Health for the Millions, Vol. 4, No. 6, Dec. 1978
Item
- Title
- Health for the Millions, Vol. 4, No. 6, Dec. 1978
- extracted text
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VOL IV MO. 6
A bimonthly of the Voluntary Health Associalfifli/IMUhPKt^i HEAlRf<C^HBER 1978
326, V Main, I Block
Koramangala
Bangalore-560034
India
LtheyearofthjfflLOishepe
from the united nations
message
On behalf of myself and the UN International
Year of the Child Secretariat please
accept our good wishes for your special
issue devoted to the theme of “The Year of
the Child Is Here”.
India already is a glorious example to the
developing countries in the depth and range
of its efforts to place children at the centre
of its planning for the future according to the
UN mandate for the year. The reconstituted
national children’s board has by now prepared
a comprehensive draft identifying priorities
directly under your Prime Minister.
My visit to India earlier this year reinforced
my conviction that India’s targetting for the
future would begin with Primary Health
Care programmes for the vast masses of its
people. The “Anganwady” pilot villages
bring to life this concept and the whole world
will be watching your efforts which are of
such vital relevance especially in the context of
of the recent WHO/UNICEF Primary Health
Conference in Alma-Ata in the USSR.
Wc warmly welcome all your initiatives as we
prepare to devote next year to focus attention
on the needs of children everywhere.
With best regards,
Estefania Aldaba Lim
Special Representative
for the International
Year of the Child
NEW YORK.
2
iyc
ideas for
The year 1979 has been declared the International Year of the Child. The IYC programme
should serve as a challenge for all of us.
India is one of the few countries to adopt a National Policy for Children, which provides
a focus and a framework to evolve programmes and measures for child welfare. Declaring
children as “a supremely important asset” whose ‘‘nature and solicitude are our responsibility”,
the policy advocates measures to meet the needs of the slate policy “to provide adequate
services to children, both before and after birth and through the period of growth, to ensure
their full physical, mental and social development.” These measures are: a comprehensive
health programme; nutrition services with the object of removing deficiencies in the diet of
children; free and compulsory education for all children. upto the age of 14, etc.
Hie National Plan of Action of the Government of India rightly has as its first priority :
Health and Nutrition including environmental sanitation and supply of safe drinking water.
These programmes cover immunization, MCH services,' multipurpose health workers,
nutrition, school health programmes, training and research.
Among its specific objectives for the observance of the IYC in India are “to promote community
awareness and education about the crucial importance of the health development of the
child and a happy family life as the foundation for the child’s security and well being” and
“to make concerted efforts to significantly reduce the incidence of maternal and child mortality
and morbidity by providing effective programmes and services for their health and nutritional
needs.”
Recognizing the importance of voluntary bodies in this regard, the National Plan of Action,
in Chapter 8, on “Operational Guidelines for Implementing the Action Plan during IYC”
details the role of voluntary social welfare organizations.
The initiative is undoubtedly in our hands. Our hospitals, dispensaries and health programmes
have the opportunity to be among the vanguard in all IYC health programmes. High
enthusiasm will be created during the year. Let us ensure that the programmes initiated
will continue even when the year has ended.
3
of Bihar, Orissa, Madhya Pradesh, Rajas
than and Uttar Pradesh, possibly we could
work with the state governments assisting
them to train enough dais to cover all the
districts in each state.
Below are sonic possible activities. Each
place may select the ones that seem most
appropriate for them.
1.
Set an immunization target for the children
in our area.
2.
Persuade pregnant mothers
tetanus toxoid injections.
3.
Conduct surveys to identify the nutritional
status of children in our com mu nity/neigh bourhood. Simple aids for the survey like
arm circumference tape, strip and the child’s
bangle can all be used by older children in
the community itself with a little bit of
training. Involving them in this survey
would be an educational game emphasizing
the need for good nutrition.
4.
5.
to
6.
Medical check-up for all school children
in our area.
7.
Introduce a school health programme in at
least one school.
8.
Open a day care centre.
9.
Start creches, balwadis, anganwadis, for
the children of working mothers.
10.
Popularize health records, arm circum
ference tapes, strips and other materials
which the community itself can use to iden
tify and rectify its health defects.
accept
Treat children with symptoms of serious
deficiency, and teach mothers and children to
recognize early signs of deficiency diseases,
and give them proper nutrition. The govern
ment has launched a programme of “Pro
phylaxis against blindness due to vitamin
A deficiency among children between 1 to
5 years of age”. We could enlist the help
of mothers and the older children in ensur
ing that all the children between these ages
receive their doses of vitamin A every six
months.
1L Disseminate health related children’s lite
rature.
12. Undertake training courses for village
health workers who will in turn care for
children.
The objectives of the International Year of
the Child are not confined to providing health
services for the children. Education of children
in health is as important as curative and pre
ventive care in the form of medicines, immu
nizations, regular check-ups, etc. We snout
try and involve children, wherever possio c m
health education. School health programia
are one way where children are taug i
Renewed emphasis on MCH services, ante
natal and postnatal care. With the new
scheme of trained dais that the government
has launched to cover twelve of the most
remote and backward areas of the states
4
fundamentals of basic health care and hygiene.
Cooperation of primary and secondary school
teachers may be sought by the health person
nel when they are conducting such programmes.
The Ministry of Health and Family Welfare
is preparing small booklet on the “CH1JLDto-child” programmes. These booklets will be
distributed widely to school teachers. A copy
of these will help in formulating lesson plans
for such programmes.
Children could be interested in preparing
posters, flashcards, or flipcharts for health
education in the community. They can be en
couraged to tell original health stories, and
enact plays with health education messages
for the benefit of the community. They can
be taught about the advantages of kitchen
gardens for good nutrition, and can be supplied
with seeds and fertilizers at nominal costs.
Another idea is to circulate popular maga
zines, periodicals and newspapers with appro
priate IYC articles. Successful innovations
may be highlighted so that others can draw
inspiration from them.
The Voluntary Health Association of India,
on its part is providing a number of health
education materials.
The government is working on a Review
Document on the Status of the Child and a
Statistical Compilation related to children.
Government may need our assistance in the
course of this work.
Finally, but most important, we are invited
to remember that the closing of the year 1979
docs not mean an end to all activity and em
phasis on the child. Though an oft-repeated
cliche, it is worth remembering that the child
of today is the man or woman of tomorrow.
The accomplishments of the IYC are designed
to endure. We shall be praiseworthy if for us
each succeeding year continues to be “The
Year of the Child.'’
5
four
lyc steps
Where ? How ? Why ? (motivation of
VHP is most important).
Our health programmes in various parts of
the country are gearing up for the Interna
tional Year of the Child.
D.
Sec if you have everything you need
to begin (check list).
Raigarh, Ambikapur Health Association
(RAHA) which has trained by now 14,000
village health promoters (VHP) is among the
most significant village health programmes in
the country.
i.
Child Health Cards.
ii.
Weighing scale (portable one pre
ferable).
Here is the edited version of a circular sent
by coordinator of RAHA to its members.
iii.
Health education posters, flash cards,
etc.
iv.
Immunization :
DPT,
smallpox,
BCG, TABC, polio, measles, etc.
(Ask local Primary Health Centre
if they will give vaccine to you, then
you report directly to PHC regard
ing use.)
v.
Visual aids on family welfare. (Be
creative, think up your own.)
vi.
Guide for complete health check of
child (at least monthly) “head to toe”.
Create your own from experience
and textbooks provided by RAHA.
vii.
Nutritional supplement: either pro
tein biscuits, or soyabean mixture,
or peanuts and jaggery or winged
beans or other.
This is only one among the reports we
have received in connection with International
Year of the Child. More will appear in the
subsequent issues Health for the Millions.
In four suggested steps the coordinator
suggests how best they can use the village health
promoters to identify the deprived children
and promote their welfare.
STEP ONE:
Read chapter 14 of Dr Shanti Ghosh's
book, “Feeding and Care of Infants and
Young Children’’ on the under-5 clinic. The
concept of an under-5 clinic is to combine the
assessment of nutrition and growth with immu
nization, treatment of illness and advice on
family planning. Baby clinics and the outpatient
departments usually treat only illness and very
little emphasis is given to nutrition assess
ment, advice, immunization, etc.
What do they think is best for their
people ? Help them toward self suffi
ciency.
Discuss this programme with your VHP
and explain how this fits with the medical
insurance scheme. If health promoters want
to serve their community by giving compre
hensive health care to the children under five
in their village, then give one plastic (4 cm
diameter) bangle or an arm circumference
strip to the VHP. He/she will test all the
children under five in the village. The names
of the children who are “bangle positive”
(bangle goes over elbow up to armpit) must
be written down in the copy book.
STEP THREE :
Begin possibly in the following way.
(Though your programme can and should be
different, uniquely suited to your people). Note
well: You may begin even if you don’t have
all the items on the previous check list, but get
them as soon as you can.
A.
STEP TWO :
When your VHPs bring back their reports
at the next follow-up meeting, plan your pro
gramme together with them :
A.
Which one village will you begin with ?
B.
Is the VHP ready to help? Do the
people want to help themselves ?
C.
Decide who
will do what ?
When ?
6
Daily the Village Health Promoter will
give out the nutritional supplement (this
is an extra food besides the regular and
of the family) in the village to the chil
dren at a time convenient to all. If cook
ing of the supplement is required, the
children should bring the wood and
something to eat out of (leaf, plate, etc.)
The VHP will give a simple hygiene talk
to the children each day, e.g., if child
ren do not come with clean hands and
face, tell them to go home and wash and
then return for the snack. VHP writes
in copy book : date, how much given,
and to whom.
B.
C.
Once in a month in the village to the
children and mothers.
i.
Immunizations arc given by the nurse,
assisted by the VHP, to the children.
ii.
Health talks on how to prevent and/
or treat the common disease of this
season are given by the VHP and
supervised/encouraged by the nurse.
iii.
Natural family planning talks are
given by the VHP and supervised/
encouraged by the nurse.
iv.
A complete “head to toe” check on
the health of each child is done by the
nurse assisted by VHP.
v.
