Health for the Millions, Vol. 4, No. 3, June 1978

Item

Title
Health for the Millions, Vol. 4, No. 3, June 1978
extracted text
COMMUNITY HEALTH CELL
326, V Main, I Block
Koiamongala
Bangalore-560034

health
for the
VOL IV

NO. 3

ns

A bimonthly of the Voluntary Health Association of India

VOLUNTARY HEALTH ASSOCIATION OF INDIA
tamilnadu voluktaru health association
THEME: HEALTH &. DEVELOPMENT

JUNE 1978

separate legislation
Mr P. C. Chunder, Union Minister for Education and
Social Welfare, staled in the Rajya Sabha on May 10, that some
alternate legislation was being prepared for voluntary associa­
tions. To seek further clarification, on May 19th I had a
pleasant interview with him.
I began by expressing our great satisfaction that we could
now hope for separate legislation for voluntary associations and
institutions.
Q. Is it true that government is thinking of having sepa­
rate legislation for voluntary organizations ?
Minister. Yes. While the final decision is with the Par­
liament. we have talked this over in the Cabinet, and the Prime
Minister and we are agreed that small voluntary associations,
having less than twenty employees should be exempt from the
eventual Industrial Relations Act.

Q. What about institutions and associations having more
than *20 employees ?
Minister. They, of course would have to be covered.
There would be separate legislation for them These would
include hospitals, schools, universities, etc.

Q. Our hospitals are inclined to be frightened of the
Labour Courts. Would it be possible for them to have some
other kind of tribunal ?
Minister. Yes. We are planning for larger voluntary
associations and institutions, that for disagreements there would
be compulsory arbitration. In situations in which peace could
not be obtained in this manner, there would be tribunals diffe­
rent from the Labour Courts.

editorial

Q. These proposals essentially satisfy all the requests that
our members have made. We are highly pleased to hear them.
We are all agreed on adequate provisions for social justice. 1
will mention that our association had planned a conference in
August to make proposals for separate legislation. As govern­
ment thinking has advanced this far, I wonder if it is still worth­
while for us to go through with it.

Minister. I suggest that you go on with your plans to
have it. We will be pleased to receive any suggestions you
wish to make.
Q. We are aware that the Ministry of Labour is concerned
with the proposed Industrial Relations Bill. Which ministry
will be dealing with the part concerning voluntary agencies ?

Minister. The Labour Minister, Mr Ravindra Verma, will
be dealing with that also. But we in the Education Ministry,
arc also interested and concerned.

poverty begets ill health begets poverty
Leading health professionals from al! over India gathered at the 1978 National Convention
of the Voluntary Health Association of India. Health and Development was the theme. Here is
a report by Augustine J Veliath

Over 150 health profes­
sionals representing 15 state
voluntary health associations
resolved to broaden the hori­
zons of their institutions and
activities to fit into the total
picture of development of the
country. Convinced that the
factors responsible for under­
development arc also respon­
sible for ill health, the partici­
pants at the four-day National
Convention of the Voluntary
Health Association of India,
determined to identify these
causes and strive to solve them.
The Convention
was
at
Gandhigram near Dindigul. It
was hosted by the Tamil Nadu
VHA.

Inaugurating the Conven­
tion on April 16, Dr L. Ramchandran, Director of Gandhi­
gram Institute
of
Rural
Health and Family Planning.
emphasized the link between
health and medical care deli­
very systems on the one hand
and production and economic
development on the other.
The resources, he said,
should be utilized to deal with
the common diseases of the
majority of the population liv­
ing in the countryside, rather
than on the treatment of and
research into the diseases of
the elite.

Citing the highly successful
Chinese experience, Dr Ramchandran recommended the
removal of control of health
care from medical professionals
and the use of traditional
practitioners to develop and
expand the health system.
These should be supplement­
ed by the increased use of
massline intermediate techno­
logy ’ and training of health
workers with skills to match
specific tasks. Dr Ramchandran pointed out that in many
democracies health care sys­
tems arc based on and sup­
ported by voluntary effort. It
is the voluntary organization
that has blazed the trial.
“A serious mistake to which
we have been alive, but for
which no action has been taken
in the past,” according to him,
“is the lack of attention (on
the part of health profes­
sionals') to the improvement
of socio-economic and cultu­
ral conditions. It is because of
the underdeveloped conditions
of life in which a vast majo­
rity of our people are living
that the services which the
government is trying to dis­
tribute are yet not equally
available or accessible to the
rural community.” “Put your
faith into strong mass move­
ments, mass campaigns, pro­
paganda and mass motiva­
tion.” he exhorted. Increased
use should be made of co­
operatives and health insu­
rance schemes.
He also wanted the volun­
tary agencies in India to adapt
as far as possible the experi­
ments in Puerto Rico and
Costa Rica, where health wor­
kers have been able to pick
up a reasonable adult from

3

every house and involve him/
her in non-formal education
with all matters concernmg
health and turn that person
into a custodian of health in
his or her home. He further
advocated the revival and reinforcement of safe and cheap
home remedies.
Earlier, Dr James S. Tong,
Executive Director of VHAI.
introducing the theme, said
that poverty and ill health
together formed a vicious cir­
cle. To radically change the
situation we have to enter this
circle and break it. Health, he
said, provided an ideal entry
point.

