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O
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GUINEAWORM ERADICATION PROGRAMME
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XII TASK FORCE MEETING
15th and 16th January 1990
DELHI
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REPORT
AND
RECOMMENDATIONS
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NATIONAL INSTITUTE OF COMMUNICABLE DISEASES
(Division of Helminthology)
22, SHAM NATH MARG, DELHI-110 054
(Directorate General of Health Services
Ministry of Health, Govt, of India)
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11173
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Edited by :
Dr. Ashok Kumar, M.D.
Deputy Director
J
i
Mr. S. M. Kaul, M.Sc.
Asistant Director
Dr. Gautam Biswas, M.D.
Senior Medical Officer
if.
Dr. T. Verghese, M.D.
Director
NATIONAL INSTITUTE OF COMMUNICABLE DISEASES
22, Sham Nath Marg, Delhi-110054.
I
LIBRARY
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Page
A« P r a c e e d i n g s
1
B. Current GW Situation in India
4
C. State-wise GW Situation
Andhra Pradesh
9
Guj arat
13
Karnataka
Ma dh ya P r ad esh
16
19
Maharashtra
Raj asthan
24
29
Tamil Nadu
33
D. Major actions taken during 1989
34
E. Recommendations of 12th Task Force Meeting
38
F. Epidemiological Acheivements of GWEP
42
G. Future plan of Action for 1990
44
A ppe ndices
L
II.
Programme of 12th Task Force Meeting
Guidelines to States regarding Format for
p r e s e n tat i on
III. Li s t o f Pa r t i c i pan t s
IV.
Reccomendations of 11th Task Force Meeting
A c k n o w 1 e dg ern e n t s
45
48
49
52
58
A.
Proceedings of 12th Task Force Meeting on
Guineaworm Eradication Programme (GWEP) of India held at
National Institute of Communicable Diseases (NICD), Delhi
on 15th-16th January, 1990
Besides concurrent and independent evaluation, the GWEP
is annually reviewed in depth by a "Task Force Group" under the
chairmanship of the Director General of Health Services
(DGHS),
Govt. of India. The Task Force group on GWEP is constituted by
(a) Director and Deputy Director (Helminthology) of NICD, Del h i
as convenor & Co-ordinator of meeting (b) Directors of Health
Services, State GWEP Officers, Chief Engineers (PHED Rural Wat e r
Supply)
of guineaworm endemic states and Director/Adviser of
National Drinking Water Mission, as members, and (c)
inv i ted
experts from WHO, UNICEF, SWACH, Central Health Education Bureau
and various other organizations.
The 1Eth Task Force Group on GWEP (Appendix-Ill) met at
National Institute of
o-f Communicable
Commun i cabl e Diseases, Delhi, the nodal
agency for national GWEP, on 15th and 16th January, 1990. In the
inaugural session on 15th January, 1990 morning, while
wh i 1 e welcoming
the chairman, members and invitees. Dr.M.V.V.L.Narasimham,
then
Director, NICD, Delhi, spelled out the following objectives of
this 12th Task Force Meeting on GWEP:I. In-de pth review ofc
1. Epidemiological situation of Guineaworm
disease in the country as on 31st December,
1989/1st January 1990.
The implementation & performance of various
operational components of GWEP during 1989.
3. Achievements of GWEP from 1984 till 1989.
II.
Recornmendations for an efficient & effective
p 1 ann ing , imp 1 ernentat ion/supe rv ision and
evaluation of GWEP to achieve zero guineaworrn
incidence in the country by •1991, and
III. Prepare the plan of action on GWEP for 1990-91.
1
In his address, Mr. J. Vasudevan, Joint Secretary to
Govt, of India, Union Ministry of Health & Family Welfare, Delhi,
lauded the excellent inter-sectoral co-ordination established by
NICD between the health & rural water supply
engineering
departments, and felt that is the key to the success of GWEP.
he
While assuring of the continued resource inputs to GWEP,
requested that guineaworm endemic states should p r o v i d e due
priority to GWEP in terms of sufficient allo cat i on and full
utilization of funds under this programrne.
Mr. Inarnul Haq, Adviser to National Drinking Water
Miss ion emphasized the commitment of Ministry of Agriculture,
of India to provide adequate safe drinking water supplies
Go v t.
on
to every guineaworm affected village, hamlet and habitation.
priority, He informed that even the norms are being relaxed to
meet the complete requirement of safe water supplies/sources to
guineaworm endemic areas.
Dr. P.Micovic, W.H.O. Co-ordinator and Representative
for India expressed his satisfaction over the good management of
GWEP in India and thus hoped that this programme will achieve its
objective in the stipulated period and could serve as a model for
other guineaworm endemic countries. He expressed happiness over
the declining guineaworm trend in India by adopting an inter
in
sectoral approach and actively involving WHO & UNICEF
of
assisting GWEP. While appreciating the efficient deployment
in
ten Epidemiological Surveillance Teams under GWEP, by NICD,
endemic states, he felt that these teams will be required to be
continued to function even after achieving
zero-guineaworm
incidence in the country for maintaining active guineaworm
surveillance for a defined period.
In his inaugural address. Dr. A.K. Mukherjee, Director
General of Health Services and Chairman of Task Force on GWEP had
recalled his impressions of attending the inter-national meet ing
on guineaworm eradication in April, 1989 in Pakistan, wherein
India’s success in guineaworm eradication was widely acclaimed by
other countries, The valuable expertise generated by NICD in this
field has been usefully exploited for guineaworm eradication in
their .countries.
He cong ratulated the Rural Water
Supply
Enginners for their support to GWEP and rnent i oned ’ that hand-pumps
designed by them are widely appreciated all over the world.
While expressing his pleasure & optimism that India would be much
ahead of other countries in achieving zero guineaworm incidence
by 1991,
he, however, coutioned that there are still problem
areas like Udaipur, Dungarpur, Jhalawar districts in Rajasthan,
Rajgarh district in Madhya Pradesh and in other states where
concerted efforts would be required on priority.
2
T h e i n a u g u r a 1 s e $ s i o n o -f t h i s m e e t i n g was c o n c1u d e d wi th
a vote
of thanks proposed by Dr. Ashok Kumar,
D ep u t y Dire c t o r
(H e ]. m i n t h o 1 o g y) , N .1C D, De 1h i.
Further proceedings of the meeting were held as per t h e
scheduled
programme (Append!x-I) in seven sessions during wh i ch
the
Directors of Health Services/GWEP Officers and
Chief
Engineers (RWS) of all the endemic states presented the
de ta i 1 e d
guineaworm status reports of their respective states, as per
the
guidelines
(Append!x-II)
provided to
them.
The
corn pi 1 ed
in-f o rmat i on
on
g u i n e awo r rn sit ua t i o n an d GWEP
i rn p 1 e m e n t a t i o n
during
1989 as well as future plan of action under GWEP
in
the
coun try and e n d e m i c
states is detailed subsequently in
t hi s
r e p o r t.
The concluding session of this meeting on 16th January,
1990 evening was chaired by Dr. N.K. Shah, Director
D i r e c t o r Prevention
Pr e v e n t ion &
Disease Control,
WHO (SEARO), Delhi.
The first
part
this
Control y
pa r t of
session was devoted to "Research needs in GWEP" and the
second
part discussed the "Recommendations of the 12th Task Force Group
on GWEP".
The special invitees viz. Prof.
I.C.
Tiwari,
Prof.
Nagalotirnath and Prof. V.K. Kochar suggested some Operational,
c1 inico-patho1ogical
A Behavioural
Research needs
in
GWEP,
nee ds
respectively.
They were requested to kindly send write
u ps on
these aspects
in order to incorporate the need based
r es ear c h
within GWEP.
The house resolved that the recommendations of •1-1th
Task Force Group on GWEP, January, 1989 (Append!x-IV) were
very
exhaustive and still hold good for their continued implementation
during 1990-91.
However, the additional recommendations of
this
meeting were recorded.
While
concluding,
Dr.
N.K. Shah hoped that a 1 J.
the
guineawo rrn
endemic states would have drawn their plan of a c t i o n
f o r 1990--91 a n d w o u 1 d m a k e a 11 sincere efforts to implement them
efficient ly & effectively to achieve the national
objective
of
zero
g u i n e a w o r rn i n c i d e n c e b y 1991 .
H e expressed happiness
over
the
performance & achievements of GWEP.
Mr. S.M. Kaul
proposed
vote of thanks.
3
B.
CURRENT GUINEANORM
SITUATION IN INDIA
country
The current Guineaworm disease situation in the
on the basis of the three active guineaworm case searches during
1989
is summarised in the tables
Ha A b) be 1ow-
Table 1a
State-wise Number o-F GW ATTected Districts
412
total districts in the country
GUINEAWORM
ENDEMIC
STATES_____
Andhra Pradesh
Guj arat
Karnataka
Madhya Pr ad e s h
Maharasht ra
Raj asthan
TOTAL
AFFECTED
AS ON 1.1.89
6
8
7
14
13
17
NEW/RE AFFECTED
DISTRICTS
DURING 1989
Nil
1
Nil
3
Nil
Nil
65
3
1
AFFECTED
AES ON
1.1.90
8
8
7
16
10
16
5
63*
DELETED
IN 1989
Nil
1
Nil
Nil
3
Only 46 districts reported active GW cases during 1989,
others were under surveillance.
During 1989, only 5 districts were deleted after 3 years
of surveillance during which no guineaworm case was found. These
districts include Junagarh in Gujarat; Nasik, Pune and Ahmednagar
in Maharashtra; and Bundi in Rajasthan. The state of Tamil Nadu
is free from GW disease from 1984-85.
Table 1b
State-vise GU Sisease Situation
total in Country PHCs : 14,609; villages : 557,137; population : 685,185 (1981 Census)
AFFECTED AS ON 1.1.1989 NEWLY AFFECTED IN 1989 DELETED IN 1989 AFFECTED AS ON 1.1.1990
S.No GUINEAWORM
ENDEMIC
PHCs VILL- POPULA- CASES PHCs VILL- POPUL CASES PHCs VILL- POPUL PHCs VILL- POPUL CASES
AGES. ATION
AGES. ATION
STATES
AGES. TION
AGES. ATION
9 20285 17 7 101 208532 26 150 348125 224
407 Nil
1. Andhra Pradesh 33 241 536363
6
8
32 35235 30 52 319085
81 347468
3 5852
3
2. Gujarat
35
27 3
41 356 690426 1909 Nil
22 34566 129 7 107 156017 34 271 568975 896
3. Karnataka
correct information not provided — 61 825 920589 1408
4. Madhya Pradesh 70 867 916251 2565
113 475 362528 1496
8 40 23708: 106 32 226 236147 89 289 152775 475
5. Maharashtra
83 2258 1864546 5619
4 195 134170^ NA 11 444 360845 76 2009 1637871 4872
6. Rajasthan
| 375] 4278|4717794| 12023] 15] 269|218581| *255]J 65|
■'] 910| 996776] 316] 3596]3947420] 7881
--------------- ---- excluding Madnya
Inya Pradesh
Pradesh---------------------------------------* excluding Madhya Pradesh & Rajasthan,
which did not provide information
TOTAL
4
It
may be observed that the number of guineaworm
cas es
have
reduced by 347. from 12023 in 1988 to 7881
in
1989,
the
highest percentage decline being in Gujarat (787.) and Maharashtra
(687.) .
The State of Rajasthan contributed 627. of total GW cases
in
India
(1989)
followed by Madhya Pradesh
(187.),
Karnataka
(117.) , M a h a r a s h t r a (67.) 7 Andhra Pradesh (37.) and Gujarat (O.17.) .
The number of affected villages have reduced by 167. from
4278 as
on
1.1.1989 to 3596 as on
1.1.1990.
Likewise
the
p o p u 1 a t i o n at risk reduced from 4.7 million in the beginning
of
1989 to 3.9 million
in the end of
1989.
During
1989,
269
(e x eluding Madhya Pradesh
Pradesh))
villages got
newly affected
or
r e i n f e c t e d from guineaworm disease, of which 195 (557.)
we r e
in
Raj as t han„
On
1.1.1990,
Rajasthan accounts
for 567. of
the
guineaworm affected villages in India.
The
sex distribution of guineaworm cases s howed
a 1 mo s t
equal
di st r i but i on
of cases amongst males
and •f e ma les.
w bile
majority (567.) of GW cases were adul t pat ients.
Drinking Water Supply Situation
Table E
Drinking Hater Supply Situation in GW Affected Areas
S.No GUINEAWORM
NO.OF
NO.OF VILLAGES
SAFE DRINKING WATER SOURCES
UNSAFE DRINKING WATER SOURCES
AFFECTED WITHOUT A SINGLE,HAND (DRAW |PIPED)OTHER TOTAL STEP |PONDS|TANKS|OTHERS TOTAL
Tillages SAFE SOURCE PUMPS WELLS WATER
WELLS
1. Andhra Pradesn 150
1
758 361 35 Nil
1154
229
65 Nil Nil
294
2. Gujarat
256| iso:
180| 23 Nil
i
52
Nil
459
6; 729
3
35
873
ENDEMIC
STATES
3.
Karnataka
4. Madhya Prades.
5. Maharashtra
6. Rajasthan
TOTAL
•Ji-
183*
Nil
825
2
289
81
2009 No information
3596
84w
486 442 35
4295 6172' 64
555 1274 119
5188 6119: 283
Nil
90
Nil
Nil
963
10621
1948
11590
159:
1009:
954:
1393;
115381145481 559
90
26735
37501 3358
5
982
602
975
Nil
980
87
Nil
192
3413
1643
2368
244! 1102
8783
25.
216
Nil
Nil
Relates to only 183 of the total 271 GW affected v :i. 11 a g e s in Karnataka
Provisional
Nat i onal
Drinking Water Mission,
o-f
l*l i n i s t r y
dr ink ing
Agriculture, Delhi has assured not only to provide safe
water
in all those villages which do not have any, but also
to
provide water
sources in every hamlet/habitation
of
villages
af f e c t e d w i t h Gu i n e awo rm d i s ease.
on
5
The state-wise in-formation regarding GW situational case
management,
drinking water position, vector control, health
are
education and trained manpower development under GWEP
summarised, in subsequent text.
6
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JAMMU 2f KASHMIR
guineaworm
endemicity map of INDIA
AS ON 1.1.90
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Z ^PRADESH
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PRADESH
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ORLSSA
MAHARASHTRA
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iih
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PRADESH
maar
^is
t>'vW
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GOM k*
yYaTxY^t/o<^
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jy^r f
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ivnct
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7VW<3A<
ZipwiMi
.KARNATAKA
\A T
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aaul hadu1
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LAKSHADWEEP ISLANDS
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6
L£G EHD.
DifitncU vM GWcasQS A
dwvng WSq
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buV uMer sarveUtance.
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State-wise Distribution of GW Cases
in India during 1989
Rajnn t ha n
01,8%
A. P r n d n fl h
2.8%
■
Giijnrfll
0.1%
Kor nnl okn
11.4%
un!u:::n:::n^
M fl h fl r n n h I r n
6.0%
M. Rrndonh
17.9%
State-wise Distribution of
GW affected Villages
in India during 1989
Maharashtra
8%
RnjaBthan
66%
Madhya Pradoah
23%
Andhra Pradooh
4%
Gu J n r at
Karnataka
8%
1.
C. STATE-WISE GUINEANORM SITUATION
ANDHRA PRADESH
GW Situation
The state
carried out 3 active
guineaworm case
s> e a r c h
operations,
in the months of April, June and December 1989.
