Dr. Harishchandra Zagade CHLP 2006 FR 22.pdf
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Necessity to work on the roots of Health and Ill-health of society
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The Determinants of Health
w.r.t.
HEALTH EQUITY
Fellow- Dr. Harishchandra Zagade
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Community Health Fellowship: 2006-07
COMMUNITY HEALTH CELL (C.H.C.)
Bangalore
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Necessity to work on the roots of Health and III health of Society
The determinants of health
LOOKING AT HEALTH THROUGH VARIOUS DETERMINANTS AND
INFLUENTIAL FACTORS OF HEALTH w.r.t. HEALTH EQUITY.
Fellow-Dr.Harishchandra Zagade
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Community health fellowship-7th Aug.2006 - 6th Feb.2007
COMMUNITY HEALTH CELL (C.H.C)
Bangalore
CONTENTS
1.Looking at health through various determinants and influential factors of health
w.r.t. Health equity.
Introduction
2.Social Determinants Of Health... Beyond The Medicine
Getting at the roots...
2.1 Why the necessity to rethink?
2.2 What is the immediate way?
2.3 Enabling? Empowerment?
2.4 Some determinants of the health
2.5 Necessity of starting with the Primary Health care
2.6 How this consciousness got in? is there any example to any extent ?
2.7 Why to strengthen the peoples' movements?
2.8 Expectations within the given framework ofpresent situation
2.9 Why the social determinants of the health?
Revealing the context...
3.Through the heart of Badaami-Bhoomi
A Representative Reflection from a South Indian journey
3.1 Geographical and ecological conditions
3.2 Socio- economic
3.3 Health
4.Some important considerations in COMMUNITY HEALTH
5.The necessity of shifting our approaches.
6.Health/public health/primary health/community health-important happenings
T.Health Structure, Programmes And Policies. Historical development of health
structure in our country.
7.1 Important Aspects Of Globalization
7.2 India's health in general-the context and the happenings
7.3 India fs Health Policy
7.4 Poverty, Globalization, development and health
S.Rights, Human Rights and Campaigns
9.1ssue of drugs
IQ.Urban Health
11.Child health based on Rights
12.Determinants of health with respect to Tb/HIV/AIDS
13.Rights of Physically Challenged and Disabled people
14.Gender and Women’s empowerment
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IS.Mental Health
16.Determinants of Health with reference to Malaria /Diarrhoea/Noncommunicable diseases some important aspects
Visit to
National Institute of Malaria Research, Bangalore
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17.The challenge of TOBACCO.
IS.Nutrition
19.ENVIRONMENT And HEALTH.
Components ofEnvironment, Lay Epidemiology_with reference to Health.
20.A seminar presentation by our self on “PEOPLE’S CHARTER FOR HEALTH”
21.Report of the studies at FRLHT,Bangalore
21.1 Gross outline
21.2 Knowing about FRLHT
21.3 Conservation OfNatural Resources'.
A bridge between Traditional Knowledge and Science
21.4 How laboratory and research helps in community health
21.5 Scientific replenishment ofNatural Resources
21.6 Revitalization of Folk healing systems and LHTs
21.7 Community Based Enterprise: GMCL
21.8 Database work
21.9 RHAM
21.10 Mainstreaming ofISMs
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Some Ways of Empowering People Possible Within the Given Condition
22. Efforts in community health: BAIF
22.1 Approachesfor community health
22.2 Primary Health Care service
22.3 Promotion ofAyurveda and Traditional system of medicine
22.4 As a multidisciplinary center
22.5 Empowerment22.6 Some reflections about the Javhar
23. Gender- women centered efforts Lokseva Aushadhalaya Antiaddiction activity w.r.t.MASUM
Visit to MAHILA SAMAKHYA, Karnataka, Bangalore,
24.Community Participation and empowerment, primary health delivery and its
aspects- FRCH
The TALs
Pluralism ofcommunity health worker
25.Shelter and Housing as an important determinant of Health:Godutai Parulekar Mahila Vidikamgar Cooperative Housing Soc.,Sholapur
A history happening in Pro-people Housing!
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26.Some aspects in understanding the SOCIETY:
Social exclusion in India and the inclusion policy..
A lecture delivered by Dr. Sukhdeo Thorat
27.2nd World Ayurved Congress-2006, Pune
28.CHRD
[Community Health Research and Development]
29.Rural health: current dilemmas
A discussion.