The Voluntary Health As­
sociation, said Dr Tong, was
proud to present this new
vision — that of the mainte­
nance of health as a dominant
goal — to the health profes­
sionals. Maintenance of health.
he pointed out, is a broader
and more inspiring goal than
even prevention which is a ne­
gative concept. Father Law­
rence Thottam, the outgoing
president of the VHAI Board
expressed the hope that this
convention would be a mile­
stone in the history of health
delivery in India as it sought to
place it in the overall context
of development.
In the session that follow­
ed. community health experts
from various parts of the coun­
try shared their experiences in
community health as related
to the socio-economic deve­
lopment of the people.

Dr Jacob Cherian of the
Christian Fellowship Commu­
nity Health Centre, Ambillikkai, cautioned those who are

health is a political decision
rushing into community health
because it is the “in thing”. It
involves far more dedication
and willingness to work with
and for the people than gene­
rally understood. No amount
of bookish knowledge can
make a community health
programme succeed.
Very
often community health can
be more tense than even an
operation theatre, the veteran
warned.
Dr Daleep Mukherjee, Pro­
gramme Director, Rural Unit
for Health and Social Affairs
stressed the need of each com­
munity health team itself
growing into a community
first. The doctor or the medi­
cal professional need not arro­
gate to himself the captaincy
of this team. Very often he
would be more effective if he
left the leadership to some­
one else who had the skill and
aptitude. Both Dr Mukherjee
and Mr Ram Das of the Cen­
tre for Developmental Re­
search and Action insisted
that health is essentially a po­
litical decision. In a society
which brutally exploits the

''STANDING VP TO BE SEEN AND HEARD"* is Dr
Daleep Mukherjee, Director RUHSA. Others on the pane!
of ^Community Health are Dr Marie Therese Chambers
(partly visible), Mr Rantdas of CEDRA, Dr Kausallya Devi
from Gandhigram Hospital and Father Lawrence Thottam.

have-nots even the decision to
remain apolitical is a political
decision that favours the vest­
ed interests.

DEFINING HEALTH AND DEVELOPMENT is Dr Char­
lotte Manoharan of Ambur. A scene from the lively group
discussions that followed the inaugural sessions.

4

Dr Marie Therese Chambers
illustrated with an example
how a hospital in addition to
being a curative centre can
also be a source where correc­
tive measures for the ills of so­
ciety and the environment can
originate. She cited the exam­
ple of the hospital to which a
case of lead poisoning was re­
ported. While treating the
patient, the doctor also took
the initiative to get the soil
examined thereby forcing the
government and the people to
take the necessary action to
remedy the problem al its
source.
Dr Charlotte Manoharan of
Ambur related an experiment
in her hospital which showed
how it was possible to get the
people’s support even for a
seemingly unpopular but ac­
tually beneficial programme. Dr
Kausallya Devi, Medical Supe­
rintendent of Gandhigram
Kasturbai Memorial Hospital,
who presided over the session

they who organize
the Convention took pride in
their growth into the largest
state VHA, thanks to the
untiring efforts of Sr Jane
Camoens.
Karnataka has laid the foun­
dation for a model of regiona­
lized health planning and
mobilization of local resources,
agencies and people.

For its constituents, the
North West VHA, with its
new plan for eye camps, has
worked out a formula for con­
certed and streamlined attack
on ill-health instead of the
sporadic and overlapping “hitand-run” moves.
FAR FROM THE MADDING CONVENTION CROWD, the
organizing secretaries meet. George Ninan, Southern Region
Programme Assistant (with back, to the camera); Anney
Kurien, Bihar; Terezina Dias, Rajasthan; Thomas D'Souza,
Karnataka at an animated discussion. Stooping to conquer is
Manav Chakravarthy, from Health Services Development.
related the pioneering and
successful efforts of her voluntary hospital in the fields of
community health.