The
GW situation in the State is given in Table 4.
Table - 4
District-wise GW Situation in the State
Total in State : Districts - 23; PHCs - 455; Villages - 27221; Population - 53549673
S.No NAME OF THE
AFFECTED
DISTRICTS
AS ON 1,1,1989
AS ON 1.1,90
NEWLY AFFECTED IN 1989 DELETED IN 1989
PHCs VILL- POPULA- CASES PHCs VILL- POPUL- CASES PHCs VILL- POPUL- PHCs VILL- POPUL- CASES
AGES TION
AGES ATION
AGES ATION
AGES ATION
1. Ananthpur
5
2. Cuddapah
1
3. Kurnool
14
4. Mahboobnagar
9
5. Prakasam
6. West Godavari 3
15 47440
1
900
161 359587
52 78867
1
2151
11 47418
33
TOTAL
o n 1 y 36
sur ve i1lan ce
9
39
172
175
1
11
Nil
2 2862
Nil Nil
Nil
Nil
7 17432
Nil Nil
Nil
NA NA
NA
Nil Nil
Nil
241 |536363 | 407 | Nil]
v i 11 a g e s
had
2
Nil
15
Nil
NA
Nil
3
8 21364 2
Nil Nil
Nil 1
1 72 148753' 13
3 17 24332 6
Nil Nil
Nil 1
Nil
4 14083 3
9 (20285 | 17 |
active
cases.
8
9 28938
1
900 18
96 228266 190
35 54535
6
2
2351 Nil
7 33335
2
7| 101 |208532] 26 | 150*|348125| 224
othe rs
were
under
e n d of the year, the numbe r
o-f
GW
a -f f' e c t e d
v i11ages have d e c1in ed by 387. and the number of GW cases by 457..
Th o ug h n on e
of
the districts qualify for
dele t ion,
distri ct
P rakasarn has
only two affected villages while
in Cuddapah
d i strict
only one village is affected, Howeve r, t he di st r i c: t
of
K u r n o o 1 , deserves close attention as a 107. increase in the number
guineaworm cases
cas e s
is
observed , and also
t h e 9 n e w ]. y
of
of
the
a F f e c t e d villages detected in the State, 7 sue h
v i1lages
were
detected in this dist ri ct a1 one.
At
the
Case Management
All
t h e 22 4 g u i n e a w o r rn c: a s e s d e t e c t e d i n 19 8 9
r e p o r t e d t o b e cured without developing any complications.
9
we r e
Drinking Water Supply
O-f the 150 affected villages as on 1.1.1990, one village
Pinnapuram in Panyam PHC of District Kurnool is without any safe
drinking water source.
There are 1154 total safe drinking wate r
sources i.e. 807. of the required number of 1393.
Table - 5
Drinking Hater Supply Situation in the State as on 1.1.90
NO.OF
S.No NAME OF THE
NO.OF VILLAGES
SAFE DRINKING WATER SOURCES
UNSAFE DRINKING WATER SOURCES
AFFECTED
AFFECTED WITHOUT A SINGLE HAND DRAW PIPED OTHER TOTAL STEP PONDS TANKS OTHERS TOTAL
DISTRICTS
VILLAGES SAFE SOURCE
PUMPS WELLS WATER
WELLS
14
9
Nil
6
88
11
3
Nil Nil
1. Anantpur
61 21
Nil
1
Nil
Nil Nil
2. Cuddapah
1
Nil
4
6
1 Nil
2 Nil
Nil Nil
96
216
Nil
3. Kurnool
1
386 242
25
653
170 46
4. Mehboobnagar
Nil
45
Nil
121 64
1
186
44
1
Nil Nil
35
5. Prakasam
Nil
2
11 10 Nil
Nil
21
3 Nil
Nil Nil
3
Nil Nil
6. West Godawari
Nil
3
Nil
Nil 15
15
7
175 22
200
TOTAL
150
35
758 361
1
Nil
1154
22?
65
Nil
Nil
Against a target o-f 300 unsafe sources •for conversion, only
(427.)
were c o n v e r t e d du r i n g 1988-89.
294
•126
Vector Control
Table - 6
Cheaical Treatment of Unsafe Drinking Hater Sources
S.No NAME OF THE
AFFECTED
DISTRICTS
1.
2.
3.
4.
5.
6.
Anantpur
Cuddapah
Kurnool
Mehboobnagar
Prakasham
West Godawari
TOTAL
Table
6
NUMBER OF UNSAFE NUMBER OF UNSAFE WATER SOURCES
AMOUNT OF TEMEPHOS IN LITRES
WATER SOURCES
TREATED WITH TEMEPHOS
CONSUMED
BALANCE
TARGETTED
NEVER 1-23-4 5-67-8 DURING THE YEAR AT THE END OF THE YEAR
TIMES TIMES TIMES TIMES
11
Nil Nil Nil Nil
14
11
55
11
34
1
Nil Nil Nil Nil
1
170
29
4
42
8
81
10
303
44
10
24 Nil
3
7
163
1
3
Nil Nil
2
1 Nil
7
13
4
Nil Nil
1 Nil
103
Nil
3
233*
66 I
37
40
90
32
665
43
All were step wells except in district West Godavari where
■four ponds were treated.
Only 157. unsafe water sources w ere treated with t e rn e p h o s
7-8 times,
while
387. unsafe water s o u r c e s were
treated 5-6
times.
The state regretted for the poor performance in
terne ph os
application
due
to shortage of temephos as only 600
litres
of
temephos was requisited. However, it may be noted that the
state
10
• W- -■>
has a balance of 43 litres at the end of the year which
could
have been reappropriated to Kurnoo1/Mahboobnagar districts, where
the perforrnance was poor.
Health Education
Table 7
Table 7
Health education aaterial distributed and activities conducted
in Guineavorn affected districts
S.No.
DISTRICTS No. of No. of No. of No. of No. of No. of No. of Awareness
group film video
recog. posters sticker Camps
film
meeting shows casettes slides cards distri- distri conducted
shows distri- bated buted
buted
92
50
35
44
4000
2000
1100
100
1400
Nil
200
200
270
150
80
Nil
25
11
12
Nil
30
627
8644
900
78
Anantpur
Cuddapah
Kurnool
Mehboobnagar
Prakasha®
6. W. Godawari
52
7000
8909
480
Nil
300
Nil
Nil
36
4
Nil
10
1
1
1
1
1
1
Nil
20
60
50
Nil
14
50
100
300
TOTAL
16741
50
6
144
1.
2.
3.
4.
5.
v i1lages were
covered
by
Hea1 th
Education Activities of which 1539 (877.) were in Ma h ah b o o bn a g a r
district alone.
A
tr 0 tr Cl 1
Of
•1765
The guineaworm education day was celebrated in only 69 villages
- 61 in Mehboobnagar district and 8 in West Godawari district, on
29.4.1989.
A community procession was taken out
to
increase
public awareness about
t h e causation and
prevention of
the
disease■ Radio talks were also arranged from AIR and spots
shown
on Doordarshan telecast.
Health Infra-structure & Trained Manpower Development
The State has an officer of the rank of Deputy Director
as
the State GWEPO, who is assisted by a non medical
Technical
□ ff i ce r
for the implementation of the GWEP in
the State■
The
Health infrastructure at the PHC level and their training
status
in
the guineaworm eradication programme
prog ramme is given in the table 8
be 1ow»
11
Table 8
Health Manpower and Q£P Training Status of PHC level functionaries
S.NolNAME OF THE
AFFECTED
__ DISTRICTS
1. Ananthpur
2. Cuddapah
3. Kurnool
4. M'boobnagar
5. |Prakasam
6. W. Godavari
TOTAL
NA
STAFF
SANCTIONED
MOs HAs MPWs
NA NA
NA
1 3
15
74 60 230
82
6 21
NA NA
NA
2 9
25
STAFF
TRAINED TILL TRAINED DURING
IN POSITION
PREVIOUS YEAR
THE YEAR
MOs HAs MPWs MOs HAs MPWs MOs HAs MPNs
NA NA NA NA NA
NA Nil Nil
Nil
1
3 15 Nil Nil Nil
1
3
15
73 55 211 Nil Nil Nil 48 Nil
Nil
5 20 78 Nil Nil Nil
3 18
70
NA
NA
NA
Nil
Nil
NA
NA NA
Nil
2
9 25 Nil Nil Nil
2
9
25
83 93
81
352
87 329
Nil Nil
Nil
54
30
STAFF REMAINED
UNTRAINED AT THE
END OF THE YEAR
NA
Nil
25 MOs, 55HAs, 211MPWs
2 MOs, 2HAs, SMPWs
NA
Nil
110
In Format ion not aval lable/provideci
Training of PHC
level Medical Officers and health
in the districts of Ananthpur and Prakasam could not
be
undertaken as the district health officers of
these
districts
we re
themselves nnot
ot
in the guineaworm
eradication
ra i n e d
ttrained
wo rk e r s
prog ramme.
in
27
MOs, 57 HAs, 219 MPWs need to be trained in 1990
Kurnool and Mehboobnagar districts, on priority, besides training
staffin other districts.
12
-
GUJARAT
GW Situation
The
state of Gujarat reported that 3 active guineaworm
case
searches were
conducted, however, it was observed during
the discussions that the case search operations were not
planned
in a requisite manner. A detailed house to house guineaworm
case
search was not undertaken in specific,
rather
health workers
enquired about GW cases during their routine visits to
v i1lages
for all diseases. Since the state claims to have a c h i e v e d z e r o
t ransmi ss i on,
as
all the GW cases detected were
i m p o r t e d,
the
state was
requested to conduct well planned and t h o r o u g h GW
active
case
search
operations
in
the
state
for
close
surveillance. The detail of guineaworm s i tuat i on is p rose n t e d
in
the table below:
Table 9
GW Disease Situation in the State
Total in State : Districts - 19; PHCs - 251; Villages - 18275; Population - 33960905
S.No NAME OF THE
AFFECTED
DISTRICTS
1. Sabarkantha
2. Panchmahal
3. Vaisad
4. Banaskanlha
5. Kutch
6. Mehsana
7. Kheda
8. Junagadh
9. Jamnagar
AFFECTED AS ON 1.1.1989
NEWLY AFFECTED IN 1989 DELETED IN 1989 AFFECTED AS ON 1.1.1W
PHCs VILL- POPULA- CASES PHCs VILL- POPUL- CASES PHCs VILL- POPUL- PHCs VILL- POPUL- CASES
AGES TION
AGES ATION
AGES ATION
AGES ATION
12
7
3
2
3
4
3
1
Nil
TOTAL
47
10
8
3
3
6
3
1
Nil
71809
38966
25790
68865
24706
92656
23840
836
Nil
12
8
3
3
Nil
Nil
1
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
1
Nil
2
35 I 81 |347468 | 27
3
Nil
Nil
Nil
Nil
Nil
Nil
1
Nil
2
Nil
Nil
Nil
Nil
Nil
Nil
2619
Nil
3233
Nil
Nil
Nil
Nil
Nil
Nil
1
Nil
3
3 | 5852 |
5
2
Nil
Nil
Nil
Nil
Nil
1
Nil
29
2
Nil
Nil
Nil
Nil
Nil
1
Nil
27604 7 18
3176 5
8
Nil 3
8
Nil 2
3
Nil 3
3
Nil 4
6
Nil 4
4
836 Nil Nil
Nil 2
2
44205 1
35790 1
25790 Nil
68865 Nil
24706 Nil
92656 Nil
23840 1
Nil Nil
3233 3
3 | 8 | 32 | 35235| 30 | 52* |319085| 6
•a- only 5 villages reported active GW cases y
others were under survei1lance.
district
of Junagarh is deleted from the
affected districts, being free from guineaworm disease
last three years.
The
During 1989, only 6 guineaworm
as compared to 27 cases in ■1988, all of
cases,
imported
cases,
5 from Madhya Pradesh
These
cases were reported to have been
13
c a s e s have been
list
of
for
the
detected
whom were reported to
be
and one
from Raj asthan.
invest igated
tho roughly■
six
These
cases w e r e d i s t r i b u t e d i n 5 v i 11 a g e s
one
each
in
district Sabarkantha,
Sabarkantha,
Panchmahal
and Kheda and
in
two
n ew 1 y
affected villages of Jamnagar district.
Case Management
Al 1
the
six
g u i n e a w o r rn
developing any corn pl i cat i ons .
we re
cases
c ii r e d
w i t hout
Drinking Water supply
A joint survey was carried out by the Health Directorate
and the PHED in January and November/December, 1989 to determine
drinking water sources in the guineaworm affected villagesThe
drinking water situation in the guineaworm affected villages
on
1.1-1990 is given in the table below:
Table 10
Drinking Hater Supply Situation
S.No NAME OF THE
AFFECTED
DISTRICTS
1. Sabarkantha
2. Panchmahal
3. Valsad
4. Banaskantha
5. Kutch
6. Mehsana
7. Kheda
8. Janina gar
TOTAL
NO.OF
NO.OF VILLAGES
SAFE DRINKING WATER SOURCES
UNSAFE DRINKING WATER SOURCES
AFFECTED WITHOUT A SINGLE HAND DRAW PIPED OTHER TOTAL STEP KACHA TANKS VIRDA TOTAL
VILLAGES SAFE SOURCE
PUMPS WELLS WATER
WELLS WELLS
18
Nil
131
59
6 Nil
196
5 337 Nil
Nil
442
Nil
8
82
92
1 Nil
175
1 381
3
9
394
8
Nil
14
27 Nil Nil
41
Nil Nil Nil
26
26
Nil
3
2
2
1 Nil
5
Nil
11 Nil
Nil
11
3
Nil
Nil Nil
3 Nil
Nil Nil Nil
Nil
Nil
3
Nil
6
Nil Nil
6 Nil
Nil Nil Nil
Nil
Nil
6
4
Nil
Nil Nil
3 Nil
Nil Nil Nil
Nil
Nil
3
2
Nil
27 Nil
2 Nil
29
Nil Nil Nil
Nil
Nil
52
Nil
256
23
180
Nil
459
6
729
3
35
873
As per the norms
n o r rn s of one
o n e safe drinking water source
pe r
250 population, 1272 safe drinking water sources are required
in
the 52 currently guineaworm affected villagesHowever, only 459
(36%)
safe
drinking water sources are available
including S3
piped water schemes in these villages.
Vector Control
During
1989, around 95% of unsafe water s o u r c e s in
the
GW
and the
affected villages remained untreated with temephos,
remaining 42 (57.) unsafe sources received t e m e p h o s . a p p 1 i c a t i o n
only 3-4 times, from February to September, 1989 No indent
for
s u p p J. y of temephos was made by Gujarat during •1988-1989, to
the
•14
Centre.
The Temephos was borrowed from the Malari a E; rad i cat i on
P rog ramme. The District wise application of Temephos is shown
in
table 11.
Table 11
Cheaical Treatment of Unsafe Drinking Water Sources
S.No NAME OF THE
AFFECTED
DISTRICTS
1.
2.
3.
4.