30.1nformative inputs received from AIDAN, MFC Meets
and PreNHA-2 preparatory meet,Bhopal
31.Traditional Medicine & Right to Health For All
South Asian Regional Conference, Bangalore.
32.A vertical decision in health found useful for people in Tamilnadu
33.The practical efforts of conservation and revival of indigenous health traditions
and organic components in farming.
Heart-warming visit toCenterfor Indian knowledge systems (CIKSfKotturpuram, Chennai
34.Sittlingi Tribal Imtiativcs,At.post.-Sittlingi, Tal-Harur, Dist-Dharmapuri,
Tamilnadu.
34.1 The structure
34.2 Health education
34.3 Their opinions about Govt. PHC nearby
34.4 Basic ideology
34.5 Experiments in Education
34.6 Local Socio-economic structure
35.Whilst contributing to the community moving towards health equity
36.Skills, and values.. An exploration
Life Skills
37.Community health fellowship
Why?
Objectives
How done
Learnings
Organizations, Institutes visited
Other activities done
Future Plans
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ACKNOWLEDGMENTS
I owe my special thanks to the very friendly and familial team of C.H.C. Bangalore for
taking hard efforts to help in the Fellowship-studies. Especially Dr.Thelma Narayan’s
endless efforts to assist were and are always with us.
The staffs of organizations, institutes visited kindly cooperated, especially the Godutai
Parulekar Mahila Sahakari Gruhanirman Sanstha-Sholapur, the staff of BIEF like
Dr.SarafDr.Deshpande, the Cehat, FRCH, MASUM-Pune, Mahila SamaakhyaKamataka, NIMHANS-Bangalore(National center for mental health and
neurosciences), National Malaria Center-Bangalore, CIKS-Chennai, HCMCRD,
Sittlingi Tribal initiatives, AIDAN, MFC, PHM kindly supported the studies.
FRLHT,Bangalore-The Govt center for excellence in plants and the distinguished
people there like Dr.Unnikrishnan potentially upgraded the whole thing.
And yes, proud to mention my mentor Dr. Ravi Narayan for continuously and
immensely taking pain to assist and make worth the Fellowship-Studies!
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Necessity to work on the roots of Health and III health of Society
The determinants of health
1. LOOKING AT HEALTH THROUGH VARIOUS DETERMINANTS AND
INFLUENTIAL FACTORS OF HEALTH Wil HEALTH EQUITY.
Fellow-Dr.Harishchandra Zagade
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The major calamity in the health very obviously seen today is strong and painful
divide between the health service availability. We have to be sensitive enough first, to find
the contrast and contradiction, the disparity. A handful people have all sorts of health
facilities at their doorstep and a majority mass of society throughout the world is being
ignored, rather thrown away from very basic needs and primary health-care. This is
prominent especially in the third-world countries. Today the health-care means super
specialty hospitals with facilities like air-ambulance. All the health-picture is being tookover by these concepts. Their concerns are obviously the concerns of a certain class only.
One may see a lot glaring health structures and hospitals in cities, but they in reality are
this one.
There is a superficial and sectored approach. It may be purposeful or ignorance. Basically
the problem starts from the present health providence system's quest for health for allwhether it is genuine or artificial/superficial. It seems very well that the health policies and
approach in the private-capitalist globalization are very well related to its commercial
interests and health is being converted into a 'commodity of trade'.
The very pitiful thing is that all this side of the capital in rule took the goal of'Health For
All by 2000 A.D.' very un-seriously or, say- ridiculously.
The other thing is that this power flow is changing the whole concept of health for all. In
that sense, a well network of paid star health services (mainly chemical surgical) will be
established and opened for everybody as 'pay and use' service! This is very cruel crusade
of the market centered- private profit oriented econo-polity.
So there is a prompt necessity both the ways. Econo-polity is the major medium which
operates through, and is formed of various factors like social norms, gender views,
industrial and agronomic developmental visions, environmental attitudes, and cultural
presentations- all are the very basis of health: both, individual and community.
As 'pay and use' based market-centered private oriented health attitude has nothing to do
with community's needs of health, it is the private capital in the market that will decide the
needs of community! These needs, on the other hand also will be tried to be created by its
well partner i.e. the 'media'.