The fourth General Body
Meeting of the Voluntary
Health Association of India
noted with admiration the
steady progress the voluntary
health movement is taking in
the seventeen states. The pro­
motional secretaries were cer­
tainly on surer grounds this
time. In many states the “pro­
motional” phase has ended.
The new role of the secreta­
ries is spelt out in the new
designation they asked for, a
suggestion which was gladly
accepted. They arc now orga­
nizing secretaries.

In the tune with the national
needs and priorities, several

A BLUEPRINT FOR TOMORROW t Sr Anne Cummins,
Regional Coordinator helps K. M. George, Kerala, Denis
Carlo, Maharashtra and Dhiren Bosu, West Bengal to plan
for future, at a meeting of the organizing secretaries.

Achievements arc manifold.
From .Andhra came the talc
of health care in disaster, how
scores of hospitals and health
care units lived upto the cliallanges of a ravaging cyclone.

Tamil Nadu, the hosts

In Gujarat, the question of
“what the VHA can do for us”
is being reformulated by the
members into “what we can
do together for the people”.

of

5

people based programmes all
state VHAs have conducted
and promoted training pro­
grammes for health workers.
The fourth General Body
Meeting proclaimed “VHAI
is also concerned with the
improvement of the effective­
ness and efficiency! of the
health workers and broaden­
ing of their horizons to fit into
the total picture of develop­
ment.”
The VHAI annual report
noted with satisfaction “A
trend towards people-based
programmes continues to grow.
The VHW movement with
which we have been identified
almost since our inception has

now become
a
national
programme of the government
of India and is approved and
accepted by the World Health
Organization,
Unicef
and
other international agencies.

Bihar is in the fore-front in
several areas: teaching teams
have been established for the
training of personnel in the
methods and content of train­
ing village health workers. A
follow-up of those who have
launched community health
programmes has been under­
taken in Gujarat with specific
emphasis on reinforcing the
efforts now underway in train­
ing village health workers.

Similarly VHAI and the Raigarh and Ambikapur Health
Association
(RAHA)
in
Madhya Pradesh have coope­
rated with one another both
in training of village health
workers and preparing a guide
for the same. Considering the
geographical monstrosity that
is Madhya Pradesh with 44
districts in all, some of them
even bigger than Kerala, in­
numerable difficulties are being
overcome.
The governments and many
states VHAs have drawn do­
ser. The government of Kerala
asked the state VHA to ana­
lyze the health data pertain­
ing to six districts collected by
the government. The analysis
is to form the basis for pro­
jecting future plans. In Ben­
gal. between the government
and the VHA there is an un­
precedented sharing of health
intelligence.
Orissa has taken this coope­
ration further down to the
grass roots, arranging seminars
and workshops with the gov­
ernment. With the active co­
operation of the Chief Medi­
cal Officer, Kora put. the VHA
is conducting a survey into
the forty villages from which
starvation deaths have been
reported. Quarters for the en­
tire team arc being provided
by the government and the
government has also allocated
a sizeable number of primary
health centres and dispensary
staff to assist the VHA in the
survey — proof that a small
VHA need not lag behind
any one in dynamism.

for vhws

MISS NUTRITION 1978 was among the
star attractions in the exhibition. This young
lady offresh green vegetables from the Health
for a Million Programme, Trivandrum, was
worth a bite ...every inch. Community Health
and Leprosy Control were the two subjects
which figured most in the exhibition, glimpses
of which are provided in the cover picture.

6

The Central Social Welfare
Board has informed us that
they have a limited amount of
money available that can be
used as grants to finance the
training of village health
workers.
To apply there
are printed forms which you
may obtain from their State
Office.

from jamkhed to the nation
As a fitting finale to the
Convention on health and de­
velopment, two stalwarts of
community health have been
elected president and vicepresident of the Executive
Board of the Voluntary Health
Association of India. They are
Dr Rajanikant Arole of Com­
prehensive Rural Health Pro­
ject, Jamkhed and Dr Prem
Chand ran John of Deenabandhupuram Medical Mission,
R.K. Pct, Tamil Nadu.