Sabarkantha
Panchmahal
Vai sad
Banaskantha
NUMBER OF UNSAFE NUMBER OF UNSAFE WATER SOURCES
AMOUNT OF TEMEPHOS IN LITRES
WATER SOURCES
TREATED WITH TEMEPHOS
CONSUMED
BALANCE
RECORDED
NEVER 1-23-45-67-8 DURING THE YEAR AT THE END OF THE YEAR
TIMES TIMES TIMES TIMES
442
411 Nil
31 Nil Nil
35
Nil
394
— 3$4 — Nil Nil Nil
20
Nil
26
26
5
5
11
Nil Nil
11 Nil Nil
Nil
4
873
831 —
42
Nil
Nil
64
5
Health Education
O-f
the two video cassettes r e c e i v e d by t h e
state
f r om
NICDx
one was
supplied to Sabarkantha
and one
r e t a i n e d at
headquarte rs, f or h e a11 h education ac ti v i t i e s.
Three slide
sets
supplied by the NICD were used by the state
for
training of
various
categories of
persons
in
programme
i m p 3. e m entation.
Training of NGO was organised by voluntary organization "Chetna".
All
primary health
centres
in
the affected districts were
targetted for health education during 1989, however
details
of
health education material and activities were not provided.
Health Infrastructure & Trained Manpower Development
The State h a s a p p’o i n t e d a senior offi.ce r of the rank
of
Joint
Director of Health Services as the GW Prog ramme Officer.
The
State has not
provided information
regarding
h e a 11 h
infrastructure existing in the state and their training status in
GWEP as
per the guidelines.
However,
five district
health
officers were trained in the guineaworm
e radi cat ion
programme
during July and September, 1989 at NICD, Delhi.
During a
c ras h
training programme organised by the states in September,
•1989 y
only 7 mass media officers and other
cat ego r ies of
h e a 3. t h
functionaries were trained by the state.
15
KARNATAKA
GW Situation
The district wise GW situation in Karnataka is given
table below.
in
Table 12
District-wise GW Situation in the State
Total in State : Districts - 19; PHCs - 268; Villages - 270284; Population - 37043451
AFFECTED
DISTRICTS
AS ON 1.1.90
AS ON 1.1.1989
NEWLY AFFECTED IN 1989 DELETED IN 1989
PHCs VILL- POPULA- CASES PHCsIVILL- POPUL- CASES PHCs VILL- POPUL PHCs VILL- POPUL- CASES
AGES ATION
AGES TION
ACES ATION
AGES ATION
Belgauiri
Dharwad
Bijapur
Gulbarga
Bidar
Raichur
Bellary
1
4
8
17
3
7
1
S.No NAME OF THE
1.
2.
3.
4.
5.
6.
7.
TOTAL
1
526
8 26088
35 104073
234 459012
9
9770
67 87337
2
3620
1
1
511
1255
23
117
1
Nil Nil
Nil
1
Nil
2
Nil 17
Nil Nil
Nil
2
Nil Nil
Nil Nil
234
1
2405
2
29909 31
578
3
1440 92
Nil Nil
41 | 356 (690426 | 1909 | Nil] 22 | 34566) 129 |
Nil Nil
Nil 1
3
4 19739 1
3
8 12320 5
Nil 87 120658 17
Nil Nil
Nili 3
3300 6
T 8
Nil 1
Nil Nil
526 Nil
1
5
6583
1
29 94158 205
164 368263 478
9 10348: 3
61 85477^ 209
2
3260 Nil
7] 107 |156017) 34 | 271*|568975] 896
* Correct information regarding villages reporting
active GW cases was not provided
compared to 1988, the number o-F a-F-Fected
a P F e c t e d villages
The districts o-F Belgaum
were reduced by about 537. during 1989.
and Bellary did not record any cases while Dharwad and Bidar
had
only one and three cases, respectively.
In Raichur district, t h e
guineaworm
cases increased by about 807. in 1989 as
com pa r e d
to
probl emat i c
1988. The districts o-F Gulbarga and Bijapur r e ma i n e d
districts o -F the State, however they showed a decline o-F GW cases
by 607. at
the end o-F 1989. About 777. of
the n e w 1 y a-F-Fe c ted
villages were from Gulbarga district in the state. No explanation
•For
the rise in the number o-F cases
c a s e s in Raichur district was
put
•Forth.
As
Drinking Water Supply Situation
The drinking water situation in the GW a-F-Fected villages
in the State is given below.
•16
Table 13
Drinking Water Supply Situation as on 1.1.90
S.No NAME OF THE
AFFECTED
DISTRICTS
1. Belgaum
2. Dharwad
3. Bijapur
4. Gulbarga
5. Bidar
6. Raichur
7. Bellary
NO.OF NO.OF VILLAGES SAFE DRINKING WATER SOURCES
UNSAFE DRINKING WATER SOURCES
AFFECTED WITHOUT A SINGLE HAND DRAW PIPED OTHER TOTAL STEP PONDS TANKS OTHERS TOT/U.
VILLAGES SAFE SOURCE PUMPS WELLS WATER
WELLS______________
Nil
• no information available --------1
Nil
1
1 Nil Nil
2
1
Nil Nil
Nil
1
28
Nil
106 84
11 Nil 201 25
2 6 Nil 33
150
Nil
365 348
23 Nil
736 129
3 19 Nil 151
Nil
4
1
3
1 Nil Nil
2
Nil Nil Nil
2
3
Nil
8
11
1 Nil
20
2
Nil Nil
Nil
2
Nil
no information available
183*
TOTAL
Nil
486
442 I
351 Nil
963
1159
5I 25
Nil I 192
Data pertains to only 183 o-f the 271 GW affected villages
1.1.90
35
on
progress in the conversion of step wells
is
hampered, by their location in private holdings. Only 40 (357.) of
the
114 targetted unsafe drinking water sources were converted.
The PHED has now issued guidelines for conversion of only t hose
step wells, which are the sources of infection,
currently. The
Government of Karnataka had already released Rs. 15 lakhs •for
conversion of 159 step wells into draw wells. The Chief Engineer
opined that for open ponds, a design has to be provided to ensure
cost effectiveness.
The Engineer in Chief(PHED) also assured
that his department was aware of the problem of brackishness and
was taking steps to tackle it.
The
Vector Control
The vector control measures
mecAsures (by
ternephos) were very
unsatisfactory during 1989, only five applications with Terne phos
s o rn e
were made in some
of the unsafe water sources in d i s t r i c t
Gulbarga. In other GW affected districts the unsafe water sources
were not treated with ternephos.
Health Education
Health Education activities were carried out through
distribution of handbills, posters and other mass media available
in the district. The details o-f health education activities
carried out in the State are given below.
17
Table 14
GU Health Education Activities Carried Out
DISTRICTS No. of No. of No. of No. of No. of No. of Orienta Exhibi
group film/ posters sticker Plasticpampha- tion
tion
meeting video distri distri- Cards lets
Camps
shows buted buted distr distri
ibuted buted
S.Nd.
1.
2.
3.
4.
5.
6.
7.
Belgaum
Dharwad
Bijapur
Gulbarga
Bidar
Raichur
Bellary
Nil
600
Nil
Nil
15
Nil
102
Nil
10
Nil
Nil
2
Nil
Nil
Nil
95
100
Nil
150
Nil
300
Nil
75
500
Nil
Nil
Nil
1000
Nil
50
Nil
Nil
Nil
Nil
Nil
Nil
1800
42500
Nil
200
Nil
5000
Nil
25
Nil
Nil
Nil
Nil
Nil
Nil
6
Nil
Nil
Nil
Nil
1
TOTAL
717
12
645
1575
50
49500
25
7
The GW education day was celebrated in 243 villages,
However 7
it was not celebrated in the districts of Gulbarga and
R a i c h u r , two of the highly endemic districts.
The health education activity as can be judged from the
table
is far from satisfactory , specially in the highly endemic
an d p r i o r i ty districts.
Health Infra-structure & Trained Manpower Development
A Joint Director of Health services has been w o r k i n g as
State GW Eradication Programme Officer and assisted by a
D e p n t y Director and Technical Officer. The Health man powe r and
training status of PHC level health functionaries in GW affected
areas is given below.
the
Table 15
Health Manpower and GWEP Training Status of PHC level functionaries
S.No NAME OF THE
STAFF
STAFF
TRAINED TILL TRAINED DURING
SANCTIONED
AFFECTED
IN POSITION
PREVIOUS YEAR
THE YEAR
MOs| HAs| MPKs MOs| HAs[ MPNs MOs| HAs| MPNsI “MOs
DISTRICTS
“ '| HAs| MPWs
1. Belgaum
information'not available/provided
2. Dharwar
17 20 110 17 19 110 17 19 110 Nil! Nil Nil
3. Bijapur
13 10 140 12
9 130 Nil Nil Nil 12 9 130
4. Gulbarga
information not available/provided
2
14
1: 2
5. Bidar
8i 11 2
8| Nil: Nill Nil
6. Raichur
55
8
6
5
55; Nil Nil Nil) 6. 5
55
16
7. Bellary
2' 2
2\ 1
16; Nil NiL Nil Nil, Nil Nil
TOTAL
42
40
335
40
36
319
18
21
•18
118
18
14
185
STAFF REMAINED
UNTRAINED AT THE
END OF THE YEAR
Nil
Nil
8 MPWs
2 MOs & 1 HA
2 MOs 1 HA & 16 MPW
MADHYA PRADESH
GW Situation
T hi r e e a c: t i v e g u i n e a w o r m c a s e s e a r c h e s w e r e c o n d u c t e d
in
the State in the months of May, June/July and December 1989.
Th e
GW situation at the end of the year is presented below.
Table 16
Current Guineaworm situation in the state
Total in State : Districts - 45; PHCs - 290; Villages - 22418; Population - 52131717
S.No NAME OF THE
AFFECTED
DISTRICTS
AS ON 1.1.1989
NEWLY AFFECTED IN 1989 DELETED IN 1989
AS ON 1.1.90
PHCs VILL- POPULA- CASES PHCs VILL- POPUL- CASES|PHCs VILL-JPOPUL PHCs VILL- POPUL CASES
AGES TION
ACES ATION
i
AGES ATION
AGES ATION
1. Rajgarh
2. Dhar
3. Jhabua
4. Ujjain
5. Dewas
6. Guna
7. Barwani
8. Shajapur
9. Sagar
10. Sehore
11. Shivpuri
12. Mandsaur
13. Khandwa
14. Vidisha
15. Damoh
16. Panna
6
13
11
1
3
2
10
7
7
1
4
4
Nil
Nil
1
1
464 504194
84 66824
198 205694
11
5556
9
6362
7 10630
35 68546
28 22208
4
1678
3
1239
12 17386
8
704
Nil
Nil
Nil
Nil
3
3707
1
992
1239
555
367
126
81
37
23
114
11
9
1
2
Nil
Nil
Nil
Nil
TOTAL
70
867 916251
2565
Nil| 42 |19610 | 110] Nil| 87 | 35047 6
information not provided —
11
2
‘76 107535
Nil
6 4584
9
1
1
215
Nil
5
NA 2
information not provided
4
Nil 20 1145
Nil
9
NA 2
Nil Nil
Nil
1 i23
2575 9
• information not provided ---—
6
• information not provided --- 1706 4
Nil Nil
Nil Nil
Nil
Nil 1
Nil Nil
Nil
1
8
5518 2
Nil Nil
Nil
3
7
506 1
1
1
750
Nil Nil
Nil 1
680
Nil Nil
1
1
Nil 1
Nil Nil
Nil
Nil
2
2251 1
Nil Nil
Nil
Nil Nil
Nil 1
419 488757 530
182 154062 484
128 129414 66
7
5781 115
15 17568 86
18 11775 54
12 65971
2
21 28729 66
11
1678 Nil
3
1890 Nil
4 10888 Nil
1
198 Nil
1
750
2
1
3
680
1
1456 Nil
1
992 Nil
61
825 920589 1408
information not complete
At the end of
■1989, 16 districts of the state
continued
to
b e a f f e c t e d w i t h g u i n e a w o r rn p r o b 1 e m.
The number of
af f e c t e d
villages was reduced by about 57. as compared to
p r e v i ous
year.
However, the decline in the number of guineaworm cases was
about
457..
The
reduction
in cases was remarkable
(80"Z)
in
J habua
d i s t r i c t.
In Ujjain
and Dewas districts, the position seems
to
be a 1 rnos t s tat i c - In the district of Guna an increase in GW cases
In K han d wa d i s t r i c t, which h a d
is
reco r d e d.
been
d e ]. e t e d one
i rn p o r t e d c a s e was recorded.
In Vidisha district, NICD team found
three
cases
referable to the period June-July w h i c h w e r e
not
record e d
by the State. Six districts-Sagar,
Sehore,
Sh i v pu r i ,
Mandsaurr
D a rn o h a n d P a n n a did not report any case
during
•1989.
Overal1
it a p p ears t hat,
there
is
c o n s i d e r a b1e
scope
fo r
improving surveillance in the state.
•19
Drinking Water Supply Situation
Table 17
Drinking water supply situation in the Guineawora
affected districts of the state
S.No NAME OF THE
AFFECTED
DISTRICTS
1. Rajgarh
2. Shajapur
3. Jhabua
4. Barwani
5. Dhar
6. Dewas
7. Ujjain
8. Guna
9. Shivpuri
10. Sehore
11. Sagar
12. Damoh
13. Panna
14. Khandwa
15. Vidisha
16. Mandsaur
TOTAL
UNSAFE DRINKING WATER SOURCES
SAFE DRINKING WATER SOURCES
NO.OF
NO.OF VILLAGES
AFFECTED WITHOUT A SINGLE HAND DRAW PIPED OTHER TOTAL STEP PONDS TANKS OTHERS TOTAL
WELLS
VILLAGES SAFE SOURCE
PUMPS WELLS WATER
392
3
Nil
1703 387
2
419
Nil
849 848
6 Nil
619
18
16
Nil
5608 585
21
Nil
1797 3774 37 Nil
1775
93
925
3 Nil
1773
3 754
128
Nil
980 790
NA
7
NA
NA
13
NA
12
Nil
11
2 Nil Nil
382
53
87
969
20 204 105
493 386
3
182
Nil
6
4 Nil Nil
2
68
42 Nil
3
113
15
Nil
NA
7
NA
NA
NA
NA
NA
NA
NA NA
7
2
93
NA
NA
NA
NA
NA
NA
NA
NA NA
18
Nil
NA
104
NA
109
NA
NA
81
3 Nil
4
Nil
25
Nil
7
8
7
Nil
Nil
8
Nil
Nil
Nil
3
Nil
Nil
Nil
7 Nil Nil
36 Nil Nil Nil
11
Nil
29
Nil
1
2’ Nil
9
1 Nil Nil
7
Nil
Nil
1
NA
NA
22
NA
NA
NA
NA
NA
Nil
NA NA
1
Nil
5
280
2
3 Nil
Nil
28 240 12 Nil
1
NA
NA
NA
1
NA
NA
NA
NA NA
NA
Nil
1
NA
NA
NA
NA
NA
NA
NA NA
NA
NA
Nil
1
825
Provisional
2*
NA
4295I 6172
64
90
10621 11009
982
216
980
3421
information not available
of
Only two villages still remain without the provision
programme
any safe water supply as per informations given by the
The Chief Engineer informed that
in
16 guineaworm
officer,
though only 55'5 additional hand
pumps were
endemic districts,
installed
as
p e r norms
per
but PHED actually
required to be
installed 2746 hand pumps. Of the total step wells targetted for
conversion, 472 remained unconverted into safe draw wells.
Vector Control
The State regretted regarding the poor
performance
in
Temephos application in the State and promised better performance
in
1990.
The
performance regarding Temephos
application and
consumption of Temephos is given below.