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As health is not an 'optional' or bypass-able or avoidable thing, for poor and toiling
masses, (though they try to carry maximum illness on the body to maximum extent), this
thing has become now a new tool of exploitation! Expenses on health are putting back to
these people in their life. And even very often if it takes to the cure, it simply puts in an
altered distress. One may survive from death but will have to live a death with debt! That's
why health expenses are major contributing factor to the farmer's suicides. Even in a
suicide, along with physical and mental illness it is this system of health providence where
the roots of ending life take place.
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Getting at the roots...
Social determinants of health... beyond the medicine
Disease? Pains? ..just write the name of medicine or surgery on the chit and hand it over
to the patient. Your roll finished... next patient! That's where the great healing, scientific
humanity-based art have been reduced today! It doesn't stop there only. The part of
collecting money I have not mentioned! One of the noble deeds of ancient times have
today reached to a big professionalism-big chain of star hospitals and pharma MNCs. But
the pains and diseases of humankind?- they are there as usual. A majority of human and
non-human world today is away from very basic and primary health care. Why?
Asking the question is beginning.
2.1 Why the necessity to rethink?
The necessity to have a social audit of health system today has become the need of the
time as a large disparity among people for the very basic needs of life or life with a dignity.
The present health system has failed to a great extent to provide a justified health for all
and the quest by people for the health equity is becoming more and more important as
the situations are worsening very badly in this era of the globalization of exploitation and
poverty and exploitation of natural resources. The bad situation of the commons is very
obvious and not necessary to mention.
The present health providence approach has never considered the people first. It is not
people or the community centered. It is based on very narrow vision and obvious it has
some vested relations. For ex, it's planning is very vertical and also it focuses only a
disease or an entity isolated from the root causes or determinants. So the policy makers
guard their own interests. That's why it is becoming more and more commercial and
private. The logic to rethink this model is very simple that it has failed to provide health for
all irrespective the spending capacity and the poor and marginalized are being forced on a
large scale from the picture of a healthy society.
2.2 What is the immediate way?
Once we grant the necessity of querying, then about the answers, the very first thing that
matters is attitude, approach, perspectives of looking towards the disease. The total 'shift'
in approach is needed. It is required to go at the roots of the disease- to the maximum
possible extent. It is necessary to delimit vision, widen it, not thinking the human body as
an individual body; considering it's relation with society and the surrounding. Society,
surrounding and the individual are interdependent and influence each other. Consider the
structure of society, consider society's influence on individual's body and mind. Understand
the individual and community relationship.
ShiftChemical-surgical 'medical' model to 'health' model.
Individual to social
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>
Sectoral to intersectoral.
Patient as a part of people.
Curative to cause-eliminative.
Vertical to multilateral, participatory.
Providence to generating.
Health has a very wider meaning. It is thinking beyond disease, its mechanical or
microbiological causes and the mere chemical-surgical medicine. It concerns about the
social factors that determine, produce or maintain the disease. This means shifting to
social determinants. It is enabling and empowering people to keep well being. It concerns
with giving people a chance to involve, enabling them to act.
2.3 Enabling? Empowerment?
In fact, whatever is to be done, that is to be done by the people, for the people and with
the people. That's why whilst talking about doing something for people is not meant as
something to be provided by someone to the people. That's why it's the peoples' collective
initiative that matters. Also the govts are (supposed or necessary to be) the bodies that
are responsible for the people and selected by the people, providence by govt, has
ultimately to be necessarily in accordance with the peoples' needs. But as the socioeconomico-political structure of a large part of the society is dominated by certain class of
few peoples, it is hijacked very well by them. It is necessary to circulate this consciousness
about the facts among the people. This is a very long term consideration, the immediate
thing possible within the given framework has to make aware the people about their rights
and one should not keep the people always in the taker mode. With limitations of
compromising to some extent we require to empower the people for their right as well as
build the service from themselves or by their responsible body, say govt, for the
community participatory initiatives or efforts, considering the determinants of health are
the most important and prime means. For that providing people the knowledge, training is
required. But it is much beyond the training also. The knowledge here concerned is about
bringing the change; the change in the factors that determine the health.
To educate, participate and mobilize the society or community even, towards the minor
determinants of health say about hygiene and cleanliness, we require gathering the
community, uniting the community, to build the community. Building the community is a
major task; because there are major determinants that determine all the relations in the
community. Class-caste-gender issues, issues like communalism, power relations are major
obstacles in community building.
2.4 Some determinants of the healthSocial
Economical
Cultural
Ecological
Educational
Hereditary
Individual
Political
Genetic
Determinants of community/society-
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Distribution of resources,
Production structure.
