Amen's report.pdf
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VISION: - To acquire the knowledge and skill necessary
to lead an effective community health programme in the
areas where primary health care is not accessible.
OBJECTIVES:1 Basic understanding of concept of health and
diseases, including health for all and primary
health care.
2 An understanding of the philosophy and
organization of a community health programme the
component and the relationship between the
components.
3 To have a first hand experience of the suffering and
the struggle of the mining affected peoples .
4 To have a brief exposure to mining affected areas.
5 To have understanding of model of primary health
care .
1
SL.NO
1
WHAT
* ORIENTASTION
AT CHC.
* EXPOSURE TO
VARIOUS
MODEL OF
COMMUNITY
HEALTH
2
FELLOW MEETS
WHY
* BASIC
WHEN
MARCH 15
– APRIL 12
UNDERESTANDING
OF COMMUNITY
HEALTH.
*
UNDERESTANDING
OF COMMUNITY
DYNAMICS AND
DETERMINANTS
* DEVELOPMENT OF
VARIOUS SKILL
COORDINATION
AND INTERLINKS
BETWEEN THE PAST
AND PRESENT
FELLOWS .
WHERE
* C.H.C
* NIMHANS.
* RADS
* APSA
* H.D KOTTE
* HANNUR
APR 13 TO
APR 15
2
ISI BANGLORE
WHO
* DR. C.M
FRANCIS
* DR. RAVI
* DR. THELMA
* DR.PARESH
* MR RAJENDER
* MR CHANDER
* DR. BALLA
* SR.DR
AQUINAS
* STAFF OF
RADS AND
APSA
HOW
* ORIENTATION
* GROUP
DISCUSSION
* SESSIONS
* DISCUSSION WITH
MENTOR.
* LIBRARY WORK
* READING
ASSIGNMENT
* PAPER
PRESENTATION
* ORGANIZATION
VISIT.
* COMMUNICATION
CLASS
* VIDEO SHOW.
* CHC FAMILY.
* DR. SUNIL
KAUL
* DR. ULLHAS.
* DR. NARENDRA
.
* PAST AND
PRESENT
FELLOWS
* TECHNICAL
SESSIONS.
* GROUP
DISCUSSION.
* QUESTION HOUR.
* LISTNING
EXPERIENCE
AND
CHALLENGES.
3
* MENTOR
ATTACHMENT.
* PLACEMENT AT
GREEN PEACE.
4
FIELD
PLACEMENT AT
OMAPAN
*
UNDERESTANDING
OF ENVL.
HEALTH.
*
UNDERESTANDING
OF NETWORKING
BETWEEN HEALTH
AND ENV.L NGOs.
APR 20 TO
MAY 8
* PHM
* CHC
* GREEN PEACE
* DR RAVI
NARAYAN.
* DR THELMA
NARAYAN
* MR BIDHAN
SING
* LIBRARY WORKS
* DISCUSSION WITH
MENTOR.
* MATERIAL
COLLECTION.
* READING
* WEB SEARCH .
*
.UNDERESTANDING
OF MINING AND
HEALTH.
*
ORGANIZATIONAL
EXPERIENCE.
*
UNDERESTANDING
THE NGOS NET
WORKING IN
ORISSA.
* STUDY THE
EFFECT
OF MINING IN
ORISSA.
MAY 11TO
JUNE 11.
* OMAPAN BBSR.
* ROURKELA.
* UNDP OFFICE.
* TALCHER.
* MANAS JENA
* SISIR
TRIPATHY
* SMITHA
PATTANAIK.
* CHAITYANA
SAHU
* DISPLACED
PEOPLES OF
TALCHER .
* REVIEW OF BOOK
AND MATERIAL
* KEYNOTES
PREPARATION
FOR
THE
CONVENTION.
* HELLP IN
ORGANIZING
CONVENTION.
* REPORTING OF
CONVENTION
AND
PREPARATION OF
FINAL REPORT.
* MINING AREA
VISIT
( GROUP
DISCUSSION,
CASE STUDY)
3
5
PLACEMENT AT
BISSAMCUTTACK
MITRA PROJECT.
*
UNDERESTANDING
CONCEPT OF
HEALTH AND
DISEASES .
* CONCEPT OF
HEALTH FOR ALL
&
PRIMARY HEALTH
CARE.
* BASIC
EPIDEMIOLOGY &
HEALTH
INFORMATION
MANAGEMENT
SKILL.