Dr Arole (44), who with his
doctor wife Mabcllc put Jam­
khed into the world health
map. is an MP1-I from John
Hopkins University.
Hailing from Maharashtra,
Dr Arole took his MBBS

from CMC Vellore. In 1962
he developed health care ser­
vices for the rural community
at Vadala Mission.
In 1965 he won the first
Paul Harrison award for out­
standing services in rural areas.
Selected for Fullbright Scholar­
ship for further studies in
USA, he had his surgical resi­
dency in Cleavland, Ohio and
attended courses on tubercu­
losis and leprosy. He spent
four months on Navajo Indian
Reservation, Arizona, study­
ing their health care delivery
system.
In 1971. He started the Jam­
khed health care delivery sysContinued on next page

south kanara does it
South Kanara has done it.
The government, voluntary
agencies, Rotarians, Giants,
Lions, the press and the radio
were involved in an allencompassing health survey of
the district. Though regiona­
lized health planning has been
talked about for the last
thirty years, this is the first
concerted effort in this direc­
tion. A five-year planning and
implementation phase is to
begin in five taluks in the dis­
trict.
The suggestion for the sur­
vey came at the Karnataka
VHA meetings. The initiative
was taken by Fr Muller's Hos­
pital, one of the two largest
voluntary health units in
South Kanara.
The survey is intended as
the basis for initiating and
building up out-reach commu­
nity health programmes.
•The survey in itself was its
own reward. Communication
barriers between government

departments, service agencies,
and popular leaders have bro­
ken down. New awareness has
been created, and possibilities
of pooling the total available
resources have been establish­
ed. Community involvement
and commitment is assured.
Addressing a session of the
Convention, Fr Moras said
that many isolated border
areas lacking means of trans­
port and infrastructural faci­
lities have been identified. Ac­
cording to the survey, the ail­
ments mentioned most com­
monly arc preventable. There
is considerable anxiety over
the prevalance of malaria and
TB.

Only 30 per cent of the
Panohayats have some kind
of health facility. Not even
two schools for every ten that
responded have had a health
check up in their schools.
Public health units are few
and far between. Ill-equipped
as they are, their credibility is
far from satisfactory.

7

Positive health as a concept
is by and large unheard of.
Preventive health care still re­
mains a catch phrase, and if
at all practised begins and
ends with immunization.
People arc yet to establish
in their minds the co-relation
between health and hygiene,
sanitation, nutrition and lat­
rines.
The survey has recommend­
ed that each voluntary agency
in the district is to plan out­
reach programmes. It has been
suggested that these commu­
nity out-reach programmes
raise the level of health con­
sciousness among the people by
educating them in nutrition,
prevention of diseases, promo­
tion of health measures, to
construct latrines and educate
people in using them; to plan
development schemes to bring
up the socio-economic level of
the people; provide health as­
sistants where there are no
doctors and to set up MCH
projects throughout the dis­
tricts.

executives in session

THE EXECUTIVES IN SESSION. The board meeting is the most important
happening at any annual meeting. Prem Chandran John, Vice President (back to the
camera); Edwin E Nabert, Treasurer; Raj Arole, President', James Victor; R R Doshi;
Mrs Dhillon, Secretary; James S Tong, Executive Director; and Lawrence Thottam,
Immediate Past President,
tern that would cover the
entire rural population, in a
given area and meet the total
health needs of the commu­
nity. A three-tier system of
health care delivery has been
developed. The first consists
of the health worker who is a
resident of the village. The
second is the mobile health
team visiting each village once
a week or fortnight. The last
is the health centre at Jamkhed with diagnostic facilities
and modern equipment for
emergency care and beds for
inpatients.

Dr Arole, who believes that
rural health problems are pre­
ventable and amenable to
health education, has very
successfully developed and

used village health workers as
components of a well-knit
health team.
Dr Prem Chandran John too
has an equally successful com­
munity health programme at
the Medical Mission in Chinglcput. He Too has a Masters
Degree in Public Health from
John Hopkins University.
Dr (Mrs) Dhillon and Mr
Edwin Nabert have been re­
elected Secretary and Trea­
surer respectively. The new
board also has as its members
besides
Father
Lawrence
Thottam the outgoing presi­
dent, Dr R. R. Doshi of Guja­
rat, Dr C. F. Moss of Padhar,
Dr N. E. G. Philip of Andhra
Pradesh, Sr Philomena Marie

8

of Kerala and
Rao of Orissa.

Dr K. S. N.

Dr Dalecp Mukherjee. Pro­
gramme Director, RUHSA of
Vellore, has been added as the
third co-opted member in ad­
dition to Sr Carol Huss and
Dr P. N. Ghei.

forthcoming
Training of Trainers of Vil­
lage Health Workers : Jamkhed will again be the venue
from July 17-27 for a training
programme to be conducted by
VHAI stall for the Bombay
region of Catholic Relief Ser­
vices. It will be open to a
limited number of VHA train­
ing efforts in Maharashtra,
Madhya Pradesh and Gujarat.

health and
development

the vellore
formula

There has been for some
time both in India and abroad
a certain concern about the
development of health pro­
grammes for rural communi­
ties. This is related to the
larger questions of priorities,
limited resources, needs of the
people and training of appro­
priate personnel. There has
been a general feeling that the
preservation and restoration

of health as usually practised
tackles only a part of the
needs of the individual who
presents himself as a patient.
The person goes back to his
community and environment
and frequently he gets ill
again. Many of the inputs in
a community that may contri­
bute to better health are not
necessarily inputs controlled
by health services, whose
availability is
often
low,
inappropriate, inacessible, and
unrelated to the needs of the
people. Common preventable
conditions of illness that need
early diagnosis and simple
treatment account for much of
the morbidity and premature
mortality.