Nutritional education given by VHP
(purpose is to help the families be
come self-sufficient nutritionally from
their own fields). Weighing of children
and marking of “Road to Health”
cards is done by VHP with supervi
sion of nurse.
Occasionally the nurse visits the village
when not expected, to see how the daily
nutrition programme is proceeding and
check the copy book. Any abuses should
be discussed at the VHP follow-up
meeting and appropriate action taken
there.
STEP FOUR :
Evaluate your programme with the VHP
at the follow-up meetings. Decide together what
improvement should be made, which village
(villages) will start next.
♦
♦
*
Raigarh Ambikapur Health Association
(RAHA) proposes to launch
an extensive
school programme which will include health
and nutrition education, school nutrition
supplement, annual physical check up by a
physician, treatment and follow up of all me
dical problems.
7
Preview
CHILD-to-cNn programme
A health clock can be drawn with numbers
1 to 12. A hand can be attached to the centre
of the clock. The five strokes between each
number can represent an important health
task which the non-school child does every
Jay. She turns the hands to the next number
when she had done all the tasks. These arc
the health tasks the child can do : (i) clean
baby's teeth; (ii) cover faeces; (iii) wash hands;
(iv) wipe baby's face and (v) play with the
baby.
CHILD-to-child is an international pro
gramme for teaching and encouraging school
children to concern themselves with the health
of their younger brothers and sisters, or other
younger children in their community.
It
includes simple preventive and curative acti
vities appropriate to the local situation, which
will usually be demonstrated and taught to the
children in school for them to pass on in the
family, in the village or urban environment.
However, there are no hard and fast rules and
it is hoped that those concerned with the
health of the children and the community will
design their own CHILD-to-child activities
appropriate to local needs and suitable for
older children to teach younger children. The
programme is one of the projects of the Inter
national Year of the Child (1979). The activi
ties have been brought together incorporated
in a book.
Children can be very effective in finding
out about the health needs of the community.
Surveys are “find-out” projects which the
children practice in collecting health informa
tion and making use of it. Children can find
out about the health conditions of babies and
young children in their community. Illnesses
and deaths from diseases like diphtheria,
tetanus, polio, can be prevented in babies
when young children are immunized. An
important survey that the children can make
is to find out which children in their community
have been immunized against these diseases.
Before carrying out the survey discuss with the
children :
This is a
book
of
ideas
about
how children can help each other and their
communities towards belter health. It is written
mainly with school teachers, health workers,
parents and other adults in mind, ft may also
prove interesting and valuable for the older
children themselves, for whom, as “teachers”
of their younger brothers and sisters, the pro
gramme is designed.
The reasons for immunization.
This book calls on us to recognize what
children already do towards helping each other
and helping us. It suggests ways in which we
can support them and in which we can make
their contribution more effective, easier and
more fun.
Which immunizations arc common in your
area.
Who provides them.
Who receives them.
Several CHILD-to-child activities are pre
sented in this book. Most of them refer to
the ways older children can help their younger
brothers and sisters, but some discuss ways in
which the school child and the non-school
child can help each other. Role playing and
dramas are among the activities suggested.
Children love plays which are not too long,
where action and purpose are carefully dis
cussed, but where they are allowed to make
heart^
W°rdS rather than learninS bV
Perhaps a health worker could be invited
to discuss this with the children. To carry out
the survey the children could make a record
chart with spaces for the names of babies
and young children near them and symbols
for each of the most common given immuniza
tion, e g., BCG — triangle DPT; etc.
Children can find out about children in
their own families and those near them- They
8
can be made responsible for finding out about
several houses each. They will need to ask
parents or in some areas a BCG scar will serve
as marker that a BCG has been given. Ft is
not enough to get information. We must also
pass it on to those who can best use it. From
this survey the children will find out which
babies and children need to be immunized.
Older children can tell mothers about immuni
zation clinics and they can tell the health
worker which babies need immunization.
Finding about health services available to
the community. Often in a community there
are many people wih different kinds of health
knowledge. Some people know how to make
herb teas. There arc women who are asked to
help at child birth. Often someone knows
about first aid for treating simple sicknesses
and accidents. There are also the trained
health workers of different kinds. We need to
know where to get help quickly and which of
these people is the best person to help us.
This information is very useful for all of us
in the community but too often we do not
have it. So children can carry out a survey
of all the people in their community with some
special health knowledge, where they can be
found, what their special health knowledge is,
and who is the best person to go for help for
a particular problem.
Health workers can tell the schools when
they are to hold a clinic in the village and
school children can visit homes in the area to
give notice the day before the clinic and to
tell families the correct time and place. Perhaps
the village can be divided into areas so that
each child knows he is responsible for several
houses.
Each older child can be a health leader for
a few households. Tell the health worker where
help is needed or pass on information from
the health worker to the household.
Who has been immunized?
Nos.
Names of children in my village
A
#
•
1
SATISH
X
X
2
RAMESH
X
X
X
3
VIMLA
X
X
4
KAMLA
5
SITA
A
#
e
e
X
BCG
Protects against Tuberculosis
DPT
,,
,,
Diphtheria, pertussis & tetanus
,,
,,
Poliomyletis
POLIO
,,
,,
Measles
MEASLES
9
health cell
326. V Main, I Block
Koramangala
®a.ngalore-560034
Children can learn to pass on health infor
mation to parents, health workers and others.
For example children can adopt a new born
baby in the family or neighbourhood and make
a vaccination card for it to remind mothers
when the baby is due to be immunized against
different diseases. Children can make birth
day cards with immunization reminders and
send them to the young children they know.
Helping to clean up at the clinic
Older children can also help at home
and school. They can organize:
A first aid clinic for simple treatments
at schools,
Making toys and games for childrenminders in need of help.
Prepare food for younger children at
school,
Bring children to the clinic
parents are unable to come.
«£ BOM ^\arch 1$78
\^Oiir^vimuruzc{-tions am
when
These and other such ideas are available
in the book CHILD-to-child.
This will be
available soon. The price will be around
Rs 14. If you want to know more about this
book, write to Publications Manager, Voluntary
Health Association of India, C-14 Community
Centre, New Delhi - 110 016.
Jwo
A BCG bate-----------sa 0 P Z
____ L ' sk
® POLIO&te-____
primary child care
This card was made by a child
There are many ways in which children can
help in looking after the health of other chil
dren. One of these ways is to become involved
as a helper at the health clinic. Teachers and
health workers would need to plan this toge
ther, but some ways in which children can
help at clinics are:
£ y SPECIAL TESTS
Weighing of babies and filling in weight
charts
3 MGNOSIS
$ 6 M/lNAGLMtNT
/ /fE/GHING
$ 2 H/STORV
3 EMAIINAIIOH
7
TREATMENT
Organizing play groups for children
waiting with their mothers
£ 8 EXPLANATION
Toys and games to be made and
brought along to amuse the young
children
/O REPORTING
9
E/pf!/LY PLANNING
Here is yet another manual from the exhaus
tive pen of Dr Maurice King.
Acting as interpreter for mothers and
health workers, to pass on instructions
for feeding programmes or treatment
Amply illustrated and written in simple
English, this book aims at the medical assis
tants who have had two to three years profes
sional training. This can serve as a very handy
Helping to cook at feeding demons
trations
10
delhi news
reference and field manual to such assistants
working in remote areas with little or no referal facilities.
In India we do not have this type of medi
cal assistants in our health care hierarchy.
However, our doctors and some extent our
nurses will find this book useful.
The author seems to anticipate the follow
ing competencies in the target audience —
High reading fluency and familiarity with
figures, tables, charts, graphs, cross references,
mathematical computations, ratios and propor
tions.
Though there is a large sprinkling of tech
nical words, the language is simple and the
style precise and direct.
A large number of visuals, all of them ac
curate and to the point illustrate the book.
These again anticipate some medical backgiound in the reader.
child health calendar
This is an unusual calendar. It is a simple,
time bound guide to health and nutrition,
covering the last three months of pregnancy
and the first twelve months of the baby’s life.
Calendars are most popular in Indian vil
lages. The pictures on this calender cover sub
jects like nutrition, sanitation and hygiene.
Pictures and simple texts indicate the most
basic and essential points that a mother should
learn, remember and follow in caring for her
self and her baby.
The spaces on the calender are for the use
of both the health workers and the mother. The
health worker indicates the dates on which the
mother must go to the health centre, get im
munizations, etc., and also when to expect the
next visit of the health worker. She can also
note down important observations about the
mother and/or child to tell the nurse or
doctor.
The mother on her part may mark on the
calendar to show on what days she has actual
ly carried out instruction. Even an illiterate
mother and a health worker can have agreed
signs to mark. At each visit the health worker
discusses with the mother what has happened
since the previous visit.
If you would like to try this calendar out
in your health programme please write to
Dr H. W. Butt, Director, Indo-Dutch Project
for Child Welfare, 6-3-885 Somajiguda,
Hyderabad - 500 004, India.
DDS tablets
For sometime already the ordinary anti
leprosy drug, DDS tablets, are not easily
available in the market. Voluntary organiza
tions involved in leprosy work are facing
inconvenience in delivering the required regular
dose of DDS to their patients.
All those involved in regular leprosy control
work have become aware of cases of Leprosy
actually resistant to DDS drug. The actual
shortage of DDS will re-enforce the danger of
an increase of such resistance. Unless the
patients are under regular treatment and an
appropriate dosage of DDS such resistance are
bound to increase.
The Directorate General of Health Services,
Central Government of India, has repeatedly
issued recommendation that the state govern
ments should supply DDS tablets, free of cost,
tor free “treatment of leprosy patients under
the care of voluntary organizations”. We
would therefore advise our members involved
in leprosy work, and having problems to
obtain DDS tablets on the open market, to
contact their State Government Directorate of
Health Services (Leprosy) and obtain from
them their required quota of the drug.
Should some of our members, meet diffi
culties in obtaining sufficient DDS tablets from
their respective State Governments Directorate
of Health Services we would like them to write
to us mentioning the number of leprosy patients
under treatment with them and their monthly
need of DDS tablets.
high risk group
The incidence of venereal diseases (VD)
like syphilis and gonorrhoea is on increase in
India, according to Health Ministry sources.
