today it is nine months and no one
in the village drinks nor any person
from outside the village can enter
the village drunk. I want this news
published in the VHAI magazine
in Hindi so that the people of other
villages can benefit and people from
my village can be encouraged that
they have helped other villagers by
doing this work.
There is another village with a
population of 3000. Among them
nearly 100 to 150 are found ill every
day. They also want that drinking
should stop in their village but they

failed and they have asked my ad­
vice.

I told them that I will stay in
their village if they completely stop
drinking and distilling. So they
promised that they will neither
drink no sell.
But there are three families who
sell alcoholic drinks. They say,
“Sister, we will definitely stop
selling but how will we feed our
family. We searched for work every­
where but did not get it and that is
why we are doing this work.” What
advice can I give to them? They are
illiterate poor. I know the moment
I inform the govt, about their work,
the govt, will confiscate their belong­
ings and punish them. But I want the
govt, to say that since these people
sell out of necessity, if the govt.
punishes them then instead of pro­
hibition drinking will increase. If
the govt, will help these pople then
I will show good result from many
villages.

Please let me know if there are
any new programmes for the
villages. Please think of all these
problems and tell me what I should
do for the people of my village so

HEALTH FOR THE MILLIONS/OCTOBER 1979

Miss Dipti J. Masih
Christian Hospital,
Champa, PO Champa
Dist. Bilaspur
Madhya Pradesh.
AN APPRECIATION

Dear Fr. Tong,

Your statement of the spiritual
testament of VHAI is a masterpiece
that could only be born of inspira­
tion. I know I would not have
found the words to express it. There
is nothing I can or want to add or
take away. I am in whole hearted
agreement.
Your statement of the philosophy
of VHAI, as far as I can see, is the
only solution to a self evident truth.
The immensity of the problem
leaves me immobilised. My own
effort seems barely To touch the
fringe. I can only admire the way
you and the various VHAI staff
especially Sr. Carol, Sr Ann and Ed
with whom I have had more con­
tact carry on with faith and dedica­
tion.
Dr. K. Vasant Rau,
M.S. Child Jesus
Hospital, Tiruchirapalli. 620001
15

BOOK REVIEW

Women: The New Entrepreuners
TOWARDS SELF-RELIANCE

Income Generation for Women. >

Editors: Jessie Tellis-Nayak and
Selena Costa-Pinto. New Delhi,
Indian Social Institute, June 1979.
Rs. 12/-

The case studies are preceded by
articles describing the general con­
text of women in India and general
article on planning such projects.
An appendix provides useful infor­
mation about resource agencies
concerning finance, marketing and
consultancy.

Child Health
This is a practical guide book for
all those interested in projects invol­
ving employment generation for
poor women. Some of them can be
used by people involved in commu­
nity health projects.

JEEVANDAAN

The industries described are on
the basis of case studies. They are:
garment making, ropes, mirrors,
dolls, theatre craft, tailoring,
nutrient mix, batik, masalas, reed
work and hand weaving. All of
them are of the type which women
have been doing at home in one
from or the other. What is new is
that these projects describe attempts
at making these women self-reliant
by the efforts of voluntary agencies
and creating istitutions like coopera­
tives.

In this year of the Child, child
health has received a lot of atten­
tion. However most of the literature
is still in English and therefore out
of reach of many people. This
special issue of Jeevandaan is a
notable contribution to fill this gap.

Special Issue on Child Health and
Diseases. (In Hindi) Vol. V. No.
4,5,6. 1979, 325, Ramganj Bajar,
Jaipur 302 003 (Rajasthan)

Written in a simple style, it gives
a fairly comprehensive coverage of

the problems of child health It
carries articles on under five clinics,
problems of child diseases, diagnosis
and doses of common medicines
and a very interesting article on use
and misuse of tonics. There are also
articles on care of a new born baby,
growth of the baby, breast feeding
and balanced diet for children.
Indigenous medicine for children
are oficn cheaper, safer and mothers
are often familiar with them. Thus
a small article on Aurvedic medicine
could give many useful prescrip­
tions. Unfortunately the article gives
preaparation for five prescriptions
which can only be prepared by
Vaids Distributed throughout the
magazine there are important pie­
ces of information and statistics
about condition of children in India
which makes the copy worth pre­
serving.
The editor for this issue Dr. Sarla
Kabra deserves congratulations for
bringing out this excellent issue.
She has done credit to her teacher
Dr. Shanti Ghosh, the author of the
well known books like “Shishu
Palan” and “The Feeding and Care
of Infants and Young Children”.

Health for the Millions Becomes Priced Magazine

From January 1980, Health for
the Milltons will be available at
Rs. 12/. per year (Rs. 2/- per copy).
Our motive really for starting to
ask for a subscription price is
service, not primarily gain. We are
improving the magazine so that it
will be genuinely worth the amount
asked. In the past we have been
sending it free of charge, one copy
to each voluntary hospital and
dispensaiy. One of the disadvan­
16

tages of this procedure is that it
goes to the Medical Superintendent
of the hospital, and often others
in the hospital do not see it. Often
it does not even get into the
common reading room. We have
thought, therefore, that the maga­
zine would be more effective if we
charge for the magazine, and have
a subscription list. Then it can go
to every individual who may wish
to receive it. This is no doubt a
great leap in policy. We have

hopes of building up a paid sub­
scription, and that way come one
step closer to being self-support­
ing.

CARDS RECEIVED. We are
grateful to all of you who have
returned our cards requesting your
suggestions concerning Health for
the Millions. In future issues we
shall be aware of the topics of
genuine interest concerning which
you have asked us to write.

HEALTH FOR THE MILLIONS/OCTOBER 197P
Media
Health for the Millions, Vol. 5, Oct. 1979.pdf

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