The challenge to the nation
is to develop a health service
that attempts to cover the
population effectively and effi­
ciently. The personnel involv­
ed in the health care delivery
programmes need to be train­
ed appropriately to understand
the socio-economic environ­
ment in which they work. There
is need for an integrated ap­
proach to the problems of the
people. Health is an integral
part of the people's welfare
and development. A multi­
disciplinary approach consis­
tent with the resources avail­
able, must be evolved in con­
sultation with
the people
concerned.
Keeping this concept in
mind, the Christian Medical
College and Hospital, Vellore,
introduced the Rural Unit for
Health and Social Affairs
(RUHSA) programme. The
ultimate aim of RUHSA is
the improvement of the com­
munity's welfare through an
organization that will (a) im­
plement an integrated multi­
disciplinary rural health and
socio-economic
development
programme for a defined area
and population in association
with the local community
and government consistent
with the resources available;
(b) use this programme as an
extension of CMCH's service
in the community and in the

9

training of its students for the
needs of India. The specific
objectives for the first three
years include decrease in
infant mortality rates by 25 per
cent: decrease in age specific
mortality rates of children
between one
and
four
years by 25 per cent; de­
crease in birth rates bv 30
per cent and increase in birth
intervals: increase in the num­
ber of people having access
to health services by making
available facilities, personnel
and a pattern of service con­
sistent with local resources to
cover
every
Panchayat;
improve antenatal coverage
and the immunization status of
children; increase the econo­
mic status of families specially
those below an arbitrary level
of poverty; establish or revita­
lize women's clubs, nursery
schools and youth organiza­
tions: develop rural employ­
ment oriented programmes;
and establish Village Advisory
Committees in all Peripheral
Service Units for community
involvement
in
RUHSA.
Achieving general awareness
of and cooperation and parti­
cipation from individuals in
the RUHSA programme is
also one of its objectives.

methodology
The methodology of the
RUHSA programmes are bas­
ed on the principles of com­
munity participation in plan­
ning. developing and evaluat­
ing the programme, the inte­
gration of health with socio­
economic development and a
need based approach to meet
the essential felt needs of the
community; especially to en­
courage and utilize the servi­
ces of the rural unemployed
youth.
Training is provided to me­
dical. nursing, paramedical
students, rural community or­
ganizers and village level wor­
kers in the rural environment
to give them a better under­
standing of the socio-economic
conditions, (general . <^|uca.326, V Main, I Block
Koramangala
Bangaiorp-560034
India

education, vocational training.
and non-formal education. In
association with the govern­
ment and other agencies.
RUHSA plans to have an
extension programme in agri­
culture providing expertise,
credit, seeds, fertilizers, pesti­
cides. and irrigation program­

mes, the centre being in a
village 25 miles from Vellore.
It has established 16 Periphe­
ral Units (one for each 5.000
population) in the field cover­
ing all 39 Panchayats. Mobile
teams of health and develop­
ment workers visit these cen­
tres regularly. These are staff­

TRAIN ED TO UN DERSTAND appropriately the socio­
economic environment in which they work, RUHSA staff act
as agents of social change.
mes. Emphasis will be given
to animal husbandry, cattle
and sheep rearing, kitchen
gardens, agro-industries, etc.
In the field of medicines,
RUHSA is developing a plan­
ned comprehensive community
based health programme giv­
ing special attention to pro­
moting health,
preventing
disease and providing low
cost early available primary
health care. This includes
antenatal and family welfare
services, care for children un­
der five, special health pro­
grammes for protection against
T.B. and leprosy, and to pro­
vide nutrition and immuniza­
tion services, etc.

self-developing team
RUSHA cover a population
of 1,00,000 people (about
20,000 families) in over 80 vil­
lages in a total area of 125 sq.

ed by multi-disciplinary spe­
cially trained Rural Commu­
nity Organizers (RCOs) whose
accommodation is provided
rent free by the community.
The RCO who is from a rural
background
herself/himself
acts as an agent of social
change linking the needs and
problems of the community
with the resources and exper­
tise of RUHSA. government,
and other agencies, helping the
community to plan and orga­
nize their own programmes of
development. These are impor­
tant people and it is through
them that RUHSA can effec­
tively and meaningfully reach
and serve the community.
This is an exciting and chal­
lenging task for them and the
programme, as the multi­
disciplinary team in the final
analysis will act as a commu­
nity itself, each concerned
with his or her own develop­
ment as a member of the

10

team. The community deve­
lopment really starts with
self-development and realiza­
tion of what one’s strengths
and weaknesses arc and how
one can work with others
both in the team and in the
community.