According to Dr Dharam Pal, STD adviser
to the Union Health Ministry the high risk
groups susceptible to such diseases comprises
of college students, tourists, executives those in
jobs entailing tours, jawans and policemen. He
oited a study among policemen which revealed
a 11.5 per cent prevalance rate of syphilis and
gonorrhoea against a five per cent for the
general population.
Dr Dharam Pal says, STD ranks next only
to malaria and tuberculosis amongst communi
cable diseases.
11
CHILD to Adult programme?
—Why not!
Services were provided to the case diag
nosed as TB case, and the unprotected children
were immunized with BCG.
Children can be very handy where adults
fear to tread. Student force can be mobilized
to make up for the paucity of para-medical
personnel.
observations
In an experimental campaign in the tribal
hamlets of Palghar and Gotham Pad a, Maha
rashtra, students were found very useful in iden
tifying and motivating all TB cases for diag
nosis and sustained treatment and in immuniz
ing all unprotected children.
The students missed only two sputum posi
tive cases, as these houses were closed on the
day the students carried out house to house
inquiry.
the strategy
On account of this survey, students learnt
about TB, treatment and prevention by active
participation. Importance of BCG immuniza
tion, early detection of cases and complete and
regular treatment was impressed upon them.
Students of 7th-8th standard were available
in the neighbourhood. They were sufficiently
literate, they could be motivated to learn dur
ing the social service hours in their curriculum,
could easily be motivated in this field of social
work along with their teachers. They were
willing workers. There was no extra cost. This
approach had an element of Health Education.
The students are sensitive. Their attitudes and
outlook towards disease and health can be
moulded if we “catch them young.”
..........From this experience it is felt that
local students can be involved in delivery of
other health services. The sense of involve
ment will help in creating awareness and will
stimulate active participation of the commu
nity in comprehensive health care programmes.
It should be stressed here that participation of
students should be supplementary. In no way
they are intended as substitutes for regular
health workers. In a developing country like
ours, every school child cian be a health worker.
There were several reasons for selecting
students.
materials and methods
The plan and details of the survey were dis
cussed with school teachers. The students were
shown BCG scars in children and M. tuber
culosis under the microscope, to satisfy their
curiosity. Technical responsibility rested with
the Rural Health Unit, Palghar, where medical
interns and nurses (ANMs) come for training.
Two classes were conducted for a band of
fifteen student volunteers:
nutrition meet
Brazil hosted the XI International Congress
of Nutrition this year. Held at Rio de Janeiro,
the theme of the Congress was the “Practical
utilization of available multisectoral technical
and scientific knowledge to solve food and
nutritional problems.” The two sessions on
xerophthalmia were both well attended.
Dr Vinodini Reddy and her colleagues in India
reported that in pre-school children from a
poor community, addition of 5-10 gms fat to
a diet containing 40 gms spinach providing
1.2 mg beta carotene per day, enhanced the
rise of serum vitamin A. All children showed
a significant rise, those with the lowest levels
at the start showing the largest rise four weeks
later. This confirmed the benefit of green
leafy vegetables in the diet of young children,
and that addition of fat in small amounts en
hances the benefits.
(i) to educate the students about tuber
culosis in all its aspects and
(ii) on survey methodology.
The proforma was discussed and made clear
in local language. Importance of census and
enlisting all members of the household was
emphasized.
The survey by the students was followed
by repeat surveys by ANMs and medical in
terns, independent of each other in the same
hamlet. Findings of each group were unknown
to each other.
12
cautions concerning hospital bill
A second more serious caution is that the
Bill does not specify that the members of the
Grievance Settlement Committee be employees.
Phis seems to be a dangerous oversight on the
part of those who have composed the Bill,
for while outside persons arc not allowed to be
officers in the hospital trade union, the same
exclusion is not prescribed for the members of
the Grievance Settlement Committee. Thus, as
it is presently worded, it would seem to be
theoretically possible for the employees to in
troduce a leader of a trade union from outside
as member of the Grievance Settlement Com
mittee. This eventuality could vitiate and vio
late the whole purpose of the Bill, which is
to promote harmony in the settlement of emp
loyment disputes in our hospitals and educa
tional institutions.
One of the key demands of the “Conditions
of Service and Settlement of Disputes Bill
No. 141”, applicable to hospitals is that there
should be in each hospital (and education
institution) a Grievance Settlement Committee
(Section 3) and a Consultative Council (Sec
tion 4).
The Grievance Settlement Committee is to
have a minimum of four members, half to
represent the employees and half the manage
ment. The Consultative Council is to have at
least six members, likewise half representing
employees and half I he management. In both
committees the management is privileged to
appoint the chairman.
The first caution comes from the concept of
an even number of representatives representing
both employees and management. With this
arrangement, if there is any genuine diffe
rence of emphasis on any issue between emp
loyers and employees, will any decision be
possible ? Will tie vote be the normal result ?
Possibly a period of experience will be neces
sary for us say for sure, but ordinary expecta
tion indicates that a tie vote will be frequent,
and consequently decision and action will be
blockaded.
A third caution is the uncertainty of the cost
of the operation of the Consultative Council,
the Grievance Settlement Committee and of
arbitration. Section 7 of the Bill says “A mem
ber (of any of these three committees'), being
employees’ representative, shall be paid bv the
employer, in relation to any function discharg
ed by him as such member, such as travelling
and other compensatory allowances as may be
prescribed.”
Section 13 tells us that the remuneration
payable to any arbitrator, or board of arbitra
tors or assessors (consultants) called in by the
arbitrators shall be such as may be prescribed.
and shall be paid by such of the parties to the
dispute, or in such proportion as the arbitra
tors) may determine.
One possible remedy may lie hidden in
Section 3(5) of the Bill which says : “Subject
to regulations (of government), the Grievance
Committee shall have power to regulate its
own procedure.” In making the procedure
jules for the use of the Consultative Council
and the Grievance Committee the hospital is
advised to be aware of this difficulty. In some as
sociations, there is provision, in case of the
vote, for the chairman to have the deciding
vote. In the present situation, this may seem
unfair, but we could counter by saying that a
system that makes the decision making pro
cess of an institution impossible could also be
called unfair.
The financial memorandum attached to the
Bill says that travel and other allowances for
the members shall be paid according to the
rules. Once the Bill becomes an Act, the gov
ernment will prepare appropriate rules pertain
ing to it. There is really no wav of knowing
beforehand how many arbitration sessions
there may be to settle a case, or how high the
cost could mount.
The opportunity for the hospital to take
advance care to compose a fair and workable
procedure is further contained in Section 9
of the Bill, sub-section (l)(c) and (l)(d), which
say: “Every employer in relation to any estab
lishment shall make regulations to provide for
the following matters, namely:
We recommend that our larger hospitals
discuss these reasons for caution in their per
sonnel committees. VHAT would appreciate
reveiving any constructive suggestions that may
occur to you. There is still time to send in fur
ther recommendations. The Bill has not yet
been presented to the Rajya Sabha. Also, the
Joint Select Committee to study the Bill has
not yet been appointed. When they are appoint
ed they will gladly accept suggestions from the
concerned public.
(c) procedure for settlement of individual
disputes before an employee applies to
the Grievance Settlement Committee,
(d) procedure to be followed by the Griev
ance Settlement Committee.
—James S. Tong
13
from the states
andhra v h a goes to school
□ Andhra Pradesh Voluntary Health Associa
tion intends to extend their services to school
health programmes, in addition to hospitals
and community health work. Just recently the
Government of AP has planned to expand the
programme of immunization to the primary
school children in connection with the Inter
national Year of the Child. Instructions have
been given to all district medical and health
officers in the state and to all the superinten
dent headquarters hospitals and teaching
hospitals. The principle involved in this expan
sion programme is that in the first two classes
of the primary schools will be covered by the
programme. They plan 90 per cent coverage
of children belonging to 1st and 2nd classes
of the schools taken up. This programme will
commence from 1-10-1978 and completed by
31-3-1979.
maharashtra :
welcome initiatives
□ Maharashtra Health Minister Dr Pramilatai
Topic has welcomed the initiatives taken by
the state VHA in the areas of community
health and health care management. Inaugu
rating a seminar on hospital management and
community health project at the B. J. Medical
College, Pune on September 9, she assured
the voluntary hospitals that her government
would take concrete steps to i educe and solve
the problems faced by the voluntary sectors.
Dr Rajnikant Arole, the Chairman of
VHAI Board and Director of Comprehen
sive Rural Health Project, Jamkhed, said that
voluntary agencies should reach-out to people
who arc neglected.
□ The Village Reconstruction Organization,
India with its headquarters in Guntur has
initiated a comprehensive rural health service
in ten centres covering such positive aspects
as health insurance, environmental care,
nutrition and diet, family welfare and family
health records. Three mobile health units who
provide rural pathological service are also
active.
According to him skilled manpower is
expensive and is concentrated largely in the
urban areas. A lot of time and money is spent
in getting to a city or town hospital. To avoid
this the villagers should take the help of village
healers who share their culture and stay in the
same village. They are available at any time.
These people normally do not charge for their
help and guidance.
Over one hundred full time workers are
engaged in 70 villages in Andhra Pradesh,
Orissa and Tamil Nadu. The Rural Recons
truction also includes low cost housing, agri
cultural development, formal and informal
education, training for rural industrial employ
ments, rural sanitation and water supply com
bined with energy production.
Dr S. T. Gujar, Chairman of Maharashtra
Voluntary Health Association (MVHA), said
this was the first seminar held by MVHA who
hoped to form an association of hospitals to
provide the best service to the patients and
humanity in general. Efforts are being made to
improve the hospital legislation, taxation,
management, etc., in order to provide quick
and efficient service. This could be achieved
only if it underlines the importance of coordi
nation among the hospitals.
□ A four day seminar on “Personnel Manage
ment” for medium and big size hospitals was
conducted in Hyderabad on 8th September.
The seminar organized by the Andhra
Pradesh VHA drew more light on the problems
related to Industrial Dispute Act, setting up of
personnel policies and procedures, improve
ment of communication between the employer
and the employee, the role of personnel officer
in a hospital and so on.