20
/
Table 18
Identification of unsafe water sources and
Application of temephos
S.No NAME OF THE
AFFECTED
DISTRICTS
1. Rajgarh
2. Shajapur
3. Jhabua
4. Barwani
5. Dhar
6. Dewas
7. Ujjain
8. Guna
9. Shivpuri
10. Sehore
11. Sagar
12. Damoh
13. Panna
14. Khandwa
15. Vidisha
16 Mandsaur
TOTAL
NUMBER OF UNSAFE NUMBER OF UNSAFE WATER SOURCES
AMOUNT OF TEMEPHOS IN LITRES
WATER SOURCES
TREATED WITH TEMEPHOS
CONSUMED
BALANCE
RECORDED
NEVER 1 - 2 3 - 4|5 - 6 7 - 8 DURING THE YEAR AT THE END OF THE YEAR
TIMES TIMES TIMES TIMES
392
120
118
86
46
22
133
40
619
499
2 Nil Nil
60
118
Nil
1775
1274
Nil
17 106 378
218
20
7
Nil
Nil Nil
7 Nil
3
2
382
252
67
57
120
6 Nil
30
6
Nil
Nil Nil
6 Nil
17
19
7
Nil
Nil
4
1
2
40
20
93
Nil
21
27
34
11
22
38
104
Nil
Nil
73
31 Nil
37
13
7
Nil
Nil Nil
7 Nil
40
20
Nil
Nil
Nil Nil Nil Nil
Nil
Nil
1
Nil
Nil
1 Nil Nil
1
2
2
22
Nil
22 Nil Nil Nil
8
5
Nil
Nil
5 Nil Nil
5
15
1
1
Nil Nil Nil Nil
Nil
Nil
Nil
Nil
Nil Nil Nil Nil
Nil
Nil
3421
2146
285
215 I 305
470
698
227
OF
the 3421 un safe wat e r s o u r c e s r e c o r ded For
chemi cal
t reatment
during
1989,
a majority (637.) did
not
receive
did
any
Ternephos application, others (147.) were treated inadequately and
only 237. were treated 5-8 times.
Health Education
Health e cl u c a t i o n activities have been taken
up on a
1arge
s cal e
in the districts o-F Rajgarh, Shajapur,
J habua and
Dha r
o n 1 y.
They are proposed to be
intensified
du r i ng
1990.
UNICEF is also assisting the activities and have
c o mmi 11ed an
ass i stan ce
of Rs. 12 1 a k h s f o r h e a J. t h e d u c a t i o n .
The
d i s t r i c t -•
w i s e i n f o r m a t i o n o n h ea11 h e du cat ion a c t i v i t i e s i n t h e S t a t e are
s h o wn i n t ab1e 19.
21
Table 19
Health education aaterial distributed and activities conducted
in Guineawora affected districts
S.No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
DISTRICTS No.of No. of No. of No. of No. of No. of No. of No. of No. of No. of No. of Health
group film video
kala slogans posters sticker tin- pampha- OTC offi- ExhibiHand
cials and
lion
meeting shows casette
plats lets
bills pathak
distri- non-offislide
drama
bution cials
show
prog.
Nil
800
Nil
2000
Nil
Rajgarh
1300
Nil
Nil
800
Nil
32000
Nil
300
7000
150
101
Shajapur
18
6
60000
50
Nil
Nil
18
Nil
Nil
Nil
5
37
3247 7096
Nil
110
7590
19
Jhabua
Nil
31
Nil
6000
36
Nil
Nil
Barwani
190
Nil
Nil
6000
Nil
385
150
8000
Nil
8
10
6000 8000
Nil
150
10
Dhar
12
358
Nil
Nil
Nil
Nil
Nil
Dewas
Nil
Nil
Nil
Nil
440
Nil
Nil
Nil
100
5000
Nil
Nil
Yes
Ujjain
Yes
Yes
Nil
Nil
Nil
Nil
Nil
Nil
10
4000
Guna
Nil
Nil
Nil
Nil
Nil
Nil 3000
9
Nil
3000
Nil
1300 3000
Nil
28
3000
12
Shivpuri
Nil
Nil
Nil
Nil
Nil
Nil
Sikar
998
Nil
4
Nil
Nil
Nil
Nil
Nil
12
Nil
12
Nil
45
Nil
Nil
105
Nil
Sagar
2
Nil
Nil
2
Nil
Damoh
Nil
36
Nil
Nil
Nil
38
32
3
Nil
3
Nil
Nil
Nil
Nil
22
Nil
Panna
432
Nil
Nil
Nil
Nil
Nil
Nil
260
510
Nil
Nil
Khandwa
Nil
Nil
Nil
Nil
405 10000
Nil
Nil
Nil
Nil
Nil
Vidisha
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Mandsaur
Nil
Nil
Nil
TOTAL
2093
16
3416
6800
53
105120 31772
6800
4071
37100
183
Health Infrastructure & Trained Manpower Development
Table 20
Health Manpower situation and training status with respect to GHEP
S.No NAME OF THE
AFFECTED
DISTRICTS
1. Rajgarh
2. Shajapur
3. Jhabua
4. Barwani
5. Dhar
6. Dewas
7. Ujjain
8. Guna
9. Shivpuri
10. Sehore
11. Sagar
12. Damoh
14. Khandwa
TOTAL
STAFF
SANCTIONED
MOs HAs MPWs
12 36 210
29 52 282
46 83 272
56 49 213
50 92 278
13 32 126
NA NA
NA
8 12 108
16 35 126
36 38 240
8 26 100
4 11
50
2
2
19
STAFF
TRAINED TILL TRAINED DURING
IN POSITION
PREVIOUS YEAR
THE YEAR
MOs HAs MPWs MOs HAs MPWs MOs HAs MPWs
12 36 210 12 36 210 Nil Nil Nil
25 42 262 Nil Nil Nil 21 42 262
37 52 217 Nil Nil
12 30 49 191
41 45 188 35 38 172 41 45 168
40 61 235 Nil Nil
19 27 50 272
14 26 112 Nil Nil Nil
7 26 112
43 Nil Nil Nil
3
43
3
1
1
9
98
4
9
5
2
9
76
22
15 36 114 Nil Nil Nil 14 30 114
36 38 240 Nil Nil Nil 36 38 240
14 26
4 26
92
92 Nil Nil Nil
36
3 11
50 Nil Nil Nil Nil 10
2
2
2
19
2
19 Nil Nil Nil
STAFF REMAINED
UNTRAINED AT THE
END OF THE YEAR
8 MOs
4 MOs
7 MOs, 3 HAs & 26 MPWs
22 MPWs
13 MOs 8 11 HAs
7 MOs
1 M0
1 MO 4 6 HAs
10 MOs
3 MOs, 1 HA & 14 MPWs
|380 |468 |2023 |247 |385 |1879 | 49 | 83 | 489 |189 |328 |1571
Notes Information for Panna, Vidisha and Mandsaur districts
not provided
110
The Chief Medical
and Health Officers
of
Ujjain,
Shajapur,
Guna and Dhar have already been trained
in
GWEP
in
August and September. A two days Orientation Training Programme
for mass media officers of the affected districts was carried out
in September at Shajapur
Shajapur..
According to the Programme Officer,
Mecii
cal
247 Medical Officers 385 Health Assistants and 1879 MPWs
have
already been trained in the various components of the
gu i n e aw orm
e radi cat i on.
NOTE
: The situation presented for the year 1989 shows
that Madhya Pradesh needs to immediately prioritise and intensify
GWEP
implementation, its supervision, record & reporting system
and concurrent monitorinq/evaluation
monitoring/evaluation
inorder to
improve
GW
situation in the state.
23
MAHARASHTRA
GW Situation
of
Maharashtra is
conducting monthly GW
in
put
in
the GW affected districts,
and have
searches
•from t h e
to contro1/eradicate GW disease
efforts
cons i de rable
State .
State
The
Table 21
District-wise GW Situation in the State
Total in State : Districts - 29; PHCs - 477; Villages - 39354; Population - 62784171
S.No NAME OF THE
AFFECTED
DISTRICTS
1. Thane
2. Raigad
3. Ratnagiri
4. Pune
5. Ahmednagar
6. Satara
7. Nanded
8. Seed
9. Parthani
10. Osmanabad
11. Chandrapur
12. Latur
13. Nasik
AS ON 1.1.90
AS ON 1.1.1989
NEWLY AFFECTED IN 1989 DELETED IN 1989
PHCs VILL- POPULA- CASES PHCs VILL POPUL CASES PHCs VILL POPUL PHCs VILL POPUL CASES
AGES, ATION.
AGES. ATION.
AGES, ATION,
__ AGES TION
47 Nil
62 39300 29 96 63925 220
26
141 90689 581
3
17
9462
31
14
1
1
5
10
7
8
5
1
4
Nil
188
55
1
1
6
36
11
22
5
2
7
Nil
76229
13008
75
2914
64570
30362
15449
33516
27429
684
7603
Nil
621
151
1
Nil
3
48
8
28
8
Nil
47
Nil
187*
18
Nil
Nil
Nil
39
Nil
2
1
1
2
Nil
Nil
9
1
1
3
5
4
5
4
Nil
Nil
Nil
78 389990 32 127
5353
6 31
25
1
75 Nil Nil
2914 Nil Nil
1
3
3 60409
2
19380
6
13
25
9914
3
3
8
7
3
15 28034
2
4 25286
2
253
2
2
1
3
6239
4
5
Nil
Nil Nil Nil
8I 40 |23708 | 106
32
226 |236147| 89| 289a|152775| 475
Nil
Nil
Nil
1
Nil
Nil
1
1
Nil
Nil
|113 | 475 |362528 | 1496
TOTAL
42035
7965
Nil
Nil
4253
16753
5535
5482
3045
1175
2607
Nil
53
1
Nil
Nil
Nil
2
Nil
Nil
1
1
1
Nil
1
4598
310
Nil
Nil
Nil
6443
Nil
Nil
902
750
1243
Nil
17
1
Nil
Nil
Nil
2
Nil
Nil
1
1
1
Nil
of villages reporting active GW cases during 1989 were ■103.
Of the 187 GW cases detected in Raigad, six cases were
traced
to
be originally
resident
of an urban
s 1 urn
slum
in
Aurangabad
district. There have been no GW case
casess in Aurangabad, and since no
unsafe drinking water source is existing in the particular
s 1 urn,
these
cases have been recorded in Raigad district,
where
the
patients stay a major part of the year for employment
reasons »In
Sangli
and Jalana districts, which had been deleted after a 3
years of survei1lance, 2 imported cases in one village of Sang 1i
and 3 imported cases in another village of J a1an a we re
d e t e c: t e d
w h i c h h a v e b e e n included in t h e total cases.
a) No.
->
At
the
en d o f
•1989,
there
has
been a 69%
reduction
in GW
and 38% reduction in the number of affected villages. About
90%
of the GW disease problem is confined to the
three
coastal
districts ie. Thane, Raigad and Ratnagiri.
cases
34
Drinking Water Supply Situation
Out
of 318 step wells which
we r e
t a r g e 11 e d
for
conv e r s i o n du r i n g 1989 a total of 155 were c o n v e r t e d. T here were
75 villages without single source
s o u r c e till
t i 11 1988. However,
six
rn o r e
such villages were
w e r e identified in 1989 making a total of 81.
Out
of
these 81 villages 14 villages have got the sanction for
saf e
the
water
supply under the Regional Schemes. IInn six
villages,
six
wo r k
is under progress. 163 step wells cconversion
on v e r s i on
is
targetted
for
the year 1990-91. Most of the guineaworm affected villages
h am 1et s are
hav e
less
than 900 population.
Number of
such
There
and situated far away from the main village.
inaccess i ble
is need to relax the existing norm of safe sources/populat ion and
capita expenditure n
norm.
as
o r rn . The drinking water supply situation
on 1 1.90 is presented below.
Table 22
Drinking Water Supply Situation
S.No NAME OF THE
AFFECTED
DISTRICTS
1. Thane
2. Raigad
3. Ratnagiri
4. Satara
5. Nanded
6. Deed
7. Parbhani
8. Osmanabad
9. Chandrapur
10. Latur
TOTAL
NO.OF VILLAGES
SAFE DRINKING WATER SOURCES
UNSAFE DRINKING WATER SOURCES
NO. OF
AFFECTED WITHOUT A SINGLE HAND DRAW PIPED OTHER TOTAL STEP PONDS TANKS OTHERS TOTAL
WELLS
VILLAGES SAFE SOURCE
PUMPS WELLS WATER
36
490 Nil
9
535
96
NA
213 462
27 Nil
702
841
658
754
26 Nil
61
127
NA
123 507
28 Nil
9
81
78
10 Nil
98
57
65 Nil
131
NA
10
4
6
3
Nil
5
4 Nil
9
2 Nil Nil
NA
59
85
22 Nil
166
49
3
60
8 Nil
13
NA
8 Nil
47
11
9
2 Nil Nil
3
13
26
NA
7 Nil
46
81
44
NA
70
158
1 Nil
1
7
24
40
6 Nil
70
1
6 Nil
4
11
2
NA
3
4 Nil Nil
7
Nil
Nil Nil Nil
Nil
2
NA
5
12
11
6 Nil
29
Nil
1 Nil Nil
NA
1
289
81 *
119
I 555 11274
Nil
1948
954
602I Nil
87
1643
the district wise breakup of the 81 villages was no t availab1e
(NA)
Vector Control
The application of Temephos in the State has been
quite
satisfactory.
Out of 2927 unsafe drinking water sources
in
the
affected villages, only 90 (37.) could not be treated with Temeph,
while 1806 (627.) were
w e r e treated more than 7 times.
25
Table 23
Chemical Treatment of Unsafe Drinking water Sources
|
S.No NAME OF THE
| AFFECTED
NUMBER OF UNSAFE NUMBER OF UNSAFE WATER SOURCES
WATER SOURCES
TREATED WITH TEMEPHOS
AMOUNT OF TEMEPHOS IN LITRES
CONSUMED
BALANCE
DISTRICTS
TARGETTED*
1. Thane
2. Raigad
3. Ratnagiri
4. Pune
5. Ahmednagar
6. Satara
7. Nanded
8. Seed
9. Parbhani
10. Osmanabad
11. Chandrapur
12. Latur
902
1677
186
3
Nil
11
56
12
63
8
1
8
NEVER 1-23-45-6 >7 DURING THE YEAR
TIMES TIMES TIMES TIMES
Nil
177
74
43 608
615
89
143 347 210 888
949
1
2
5
11 167
110
Nil
Nil Nil Nil
3
5
Nil
Nil Nil Nil Nil
Nil
Nil
29
NIL Nil Nil
11
Nil
NIL Nil
8
48
84
Nil
12
12
NIL Nil Nil
Nil
7
4
NIL
52
130
Nil
NIL Nil Nil
8
41
Nil
NIL Nil Nil
1
1
Nil
NIL Nil Nil
8
33
TOTAL
2927
90
322
433
276 1806
AT THE END OF THE YEAR
33
71
Nil
Nil
Nil
10
6
3
31
8
7
13
2009
182
this includes unsafe water sources and draw wells
Health Education
Table 24
Health Education Activites in the State
S.No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
DISTRICTS No. of No. of No. of No. of No. of No. of No. of No. of No. of No. of No. of Health
group film video
Radio
kala slogans posters sticker tin- pampha- OTC offi- Exhibimeeting shows casette
prog. pathak painted distri- distri- plats lets
cials and tion
slide
drama
buted buted
distri- non-offishow
prog.
bution cials tend
Thane
Raigad
Ratnagiri
Pune
Ahmadnagar
Nasik
Satara
Nanded
Beed
Parbhani
Osmanabad
Chandrapur
Latur
Aurangabad
Sangli
Jalna
2347
4059
2370
13
7
84
78
1257
410
290
569
432
40
10
71
22
44
89
29
Nil
2
Nil
Nil
2
Nil
9
8
605
Nil
Nil
6
2
22
Nil
4
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
10
5
Nil
4
Nil
3
Nil
1
1
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
9
20
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
3
Nil
4473
15504
2746
703
49
311
246
1377
256
1011
431
115
292
TOTAL
12967
796
45
5
32
26
22
666
65
1759
2680
932
50
Nil
132
143
425
102
282
Nil
2142
58
15
1021
95
1684
1138
1069
Nil
Nil
Nil
123
356
Nil
388
Nil
Nil
39
20
28
Nil
365
54
93
Nil
Nil
Nil
11
20
Nil
87
Nil
Nil
3
Nil
Nil
Nil
2118
5680
2447
500
2112
205
139
2144
295
990
8793
Nil
Nil
20
810
1000
46
2
12
Nil
Nil
Nil
6
2
Nil
Nil
Nil
Nil
8
Nil
1
1
53
Nil
10
Nil
Nil
Nil
30
Nil
Nil
6
Nil
5
Nil
Nil
39
Nil
23711
9842
4845
633
27153
78
143
Most of the affected population was found to be
tribal,
illiterate and
residing in the remote vi1lages/hamlets.