RUHSA has started, though
not formally inaugurated. Yet
it is hoped that the experience
wc gain will be of benefit not
only to the community that
wc serve — K. V. Kuppam
block — but the community
that is India. The pattern of
stalling, coverage and service
should be reproducible with
adaptations in similar settings
elsewhere in India and wc hope
to learn from keeping in touch
with other health and deve­
lopment programmes. If wc
are concerned with health, and
and by this wc mean the well
being of the individual in the
physical, mental and social
state, and not just absence of
disease, then wc arc concerned
with development. The indivi­
dual must be seen in the con­
text of his family, environment.
and community such that there
is total development of the
whole. A society and commu­
nity cannot be healthy if there
is . uneven development. As
voluntary agencies, wc have
an important role to play as
we have the freedom to expe­
riment, to pioneer, to lobby,
to influence, to change and to
challenge. What wc can and
must do together if we arc to
make our society and nation
truly a developed society
where minimum needs are met
and those who need more can
have access to more in the
process of democracy, com­
munity participation and pro­
gress, is the challenge.
SITUATION WANTED

A laboratory
technician
with diploma has one year
experience in a leading volun­
tary hospital. Good academic
background. Please write to :
“Health for the Millions”
(Classified),
VHAI,
C-14,
Community Centre, Safdarjung Development Area, New
Delhi - 110 016.

a new delhi report

stimulus
for
family
welfare

A two-clay national con­
ference aimed at stimulating
family welfare programmes
concluded in New Delhi on
May 2nd. Convened by the
Ministry of Health and Family
Welfare, and attended by the

highest officials of the Central
and Slate governments and
most of the voluntary agencies
involved in family welfare
activities,
the
conference
acknowledged the pioneering
and major role played by the
volags in the field of family
welfare.

Calling for doubling of
efforts. I he conference asked
the voluntary organizations
to identify
village
level
change-agents and work with
sister organizations engaged
in similar social and develop­
ment programmes. The orga­
nizations/ it fell, should be
encouraged to develop and
experiment
in
innovative
schemes for the delivery of
basic health care with empasis
on family welfare and MCH
programmes in rural areas,
urban slums and industrial
colonies. The conference call­
ed upon the political leader­
ship from the national to
panchayat level to fully in­
volve itself in the motivational
and educational family wel­
fare done by voluntary orga­
nizations.

The Conference also under­
lined the need for increased
cooperation between the gov­
ernment and the volags who
should coordinate their work
with family welfare centres
and primary health centres.
It was recommended that
an apex of voluntary organi­
zations dealing with family
welfare will be set up to main­
tain constant liaison with the
cell. The Conference further
recommended that the agen­
cies concerned meet at the
stale level once a year and
more oflen with the various
State
and District Grant
Committees in order to make
their activities more suppor­
tive of each other. The need
to assign specific duties to
governmental organs and the
various agencies depending
on their resources was deem­
ed necessary, for achieving
belter results.

Assistance and encourage­
ment of the government in

11

the form of grants is to be nc
longer confined to organiza­
tions directly involved with
sterilization. The Conference
felt that other criteria, such
as the number of people/
households
approached/pro­
grammes organized, and other
performance levels to be pre­
determined by the government
for releasing grants would
would ensure flexibility of ap­
proach. These progam mes
may be motivational, MCH
services, education of school
dropouts, etc. The need for
offering integrated health care
delivery in areas where servi­
ces for family welfare alone
would not be accepted, was
realized and the government
has been requested to “pro­
vide voluntary organizations
whatever help is needed in the
form of vaccines, drugs, surgi­
cal and other equipment,
infrastructure,
motivational
materials and contraceptives
on similar lines as the govern­
ment tries to help its own or­
ganization working in rural
and difficult areas.”