Dr J. Tong, Executive Director of the
Voluntary Health Association of India (VHAI),
gave a brief outline of the working of VHAI.
The main aim of the VHAI is to give health
care to the millions of rural and poor urban
people. This can be achieved only by their
involvement and participation. Health Educa
tion is carried out more effectively by practical
research and experimentation.
Dr Carol Huss, George Ninan, K. J. John
both from VHAI and A. Padmanabha from
N. T. Co., Guntur were among the faculty.
14
*sasy
UP
r the
L
VOL IV
NO, 4
ns
A bimonthly of the Voluntary Health Association of India
____ ____ ___
. __
AUGUST 19
community health ceu
»w
326, V Main, I Block
Koremsnvala
®enga)ore-56Q034
India
"TECHNOLOGY CAN ONLY qe
CONSIDERED APPROPRIATE IF
IT HELPS LEAD TO A CHANGE
IN THE DISTRIBUTION OF
WEALTH AND POWER.”
✓
editorial
A topic of growing impor
tance is appropriate techno
logy. With reference to deve
loping countries sometimes the
name used is intermediate
technology. This word indi
cates a technology in between
rudimentary village technology
and the highly sophisticated
technology of more advanced
countries. The word appro
priate technology is better be
cause it is flexible enough to
cover all situations in all coun
tries.
opportunity
beckons
Appropriate technology is
applicable to all aspects of de
velopment and manufacture,
and in India is suitable espe
cially for agriculture and
health activities. As an illus
tration, the Indian Institute of
Management in Bangalore has
recently completed a design
research project to improve
bullock carts. As a result they
have developed a carl that can
carry three tons. The typical
village cart will carry only
about one ton. In Madras
some of the new Bangalore de
signs are being used, and the
carl drivers are said to be earn
ing about Rs 70 per day.
As our interest is primarily
in the health field, an example
would be a shadowless opera
tion room lamp that was de
veloped and used by Dr
Charles Perrill, Medical Supe
rintendent and Surgeon for
several years al Christian Hos
pital, Vrindavan, near Ma
thura in U.P. The shadowless
operation room lamp which
he designed was made by a
village tinsmith, and cost al
that time Rs 35. Il is made of
aluminium, and has in the mid
dle only one 60 watt bulb. Dr
Perrill personally used this
lamp for abdominal and other
’ surgery successfully for many
years. As an auxiliary lamp,
for limes when the electricity
would go off, he had designed
a headlight of a car attached
to a movable and adjustable
frame made of small iron rods
in the village blacksmith's shop.
Its wire was attached out
through window to his jeep
battery. When the current fail
ed, he would ask someone to
start the jeep motor, and he
would have a light for his
operation table equal in bright
ness to the headlight of a jeep.
Solar waler healers are now
being made in India. Simple
ones can be made in our va
rious technical-cum-production
schools.
Other examples related to
our community health pro
grammes are improved simple
water filters, improved chula
(cooking arrangement), simple
cooler for preserving vegeta
bles. improved latrines that do
not waste waler, gobar (bio)
gas plants, improved wash
boards or churns for washing
clothes, and numerous similar
things.
Appropriate technology is
applicable not only to equip
ment but also to techniques,
skills and arts; for example,
improved and cheaper scienti
fic ways of preparing food.
medicines, and therapeutic
materials.
We could include even suc
cessful management techniques
related to local customs and
culture. At the health centre for
example, there would
be
opportunities for improved
ways of keeping and retrieving
needed patient records with
out consuming too much time
and paper.
In Jamkhed.
the village
artist paints health posters on
powdered milk tins that are
battened out. lhey are very
durable. In some places ihe vil
lage maternity box is more
practical than in others
Such lists are endless. Op
portunity beckons to every
one s mind to be creative in
all the areas related to our life
and work. By using, adapting
or inventing appropriate tech
nology, we participate in, conworld and lmp.rove uPon the
h
r ■ re“lved from the
hands of its Creator.
appropriate technology tor health
towards a world network
Forward together, symbolically represented on the cover by WHO, is the theme of a world
wide programme to promote appropriate low cost health care. The major part of this issue
is devoted to various ideas promoted by VHA1 and various health programmes. The article
below is an introduction to the global Appropriate Technoloiogv for Health (ATH) pro
gramme.
WHO has now embarked
on a new programme entitled
appropriate technology for
health. Ils objective is to help
national governments solve the
problems encountered in pri
mary health care programmes.
particularly those aggravated
by the lack of an appropriate
technology, at the same lime
both reducing the current de
pendence on imported techno
logy and increasing the effec
tiveness of national health
services.
Appropriate technology for
health has been defined as a
vide ranging set of activities
utilizing skills, knowledge and
creativity, for inventing, dis
covering. testing, improving or
adapting, applying or using
methodologies and techniques
together with methods of ma
nagement for solving health
problems.
Health related appropriate
technologies cover a wide
field : solar power, wind po
wer. water supplies, sanitation
techniques, food preservation
and transport. Technology is
not only hardware.
Il in
cludes techniques which may
also be arts (skills) and the
knowledge to go with them.
According to Dr Katherine
Elliott a technology useful in
primary health care is an ap
propriate one:
if it is economically feasible
within the resources available,
if it is culturally accept
able, not destroying the fabric
of society which may already
be fragile.
if it is
harmless.
been identified. But there are
still many areas which need
further investigation.
environmentally
Appropriate Health Resour
ces and Technologies Action
Group (AHRTAG — UK) is
now functioning as a clearing
house established to explore
the needs for information ser
vices, identify groups and ins
titutions capable of taking the
responsibility for meeting these
needs, and develop a system
of information dissemination.
Dr Katherine Elliott whose in
terest in the health needs of the
third world extends over a
great many years is its hono
rary director.
A list of centres and institu
tions involved in the develop
ment of health and health re
lated technologies have been
drawn up with the aim of
creating a world network of
collaborating ATH centres.
The ultimate aim of the pro
gramme is to achieve national
self-sufficiency in problem
solving in the health field.
WHO's contractual agree
ment with AHRTAG — UK
provided the initiation of re
search into certain technolo
gical needs such as village
obstetrics, oral electrolytes for
rehydration, vitaman A defi
ciency and anaemia screening
at the periphery.
A certain number of prob
lems and constraints encoun
tered in the application of
technology at the primary
health care level have already
3
.Among the targets of the
WHO programme arc estab
lishing clearing houses in
various parts of the world for
information gathering, assess
ing and disseminating informa
tion and a constantly updated
display of selected simple tech
nologies. It also intends
to explore problems in the
identification of technological
requirements, and in the field
testing of technologies as well
as problems related to accept
ance. production, marketing
and evaluation;
to elaborate and revise lists
of equipments and supplies for
peripheral health sendees with
the assistance of countries, ins
titutions and field workers;
to formulate guidelines for
supporting countries in their
efforts to adapt health techno
logy for their own use;
to establish and continue to
develop a network of collabo
rating insJitutions to assist in
developing, adapting, testing
and producing appropriate
technologies for health:
to establish an efficient
mechanism enabling WHO to
contract or sub-contract re
search work for the develop
ment of appropriate techno
logy for health to suitable
national.
private or semi
private institutions and to dis
seminate the results of the re
search undertaken to countries.
appropriately from vhai
The
determination with
which Voluntary Health Asso
ciation has championed the
cause of community health is
well known. Low cost health
care has always been one of
our priorities. Naturally the
publication and distribution
service of the association has
pioneered a number of items
in the best traditions of appro
priate technology.
Patient Retained Health Re
reads have been introduced in
India on a vast scale by VHAT.
These records are designed to
encourage high standards of
health care while serving the
people. The cards are of bright
colour (yellow for under fives,
green for antenatals, pink for
T.B. patients and blue for
others). Each card is 25 cm
when folded and is kept in a
strong plastic cover. It is issued
to the patients with instruc
tions to bring for every visit to
the clinic.
Illiterate people who have
little paper in the house seem
to value these cards more than
the educated patients who are
often the ones who forget to
bring their cards.
The doctor's assistants using
health cards can easily carry
out the health checks and tests
before the doctor sees the pa
tient. The weight graph on the
4
child health card, and the co
lumns on the antenatal card
give the doctor most of the in
formation he needs. He is then
able to quickly answer the pa
tients and decide that protein
supplements or immunizations
or anaemia treatment are need
ed. Such efficiency and speed
are essential if routine health
icare is to be given to large
number of patients.
. Further, the health card
forms a natural talking point
and personalized health leach
ing aid whenever the auxiliary
nurse makes a home visit. The
child's name already on the
card makes introduction easy
when the nurse calls.
single text below each frame.
I hesc reach into villages where
(here arc health workers but
no projectors or electrictiy and
are used for teaching very
small informal groups.
in the local language and
local pictures.
Frontline health workers, now
sponsored by the Government
of India and promoted by
WHO are considered the most
appropriate healfh personnel
with appropriate health skills
to meet the basic rural needs, ft
is no wonder, then the Guide
for Teaching Village Health
Workers has turned out to
be an ideal guide to stimu
late health educators, village
health workers or talented
people to produce materials
on their own. It also includes
an orientation to the proper
use of audiovisual aids.
Better Child Care, the first
in the series has been widely
accepted. It is now available in
15 languages. Nearly two lakh
copies have been distributed
in various parts of India.
It is a matter of great satis
faction that this booklet has al
ready inspired village artists
to adapt the messages to local
media. An example is on p 50
of the book.
The second in the series is
Better Care in Leprosy de
signed to inform peripheral
health workers about leprosy
and its control. This booklet
emphasises early leprosy, early
recognition, early treatment,
avoidance of deformity, pre
vention of complications, re
gular treatment, and is aimed
at reducing unwarranted fears
and misunderstanding about
leprosy.
Our publications not only
provide people with health
education material, but also en-
Salter Scales
courage them to produce their
own materials. How to Scienti
fically Make Your Own Flash
card Sets is based on the be
lief • “Health education be
gins with local beliefs.”