More
stress was given on regular visit of health worker
and medical
officers and also involvement of non-officials like Sarpanch etc.
74 orientation training programmes for Sarpanch, Gramsevak
etc.
we r e
o rgani sed
in
endemic
stste
of
the
state.
Guineaworm
education
day was
ce1ebe rated
in
257 guineawo rrn
affected
v i1lages .
2500 sieves (cloth) were prepared and distributed to the
families of endemic villages for filtering t he wat e r be f o r e u s e .
Health Infrastructure & Trained Manpower Development
The State has Jo int Di r e cto r of Hea11h Services as
the
State GW Programme Officer and a Assistant Director of H e a 11 h
Services as the Technical Officer for the irnpl emen tat i on of GWEP.
Training
programmes were organised f or medi ca1
officers,
para
medical workers, district mass media officers and regional health
office r s, during 1989.
Table 25
Health Manpower and GWEP Training Status of PHC level functionaries
S.No NAME OF THE
STAFF
AFFECTED
SANCTIONED
DISTRICTS
MOs HAs MPWs
1. Thane
52 117 348
2. Rai gad
53 127 390
30 50 142
3. Ratnagiri
2
4
11
4. Ahmednagar
10
9
9
5. Satara
24 51 148
6. Nanded
81 146 499
7. Beed
14 32 102
8. Parthani
11 24
82
9. Osmanabad
10 19
52
10. Latur
TOTAL
STAFF
IN POSITION
MOs HAs MPWs
43 104 300
42
91 361
18
38 137
4 10
1
9
10
9
23
46 140
57 141 499
14
28 96
9
20 63
10
19 52
287 280 1783 227
TRAINED TILL STAFF REMAINING
END OF 1989
UNTRAINED
MOs HAs. MPWs MOs HAs MPWs
41 104 299
2 Nil
1
42
89 352 Nil
9
2
15
35 135
3
3
2
4
1
9 Nil Nil
1
9: 9 Nil Nil Nil
10
23
46 140 Nil Nil Nil
56 130 438
1
9 61
12
28 96
2 Nil Nil
9
20 63 Nil Nil Nil
19 52 Nil Nil Nil
10
500 1667 219
484 1593
8
14
74
Information for district Chandrapur not available
Supervision, Monitoring & Evaluation
officers visit quarterly
District
1 eve 1
the affe cted
areas, PHC Medical O f f i c: e r monthly, H e a 11 h as s i stan t
fortnightly
Du r i n g
s ea r c h
period v i1lages ar e
and MPWs
v i s i t weekly.
distributed among state level officers. In the coastal
d i s t r i c: t,
27
with
a separate team of health supervisors numbering 6-8
affected
o pe rat ion to visit GW
independent vehicle is in operation
villages. As per the recommendations of the 11th Task Force
Meeting all the supervisory activities are undertaken.
S3
v'W--
RAJASTHAN
GW Situation
Table 26
GW Disease Situation in the State
Total in State : Districts - 27; PHCs - 236; Villages - 33305; Population - 34261862
S.No NAME OF THE
AFFECTED
DISTRICTS
AS ON 1.1.1989
NEWLY AFFECTED IN 1989 DELETED IN 1989
AS ON 1.1.90
PHCs VILL- POPULA- CASES PHCs VILL- POPUL- CASES PHCs VILL- POPUL PHCs VILL- POPUL- CASES
AGES TION
ACES ATION
AGES ATION
AGES ATION
1. Banswara
2. Barmer
3. Bikaner
4. Bundi
5. Chittorgarh
6. Dungarpur
7. Jaisalmer
8. Jalore
9. Jhalawar
10. Jodhpur
11. Kota
12. Nagaur
13. Pali
14. S. Madhopur
15. Sirohi
16. Tonk
17. Udaipur
8
8
1
2
3
5
3
TOTAL
283
151
5
3
37
502
25
6
323
83
33
55
7
2
1
3
739
4
6
8
9
7
2
1
1
2
13
174187 178
273329 735
12996 17
3342
2
21649 31
293773 723
32928 25
10667
1
141816 546
193195 206
27638 55
105912 226
1422 Nil
1433 23
12625
1
921
3
556713 2847
[83 (2258 |1864546(5619 |
Nil
Nil
Nil
Nil
1
Nil
Nil
1
Nil
Nil
Nil
Nil
1
Nil
1
Nil
Nil
19
1
1
Nil
1
Nil
4
2
90
4
1
10
1
Nil
5
Nil
56
3847
6184
1462
Nil
1535
Nil
2329
2024
50555
2688
1781
20024
3764
Nil
11715
Nil
26262
4] 195 |134170] NA |
Nil
Nil
Nil
2
1
Nil
Nil
Nil
Nil
Nil
4
Nil
2
Nil
Nil
1
1
76 37024 8
24 32644 8
Nil
Nil 1
3
3342 Nil
6
2137 3
69 43358 5
8
9069 3
Nil
Nil 5
82 62796 6
22 35128 8
15 13317 5
9 12857 7
1422 1
7
1194 1
1
Nil
Nil 2
2
715 1
120 105847 12
226
128
6
Nil
32
433
21
8
331
65
19
56
1
1
6
1
675
141010 139
246869 159
14458 49
Nil Nil
21047
8
250415 582
26188 11
12691
4
129575 1494
160755 175
16102
2
113079 401
3764
1
239 Nil
24340 14
206 Nil
477133 1833
11] 444 |360845| 76 (2009*1637871(4872 I
* Information regarding no. of villages with active
GW cases during 1989 not provided
in
the
other affected states of
the
count ry,
Raj asthan
also
recorded a decline in the number
o£
GW
cases.
However,
the rate of decline in the number of affected villages
o r c a s e s was not as pronounced as in other States.
During
1989,
Rajasthan contributed 637. of the total guineaworm cases
re co rded
in
the
country.
There was an almost 3 times
increase
in th e
number of guineaworm cases in Jhalawar from
From 546 cases in 1988 to
1494 cases in 1989, in Nagaur there was; a two-fold increase
from
326
cases
in 1988 to 401 cases in 1989 and in Bikaner
from
17
cases
to 49 cases■ In Jhalawar, 90 newly affected
villages had
been
detected in 1989 accounting for about 507. of all the newly
affected vi1lages in the State, Guineaworm situation in Banswara,
and Jodhpur
districts has more or less
been static.
District
Bundi
was deleted from the list of GW affected districts after
being under surveillance for 3 consequtive years.
As
29
81
newly and 2E reinfected villages were
reported
in
•P r orn
1989 of which 38 villages are from district Jhalawar and 41
Udaipur.
The highest number of GW affected villages - 675 a r e
No
located in Udaipur district which contributed 1833
cases.
case was detected from districts of Sawai Madhopur,
Si roh i
and
Ton k du r i n g 1989.
Drinking Water Supply Situation
During
1989 the drinking water supply situation in
State is presented below.
the
Table 27
Drinking Water Supply situation
S.No NAME OF THE
AFFECTED
DISTRICTS
1. Banswara
2. Barmer
3. Bikaner
4. Bundi
5. Chittorgarh
6. Dungarpur
7. Jaiselmer
8. Jalore
9. Jhalawar
10. Jodhpur
11. Kota
12. Nagaur
13. Pali
14. S. Madhopur
15. Sirohi
16. Tonk
17. Udaipur
TOTAL
NO. OF
NO.OF VILLAGES
SAFE DRINKING WATER SOURCES
UNSAFE DRINKING WATER SOURCES
AFFECTED WITHOUT A SINGLE HAND DRAW PIPED OTHER TOTAL STEP PONDS TANKS OTHERS TOTAL
PHCs
SAFE SOURCE
PUMPS WELLS WATER
WELLS
226
2404 220
221
1145 1243
16 Nil
1 Nil Nil
128
599 199 291 Nil Nil
490
30 451 118 Nil
6
Nil
13 Nil Nil
13
6
6 Nil
12 Nil
4
8
3
1 Nil Nil
18
Nil
No
10 Nil Nil
23
32
49
56 Nil Nil
105
21
2 Nil Nil
433
Information
34 Nil
64 Nil Nil
380
2851 2248
5133 316
21
28 Nil Nil
2 Nil
23
3
31
21 Nil
8
9
available
5
5 Nil
9 Nil Nil
32 Nil
22
331
598
631 786
34 Nil
1451 560
38 Nil Nil
65
419
174 242 Nil Nil
416
22 397 Nil Nil
19
177 123
3 Nil
303
25 Nil Nil Nil
25
56
19
97
43 Nil
159 Nil 123 Nil Nil
123
1
5
10
1
3 Nil Nil
4
3 Nil
18
1
9
7 Nil Nil
1
1 Nil Nil Nil
16
6
20
8 Nil Nil
28 Nil Nil Nil Nil
Nil
Nil
1
7
6 Nil Nil
13 Nil Nil Nil Nil
5 Nil Nil
27
675
39 821 Nil Nil
860
22
2009
NA
5188 6119
283 Nil
11590 1393
975
Nil Nil
2368
project of Rs. 2034.54 lakhs was presented
by PHED,
Raj asthan
unde r
Water Mission for 1989 for
provision
of
safe
drinking water
supply to guineaworm affected villages
wat e r
of
14
A
districts.
Th e Govt, of India has sanctioned Rs. 491.519 lakhs
•for the project.
It is understood as per the report of the Chief
Engineer,
Rajasthan that 407. of the hand pumps installed in
the
s L a L e were out of order at any one point of time.
It was
the
experience of the PHED that the hand pump rnistry scheme had
been
a failure in the state and the department was now proposing
to
unde r take
the hand pump maintenance directly.
In
the desert
i\
a£ _ R a. j a s t h a n i n c 1 u d i n g Na g a u r d i s t r i c t, b r a c k i s h n e s s
was
---yvtxbiem which forced people
to
seek
consumpt i on
of
dr ink ing
COMMUNrrYHEALTHT^rr
/ CALL NO. . .Q.lS ' 3 O O
AUTHOR ...
J
ACC. NO
\
Terne ph os
regarding
NICD. However,
the
round
p data
ZS'
..
TITLE
...Vi,/
~ .....
....
r • -Jater Sources
Borrowed
on
Borrower's Name
Returned
on
AMOUNT OF TENEPHCS IN LITRES
SOURCES
HOS_
CONSUMED
BALANCE
TH FIFTH DURING THE YEA AT THE END OF THE YEAR
12. ROUND
1
59
40
Nil
87
55
15
9
14
2
33
11
8
19
Nil
10
il
Nil
Nil
270
113
Nil
13
19
35
Nil
16
Nil
10
Nil
521
753
180
86
4
212
55
34
25
25
68
7
Nil
Nil
Nil
Nil
Nil
4
10
10
1
Nil
6
Nil
Nil
Nil
Nil
Nil
Nil
Nil
1
9
643 1220
121
9
n
r4
l.r.
TOTAL
■1315 646 1456
4531
■1328 1457
2697
172
746
I
0 f th e 4531 unsafe water sources targetted for Temephos
treatment, not more than 1328 (307.) received 5 applications . 746
litres of temephos was consumed for the treatrnent of unsafe water
sources .
Health education
The
state did not provide de ta i1 in f ormat ion
regarding
he a11 h
e d u cation mate r ial
and activities
in
the
various GW
affect ed d istr i c t s. H o w e v e r a m e n t i o n was made that a variety of
h e a11 h e d u c a t i on ma t e r i a1 viz.-Hoarding boards,
tinplates, cine rna
31
<^LIBRARY “V
i* <
1
*
and
information
CENTRE
) ‘
>
S-lOO
11
r<^o
slides,
video
cassettes,
wooden
boards,
rexine
posters,
recognition cards, flip book, PVC hangers, stickers, -folders
and
posters were produced -for GWEP and sent to endemic districts
for
display.
A proposal of Rs. 45 lakhs for the intensification
of
Health Education has been sent to Govt.of India, und e r T e chnolo gy
Mission.
GW education day was reported to be celebrated in
the GW affected villages of the State
a 11
Trained Manpower Development
Detail
district-wise
information
was
not
presented/provided.
However, during November, a
crash
training
Programme was organised by the Director of Health Services i n a 11
the affected districts of the state to train M.Os and PMAs in the
guineawotm eradication strategy.
NOTE
: The situation presented for the year 1989 shows
and
Rajasthan state needs to
immediately prioritise
that
&
intensify
GWEP
implementation,
implementation,
its supervision,
record
reporting system and concurrent monitoring/evaluation inorder to
improve GW situation in the state.
SWACH (Udaipur)
The SWACH representatives outlined the strategy adopted
by the SWACH for guineaworm control.
They felt that
there was
need for accuracy and validation of search report and the problem
of the much higher magnitude in Barmer than was reported by
was
Health
Directorates .
However, SWACH did not
present the
the
report as per the desired guidelines-
32
1
TAMIL NADU
GW Situation
Tamil Nadu state is free from guineaworm disease s i n c e
•1984.
Regular guineaworm search operations are being conducted
twice a year to prevent imported cases establishing new foci in
the state.
During 1989, the searches were conducted in 30
d i s t r i c: t s covering all the 51800 villages.
Drinking Water Supply
Substantial inputs have been made to improve
the
drinking water supply and to maintain the guineaworm free s t a t u s
in the state. An expenditure of Rs. 61.356 lakhs has been made.
Vector Control
Ternephos application is done in the unsafe water s o u r c e s
of the villages where imported cases are detected.
Health Education
The state has printed tin plates requesting the people
to report
r e p o r t if there is any case of guineaworm to the nearest
Primary Health Centre.
3000 tin plates have been sup p1i e d t o
the endemic villages.
33
D, MAJOR ACTIONS TAKEN DURING 1989
TO IMPROVE EFFICIENCY AND EFFECTIVENESS GF GWEP,
The financial allocation under GWEP for the year •1989-90
•1 was raised to Rs.70 lakhs as against Rs.45 lakhs allocated •for
1988-89
and state governments especially
Raj as than,
we r'e
requested to make full utilization of funds.