Welfare of children has
proved to be one of the strong­
est motivational forces in
accepting family welfare ser­
vices. The year of the Child,
1979, it was fell, could suc­
cessfully be used for further
implementation of such pro­
grammes. The government
urged the voluntary associa­
tions to participate fully in
health and nutrition educa­
tion programmes to be under­
taken in the Year of the Child,
and agreed to supply them
educational and motivational
material as well as special
health education material re­
lating to Child Health Care.
Such organizations as have the
appropriate facilities were re­
quested to supplement gov­
ernment Child Health Care
programmes in the areas of
immunizations,
protection
against nutrition
deficiency
diseases, and any other area
where they could assist the
programme.

news from the states
karnataka
□ The Karnataka VHA, in
collaboration with Vishwa
Yuvak Kendra, Grail Mobile
Extension Training Unit and
Bangalore Baptist Hospital
organized a training program­
me for basic health workers
and community workers from
April 4th to 8th this year. The
group of participants included
balsevikas, gramsevikas, and
family welfare extension edu­
cators. Some voluntary social
workers and ANMs from
health projects also partici­
pated.
The emphasis of the train­
ing programme was on the
usage of communication skills
in the transmission of health
education specially on nutri­
tion, hygiene and child care to
the community. The medium
of instruction and group inter­
action was Kannada.

□ The Annual General Body
Meeting of the VHAK was
held at St Martha’s Hospital,
Bangalore, on the 12th of
March. Ms Padmasini Asuri.
Regional Home Economist of
the Government of India, out­
lined the health priorities and
the difficulties in their imple­
mentation in her inaugural
address. She emphasized • that
health is governed by other
vital factors such as unemp­
loyment and underdevelop­
ment,- and that the develop­
ment of health is closely asso­
ciated with socio-economic
development.
The book exhibition on
health and nutrition and a
display of low-cost
highcaloric luncheon packets were
appreciated.

kerala
□ Mrs Jyothi Venkitachellam,
the Governor of Kerala laid
the foundation stone of the

ChristofTel Blindcn Mission
(CBM) Eye Block of the Little
Flower Hospital. Angamally
on Sunday, 9lh April 1978.
Mr P. J. Joseph, the Kerala
Home Minister, presided over
the function.

Tamil Nadu, inaugurated the
Hill-tribes Welfare Service
Centre, at V S R Puram, Pannaikadu in Kodai Hills. The
Inaugural Function was held
on 25th May 1978.

gujarat

tamil nadu
□ The TN VHA General
Body Meeting was held con­
currently with the National
Convention of VHAT. Dr
(Ms) Soundaram Ramachandran has been re-elected pre­
sident of the VHA.

□ The TN VHA organized a
seminar on Hospital Adminis­
tration from April 20th to 25th
at J CM House, Christunagar

□ A live-day workshop cover­
ing the selection of village
health workers, teaching tech­
niques, the trainer’s mental
equipment, community
in­
volvement, content of thes
courses, and evolving one’s
own syllabus according to the
needs and concerns of the
community was held at Zankhvav, Surat district. The ex­
tremely practical workshop
was based on life-situations
found and the problems en­

MORE EFFECTIVE MANAGERS N O\V Partici pants after
the Dindigul Seminar.
near Dindigul. Among those
participating were Sr Carol
Huss, who took the introduc­
tory session, George Ninan,
and Mr G. D. Kunders. Spe­
cial attention was given to
settling hospital disputes, per­
sonnel management, job des­
criptions, and OPD services
in the light of the current
developments.
□ Ms P.
T.
Saraswathi,
Minister for Social Welfare,

12

countered in the existing pro­
grammes of the three parti­
cipating groups — Dediapad,
Zankhvav and the Ahmedabad Study Action Group at
Vasna.

maharashtra
□ The first six-week program­
me on Community Health
and Development was launch­
ed at CRHP, Jamkhcd on

May 15. It is an effort to offer
a continuing education prograii.-»Y)0
gran^jC for (hose who are
attempt).to take
take u
upp small
jects and
feel (|1C need for
some new edu^tional inputs,
from the points X.view of

uttar pradesh

□ Several teams have been
formed for the purpose of try­
ing to reorient the health work
of mostly small dispensaries
--iir-fhe rural areas, including
training of village health
derstanding village economics,
workers. Four sisters will
sociology and politics and
work together to this end in
some “booster shots” on diag­
Uttar Pradesh. Their prepara­
nosis and treatment.
tions have been experience­
based with an initial ten-day
programme in Kodarma, Bihar
orissa
and lived experiences over the
last several months in the
□ The Orissa VHA has con­
Child in Need Institute in
cluded its survey in Koraput
Calcutta, RAHA, Kunkuri,
district. The main objects of
and the Comprehensive Rural
the survey were to undertake
Health Project in Jamkhed.
an intensive health survey of
The work will be launched in
all villages in two blocks and
Ghazipur and Ballia districts.
to report on the general state
of health in the villages. They
arc now analyzing the data to
bihar
detemine long-term solutions
to meet the community health
needs of the area taking into □ The Bihar Voluntary Health
Association has recently held
account the socio-economic
a well attended training pro­
status of the community.

gramme in community health
in the Santal Paraganas.

west bengal
□ The Archdiocese of Cal­
cutta together with Seva Ken­
dra recently sponsored a meet­
ing in which VHA1 partici­
pated to assess their present
health services and to consider
how they might be reoriented
towards more community in­
volvement and greater efforts
at social and preventive medi­
cine in the context of inte­
grated development of the
people.