It is a step-by-step guide on
explaining a health problem
This book which evolved
from the learning and work
experience of successful health.
workers helps you plan your
own programmes to try out
the lessons and visual aids,
supplement
them.
change
them, add your own methods,
develop new lessons plans; test
the results and share your ex
periences.
Last but not least Health
For the Millions continues to
publish successful experiments
in low cost health care.
Items mentioned tn this article
Code No :
C-25
Ch-15
Ch-150
D-114
E-15
N-3
N-4
N-12
N-23
Health
Health
HR-5
HR-24
S-40
Description
Teaching Village Health Workers — a guide to
the process
Indigenous Calendar
Better Child Care — available in English Ben
gali. Kannada, Garo. Marathi. Tamil, Assam&se.
Gujarati, Malayalam. Punjabi, Hindi. Khasi.
Oriya. Telugu and Urdu
The Intradermal Jet Injector —‘ manual of maintenance
Simple Bacteriological Analysis of Drinking
Water Supplies
Anaemia Recognition Card — available in Eng
lish, Hindi, Kannada. Telugu. Malayalam, Tamil,
Oriya, Bengali, and Nepali
Arm Circumference Measuring Tape
Arm Circumference Strip (colour)
Childs Bangle for detection for undernutrition.
Record — HR-1. HR-2, HR-3, HR-4, HR-5. HRK7,
HR-12 in various regional languages
Records — HR-9 and HR-10
Use of Patient Retained Health Records
A record for Community Health
Belter Care in Leprosy
Rs
US s
43.00
1.00
10.00
0.40
3.50
1.00
2.00
0.50
0.25
1.00
2.00
1.00
1.00
0.40
0.50
0.40
0.40
55.00 for 250
25.00 for 250
4.00
0.50
4.50
LOO
0.40
1.25
Available from Voluntary Health Association of India, C-14, Community Centre, SDA, New Delhi-16
7
right technology right place
Dr M. V. Joseph who has recently won the Janies Flett Endowment Award in Social
Pediatrics and his colleagues in M.G.D.M. Hospital, Kangazha, have been working on
new low cost and high quality school health programmes. Here are some of the devices they
have developed.
A new device in the form of
a garment which encompasses
the various parameters, mid
arm and chest circumferences
and shoulder girth, was de
signed by a trial and error
method. Quae slick and bangle
tests’ it may be noted, are
based on a single parametermidarm circumference. The
garment for mass nutrition
screening
test was then applied on a nu
tritionally heterogenous group
of children. Eighty-three per
cent (83%) of grade I mal
nutrition could be identified.
When the test was combined
with bangle test nearly 90%
of malnutrition could be de
tected. False positives were
only 5.4% and it could be re
duced to 2.8% when combined
with bangle. The false positives
were mostly below two years
of age. The accuracy rate for
over two years when the two
tests were combined was near
ly 100% (99.1). Garment lest
is an inexpensive, simple, and
quick device for mass nutri
tional screening, and can be
garment on a malnourished
child
advantageously combined with
bangle test giving high rates
of accuracy even in the non
professional hands.
low cost dental unit
The dental survey under
taken by MG DM Hospital,
Kangazha revealed a very
high incidence of denial caries
and periodontol diseases in
school children. Hence denial
health and hygiene were con
sidered an important priority
in the health care of school
children. The follow-up rate
of children with denial prob
lems has been extremely low,
therefore, it is suggested that
a school denial health pro
gramme should have three
basic inputs viz :
I.
A school-based
facility.
curative
dental unit in use
by using variable resistances.
/\ light source (Philips comptalux 230 V/100W BC) is
socketed from the unit itself.
A portable dental chair devised
by David Halstrep forms an
accessory to the unit, all basic
denial
procedures can be
undertaken with this system.
Cost of the dental unit is
approximately Rs 1,000. The
unit is extensively used in all
community denial work.
audiometer
A survey conducted by the
same hospital on 840 school
children revealed that a signi
ficant proportion of children
were having speech and hear
ing problems.
close up of low cost dental
unit
2.
Denial hygiene education.
3.
Dental caries prophylaxis.
(Flouride).
A school-based dental cura
tive care facility can be offered
effectively through a low cost
portable denial unit. At the
Kangazha Hospital they have
fabricated one using a A-1/6
HP motor. A dental hand
piece and burr connected to
the motor through a rotating
cable forms the basic ingre
dient of the denial unit. Speed
of the motor can be regulated
When they correlated the
scholastic
performance
to
hearing loss it was found that
even mild cases of hearing loss
were scholastically backward
which suggested the impor
tance of screening for hearing
audiometer in use
loss in children. Cassette re
cord audiometer is an inexpen
sive and simple system formu
lated by the hospital. Pure
lone in the speech range that
is. 400, 800, 1000, 2000, 4000,
6000, 8000 and 10,000 Hz (it
can be also recorded from a
commercially available pure
lone record) are recorded into
a cassette tape from an oscillo
meter. Instructions for the tests
arc also recorded at the begin
ning of the tape. The children
are asked to respond by rais
ing their hand when they start
hearing the lone and put it
down when the lone stops.
Each tone is tested for sepa
rately. To the output terminal
of the recorder is socketed a
live-terminal parallel output
system and
five ear-phones
which can be plugged into the
five parallel connections. The
intensity of the tone is calib
rated using the volume control
of ihe recorder for the field
conditions, being kept to the
minimal audible level for a
person with normal hearing.
A semi-quantitative assess
ment of the hearing loss is pos
sible by a graduating system.
using the technique of alter
nate binaural loudness balance
lest. Hearing level of 30 dB is
considered as normal. 30-45
dB as mild, 45-60 as moderate,
beyond 60 as severe hearing
loss. The intensity levels are
determined by calibrating with
a pure lone audiometer using
a subject with normal hearing,
having equal thresholds in both
ears. A 30 dB intensity tone
from a pure tone audiometer
is fed into one ear. the tone
from the.cassette record audio
meter al the lowest intensity
being fed ino the other ear.
1 he intensity of the cassette
tone is gradually increased un
til the subject hears both tones
equally in the centre. The pro
cedure is repeated al levels of
45 dB and 60 dB and for each
lone separately. Once calibrat
ed, the system can be used by
itself in the field. The extra
equipment necessary will be
the earphone and the parallel
socket connection which will
cost less than Rs 100.
Even small children from
three years upwards arc able
to respond and the system can
not only be used for field work
but also in clinic set-ups by
physicians or E.N.T. surgeons.
Anybody can easily be trained
in the skill of using this sys
tem.
inexpensive ambulances
A sight that is far too com
mon is that of an injured man
lying besides the road, perhaps
bleeding to death, always in
pain and shock, surrounded by
a crowd looking on helplessly.
Not so dramatic but far more
common is the plight of some
one lying ill in his home, need
ing transportation to a hospi
tal. transportation that is not
available.
A service organization,
gathering together a few volun
teers and a few rupees could
establish an inexpensive am
bulance service which would
be of great value to a commu
nity. When the ambulance is
complete, keep it in a conve
nient place always available.
It is not necessary to purchase
a bicycle but rather use one
that belongs to a volunteer
and is equipped with a metal
ring attached to the rear frame
for attaching the stretcher rig.
It is best that the volunteer be
trained to work with it. for
there are certain rules of the
first aid to be observed.
1. Place the stretcher flat on
the ground next to the in
jured patient and using
six helpers carefully move
him on the stretcher. Care
less moving may do great
injury to a patient.
2. When the stretcher is se
9
cured on the frame, cover
the patient with the blan
ket; he may be suffering
from shock. If more secu
rity is needed, tie the pa
tient with broad canvas
bands. Drive carefully,
avoiding jolts and short
turns.
Materials
Two thick bamboo poles
8-1/2ft long.
One length strong canvas
or other heavy cloth about
7-1/2ft long and 36in
wide.
One blanket
to
co
ver the patient, a metal or
heavy bamboo frame to
hold' the stretcher. 7 ft
lOin long, about 22in
wide.
Canvas bands 3in wide
and at least 6 ft long.
\ pair of bicycle wheels
built into a metal frame
as illustrated. This will be
constructed by a black
smith.
One metal ring welded on
the rear frame of the bi
cycle to be used.
One L-sliape piece of me
tal fastened to the front
of the rack which carries
the stretcher. This will fit
into the metal ring of the
bicycle and will hitch the
bicycle to the stretcher
carrier.
Instructions
Hem each end of the canvas
so that the finished stretcher
will be 7 ft long. Sew each
long side of the canvas into
hems through which the bam
boo poles may be inserted. Be
sure to sew each seam at least
twice so that the scams will
not come open. When not in
use keep the stretcher fold
ed and always see that the
cloth is kept very clean.
In the frame which holds the
stretcher, cut deep grooves into
which the handles of the stret
cher may fit. Il may also be
necessary to lie the handles in
place to make sure that the
patient will not fall.
a home refrigerator
materials
A newly-baked porous clay
basin (size depending upon the
needs of your family), two
.‘.hallow, loosely-knit bamboo
baskets that just fit into the
basin, a piece of gunny sack,
a few bricks, rough sand, some
mud and water.
insti actions
Take the basin, choose a
suitable place for refrigerator
as far away from the chullah
as possible and place the basin
there Mark out a one foot
square around it and remove
the basin. Build a small brick
wall along the marking about
I2in high. Steep some clay in
water over night. Add a little
hay and cowdung to the clay
and mix well. Plaster the brick
wall with a thick layer of the
mud mixture. Let it dry
thoroughly. Fill the space en
closed by the mud wall and
sand to about a fourth of the
height of the wall and level it.
Place the basin in the centre
of the square. Fill the remain
ing space with more sand so
that the square is almost half
full. Sprinkle water all over
the basin and the sand so that
they are moderately wet. This
water will evaporate, making
the inside of the basin cool.
Always maintain the moisture.
Place one of the baskets in
the basin. Arrange in it the
food you wish to preserve.
Cover the food with the other
basket. Cover the basket with
the wet-gunny cloth. Now your
fruits and vegetables will keep
fresh for nearly a week.