In order to detect all quineaworm cas e s early and
2.
improve the surveillance, a third ” Active GW case search
operation" was introduced and carried out by guineaworm endemic
states w.e.f. April, 1989. The quality of the guineaworm case
search operations was concurrently monitored through
concurrent
sample checks by different levels of supervisors. GW case
manaqement and their education were improved.
3.
Vector (Chemical)Control m e a s u r e s
under GWEP were
strengthened. States were advised to treat the identified unsafe
drinking water sources with ternephos, 8 times i.e. monthly from
Feb.-June and once in two months thereafter; as against only four
temephos applications uptill 1988. This proved very beneficial.
4.
Fine nylon mesh as well as cloth s t r a i n e r s
were
distributed to house-holds in s o rn e guineaworm affected districts,
to filter drinking water at the time of collection/storage. This
received good response from community, and the
evaluative
observations
en courage to take large scale act i on in t h i s
encourage
direction during '1990-91.
Besi des improving & intensifying guineaworm
h e a1 th
5.
education activities, in order to create mass awareness and see k
their involvement in GWEP, the "Guineaworm Education Day *1 was
celeberated at different levels in the country, simultaneously by
all endemic states during last week of April, w.e.f. 1989, as per
guidelines sent to them by NICD. This will be a regular feature,
now.
8.
Efforts were made to improve the existing inter sectora1
co-ordination between state PHED (RWS) and Health fun ct ionar i es
especially at district/PHC levels, for adequate prov i s i on and
guineaworm
maintenance of safe drinking water supplies to
affected areas.
areas » This will further strengthen in terms of their
regular quarterly meetings to review the situation and draw out
plan of action in this important matter.
34
7.
D u r i ng t he y e ar 1989, high priority was accorded by NICD
'' T e a c hi n g Mo d ules
on
Io d e v e 1 o p T ra i ne d Ma npow er under GWEP.
GWEP" were
designed by NICD for
different
levels
of
health
f un ct i onar i e s v i z . District level health officers Incharge GWEP,
District Mas s-Med ia/He a11h E duc at i o n Officers,
M
Medic
e d i ca
a1
0 f f i c er
and Para Medical
staff of PHC,
and Public Health Engineers
invo 1 ved
in Rural
Water Supply.
These modules
incorporated
s pe c ia 1
emphasis on "Management aspects of GWEP" and mentioned
to
appropr iate Teaching/Learning and course evaluation metho ds
assist
the
state
health functionaries
for
t r a i n e d man power
in
deve1o prnent
their states.
Three
Orientation
T ea chi n g
Pr og rammes were
organised at NICD, wherein 45 district
level
h e a 11 h off i c: e r s involved in GWEP and 14 PHED (RWS) engineers from
guineaworm endemic states were thorougly trained.
With
tec hn i c a1
assistance
of NICD,
all
the
states,
except Rajasthan,
Raj asthan x
organised Orientation Teaching Programme
of
D i s t r i c t M a s s -- M e d i a / H e a 11 h E d u c a t i o n Officers of their guineaworm
endemic
districts
for their active
involvement
in guineaworm
h e a 11 h e d u c a t i o n prog ramme.
Most of guineawo rm affected districts in endemic states,
o r gan i s e d C r as h 0 r i e n t a t i o n T e a c h i n g P r o g r a m rn e s
o n G W EP
for
M e d i c a 1 0 f f i c e r s and Para-medical staff of their respective PHCs.
Th e s e
p r o g r a m m e s will
continue during
1990-91
for
continued
e du cat i on/tea c h i n g of health functionaries, to make GWEP function
e f f e c t i v e 1 y.
8’Set
of
25 Teaching Slides’ o n various aspects
of
GW
disease and its eradication, along with detailed commentary,
wa s
prepared.
All
the States DHS/GWEP Officers and GW endemic
districts were provided these teaching slide sets to assist
them
eeffectively
f f e c: t i v e 1 y
to
conduct the orientation teaching
programmes
on
GWEP for different 1eve1s/categories of health functionaries.
9.
Consider ing the advaneements, the 0perat iona1 Manua1
on
GWEP
(1985)
was re vised d ur i n g 1989. Th i s
revised 4th
(1989)
e di t i o n o f t h e manua1, be s i des pr o v i di n g d e t a i1e d i n for mat i o n
on
guineaworm disease and all the operational
components of
the
p r o g r a m m e , contains a n i rn p r o v i s e d "Info r m a t i o n S y s t e m u n d e r G W E P 11
for uniform data co 11ection/recording , its compilation,
analysis
and timely flow to programme managers at different
levels
for
planning and concurrent monitoring/e valuation of the
prog ramme„
This modified
information system should come into
effect
fro m
•1990-
35
to ass i st t h e c e n t r a 1 &
state
health
v a r i o u s lev e 1 F to concurrently evaluate the
efficiency of
o f GWEP
G W E P implementation
i m p 1 e rn e n t a t i o n (operational evaluation)
and
its i m pact/e f f e c t (e pi d e m i o1og i c a1 e v a1uat i o n), v a r i o u s pro f o r ma e
were designed and were utilized dur i ng 4th Independent E v a1ua t i on
of GWEP in May 1989. The report of 4th Independent Evaluation
contains the observation, r e commendat i ons and these proforrnae in
details. The mid year review of the programme was held during
August, •1989.
1989. The 4th internal evaluation of GWEP during December
1989
concentrated to evaluate the programme in those
t h o s e districts
which were reported to be free from disease for last 2-3 year o r
were deleted or were not affected any time,
The o b s e r v a t i o n s
made it clear that a constant surveillance for guineaworm disease
and health education in such districts are very essential.
The
t e iti e p h o s applications operation in the states was monitored by
NICD during March, September & October 1989. The programme was
reviewed by Ministry of Health & Family Welfare and Director
General of Health Services, during
d u r i n g the
t he year. The observations &
r e comm e n da t ions of various evaluations were forwarded well in
time to the states for their follow up and corrective measures.
•10.
In
order
admin ist rate rs
at
E p i d e m i o 1 o g i c a 1 Sur v e i11an c e Teams were de ployed
to closely
during 1989 in the following States and Districts,
mon i to r the GW situation and GWEP implementation in h i g h 1 y
endemic/problematic areas with help of well designed info rmation
systemsTeam no. &
District HQ
Districts Covered
Stat e
•11 .
T en
Andhra Pradesh
K a r I) a t a k a
Mad hya Pr ade sh
Maharashtra
Raj asthan
1. -- K u r n o o 1
2. - B i j a p u r
3. - Gulbarqa
4. - Indore
5. - Shajahpur
6. ~ Rai gad
7. - Thane
8. - Barmer
9 ■ •- Jhalawar
10.- NICD, De 1 h i
Kurnool & Mehboobnaqar
Bijapur & Raichur
G u 1 ba r q a & B i d a r
Dhar & Jhabua
S h aj a p u r & R a j q a r h
Rai gad & Ratnagiri
Thane & Nanded
Ba rm e r & J a i s a1m e r
J ha1awar & Ko ta
. pm 10
T h e s e teams in the first phase ( December *89 to
February *90 ) are conducting situational analysis with regard to
GW situation.
p r o gr amm e i m p ]. e m e n t a t i o n , s y s t e m o f prog ramrne
36
4.
I
supervision/monitoring by health in-frastrueture and to i dent i fy
training and other resource needs to make GWEP more effective i n
18 highly affected districts responsible for approximately two
thirds of the guineaworm problem in the country.
37
E, RECOMMENDATIONS OF 12th TASK FORCE MEETING
The house resolved that the re comrnendat i ons of 11th Task Force
January 1989 (Appendix IV ) are exhaustive and s h o u 1 d
Me e t i ng,
However,
t l"i e
to
be implemented during 1990-91 also.
continue
addit i onal
recommendations as emerged during this meeting ar e
mentioned here.
I. Improved Infrastructure for GWEP
ze ro
ach iev ing
1.
Considering
the national objective of
gu i n e aw o r m i n c i d en ce i n c oun t r y by 1991, it was resolved that all
for
top
priority
guineaworm
endemic
states
should accord
and
supe rv i si on
efficient
planning,
implementation,
monitoring/evaluation
of
programme
by all
levels of health
functionaries. The state level GWEP Officer should be relieved of
extra duties to enable him to concentrate on GWEP.
(Action State DHS)
2Efforts should be made to identify and involve the local
vo 1 untary/non-governrnentai organizations in GWEP implementation.
(Action State DHS/PHED)
II, GUI case finding & management
three
Besides
conducting well
planned & supervised
3.
case search operations during April,
June,
December
active GW
every year;
the surveillance should be strengthened to detect
year ;
guineaworm cases during inter-search period and efficient system
followed for
of
cross-notification of imported cases should be
The GW
timely
measures
to
interupt
the
transmission,
necessary
detected during inter-search period should be
recorded &
cases
reported for that year.
(Act i o n
State DHS)
confined to
4.
Active
GW surveillance should not only be
Act i ve
the non
know guineaworm
endemic Di stricts/PHC/Vi1lages,
but
guineawo rrn
endemic areas
are a s in guineaworm endemic states should also be covered
under g u i n e a w o r rn c a s e s e a r c h o p e r a t i o n s .
(Action: State DHS)
38
5.
The
quality of
o-F GW case management,
management.
especially
regu1ar
bandaging of their guineaworm blister/ulcer, must be improved to
the level of patient’s satisfaction.
(Act ion s State DHS)
III, Health Education & Community Involvement
intens i fy t he
6.
There
is an
urgent need to actually
in
guineaworm health education activities by GW endemic
stat e s
f
f
e
c
t
i
v
e
e
the
community on a war-footing level, using the most
methods of communication as suitable to local needs.
(Actions State DHS,CHEB)
IV, Vector Control
7.
In addition
to well
planned &
A efficient
ternephos
treatment of unsafe drinking water sources; the
hhouse-holds
o us e h o 1 ds
in
guineaworrn endemi
e nd e m i c
v illa
vi
11 ages
qe s shou
s ho u11d be
be
equi pped with
proper 1 y
d e s i g ne d f i ne n y1on me sh/d o u b1e clot h s train e r s for filter i ng t h e
drinking water at the time of its collection / storage/drinking.
(Act ion s State DHS, PHED & M.ICD)
V, Provision & Maintenance of safe drinking water
8.
In orcier to achieve the zero guineaworm incidence in the
country
by •1991,
it
is necessary that all
the
the
affected
wat e r
vi1lages/hamlets are
supply.
a r e provided with safe drinking water
Keeping
this
into
view,
all
the guineaworm affected state
Directorates
of Health Services should
prepare
the
list of
guineaworm affected (1989) villages / hamlets/habitations i)which
do not have even single safe drinking water source and ii)
those
which require additional water source to meet the community need.
Such a list should be prepared by middle of February 1990 and be
sent
to
the Chief Engineers,
Public
Health
Engineering
Departments
(RWS) of their respective states for
prov iding
providing
the
/ hamlets
safe drinking
source s
sources
in these
villages
/
d r i n k i n g water
habitati ons.
(Actions State DHS, PHED)
t h e Nat i onal
that
9.
It was
decided during the meeting
to
Drinking Water Mission (NDWM) will issue
suitable directives
3?
1
guineawo rm endemic
the Chief Engineers, PHED (RWS) of all the
guineaworm
states to provide safe drinking water sources in each
the
irrespective of
affected villages,
hamlet and habitation
be
sources will
population and that the safe drinking water
the
supply to
properly maintained to yield continuous water
d r i n k i n g water
community so
that the community only uses safe
sources and does not go back to unsafe water sources in absence
of continuous safe water supply to them.
(Actions NDWM, De 1h i)
VI, Trained Manpower Development
10.
In addition to continued Crash Orientation Teaching
Programmes
for mass-media/heal th education officials.
Medical
Officers and para-medical staff of PHCs in endemic states, as per
teaching modules designed by NICD; the stress is laid to organize
one
day Orientation Teaching Programme on GWEP for
district/PHC
in
level
PHED
(RWS) engineers by District Health Authorities
order
to orient them & seek
their active
invo1vement/co
ordination
to provide and maintain safe drinking water
supplies
in guineaworm endemic areas, on priority.
The modules for such a
teaching programme will be designed and sent by NICD.
(Action: State DHS, PHED & NICD)
VI. Information System under GWEP
11.
Considering the utmost necessity of having an efficient
& uniform information system under GWEP, the proformae have
been
designed for (i) relevant data collection , (ii) data compilation
& analysis and
(iii)
timely flow
(report)
of the data to
concerned authorities for necessary action at
var i ous
1e v els.
These proformae are appended in the revised 4th edition (1989) of
'‘Operational Manual on GWEP".
All the guineaworm endemic
states
should use these proformae, for uniformity,
with
with
effect
•f r om
1990.
(Action: State DHS & PHED)
•12.
Sincere efforts must be made
by various
supervisory
level
officials to validate the GW data collected & compiled by
peripheral workers
to make the data reliable
for
planning &
evaluation of programme.
(Action: State DHS & PHED)
40
VII, Supervision, monitorin»q and evaluation of GUEP
In order to assist the different levels of health
IS n
GWEP ,
managers to concurrently monitor and evaluate GWEP,
proformae
have been designed and pretested. These proformae are annexed in
the report of the 4th Independent Evaluation of GWEP, •1989, and
should be utilised for the purpose to improve the efficiency and
effectiveness of GWEP.
(Actio ns State DHS & PHED)
14.
A small working group of experts should decide on t h e
strategy to be adopted under GWEP in those districts/state(s)
which are nearing zero guineaworm incidence during •1990.
(Actions NICD & State DHS)
41
F. EPDEMIOLOGICAL ACHIEVEMENTS OF GWEP
Sin c e
the
inception
of
the
GWEP
in
the
1983-84,
gu i neawo rrn
s ituation
h a s cons i d er ab1y decreased,
A
comparison
regarding the GW status as in 1984 and
1989 is presented in
the
tables below.
Table 29
GUINEAUORH ENDEMICITY IN INDIA
S.No NAME OF THE
AFFECTED
STATE
AFFECTED AS IN 1984
AFFECTED AS IN 1989
DIST PHCs VILL- POPULA- CASES- DIST PHCs VILL- POPUL CASES
RICS
AGES TION
RICS
AGES ATION
1. Andhra Pradesh 6
2. Gujarat
13
3. Karnataka
8
4. Madhya Pradesh 21
5. Maharashtra
15
6. Rajasthan
23
7. Tamil Nadu
3
TOTAL
89
54
56
73
131
99
146
116011566218 4461 6
26
150 348094 224
444 1058012
426 8
52 319085
6
30
991 1666123 5239 7
34
271 568975 896
3647 2723934] 11341 16
61
825 920589 1408
12131058452| 3115 10
289 152775 475
89
5376 4849340 15210 16
76 2009 1637871 4872
9 10048
Nil De eted since Jl984-85
564 12840 12932127 39792 63
316
3596 3947420 7881
Table 30
GUINEAWORM AFFECTED VILLAGES/HAMLETS AND CASES FROM 1984 TO 1989
S.No. GW ENDEMIC STATE
1.
2.
3.
4.
5.
6.