*
UNDERESTANDING
OF THE SOCIETY
JUNE12TO
AUG 28
ANDDEVELOPMENT
OF VARIOUS
SKILL.
4
BISSAMCUTTACK
HOSPITAL.
MITRA PROJECT
AREA
TRIBAL SCHOOL
SUBCENTER
KACHAPAJU AND
DAKUL GUDA.
35 VILLAGES
DR. JHONY
OOMAN.
MITRA TEAM
VILLAGERS.
LEADERS OF THE
VILLAGERS.
* SESSIONS.
* DISCUSSION.
* STAFF MEETING
* MOBILE CLINIC
* VILLAGE VISIT.
* MAHASANGHA
* SHG MEETINGS
* PUPPET SHOW .
* HEALTH
TEACHING
AT SCHOOL.
* STUDY ON THE
IMPACT OF
SHIFTING
CULTIVATION.
* STUDY THE
HEALTH
INFORMATION
SYSTEM.
* STUDY ON
HEALTH
INSURANCE
SCHEME.
6
CHESS
7
PUBLIC HEARING
8
SHARING AND
REFLECTION
*
UNDERESTANDING
THE LINK OF ENV
AND HEALTH.
*
UNDERESTANDING
THE VARIOUS
SKILLS BY
LISTNING THE
SKILL SHARE.
* TO KNOW THE
NETWORKING
AND
COLLABORATION
OF NGOS
WORKING
FOR HEALTH AND
ENV.
TO KNOW THE
PICTURE OF DENIAL
OF HEALTH CARE
AUG 13 TO
15
BIRDY
HYDRABAD
* GREEN PEACE.
* CHC
* MMP
* NGOS FROM 11
STATES.
* TECHNICAL
SESSION.
* CASE
PRESENTATION.
* REPORTING.
* GROUP
DISCUSSION.
AUG 29
THOMAS MOUNT
CHENNAI
* LISTNING CASES.
* REPORTING.
* EVALUATION OF
OUR LEARNING
PROCESS.
* SHARE OUR
ECXPERIENCE
WITH
FELLOWS AND
MENTORS.
31 AUG TO
--
* CHC
* NIMHANS
*TARANGAVANA
* SPAD
* CHC
* JSA
* PHM
* NHRC.
* CHC FAMILY.
* PAST AND
PRESENT
FELLOWS.
* L.C JAIN
* DR. SEKHAR S.
5
* TECHINCAL
SESSION
* DISCUSSION
* REPORTING
* EXPERIENCE
SHARING.
* PRESENTATION.
* VISITS
OUTCOMES: 1
A gradual deepening of the understanding of community health.
2
Understanding the dynamics of community and the determinant which affecting the
health .
3
Got chance to be in the field with the community and understand their needs .
4
Could realize the pain and agony of the peoples of mining area due to displacement
and pollution from near.
5
Could meet many professionals and activists whose contribution bringing change in
the life of community which inspired me to take the challenge of helping the people
to help themselves.
6
Could attend the various networking meetings, which help to understand the
importance, and need to work in common platform to fight against the discrimination
in the society.
7
Understood the present health & education delivery system of the Government and
the needs of structural changes.
8
Personality and professional development.
INSPIRING EVENTS DURING THE INTERNSHIP :various person and various events inspired me Through out the six month journey in search of
community health. The contribution of various person and the events really a blessing for me
and also the answer to my various question.
(I)
Person wise :1. The critical analysis of Dr. C.M Francis with the question why? And His
contribution for the community health during his old age.
2. The commitment and the sacrifice of Dr. Ravi and Dr Thelma for the community
health.
3. The commitment of Dr. Liz med son (Founder of Bissamcuttack Hospital) for the
poor and sick tribal peoples of the Bissamcuttack.
7
4. The simplicity, leadership quality, helping nature, encouraging nature and guiding
nature of Dr. Johnny Oman.
5. The commitment and responsibility of all the staff of the MITRA team.
6. The dedication and commitment of Sr. Dr. Aquinas, Dr Sunil kaul, Dr Ullhas
jajjo.
7. The mentality of Dr Narendragupta to work with the collaboration of Govt.
system.
8. The concern and idea of L.C Jain for the present situation of the country and His
encouraging words.
(II)
EVENT WISE: 1
Reaching to unreach with the health care facilities with MITRA team
2
The non hierarchy working principles of the CHC and the MITRA
team.
3
The relationship formed by the MITRA team with the villages and the
involvement of peoples.
4
The experiences of staying in villages and their love and affection.