This refrigerator will keep
yowr fruit, vegetables, milk and
other cooked food fresh and
good for several days. It will
occupy only a small space in
your kitchen and best of all. it
can be made by you in your
own kitchen al practically no
cost lo you.
hand washing machine
*
With rising cost of deter
gents. and uncertain delivery
of the laundryman, this simple
hand washer is a boon to
house-holds. Easy lo construct,
ii simplifies washing consider
ably.
materials used
Tinsnlps.
Pliers.
Hammer.
Soldering equipment.
Galvanized iron sheeting:
140 cm x 70 cm for tub
100 cm x 50 cm for lid and
bottom
36 cm x 18 cm for agitator
Wooden handle 4 cm dia
meter, 140 cm long
The tub, lid and agitator are
made of the heaviest galvannized tin which can be worked
by. an available tinsmith.
To operate the washing ma
chine the agitator is worked
up and down with a quick
motion but with a slight pause
10
between the strokes. The
movement of the water caused
by the agitator will continue
for a few seconds before addi
tional agitation is needed. On
the upward stroke the agitator
should come completely out of
the waler. The agitator should
not hit the bottom of the tub
on the downward stroke as
this would damage both the
tub and the clothes.
* From “ Taking Technology
to Villages"
Malaria is back. Here Hie
government seeks (he coope
ration of the people in fighting
this preventable disease.
symptoms, the agents which
spread the disease, the treat
ment schedule and preventive
aspects.
where do mosquitoes
breed ?
The malaria carrying mos
quito breeds in stagnating wa
ter like defective drains, pits,
discarded empty containers.
pitchers or any other waler
collection. It takes about one
week for the development of
an adult mosquito from its egg.
Hence it rs essential that all
waler collections must be
emptied at least once a week.
how to control malaria ?
malaria
returns
The resurgence of malaria
over the last lew years has
been posing a serious challenge
to health administrators and
workers. The development of
resistance to DDT spray in
certain strains of malaria para
sites have also added to the
gravity of the problem.
Malaria is a preventable
disease. Keeping this in view.
the government has developed
a three-pronged Modified Plan
of Operation for arresting the
spread of the disease and to
bring it under control. One of
the important objectives under
the Modified Plan of Opera
tion is to increase people’s in
volvement and participation in
the malaria eradication drive.
For this purpose, the people
have to be made knowledge
able ’ about the disease, its
The mosquito sits on the
wall surface of living rooms
and cattlesheds after biting a
man. If these are sprayed with
insecticides the mosquito will
die after a few days.
In rural areas, the insecti
cidal spray with DDT is the
usual method. In those areas
where the mosquitoes are re
sistant to DDT. alternative in
secticides like BHC and Mala
thion are sprayed. Two rounds
of spray of DDT are required
during transmission season
every year, usually May to
July and July to September.
I'he effect of DDT remains on
the walls for about two and a
half months. In case of BHC
or Malathion, three rounds of
spray are given. Its effects last
for one and a half months.
remember these points
* All the rooms of the house
should be sprayed. These in
clude cattle-sheds.
* Calendars, photos
and
other wall hangings etc., are to
be removed and the walls are
sprayed completely.
* All the eatables and fodder
are to be covered before spray.
People should help the spray
workers to cover their food
and fodder.
* All the houses in the villa
ges are to be sprayed, otherwise
mosquitoes can come from un
sprayed houses.
No part of the room should
be left without spray. If a part
of the room remains unsprayed
then it will be just like putting
a fence around the field but
keeping one side open, which
will allow the cattle to enter
and eat away the crops.
* People should not mud
plaster or whitewash the walls
for a period of two and half
months after the spray so that
the effect of the spray is not
lost.
surveillance
It includes detection of
malaria cases. The surveillance
worker visits every house once
in 15 days. He enquires about
any fever case present, anyone
who was having fever, any
guest who has come who had
fever, and any member of the
family who had fever and has
gone to some other place. If
the worker comes across a
fever case, he then takes a
blood smear and gives the pa
tient choloroquine tablets for
presumptive treatment accord
ing to age.
If there is a fever case, free
medicine and
consultation
can be had from the following
agencies: Health Worker.
Health Centre. Dispensary.
Panchayals, and School.
Choloroquine is also being
made available with all the
shops on payment.
I'he NMEP can become
surely a people’s programme
when all organizations initiate
measures to educate the peo
ple.
The organizations can help
in taking the NMEP ahead by
organizing meetings
where
talks regarding cause, trans
mission and method of control
of malaria could be arranged.
During such talks they should
emphasize the need for total
coverage with
insecticidal
spray for ending transmission.
Contributed by the Central
Health Education Bureau,
New D.elhi.
COMMUNITY HEALTH CELL
11
3?6. V Main, 1 Block
Koramongala
Bangalore- 560034
news from the states
kerala
The James Flett Endow
ment Award and gold medal
for research in social pediatrics
has been won this year by Dr
M. V. Joseph of the M.G.D.M.
Hospital. Kangazha. Kerala.
He
has
been
working
on new low cost and high
quality model of school health
care. The award and gold
medal were presented at the
Conference of the Indian Aca
demy of Pediatrics held in
Madurai recently.
The
Kerala
Voluntary
Health Services organized a
workshop on Personnel Man
agement and Labour Welfare
Measures in Hospitals on July
18 and 19 in Kottayam. It was
attended by administrators,
medical and nursing superin
tendents, directors, tutors, and
others in supervisory capacity.
The aim of the workshop was
to educate the members on the
implications of the Supreme
Court judgement, labour law
requirements covering health
care institutions, measures to
be adopted to cope with the
present situation, and to share
problems and seek clarifica
tions. The chief facilitator was
Mr G. D. Kunders.
orissa
The Orissa VHA held its
General Body Meeting on May
23. Dr. S. B. Palit of the Mater
nity and Child Welfare Centre,
Berhampur,
was
re-elect
ed president. Among the high
lights were the selection of re
presentatives to the zonal meet
ing of the Eastern VHAs in
Calcutta and the possibility of
influencing the government for
separate labour legislation for
voluntary hospitals. It was fur
ther decided that in order to
provide health service in emer
gencies, the OVHA.. should
have a ready-made relief team
which can go into action with
in a very short time to provide
health relief services in an
emergency.
The OVHA has also iden
tified community health pro
jects in Orissa which can be
taken as resource centres for
other institutions. These are
Community Health Projects in
Diplipur under Sr Mills, at
Bissemcuttack under Dr Mad
sen and at Doliambo under
Dr M. Suna, the secretary of
the VHA. These projects have
gathered vast experience wor
king particularly with tribal
villagers.
bihar
The Bihar VHA held their
Regional Meeting in Santhal
Parganas on May 4 and 5. The
theme was Community Deve
lopment and Village Health
Workers. The four sessions
conducted in Hindi, covered
integrated rural development,
training of village health wor
kers, human relations. The last
session on regional planning
was based on insights gained
during the earlier sessions.
A workshop on the Indus
trial Disputes Act was held in
Navjyothi, Patna on May 8. It
was organized by Fr McGrath.
The important sections of the
Act were explained. Emphasis
was more on how to follow
the law and live with the Act,
than a discussion of loopholes
and what could be done to
avoid the provisions of the Act.
tamil nadu
The Leprosy Relief Rural
Centre of Chettipatti, Salem,
has introduced a novel feature
of care in leprosy by turning
its attention to detection and
treatment of leprosy patients
among industrial workers. This
year they conducted a multi-
12
diaenostic survey in six indus
tries in Mettur, where educated
youth volunteers were given
series of lectures and case de
monstrations in leprosy and
T B These volunteers con
ducted the initial individual
questioning and examining,
with the assistance of the Cen
tre's leprosy
para-medical
workers. Of the total of 2,427
workers examined, 87 were
found to have leprosy and are
now being given treatment.
The Leprosy Relief Rural
Centre also runs 21 mobile
clinics scattered throughout its
area of operation.
andhra pradesh
CASA is planning a compre
hensive rural development pro
gramme in 20 villages in An
dhra Pradesh. These villages,
which had been badly hit by
the cyclone last year, have
been chosen because of their
remoteness from roads, and
the communities’ willingness
lo participate in development.
One of the aims is to ensure
that each village has at least
one construction strong enough
to withstand tidal waves and
cyclones. This building will be
a centre for teaching crafts,
child health care and other so
cial services, for small industry
operations, and so on. The
two waler wells to be sunk in
each village will give the fami
lies a source of clean drinking
water.
The scheme is divided into
three stages: environmental
development activities includ
ing construction of houses and
drainage systems; socio-econo
mic and welfare activities
covering child welfare, nutri
tion, help for expectant and
nursing mothers, cattle and
poultry projects, cottage and
small industries, and program
mes for vocational training;
and development of leadership
activities and skills.
The health card also acts as
a well-documented note of re
ferral. It can be used by the
hospital doctor to summarize
the patient’s stay in the hospi
tal.
The most popular among
health records is HR 1—Child
Health Record (0-6 years).
This card was originally de
signed by Dr David Morley at
llesha, Nigeria. Also known
as Road to Health Cards these
arc now available in 15 Indian
languages. HR 3—Tuberculosis
Card, and HR 4—Health Re
cords for Adults and School
Children, HR 5—The Leprosy
Record,
HR
7—Health
Records — eye HR 9
Immunization
Identification
Card and HR 10—Insert and
Continuation Card. Dr Murray
Laugesen has also evolved a
low cost effective records sys
tem using various PRHR
cards. Details of this is avail
able in our reprint No. HR 24.
The Arm Circumference In
sertion Tape
helps
mea
sure mid-upper arm circum
ference, a useful indicator of
nutritional status of indivi
duals and communities.
Measurement of mid-upper
arm circumference is useful
for equipping nutrition health
workers with a device for de
tecting severe undernutrition.
Supplying community leaders
and parents with such a mea
sure for monitoring the extent
of undernutrition in their com
munities and children raises
their level of consciousness
concerning the problem. The
Tape also helps in preparing
baseline surveys and periodic
surveys of nutritional status of
the population
The Arm Circumference
Strip is a three-colour strip
which serves the same use as
the arm circumference tape.
This can be easily used by
mothers or peripheral health
workers.