AFFECTED VILLAGES/HAMLETS
1984 1985 1986 1987 1988 1989
1984
Gujarat
Karnataka
Madhya Pradesh
Maharashtra
Rajasthan
1160 741 599 414 241 150
444 204 140 130
81
52
991 715 662 398 356 271
3647 2855 1575 1170 867 825
1213 902 853 767 475 289
5376 3394 3276 2755 2258 2009
4461 2389 1772
426
322
181
5239 4035 2754
11341 8349 4217
3115 4211 3646
15210 11644 10500
TOTAL
12840 8811 7102 5634 4278 3596
39792 30950 23070 17031 12023
Andhra Pradesh
42
NUMBER OF GW CASES
1985 1986 1987 1988 1989
1122
164
2405
3285
2159
7896
407 224
27
6
1909 896
2565 1408
1496 475
5619 4872
7881
Guineaworm Endemicity in India
Guineaworm Cases (1984-89)
60
G.W. ce^es In thouannda
40
30
20
10
0
1984
1905
1906
1967
1900
1909
Yhnrfi
Guineaworm Endemicity in India
Villages/Hamlets Affected (1984-1989)
14
Vlllnpea affected In thouRanda
i’2784
12 -
10-
B Ci
0.81 1
7;i02
8-
G, 6 3.4...
6-
4.278
3.596
4-
2a
0
1934
1965
1986
1937
Ynarw
1988
I .
6. G£P - SCHEDULE OF VARIOUS ACTIVITIES D'JRING 1990
S. No.
Activities
Jan
Feb
Mar
Apr
May
Jun
Ju]
Aug
Sep
Oct
Nov
’<■
%
t
12th Task Force Meeting________________
Active Guineaworg; Case Search Operation
Il Guineawori! Case Manager ent______ _______
73—777???-65W?ly dunriQ the year—---Teaephos Treatment of u?sa?e vater source
Provision Maintenance of safe uater supply
------ D—iP;J?UF Activity through-out the year_
Guineavorg,
Health
Education
_____________
----Continuous
Activity
dur
inc
the
Year,
intensified
during
Feb
to
June
-----it
7, Guineamft Education Dav
i
I
____ I
Orientation Crash Teachino PfevraB^e for : !
*
Pist, Health/Med. officers at NICS Delhi
M.O./Para-Medicals
by
State
in
Districts
;
It
Ll PHED (RWS) Engineers by State in Districts ;
-I
d. Dist. Mass Media 4- H.E. officers by State ini
Districts________________ _________ >____
I
9«. rHED (RLS) Enor & Health officers g.?ylir<^______
Evaluation bv NICD
a. Fifth Independent Evaluation
b. Mid Year Revier _____
Teihephos Monitoring____
■z
d? Fifth Internal Evaluation
1.
E
■■
>
I w
IM
Note : * Inter-sectoral co-ordination meeting between Health and
PHED(RUS) engineers at state/district/PHC levels to review drinking water
situation, additional water need, target achievements during quarter
as wll as plan of action for next quarter,
\
* * Mid year review meeting of all GU endemic state programme officers.
I
. *1^
'4
Appendix I
12th Task Force Meeting on Guineaworm Eradication Programme,
15th-16th January, 1990, NICD, Delhi.
PROGRAMME
15.1 .. 1990
(Monday)
0930-1030hrs
REGISTRATION
INAUGURAL SESSION
1030-1130 HRS
1030-1040 hrs. We 1come address
1040-1050 hrs. A d d r e s s
1050-1100 hrs. A d d r e s s
1100-1110 hrs. Address
1110-1130 hrs. Inaugural
address
1130-1135 hrs. Vote of Thanks
D r . M. V. V. L. Na ras i rnham,
Director, NICD, Delhi
Mr.J.Va s u d e v an,
Joint Secretary to GOI,
Ministry of Health & FW
Mr.Inamul Haq,
Adv i se r, Nat i ona1
Drinking Water Mission
Dr.P.Micovic,
WHO R e p r e s en tat i v e t o
In d i a
D r .. A . K . Mukh e r j e e ,
Director General of
Health Services,De 1hi
Dr. Ashok Kumar,
Dy.Di r e c t or,NICD,De 1h i
1135-1300 hrs. TEA
15.1.190
(Monday)
TASK FORCE MEETING
State-wise Review of guineaworrn situation,
GWEP - irnpl ementat ion, target achievements during 1989
and future plan of action for 1990-91.
SESSION
I
Chai r person
R a p p o r t e ii r
Dr . M.I.D. Sharma
Mr. V.K. Raina
1300-1300 hrs. Status repo r t
D r.P.Ven kata Re ddy
of Andh ra Pradesh
1300-1400 hrs. LUNCH
45
SESSION
II
Chai r person
Rappo r te u r
Dr. E.S. Rahavendra
Dr. R.L. Ichhpujani
•1400-1445 hrs. Status report
of Gujarat
Dr. T.D. Gandhi
■1445-1530 hrs. Status Report
of Karnataka
Dr .. G. Vi swanath
1530-1545 hrs. TEA
SESSION
III
Dr. (Mrs.)M.R.Chan d raka pure
Dr. Gautam Biswas
Chai rperson
Rapporteur
1545-1645 hrs. Status Re p o r t
Dr.
of Madhya Pradesh
1645-1715 hrs. Status Report
of Tamil Nadu
16.1.1990
(Tuesday)
SESSION
V.B. Saxena
Dr. E. S. Rahavendra
IV
Chai r person
Ra p po r t e u r
Dr.(Mrs.) Saraljit Sehgal
Mr. G.C. Joshi
1000-1100 hrs. Status Report
of Rajasthan
Dr . M.M. Gogna
1100-1145 hrs. Status Report
of SWACH
Udai pur
Mr . Mukesh Sharma
1145-1200 hrs. TEA
SESSION
V
Chai r pe rson
Rapporteur
Dr. V.B. Saxena
Dr. R.L. Ichhpujani
1200-1300 hrs. Status Report
of Maharashtra
1300-1400 hrs. LUNCH
46
Dr.M.R. Chandrakapure
SESSION
VI
Chairperson
C o-C h air per s o nRapporteur
Mr. Inarnul Haq
Dr. Mah e ndra Du11 a
Dr. V.K. Saxena
•1400-1530 hrs. Status re po rt
on situation,
target achieve
ments and
future plan
of action
for p r o v i s ion
and
maintenance
of safe
drinking water,
i n c 1 ud i n g
conversion of
unsafe water
sources in
guineaworm
e n d e rn i c st a t e s .
PHED(R WS) Engi ne e r s
Mr.C.N.Suresh
o f An dh r a P r ade sh ,
Dr.N.S.Dave
of Gujarat,
Mr.Gulam Ahmed
of Kamatakar
Mr.M.S.Dedi
of Madhya Pradesh,
Mr.P.N.Gholap
of Maharashtra,
Mr.B.K.Su rana
of Rajasthan
1530-1545 hrs. TEA
SESSION
VII
C ha i r pe r s on
Co-chairperson -Rapporteur
-
Dr . N.K. Shah
Dr. M . V . V » L . Na r as i rnham
Mr . S.M.Kaul
1545-1630 hrs. Research needs
in GWEP
1630-1700 hrs. Re commendat ions
1700 hrs.
CONCLUSION
47
P r o F . I.C. Tiwari
Prof. S.J. Naga1o t i ma t h
Prof. V.K. Ko char
—
Appendix II
Guidelines to State Health Directorates of
Presentation of GWEP Status Report (1989)
This meeting aims to undertake a comprehensive review on
the GW situation, implementation of GWEP during 1989, as well as
to decide the further course of action towards achieving the goal
of Guineaworm Eradication by 1991. You are therefore requested
to
come prepared with your presentation highlighting
the
following facts about guineaworm situation A GWEP implementation
in your state during 1989:
1.
The complete Vi 1lage/PHC/District wise Epidemiological
situation of guineaworm disease indicating sex & age distribution
of cases, as on 31st December, 1989; basing on the active
guineaworm case searches undertaken during 1989 and details
de tai 1s on
the NEW detected guineaworm foci (villages) in each PHC and
districts.
2.
The number of guineaworm cases under management,
cured
and/or developed complications etc. and your suggestions to
improve guineaworm case management under GWEP.
3.
Identification of unsafe drinking water sources in
endemic areas which required temephos treatment, the details of
temephos applications to such water sources, and the statement on
the amount of temephos received as well as consumed, as per the
recommendations of nth Task Force on GWEP (January, 1989).
I
4.
The situation
si tuati on & target achievements on provision &
maintenance of safe drinking water supply and conversion of
unsafe water sources
s o u r c e s into safe ones, in the guineaworm affected
vi1lages/PHCs/Districts. The targets for next year in this
direction may please be specified.
5.
The details on health education activities undertaken
including Guineaworm Education Day Celebration & awareness camps
in the villages and the resource inputs for health educat i on
along with the evaluation their impact on community. A set o f
guineaworm health education material prepared by your state may
pl ease be brought along with you for display during the meeting
for benefit of other states.
6.
The district wise information on health infrastructure
sanctioned,
in position and trained in GWEP during 1989 as well
as plan of action for trained man power development under GWEP in
the state for next year.
7.
The system of supervision, monitoring & evaluation of
GWEP
in the state and various administ rative,
technical,
operational and social problems/constraints experienced while
implementation of GWEP along with their proposed solutions.
8.
Action taken on the recommendations of nth Task
meeting on GWEP held at NICD, Delhi, January, '1989.
Fo r c e
9.
' The proposed calender of specific activities and targets
to
be achieved under GWEP and manpower requirements
for
implementing the GWEP during •1990-91.
48
Appendix III
LIST OF PARTICIPANTS
I,DTE,GEN,HEALTH SERVICES &
MIN,OF HEALTH & FN,y DELHI
Madhya Pradesh
1 Dr.A.K.Mukherjee
Dir.Gen.of Health Services,
Nirman Bhawan,
New Delhi-110 011.
9 Dr.V.B.Saxena
Director (Epidemic Control),
Dte.of Health Services,
Sat pu ra Bhawan,
Bhopal-462 001
E Mr.J -S.Vasudevan
Joint Secy,to GOI,
Min.o-F Health & FW.,
M i r ma n B h a w a n r
New Delhi-110 011,
10 Dr-B.C.Saxena
Dy.Di rector (Epid)
Dte.of Health Services,
Sat pu ra Bhawan,
Eshopal-462 001
II.STATE GOVERNMENTS
11 Mr.M.S.Bedi
Chief Engineer, Tech.Mission,
P.H.E.D,, Sat pura Bhawan,
Bhopal-462 001
Andhra Pradesh
3 Dr.P,Venkata Reddy
Dy. Dir & GWEPO,
Dte.of Medical A Health
Services, A.P., Sultan Bazar,
Hyderabad - 500001
4 Mr.C.N.Suresh
Dy,Chief Engineer,
Panchayati Raj Deptt.,
Govt.of Andhra Pradesh,
Hyderabad-500 001.
Maharasht ra
12 Dr,(Mrs)M.R.Chandrakapure
Director Health Services,
St. George Hospital Compound,
Govt. Dental College Building
41 h F loo r , Bornbay-400 001 .
13 Dr.A.R.Belambe
Asstt.Dir.of Health Services
Bombay.
Gujarat
5 Dr.T.D.Gandhi
Jt.Dir and GWEPO,
Old Sachivalaya,
Gandhinagar.
6 Dr.N.S.Dave
Jt.Director (M), Tech.Mission
G.W.S.S.B., Sector 16,
Gandhinagar-382 010.
Karnataka
7 Dr.G.S.Viswanath
Jt.Dir.(CMD & DDC),
Dte.of Health and
Family Welfare Services,
Anan da. Rao Circle,
Ban ga1o re-560 009.
8 M r . G u 1 a rn A h rn e d
Engineer in Chief,PHED,
Anand Rao Circle,
Ban g a1o r e-560 009„
14 Mr.P.N.Gholap
Executive Engineer (T.M.),
Maharashtra Water Supply &
Sewerage Board, CIDCO Bhawan,
Be1a pu r, New Bombay-400 614.
Rajasthan
15 Mr.O.P.Meena
Spl.Secy.,Heal th.
Govt,of Rajasthan,
Jaipur-302 005.
16 Mr.Indu Bhushan
Director(IEC),
Medical & Health Services,
Jaipur-302 005.
17 D r.M.M.G o g na
Addl.DirGWEPO,
Rural H e a11 h,
Dte.of Health Services,
Jaipur-302 005.
49
18 Mr,V.D,Sharma
Te chni ca1 Officer,
Dte.of Med.& Health Services,
Jaipur-302 005.
28 Dr.T.K.Ghosh
(Former Dy.Director,NICD),
14 A/5, WEA, Karol Bagh,
New Del hi-110 005,
19 M r < B.K.S u r an a
S u p e r i n t e n ding Engi ne e r ,
P.H.E.D.(Rural Division),
Bungalow No.2, Civil Lines,
Jaipur-302 005.
IV,SUACHt UDAIPUR
29 M r,Muk e s h Sha rma
Prograrnme Director, SWACH,
•13-B, Sahel i Marg,
Udaipur 313 001,Rajasthan,
Tamil Nadu
<
20 Dr.E,S.Rahavendra
D i r e c t o r , Dt e . o f P ub 1 i c
H e a 11 h A P r e v e n t i v e M e d i c i n e ,
259, Anna Salai,
Madras-600 006.
21 M r,K.Nata raj an
S e n i o r Ern t o m o 1 o g i s t,
Dte.of Public Health and
Pre v en t i ve Me d i c i n e,
259, Anna Salai,
Madras-600 006.
V-DEPT, OF RURAL DEVELOPMENT,
MIN.OF AGRICULTURE, DELHI
30 Mr.Inamul Haq
Adviser, National Drinking
Water Mission,
Pariyavaran Bhawan, Block 2,
B-1,9th Floor, CGO Complex,
Lodhi Road, New Delhi-11 003.
31 Mr.R.M.Deshapan d e
A s s 11.A d v i s e r, Na t i o n a1
Drinking Water Mission,
New Delhi.
III,INVITEES
22 Dr.M.I.D.Sharma
(F" o r m e r D i r e c t o r NICD),
A 2/1, Model Town,
Delhi-110 009.
23 D r.Mahe nd r a Du 11a
(Former DDGHS),
119 D, K a m 1 a N a g a r ,
Delhi-110 007.
24 Dr„P.N.Sehgal
(Former Director NICD),
A-103,Swasthya V i ha r,
Del hi-110 092.
25 Dr .LC.Tiwari
Professor & Head,
Dept, of P.S.M,, Inst, of
Medi c:a]. Sc i en ces , B. H. U . ,
Varanasi-221 006, (U . P . )
26 D r.S.J.Naga1o ti math
Professor 6 Head,
Dept, of Pathology, J.N.M.C.,
B e J. g a u m, K a r n a t a k a -590 0134 .
27 Dr.V.K.Kochar
P r o f e s s o r A H e a d,
Dept., of Sociology, Central
University of Hyderabad,
H y d e r a b a d-500 134.
VI.CENTRAL HEALTH EDUCATION
BUREAU, DELHI.
32 Dr.S.K.Satija
DADG, CHEB, Kot la Road,
New Del hi-11 002.
33 Mr.Y.P.Gupta
Re s e a r c h Officer,
CHEB, Kot la Road,
New Delhi 110 002.
(Statistics),
VII.NORLD HEALTH ORGANISATION
34 Dr. P.Mi covic
WHO Representative to India,
Nirman Bhawan,
New De 1hi - 110 011.
35 Dr. N.K.Shah
Director, Prevention &
Disease Control,
WHO, (SEARO), I.P.Estate,
New Del hi-110 002.
36 D r.J.Ak i yama
Regional Entomologist,
WHO, (SEARO), I.P.Estate,
Ne w De1h i-110 002.
37 Dr.(Mrs) Helga Pierschel
STP (Epi dern i o 1 ogy) ,
WHO, (SEARO), I.P.Estate,
New Delhi-110 002.