5
The days of mine at the tribal school.
6
The teaching and learning process of CHC.
7
The unity and the cooperation between the tribals of the 18n villages.
8
In spite of above mentioned list also there are various events which inspired me throughout the
way and taught me various things and contribute a lot in my life in my development and also put
the challenge in front of me to share my knowledge and hand for the upliftment of the oppressed
society. Although I am not strong enough to do all this my all the event helped me to take the
challenges.
DISAPPOINTED EVENTS: 1
Protesting against the pollution and contribute for the pollution.
2
Last minutes preparation of OMAPAN.
3
The step taken by the Mahanadi coalfield Ltd. (MLC) at the talcher villages by
breaking the doors and windows of the villagers.
8
4
In mining struggle the least preference of the marginalized peoples.
5
In proposed mining sites of the kalahandi one meeting was organised OMAPAN
promise them to represent but didn’t turnoff to the meeting.
6
The shifting cultivation practices of tribal community .
Although many event like this many time provoke me and made me angry but this also helped
me to realise the fact and see myself from all point of view and to correct my self during such
shortcomings.
CAPACITY PICKED UP This six-month duration was a great opportunity to strengthen my self, my knowledge.
I picked up various things from the ocean of community health which are as follows:1
The motivation to work in the field of community health.
2
How to play the role of catalyst in the community health without being a medical
professionals.
3
The capacity and the interest to be the member of the community by sharing love
affection and respect.
4
The capacity of a good communicator.
5
Adjustment capacity in every situation.
MOTIVATION AND FURTHER GOAL:After being in the field especially in the tribal areas I understand the needs of community healrth
professional/worker like me in the area where the primary health care is not accessible.Hence I
changed my motivation from working in the field of evvironmental health exclusively to work in
the wide range of community health..
NEXT STEP: As extension of another six month has give to me .this period will really help full for me to
focus on other aspect specially the networking process of NGOS and also propagating the
concept of Jana swasthy Abhiyan (JSA ) and people” health Movement (PHM ) to the NGOS
of the Orissa.
9
OVERALL IMPRESSION
10
REPORT ON THE MITRA PROJECT CHRISTIAL HOSPITAL
BISSAMCUTTACK
THE CONTEXT: In term of health, Orissa is the most needy of the states of India. The root cause of poor health
status in Orissa is poverty and social deprivation, low literacy and structural inequality in term of
class caste gender. Its infant mortality rate is 115 per 1000 live birth is the highest in the country.
The health in fracture is one of the poorest. In the state of Orissa the southwestern part are least
developed.
THE PLACE: Bissumcuttack is a village of scenic beauty and historical interest standing at 114 feet above the
sea levels close to the picturesque Niamgiris range .The name Bissumcuttack is derived from
“Bhisma Kotta ” which means “poisonous fort”. According to the old report the place probably
got the name because of its reputation of fatal malaria.
It is a large village small town. Miles and miles of hills and forest with River Mountain surround
the town and perennial springs.
This town have how 7 schools and a small college. There are 2 banks, a police station and
government Community health centre. It is the headquarter of the tahsils
Bissamcuttack block has a population about ______________________
Out of them
1.
Schedule tribe
68%
2.
Schedule caste
18 %
3.
Others
24 %
Literacy rate is estimated at around 17 %. Infant mortality rate is probably about 140 per
thousand live births. Between 1981 and 1991 the population decreased by 8.2 % in the tribal
community. Death outnumbered birth among the tribal. Many villages are inaccessible by any
vehicles .The quantum of needs in this area is large. Health for all is distant, nebulous undreamed
of concept.
THE INSTITUTION: THE CHRISTIAN hospital Bissumcuttack is a 150 bedded hospital with 4 ward,5 operation
theatre, multidisciplinary mission hospital of Jeypore Evangelical Lutheran Church .50 years
now the CHB serving the health needs of the peoples of years now.
CHB now encompasses a wide spectrum of activities ranging from complicated surgery and ultra
sonography to community based primary health care from training nurses to night school for
adult literacy. This has been described as an Oasis in the green desert
THE BEGINNING :Two score and 10 years ago in the early 1950’s a private practitioner in Denmark Dr. Elizabeth
Madsen by name felt the urge ,the inner calling to step off the life fror some thinfs more than the
ordinary.