Another typically Indian me
thod used for the diagnosis of
undernutrition is the Child’s
Bangle. In clinic practice the
banele, of 4.0 cm internal dia
ls
ii i' n n h n it n
m
?z
zi
Arm Circumference Tape
meter, will select out those
children whose mothers need
special advice on feeding more
solid food. It is also useful as
a pre-operative check of nutri
tional status. Every toddler
child can and should be screen
ed. It takes no longer than
feeling the pulse in an adult.
It is so cheap every worker in
the child clinic can use one.
The bangle is also useful in
monitoring the
nutritional
status of sample villages in
districts and states where food
scarcity is likely to occur due
to recent crop failures. A rising
percentage of bangle positives
in sample villages scattered
over several districts can be
helpful in getting needed food
to the affected areas in good
time.
The bangle positive child
ren will include those with
marasmic or third degree pro
tein calorie malnutrition.
The Indigenous Calendar
with festivals, full moons with
conversion to English months
5
an J so on is aimed al helping
mothers place the birth of the
child on the exact date.
VHAI has also been instru
mental in popularizing an
Indian version of the famous
portable light weight English
Salter Scales by distributing
the addresses of suppliers as
well as explanatory notes on
t hese.
The Anaemia Recognition
Card is now available in
English and nine other langu
ages. With this simple card
detection of anaemia by com
paring the colour of the
tongue, lower lip and the nails
is very easy.
On the next page is a letter
which recently appeared in
Lancet, the international medi
cal journal published in the
United Kingdom. The authors
of this letter, Drs Shanti Ghosh
and Man Mohan are two well
known paediatricians from the
Safdarjans Hospital in New
Delhi.
A Sterile Delivery Pack was
introduced
by Drs Helen
m
is
Gideon and Murray Laugeseri
to prevent tetanus in the new
born. These are simple to
make and can be used by
attendants at delivery.
As for immunization VHAI
distribution section continues
to be a source of supply of
bifurcated needles. Detailed
information is also available
on jet injectors, particularly
the dermijet injectors.
'fhe numerous reprints cir
culated by our distribution sec
tion also contain several ideas
on appropriate technology for
health. These include E-15Simple Bacteriological Analy
sis of Drinking Water Suppiies” by Duncan Mara, a
member of ITDG’s water panel
and “An Intermittant Water
Filter” by Prof. N. M. Mer
chant of the Department of
Community Medicine, Pahalvi
University, .Shiraz, Iran.
“Low Cost Tube Wells” by
Anaemia Recognition Card
A. Denis N. Fernando speaks
of bamboo tube wells, (cost per
foot Rs 2/'-.). hollowed areca
nut tree tube wells (cost per
foot Re J/-) and clay pipe
lube wells (Rs 2.50).
literacy is not high, but whose
need for health education is
well known. Il is with them in
mind that VHAI has now in
troduced the ‘’Better Care”
series.
It has also been VHAI’s
endeavour to find an appro
priate level of communication
with the rural millions whose
These booklets are designed
like a filmstrip with a picture
frame 8 x 10 cm on
each
page and 50 to 100 words of
THE LANCET. APRIL 15, 1978
SIR, — Anaemia is a major
health problem in developing
countries, especially in pre school children and during
pregnancy. Since 80% of the
population live in rural area
*
a screening test for anaemia
has to be cheap, acceptable to
the community, and simple
enough to be used by a village
health worker after a short
period of training.
We have assessed the detec
tion of anaemia by compari
son of the colours of tongue,
lower lip, and nails with
appearance on an anaemia re
cognition card (produced by
the Voluntary Health Associa
tion of India and supplied by
UNICEF). The card has a pic
ture of an anaemic person one
side and a normal one on the
other, both emphasising the
colour of tongue, lower lip,
and nails. There were 568 chil
dren (453 below six years and
115 between six and fourteen
years). 207 adults, and 151
pregnant mothers.
The identification was done
by four field workers to elimi
nate personal bias and to
make the study more broadly
based. These health workers
were educated and had some
training in the basic health
care. The identification was
done in a room with adequate
daylight and also in a room
with daylight and a tube light.
The results were compared
with haemoglobin values deter
mined by cyanmelhaemoglobin
method.
100% of patients below 6 g
Hb/dl and two-thirds of those
between 6 and 9 g/dl were
correctly identified. The figures
for three health workers
varied from 66% to 72%: the
fourth worker identified almost
80% correctly. About 80% of
children with an Hb of more
than 11 g/dl were identified
correctly as non-anaemic but
in the adults there was a wrong
assessment in about 25-30% of
cases. The difference was pro
bably due to discoloration of
6
tongue and lips with tobacco
and betel leaf in adults. Half
of the patients with Hb values
of 9-11 g/dl were correctly
identified.
Every screening method has
some drawbacks, but the im
portant finding here is that
most patients with Hb values
below 9 g/dl were easily iden
tified. The anaemia recognition
card can be used as a screen
ing method for delecting
moderate to severe anaemia
in a population where medical
facilities are scarce. In India
the village level workers train
ed for the Integrated Child
Development Services as well
as the community health wor
kers could do this job.
SHANTI GHOSH
MAN MOHAN
Department of Paediatrics,
Safdarjung Hospital,
New Delhi - 110016. India.
}
new delhi reports
unique arrangement
The government is willing to
assign an important role to
the voluntary agencies in the
enormous task of rural deve
lopment.
Prime
Minister
Morarji Desai told a national
seminar of voluntary agencies.
He was inaugurating the threeday seminar convened by the
Ministry of Agriculture on
April 25 to improve rural de
velopment services of the coun
try. to discuss ways in which
Government and voluntary as
sociations could work together
more effectively.
Prof Raj Krishna of the
Planning Commission assured
the participants that to the
maximum extent of their capa
city and coverage the volun
tary agencies will be given the
task of bringing new life to
the villages, the governmental
agencies giving assistance to
them whenever and wherever
required.
As an instrument of liaison
between the Ministry and the
voluntary agencies, there is a
unique arrangement not had in
any of the other ministries.
There is a registered society
within the Ministry, on the
governing board of which there
arc some representatives of
concerned voluntary agencies.
The name of the registered so
ciety is People’s Action for
Development in India (PADI).
This shows the genuine eager
ness of the Agriculture Minis
try to have working relation
ships with the numerous volun
tary agencies working in the
field of rural development.
Some extracts of the resolu
tions arrived at during the
seminar, and read out on the
last day. express the common
desire of both government and
voluntary agencies to work
more efficaciously together for
the common welfare of the
weakest sections of society.
In order to bring about
close cooperation
between
governmental and voluntary
agencies, a line of communica
tion should be opened and
maintained through exchange
of information, regular con
tacts, cooption of representa
tives of voluntary agencies in
various committees concerned
with development, and their
association with development
planning al the grass-roots.
The group also drew atten
tion to the need for coordina
tion between voluntary agen
cies among themselves where
they are working in the same
area.
Il is intended that the auto
nomy of the voluntary organi
zation is fully protected, and
all assistance rendered to it to
develop its full potential. But
that imposes certain correspon
ding obligations on the volun
tary organization concerned.
First it has to show better
performance than the govern
mental agency, and secondly,
it has to accept full responsi
bility for better utilization of
funds, and prevention of waste.
Its accounts have to be full.
detailed, up-to-date, and cor
rect all the lime. Arrangements
will have to be made to train
its people where necessary, but
no excuse should be accept
able for bad account keeping.
A provision will have to be
made in the Panchayat Raj
Act to nominate Chief Execu
tive of the voluntary organiza
tions to the Block Samiti
and/or Zila Parishad, depend
ing upon the size and extent
of their operations. In fact.
where the voluntary organiza
tion covers the entire block, is
engaged in integrated area and
community development, and
has success in various fields to
its credit, it will be advanta
geous to the block to elect its
Chief Executive as the head of
the Block Samiti, and to place
all its resources at the organi
zation's disposal. Devoted and
competent rural leadership is a
scarce resource, and where it
it spotted, its potential should
be exploited to the full.
team builders
A six week's course in
Health Based Community De
velopment concluded at Jamkhed on June 24th. The parti
cipants included nurses and
paramedical and social wor
kers involved in community
health. Their common interest
related to building up of com
munity organizations, and also
planning organization, imple
mentation and evaluation of
community health programmes.
Equally keen was the interest
to know all about village
health workers — their selec
tion, duties, training and re
ward system. The underlying
motive was to gather * the
13
available know-how so as to
act as good team builders in
the health field and as cata
lysts of social change.
Participants went through a
wide variety of learning expe
riences. Later when asked
what they liked and in what
order, they grouped the expe
riences and suitably graded
them. Case studies came al the
lop, group discission came
next, followed by game and
stimulation experience, infor
mal lectures questionnaires.
practical work, observation
and village or field experience
were some others in order.
COMMUNHY HEALTH Cult
47/1,(First HoorlSi. Marks Hoad
BAl'JGAuQ.Tt - 560 001
book news
where there is no doctor
In a remote mountainous
area of Mexico. David Werner
has learnt about village health
care I he hard way. Now his
experiences arc available (o all
in this excellent paperback
book written by him and illus
trate J by many of his very
appropriate drawings.
Where There Is No Doctor
is not a conventional medical
book, but then, a village with
no doctor is not a conven
tional medical situation: but
the scope of its coverage
should enable a reasonably
educated person in the village
to acquire enough knowledge
of what to do in an emer
gency situation and also what
preventive measures to lake to
keep the village healthy.
Using simple words and over
1000 line drawings, the author
explains to the" reader what
he or she can do to prevent,
recognize, and treat many
common sicknesses. The book
helps individuals to realize
what they can do for them
selves. as well as which prob
lems need the attention of an
experienced health worker.
David Werner explores a
wide range of subjects rele
vant to the health of the vil
lager— from diarrhoea to
tuberculosis, from helpful and
harmful home remedies to the
cautious use ol modern medi
cines. Special emphasis is plac
ed on cleanliness, diet, and
vaccinations..
Mothers and midwives will
find the information on home
birth, care of the mother, and
children’s health clear and
useful.