50
VIII,UNICEF
53 D r.V.K.Sa xe na
Dy.Asstt.Di rector
38 Dr.Jon Rohde
Senior Adviser to Regional
Director, South East Asia,
UNICEF, 73, Lodhi Estate,
New Delhi-110 003.
39 M r . B o n Th o r bu r n
Pr o gr amm e O f f i c e r (Water)r
UNICEF, 73, Lodhi Estate,
New Delhi-110 003.
40 Dr.Jim Sherry
Senior Adviser to
Regi o na1 Director, Arne r i car
UNICEF, New York
X,INVITEES NHQ COULD NOT ATTEND
54 Dir.Gen.Armed Forces
Medical Services
M Block, Central Secretariat,
New Delhi-110 001.
55 Mr.M.S.Dayal,
Addl. Secy, to GOI,
Min. of Health a FW,
Nirman Bhawan,
New Delhi-110 011.
56 Dr.S.Pattanayak,
Consultant, WHO SEARO,
IX,NATIONAL INSTITUTE OF
COMMUNICABLE DISEASES,
DELHI-110 054
41 Dr.M.V.V.L.Narasimham
Di re ctor .
42 D r . A s h o k K nma r
Dy.Director (Helminthology).
43 Dr,Saraljit Sehgal
Director (Microbio1ogy)„
44 Dr.K.K.Datta
Dy.Director (Epi d emi o1o g y).
45 D r.Gyan Pr a kas h
C o-o r d i na t o r, GUEST.
46 Mr.S.M.Kaul
As s i s tant D i re cto r.
47 Dr.Ba1ram Mohanty
Senior Medical Officer.
I.P.Estate,
New Del hi-110 002.
57 Mr.G.Ghosh,
Jt. Secy. & Director,
National Mission on
Drinking Water,
Krishi Bhawan,
New Delhi-110 011.
58 Dr.S.C.Saha
DDGI-IS (P ) , N i rman Bhawan ,
N e w D e I. h i -110 001 .
59 Mr.M.M.Datta,
Dy. Adviser,
Planning Commission,
Yoj ana Bhawan,
New Delhi-110 011.
60 Dr.R.S.Sharma,
A s s i s tant D ir e c t o r,
NICD, Delhi.
4 8 D r . G a u t a rri B i s w a s
Senior Medical Officer,
49 Mr.V.K.Raina
Dy.As s 11.D i r e c tor.
50 Mr.G.C.Joshi
Entomologist,GUEST.
51 D r.R.L.Ic hh p ujani
Asstt.. Director.
52 Dr.S.K.Sharma
Assist an t D i r e c t o r.
51
"piS' 3oo
11170 A/O,°
Appendix IV
RECOMMENDATIONS OF THE 11th TASK FORCE GROUP
ON GUIEP (January 1989)
I.
Improved infrastructure for GWEP
and evaluation
of
1«
For an
effective
implementation
full
time GWEP
GWEP,each endemic
state
should have one
of Health
Officer of
the
rank of Joint/Deputy Director
A s s i s tan t,
Se r v i c e s as s i s ted by St en ograph er,
Statist i ca1
non-medical supervisor, driver and a vehicle, Likewise each
o f t h e 15 p r o b 1 e m d i s t r i c t s in states of Rajasthan (Udaipur,
Thane &
Jhalawar,
Barmer,
Nagaur), Maharashtra
(Raigad,
Ratnagiri),
Karnataka (Gulbarga, Bijapur),
Andhra Pradesh
(Kurnool and Mahboobnagar) and Madhya Pradesh (Rajgarh, Dhar
and Jhabua) should also have a full time team of District
Health Officer,
health supervisor, driver & vehicle
for
GWEP.
The Central Government should study the
financial
feasibility for the
imp1ementat i on
of
th i s
additional
personnel inputs into the GWEP on a priority basis.
(Action NICD, State DHS)
Deployment of Epidemiological Surveillance teams in the
affected states should be expedited.
(Action NICD)
3.
State
should make efforts for involving the
community
health guides and opinion-leaders in implementation of GWEP
viz.early detection of guineaworm case and their management,
temephos
treatment of water sources, maintenance of water
supplies and health education.
(Action DHS & PHED)
II. Guineaworm case finding & management
4.
For
efficient
GW
case
finding &
their
timely
management, instead of existing two active search operations
during May and December, it is recommended that GW endemic
states
should organize at least three active
case
search
operations
during
the months
of April,
June/July
and
November with effect from 1989.
(Action State DHS)
5.
Though active guineaworm case search
operat ions a r e
well planned, the i r imp1ementat i ons need to be
c o n c u r r e n 11 y
evaluated for its efficiency. For t h i s pu r po s e, a s am p1e
of
257.,
107. & 17. of villages as searched by
respective MPWs
should be
randomly & concurrently
cross-checked
by para
me d i ca 1
supervisors,
Medical Officer of PHC and District
52
4
Health Officer,
respectively for coverage and quality of
sear c h
in
terms of guineaworm case detected as well
as
m i s s e d by workers.
A report to this
effect
should be
included in search reports submitted by PHC/District.
(Action State DHS)
6.
In absence of effective chemotherapy for guineaworm, it
is important that the guineaworm blisters/ulcers of patients
should be constantly covered until healing. For this purpose
besides educating, patients should be assisted by providing
a
package of 12 gauze bandages to each needy
patient
for
self ulcer dressing and this should be regularly monitored.
(Action State DHS)
III- Health Education and Community Invo1vement
State should prepare a Target Oriented Plan of Action"
7.
for
implementation & evaluation
of
of
guineaworm
H e a11 h
Educat i on Programmes
to be undertaken by them at
state,
district,
PHC and village levels during
•1989 and
1989
1990.
Schoo 1
h e a 11 h
education should be given ddue
priority,
ue
A
q ua r t er 1 y
report on
performance
of
guineaworm
h e a 11 h
educat ion programmes organised should be submitted by DHO to
State DHS and NICD
(Action State DHS)
8.
The Guineaworm Education Day (GED) should be
celebrated
during the last week of April every year from 1989 onwards
by all endemic states.
This is important to create a mass
awareness and seek
community involvement
in
guineaworm
eradication
campaign.
All the endemic states
should draw
out a
plan
of action for celebrating GED
in April
at
village,
PHC,
District and State
levels,
and
the
implementation report to this effect should be sent to NICD.
(Action State DHS)
evolve d useful
9»
Some
gguineaworm
u i n eaw o r rn affected states have
h ea1th educa t i on pa c kag e(s). NICD along with C.H.E.B. s h o u 1 d
packages and
compile a digest
on such health
education
di gest
for
states
circulate the
same to all guineaworm affected
per
their
improving their
the i r
health education programmes as
local needs.
(Action NICD, CHEB and State
DHS)
the
10.
State Health Directorates and PHED should approach
in
Station Director(s)
of Doordarshan & All
India Radio
their
respective
states for
including guineaworm health
education programmes on TV and Radio at periodical interval,
free of cost.
The assistance of Ministry of Information &
Broadcasting may also be sought in this matter.
(Action State DHS & PHED)
53
11 - NICD, Delhi has prepared guineaworm health e d u c a t i o n
rubber stamps/seals for use on postal envelops & letters,
S i m i1a r st am ps/se a1s s hou1d a1so b e p r epar ed f o r rout i n e use
by states.
(Action State DHS & PHED)
12. In order to effectively conduct Guineaworm Health
Education Programmes in the schools and community, (a)
the
affected PHCs should be equipped with a set of slides on
guineaworm disease & its eradication, and (b) each affected
district should be provided with one set of colour TV, VCR
and
portable generator. The operational
&
financial
feasibility for these inputs should be worked out by Govt.
o f I n d i a.
(Action NICD, National Mission on
Drinking Water, State DHS & PHED)
13. The 16 mm film on guineaworm as shot in West A -f r i c a
should be provided to each affected district •for communi ty
health education and training purposes.
(Action NICD)
14. Wherever possible the State Governments will arrange to
secure assistance of an animator preferably a female from
voluntary organization working in the neighbourhood who
should co-ordinate health education activities in a group o-f
villages.
The State Government will furnish
to
the
Government
of
India
the lists
of
such
voluntary
organizations whose services can be utilised and will bear
the estimated cost likely to be incurred on this activity.
(Action DHS)
IV.
Vector Control
15. NICD should continue to function as a nodal agency •F o r
the procurement of temephos, its quality control and supply
to the guineaworm
guineaworm endemic
endemic states/districts
states/districts..
However,
to
ensure timely receipt of temephos, the guineaworm endemic
states should plan out well in advance,
the quantity o-f
insecticide required in respect of various districts,
The
final demand may be submitted to NICD by 15th March, 1989 to
ensure its timely supply during 1989-90.
(Action DHS)
16. Proper records should be maintained at State, D i s t r i c t
and PHC level specifying the date and quantity of terne phos
received,
consumed during the month and balance in hand at
the end of every month. This information should be sent to
NICD f o r rn o n i t o r i n g t h e t e m e p h o s consumption & •f u r t h e r
s u p p 3. y.
(Action DHS)
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17.
The
present practice of supplying temephos in 5
litre
containers
should be
discontinued..
In
view
of
the
requirement of very small quantity of insecticide at a given
point of time, it would be more convenient if
temephos
is
made available preferably in 1.0 litre packs to
the
state
GWEP Officers.
(Action NICD)
18.
The detailed advance planning for temephos appli cat i on
of
unsafe drinking water sources in villages during active
transmission season at monthly intervals (February to J one )
and once in two months during post-monsoon season should be
made
for every affected PHC.
The plan of action s h o u 1 d be
sent to the State Health Directorates and NICD.
The worker should be equipped with the necessary t o o 1 s
to
measure the water
quantity
in well
for
chemical
treatment.
The temephos application of unsafe water sources
should be recorded/stenciled at the site of the unsafe water
source.
(Action DHS)
19.
Unsafe
d r i n k i n g wate r
sources
in
e n d e rn i c
villages
r e po r t i n g
guineawo rrn
cases
from 1987 onwards
should
be
i dent i fi ed f o r
coverage with
chemical
The
t reatment.
v i1lages
h a v i n g active
c a s e s of
cases
guineaworm during
•1988
s h o u 1 d be
covered for temephos application on a
pr i o r i ty
bas i s.
(Action DHS)
20.
The chemical treatment of large water bodies or unsafe
sources with difficult access such as those encountered
in
the desert areas of Rajasthan should be taken up by district
level
team as is being done in the Banswara district
of
Raj asthan.
(Action DHS)
21.
The
Bioefficacy of
temephos treatment
should
be
concurrently monitored for coverage and correct dosages.
10
per cent and 1 to 2%
27. of the temephos treated sources
shou1 d
be
randorn 1 y
c r os s- c:he c: ked by the
t he Medical Officer
randomly
cross-cheeked
and
District
Health
Officer/State
Programme
Officers
respect i vely.
The funnel nets provided to the PHCs should be used for
recording the presence or absence of cyclops in the p r e and
post-terne ph os
treatment of water sources
and
should
be
r e c o r d e d i n t h e r e c o iti rn ended f o r m a t s .
(Action DHS of States)
55
V.
Provision and maintenance of water supply
22. There is a strong need for close and
effective
coordination between the Health Department and the Public
Health Engineering Department at State/District/PHC levels
for monitoring the programme implementation at quarterly
bas i s■
)
(Action DHS & PHED)
23. A list of 2664 villages with active cases was found to
have 2892 step wells and 1446 ponds requiring convers i on
into safe water sources has been submitted by the N1CD to
the National.Mission on Drinking Water for which the budget
has been sanctioned by the Mission. The list of such
villages should continuously be updated by 1st Aprilr
1989,jointly by the State Health and PHE Departments and
sent to National Mission on Drinking Water and NICD.
An
action plan should be prepared to provide safe water sources
to these villages by June, •1939 for obtaining the funds •for
this purpose from National Mission on drinking water.
(Action: DHS, PHED, National
Mission on Drinking Water)
24
Notwithstanding the norms for providing safe water
sources in villages, the guineaworm affected villages should
be provided additional safe water sources according to the
requirements indicated by the Programme Officers.
Problem areas like coastal districts of Maharashtra (Thane,
Raigad, Ratnagiri) require special attention for provision
of safe water supplies.
(Action DHS & PHED)
25. There is need for documentation of types of unsafe
water sources in endemic states and availability of vari ous
options for their conversion into safe water sources.
Likewise an alternative strategy should be thought to
provide safe water sources in those areas where due to soil
problem hand pumps can not be provided. For this purpose
the National Mission of Drinking Water should constitute a
Working Group to suggest suitable plan of action.
(Action National Mission of Drinking
Water and State DHS, PHED)
26. The State Governments may be requested to
ban on construction of further step wells.
ensure
the
(Action PHED/National Mission on
Drinking Water)
56
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VI.
T raining
In order to keep up-to-date technical skills of medical
27.
and paramedical personnel involved in Guineaworm Eradication
Programme, one day orientation training programme should be
periodically conducted at district and PHC levels by the
such
Training
Syllabus
for
State
Health Departments,
its
t ra i n in g
p r o g r a rn rn e s s h o u 1 d be p r e pa r e d by NICD for
u n i for m i rn p 1 e rn e n t a t i o n in all the States.
(Action DHS of States, IMICD)
28.
The
orientation training programme for the State and
District
level
Mass Media Officers
for
their
active
involvement in health education under Guineaworm Eradication
Programme should be organised.
(Action NICD, DHS, CHEB)
than
29.
The village based Government functionaries other
and
health
personnel as well as employees of local
bodies
opinion
leaders, prominent public service minded women
of
the
village
should be given
orientation
training about
guineaworm disease and its eradication at PHC/block levels.
(Action DHS of States)
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57
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Acknowledgements
Sin ce re
gratitudes are expressed to WHO for
prov i ding
financial support for conducting this 12th Task Force Meeting
on
GWEP and to all distinguished invitees and participants
•For
attending the Meeting.
Mr.V.K.Raina
(Dy.Assistant Director)
and Mr.G.C.Joshi
(Entomologist, GWEST) assisted by Mr. Satya Prakash, Mr .J.P.Behl,
Mr.Rati Ram,
are thanked for making
reception,
reg i s t rat i on ,
catering and other arrangements for the Meeting
Dr «B.Mohanty
(Sr.Medical Officer), assisted by Mr.Harbans Singh,
Mr.8.K.Gupta
(draughts men), Mr.P.C.Sood (projectionist) and Mr.Ram Singh are
acknowledged
for
arranging auditorium and
audio
visual
arrangements
during the technical sessions.
Dr.
Gautam Bi s wa s
(Senior Medical Officer),
Mr.
G.C.
Joshi,
assisted
by Mr.
Rajendra Kumar (Cornputor), Mr. Yudhister Lal, Mr. Fran ciscose and
Mr.Harendra Bhagat are thanked for
organising
exhibition and
demonstrations during the meeting.
The Secretarial assistance of Mrs. Chandramathy Arnma,
Miss Suman Lata, Mr.R.K.Chopra and Mr.P.R.Mitta1
is
thankfully
is
acknowl edged.
Technical
expertise of Dr.Gautam Biswas is
very much
appreciated for computer analysis of data and report of lEth Task
Force me et in g.
T he k i n d
co-op e r at i o n
extended by the
staff
o-f
Division
of Helminthology as well as other divisions,
and the
support from various administrative sections of our Institute
is
acknowledged with thanks.
A
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