She was borne in a pastor’s family in Copenhagen in the year 1913. After Graduating in
medicine in 1941 she developed her next few year in equipping herself to move into general
practice .All long she had the idea of working in a hospital and had away imagined herself
reaching out to the patient at his home and his own surrounding. Hence after study medicine,
surgery and psychiatry she established her clinic at Aalborg in North deutlsand and devoted
herself from 1945 – 1950.
It was during the last year of her practice she cane to be associated with the Christian scout
movement and was the leader of the group. At one her meeting she choose to speak on India.
11
While looking for reference she learned about the India from Rev Anderson’s writings she saw
and felt the need and started journey to India. She came to the area in 1954 wanting to be a
village doctor. She began with village clinics .The lack of health care facilities forced her to take
inpatient, One hut became two and a hospital was borne .To day the hospital is 150 bedded
hospital.
THE MILE STONE IN THE LIFE OF HOSPITAL :-
1954
Dr Medsen begins work from the veranda of church.
Dispensary build, mobile clinic.
OPD began functioning., 10 bedded hospital build.
1955-56
1959
Hospital close down in her absence
1960
She returned ,Hospital reopen
1976-77
She retired, moved to Bandhaguda village started extensive
community health work in 90 villages of 3 panchayat.Hospital
charge taken by Dr Hanery
1978
1980
1996
1997
1998
ANM training school started
Community health sub centre opened in Dakulguda.
GNM course introduced at school of nursing
Second community health sub centre opened at kachapaju.
MITRA tribal residential school started
12
Overall perspective of work of the Community Health Department,
Christian Hospital, Bissam Cuttack
Christian hospital
Bissam cuttack
Community Health Department
THE MITRA PROJECT
MITRA
TRAINING & RESOURCE
UNIT
MITRA
RESIDENTIAL
SCHOOL
KACHAPAJU
The MITRA Project
A Relationship with 10,431 people in 46 villages
4 Dreams for the community
HEALTH FOR ALL
-41 Swasthya Sevikas
(Village Health Workers)
-2 SubCentres with Resident
Nurses
(Treated 2769 patients in 2001)
-49 Village Clinics per month;
(Treated 2003 patients in 2001)
-Immunisation Services
In 43 villages
-Referral System to CHB
(98 referrals in 2001)
-Inpatient Care Facilities
(224 patients in 2001)
-Malaria Control Programme
with
1749 medicated mosquito nets in
45 villages
-Village-Specific Interventions in
Nutrition, TB and Anaemia based
On the Community Diagnosis
EDUCATION FOR ALL
- Facilitating children
enrollment
- in Govt Residential Schools
- Encouraging the optimum
functioning of Govt Day Schools
- Non Formal Education
Program
in 23 Literacy Centres. MITRA
provides - Teachers Training
- Supervision
- Logistic Support
- Evaluation
Each village runs it’s own school.
Students : 230 boys and 291 girls
- Circulating Library and
supply of
Oriya Newspapers through
Literacy
Centres.
13
ECONOMIC SECURITY
FOR ALL &
SOCIAL EMPOWERMENT
FOR ALL
- Supporting and nurturing the
Malkondh
Anchalika Sangho – a
peoples’
organisation of the hill tribe
area.
-MITRA Womens Development
Programme,
with formation of Mahila
Mandals –
SHGs – 24, Youth Groups – 5
- Pathorogodo Village
Mahila Mandal
Runs an Income Generation
Programme, with production
of handmade village goods,
for marketing through Mitra.
- Encouraging Savings
- Supporting Haldi
Cultivation with
supply of seed at subsidised
rates.
- Awareness programmes for
village youth
MITRA TRAINING AND RESOURCE UNIT
Training
Training Programs for
- Keonjhar Dist Administration
- LWS (India)
- 22 Doctors from Denmark
- PREM-PLAN & Allied NGO’s
- CMAI Project Managers
- Staff of RAHA, CHN, AKH
-Staff of CASA
Consultancy
Inputs provided to
-UNFPA – on Malaria
-UNICEF & Govt. of Orissa – for
creation of IMR Reduction
Strategy
-CMJI – Empowerment with
Dignity
Publications and Production of
Resource Materials
-Articles published on
Kala-Azar – an Information
booklet
MITRA RESIDENTIAL SCHOOL, KACHAPAJU
A Residential, Primary School For Children of 16 Hill-Tribe
illages
Location : 18 km from CHB
Established : July 1998
Students : 100 – 55 boys, 45 girls
Staff : 4 Teachers, 2 Cooks
Medium : Kuvi and Oriya
Runs on Love, Fresh Air and Voluntary Contributions from friends
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