El Sr Anne recently visited
Hayden Hall in Darjeeling to
see first hand once more the
work of some of VHAI’s
former workshop participants.
The work at Hayden Hall
attempts to integrate many
small economic programmes
which will help the people in
their efforts to sustain them­
selves.

news from far and near
The Union
Government
through the Ministry of Edu­
cation proposes to launch a
national programme for adult
education. Outlining the edu­
cation plan. Dr Chunder told
Dr James Tong on May 10,
that the target is for every
adult between the ages of 15
and 35 to have 300 hours of
education.
This will vary
according to situations, — at
least half of it would not be
concerned with literacy, but
would emphasize practical
education for a better life,
and improved ways of earning
a living. The plan intends to
benefit 100 million people
over a period of five years.

Hospitals, health centres, and
educational institutions during
this summer should become
alert to opportunities for adult
education according to the
needs of the weakest people
around and thus contribute a
praiseworthy share to this bold

and dynamic national move­
ment towards
life-oriented.
education for everyone. The
Minister showed keen interest
in our sample publications
that were shown to him.

laugesen
Dr Murray Laugesen, for­
merly
Community
Health
Consultant
and
architect
of VHAI publication service,
has taken over as the Princi­
pal Medical Officer (Research)
in the Department of Health
in his home country. New
Zealand. At present he is as­
sisting an expert committee
overhaul child health services.
“New Zealand used to have
the lowest infant morality in
the world, but meantime bet­
ter organized countries from
Sweden to Singapore have
done better. [ could not have
wished for a better piece of
work to take up on returning
here... Many of the things

13

I’ve learnt in the VHAI work
arc most useful in the work
here.”
Mrs Laugesen who used to
assist VHAI as a volunteer
and who authored Better Child
Care, is now assisting the edi­
tor of the Church magazine
on a part-time basis in New
Zealand.
Dr Laugesen’s address is:
3 Gurkha Crescent, Khandallah. Wellington 4, New
Zealand.

p h a m
Mr P D Zgambo has taken
over as the New Executive
Secretary of the Private Hos­
pital Association of Malawi
<PHAM). He succeeds Dr
H J J A Niemer, who died in
a tragic car accident. PHAM
works closely with the Minis­
try of Health and looks after
about 40 per cent of Malawi’s
health needsgQ WUN!TY HEALTH CELL
326, V Main, 1 Block
Korambngala
Bangalore-560034
India

Better Care in Leprosy
Your’answers to

what causes,leprosy?
how does leprosy spread?

should people fear leprosy?

how can we recognize leprosy?
how do we treat leprosy?

how can people with leprosy protect
themselves from injury and deformity?

A 64-page profusely illustrated pocket
guide In specially simplified language
designed to inform peripheral health
workers about leprosy and its control.
The booklet emphasizes early leprosy,
early recognition, early treatment,
avoidance of deformity, prevention of
complications, regular treatment to
reduce unwarranted fears of mis­
understanding ab’out leprosy.

Bette?
•©

in

Leprosy
Special features:
only the essential medical and social ideas are included

S—40

Dr M. Laugesen,

Text.

RS. 4. 50

Community Health Consultant. VHAI

•

a picture on almost every page

*

the text of 50—100 words starts with an important question
and then explains the answer

*

a 7th class student can easily read the text. The language
is simplified by using active verbs, single concepts, short
sentences, etc.

*

cartoons were pretested for comprehension by uneducated
village health workers

*

colour’illustrations have been used where necessary for
distinguishing leprosy from similar diseases, Colour
reproduction by a government recongized "A" class printer

Technical
Advice :

Dr K.C. Kandhari.
Emeritus Professor, AllMS
Dr J.S. Pasricha,
Asst. Professor. Dermatology, AllMS

Dr E. Fritschi,
Director, S.L.R. Hospital, Karigiri
Dr M. Owen,
Visiting Leprologist. Muzaffarpur
Medical college

Cartoons: Enver Ahmed: Line Drawings and
Layout: Dipak Bhattacharya:
Photography: Sunil Mehra & J. Gonsalves
Media
Health for the Millions, Vol. 4, No. 3, June 1978.pdf

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