Where There Is No Doctor
has a new introductory section
for the village health worker,
which discusses ways to deter
mine needs, share knowledge.
and involve the community in
activities that can better peo
ple’s health. The health wor
ker is encouraged to think of
health care in terms of both
immediate
and
long-term
needs of the community. He
or she is encouraged to work
toward a better balance bet
ween prevention and treat
ment as well as between people
and land.
This introductory section
stresses the importance of
using local resources whenever
possible, and of building on
the people’s local traditions
and ways of healing by adding
to (rather than replacing) them
with helpful aspects of modern
medicine.
Where There Is No Doctor
is a revised, updated transla
tion of a highly successful
book first written in Spanish —
Donde No Hay Doctor. The
Spanish version is now used in
15 Latin American countries
as a training manual for vil
lage health workers and has
been widely praised for its sim
plicity, clarity, and practical
value.
Where There Is No Doctor
presents guidelines for the
sensible use of both traditional
and modern medicines, ft ex
plains which medicines are
most useful for specific illness
and warns against ones that
are dangerous. A special sec
tion at the end of the book
gives the uses, dosage, and
precautions for each medicine
referred to in the main text.
Included in the book are an
index, tear-out sheets for pa
tient
reports and dosage
blanks, and special pages on
vital signs and the abbrevia
tions. weights and measures
used in the text. A word list
at the end of the book explains
terms that may be unfamiliar
to the reader.
14
This book will soon be avail
able from the Publication
Department of the Voluntary
Health Association of India.
To ensure your copies please
drop us a post card indicating
your requirements. This will
enable us to procure enough
copies The tentative price is
Rs. 29.00 plus postage.
Basic. Managerial Skills for
Ail: by E. H. McGrath. SJ.,
pages 371. Rs 15/- plus post
age.
We are all in one degree or
another managers. We plan
and set goals, we organize, we
motivate, and communicate.
we leach and train, we mea
sure and evaluate. Do we
manage well ?
Here is an attempt to syn
thesize, to make accessible to
a wider variety of audiences.
useful behavioural concepts.
and aids for personal deve
lopment.
This book is “unabashedly
a ‘How to’ effort with constant
use of pointers, tips, epigrams
and maxims.” All managerial
skills including often neglected
basic, skills like reading, writ
ing, listening, speaking, teach
ing and so on are covered
comprehensively with case
studies and parables.
I'he simple language used
makes the book meaningful
for all readers, whether they
are management students, or
not. T he book is useful for
those who do not have the
lime to go in for detailed
courses, non-formal educators.
and anyone who wants to
manage his own work situa
tion belter than he is doing at
present.
Appropriate Technology Vol.
I published by Appropriate
Technology Association, a
directory of machines, tools,
plants, equipment, processes
and industries brings together
several samples of appropriate
technology- and service indus
tries and includes ideas from
various sources.
This is meant for the use of
field level workers, agents of
change in the rural areas, vo
luntary workers and others
who are fairly educated to read
the drawings and descriptions
of the equipment and process
and are able to translate them
into action.
The section on Health and
Hygiene gives information on
sanitary latrines for villages,
PR AI type latrine. Quae slick,
household filler unit, child
weighing equipment and rural
health.
news from far and near
bangalore
□ Die second batch of students
in Correspondence Course in
Hospital Administration (19761978) graduated on July 22 at
Bangalore. Dr .1. S. Tong,
Executive Director. VHAI,
gave away the certificates after
the students had made pre
sentations of their term papers.
Dr long expressed the need
for hospitals to have a new
vision and assume a leading
role in low-cost health care
for the underprivileged.
The third batch of students
(1977-1979) had their mid
course seminar al Bangalore
from July 3 lo 7. Both the
groups had the opportunity lo
participate in a I-week Human
Relations workshop where
processes of inter-personal re
lationships were explored.
Copies of this directory can
be ordered from M. M. Hoda.
Executive Director, Appro □ A four-day workshop in
priate Technology Develop
Medical Staff Organization was
ment Association, Post Box
held in Bangalore in July.
311. Gandhi Bhawan. Luck Thirty-live medical superin
now. Price in India is Rs 50
tendents, administrators and
excluding postage.
chief medical officers discuss
ed the role of the medical
superintendent, rules and re
gulations for medical staff.
Major findings of South
medical audit and the relation
Kanara District Survey (C-40)
ship of lhe medical staff with
are now available. The sur
the administration.
vey, in which various sections
of the community actively
participated, was a concerted
move towards regionalized
bangladesh
health planning. This detailed
report is highly recommended
to all those who are interested □ Forty seven voluntary hos
pitals and health projects in
in or are initialing community
Bangladesh as reported earlier
health programmes.
have decided to get together
and start the Voluntary Health
The
130 page detailed
Services Society (VHSS). The
report is priced Rs 20.
Society , was inaugurated on
March 13 this year. The post
of director has been offered to
Also from David Werner
a Bangladeshi doctor. The
come two highly thought
address " of VHSS is 549 F.
provoking articles. mimeo
Road
14,
Dhanmondi,
graphed. versions of which are
Dacca-5.
Bangladesh.
now available. They are C-52
Health Care and Human Dig
nity, C-53 Village Health
antibiotics
Worker — Lackey or Libetor.
□ Streptomycin
injections
These are priced Rc 1 each.
should now be freely available.
15
According to
an
official
spokesman of lhe Hindustan
Antibiotics Ltd, lhe public
sector undertaking has stepped
up lhe production of formulat
ed antibiotics in lheir factory.
This assurance was communi
cated to Dr James S. Tong.
Executive Director, VHAI.
who had earlier taken up lhe
issue with lhe Ministry of Pet
roleum, Chemicals and Ferti
lizers.
Hospitals are directed to
write to the nearest HAL sales
depot or to : Mr V. Rathasabhapathy. Marketing Mana
ger, HAL, Pimpri. Pune ■111 018, regarding their re
quirements for the various
antibiotics manufactured by
HAL,
research talent
n Dr Ravi Shanker Mani of
St. John’s Medical College,
Bangalore and Dr J. Gowri
Shanker of Christian Medical
College, Vellore have topped
lhe all India competitive exa
mination of the Indian Council
of Medical Research Talent
Scheme held in May 1978. Of
the first ten positions St. John’s
have bagged three positions
and CMC Vellore two.
vhai catalogue
The VHAI 1978 Catalogue
of Educational Materials is
ready and is now being des
patched.
For strictly budgetary rea
sons we are forced to prune
our mailing list. We would,
however, not like to deprive
any one who really needs it.
If you still haven’t got yours
do drop us a post card.
situations
Laboratory Technician train
ed in Radiology seeks employ
ment in hospital. Interested
hospitals can write directly
to :
Ms Iqbal Kaur, c/o Kartar
Singh. H. No. 82. Fairland
Avenue, Fatehgarh Choorian
Road, Amritsar.
“A trained Medical Record
Technician with 8 years’ expe
rience in Medical Records
Keeping seeks employment in
any medium sized hospital
with bed strength of 75 to 150
bedded.” Interested hospitals
can write directly to :
Mr Suresh Carleton, Phila
delphia Hospital, P.B. No. 1,
Ambala City - 134 003. Har
yana.
A post graduate Medical
Records Technician, married
with child, and holding diploma
from
Philadelphia Hospital.
Ambala seeks employment in
hospital anywhere in India.
Age : 32 years. Interested hos
pitals may write directly to :
Francis James. 10032 Nawah
Ganj. Delhi - 110 006.
Name of post: Hospital Engi
neer.
Qualifications: B.E. with one
year experience or Dip. with 5
years experience in hospital
maintenance.
Salary: 500-25-600-30-720-35
860 plus DA Rs 190.
Responsibilities: include up
keep and maintenance of all
hospital equipment, utilities,
civil works, etc.
Age: preferably below 40
years.
Christian commitment pre
ferred. Apply immediately
with biodata and references to :
The Director, VVanless Hospi
tal, Miraj - 416 410. Maha
rashtra.
stop press
The Government of India
invites all registered volun
tary agencie> to participate in
the National Adult Education
Programme by opening centres
to train at least 30 students
in the field. The government
will bear 75 per cent of the
administrative costs and 100
per cent of the programme
costs. The programme will be
launched on October 2. I
Application forms are afart
able
le with: Ms Vina K
Secy. Ministry of Ed
lion & Social Welfare, (
ernment of India. Scheme
Assistance
for
Volun ary
Agencies in the Field of A 15£
Education. Shastri BhavtFn?
New Delhi - 100 001.
=
dairy management
The Livestock Department
of Action for Food Produc
tion (AFPRO) will be con
ducting a one month course in
English on Dairy Husbandry
and Management at and in
collaboration with the College
of Veterinary Sciences, Andh
ra Pradesh University, Rajendranagar, Hyderabad. The
course starts on September
1st.
The training will cover ba
sic know-how of successful
dairy farming. This course is
recommended for project tech
nicians, farm managers and
extension workers who wish
to organize/reorganize the’r
farms on modern lines.
Rs 100 will be charged per
participant to cover lution,
board and lodging.
Nominations may please be
sent by August 21. 1978 to
AFPRO, Community Centre,
C-17. S D. A., New Delhi 110 016.
residency in community health
The first one year resi
dency programme in Com
munity Health and Deve
lopment is scheduled to be
gin in September 1978. This
programme is designed to
give candidates theoretical
and practical training in
socio-political and econo
mic factors in development.
government
programmes
management and communi
cation skills and techniques.
and primary health care, ft
is expected that after the
training the candidate can
assume an administrative/
coordinating role for rural
health and development
programme
agencies.
in
voluntary
Applications are invited
from young men and wo
men under 30 years willing
to work in such program
mes. Sponsored candidates
will receive preference. For
further details write to :
Community Health and
Development Residency,
Voluntary Health Asso
ciation of India, C-14,
Community Centre,
S.D.A., New’ Delhi 110 016.
r il
1 SJs '?wned and published every two months by the Voluntary Health Association of
India. C-14, Community Centre, Satdarjunij Development Area, New Delhi 110 016, India. The Editor, Printer
and Publisher is James S. long SJ„ of. Indian nationality. His address is the same us the place
•of publication. Printed at Sanjivan Press, Kailash Market, N^rDelbi.
For Private Circulation only
Position: 1857 (4 views)