A big and major part of community concern in the health is a 'Public Health'. Public health
is an important part of community health. Generally public health indicates the state or
govt, responsibility. As govt is (has to be) responsible for the people, public health has to
be invariably community participatory. But as we saw, state is mainly hijacked by some
stronger powered sections in the society, presently it is very far from the actual needs of
the people. It's real form is 'community medicine' where the community itself has a
organic involvement by empowerment;
2.5 Necessity ofstarting with the Primary Health careThere are a lot highly specialized and equally commercialized technocratic heath services
and star hospitals, which are, to say, open to all but purely based on economic abilities. So
the common people neither can afford them nor they have availability of simple primary
health care. The need of the time, for the majority of the community is a strong and
efficient preventive and primary health care accessible to anyone everywhere, irrespective
of the purchasing power. It is a first and most necessary stem to health equity. It is a
basic human right.
2.6 How this consciousness got in? is there any example to any extent to look
at?
There are some examples like Cuba, china, Guatemala, Russia, Or Jamkhed, Pachod in
India, which gave a major push to necessity of primary health care. These examples have
some differences and some commonalities.
The neo-international economic alternative considerations forced WHO, UN to have AlmaAta Conference, in 1978 where Primary Health care got well-defined and a commitment of
HFA by 2000. At that time PHCare Concept was mainly proposed on the basis of equity,
community participation
intersectoralness (interdisciplinary vision)
appropriate technology
It gave a major push to PHCare in various countries, by there governments, various
health policies and programs evolved.
But after mid 80s, the accumulated capital in the upper strata of the society in the world
started invading globally as the technological advances also did spin its speed. 'Market'
started attaching, Soviet collapsed, and neo-liberal market-centered economy started
intensified, corporate-led globalization started. The majority part of it is composed of
speculative finance capital. It forced the governments to liberate all sectors for private
invasion. So majority states are now withdrawing govt, roles and expenditures on public
sectors and services like health, education, farming subsidies, energy, aviation, PDS,
insurance etc. It attacked pro-people programs. Social investing got tagged as
'expenditure'. It badly affected primary health care policies and the goal of'HFA by 2000'
faded off. There was no one to bother about this commitment, even WHO was totally
under the influence and obedience of this capital and there was nothing for primary
health; the community health not to mention.
The thing is still continuing.
But at the other hand majority of the peoples, the section of the community living and
dieing with the need of health facility, is living only with the hopes. The resistance from
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there within has gathered strongly and the voices are arising and uniting to various flows
of movements. They are strengthening day by day.
Today, people-led globalization of people's interests, solidarity and resistance is
struggling against corporate-led globalization. For the achievement of health for all and
community health as a reality, we have invariably to be on the people's side, we have to
strengthen the peoples' movements.
2.7 Why to strengthen the peoples'movements?
The answer is philosophical and practical.
To be with majority of people and to be in a direction of achieving maximum justified
society may be a good thing of reason. Also the situations full with inequity and injustice
around us are self-explaining. The present socio-economical system may seem, for a
sensitive mind, as a continuously bleeding system which produces disparities like poverty,
hunger, unemployment, wars etc. There may be something called as basic human rights.
Also there are other living organisms and the environment on this planet that constitute
our environment and existence.
2.8 Expectations within the given framework ofpresent situation:
The happenings and efforts about health should be people centered. The justification to
the argument 'why it should be people centered' is also important.
Within the limited space in this given situation, struggling for stat needs may invariably be
linked to the basic human rights. Such struggles may deliver some palliative yields, build
trust in movements and put confidence among the peoples.
As the majority of the people of our time of society today dwell at grass roots level, the
efforts for achieving health for all require to work from grass roots level. There are two
ways of looking at the achievement of health for all. One is a type of giver and taker
relation. The other is by the whole society to itself. It is one's own interest in 'which way to
go' that matters. Whatever it may be, presently to achieve anything in health requires a
community mobilization and to mobilize a society in any such direction requires uniting it
as it is very scattered on various bases. These bases are closely related to the
determinants of health. A great unity and solidarity of the society is or may the
requirement of the time-being or forever. There may be a need of educating and
empowering of the community to have a participatory and effective role in any process for
itself or for resisting the process against its interests.
As the present controller of resources and services- the globalizing finance capital is
penetrating vertically, at the very same time, people's control, resistance and alternatives
require countering it in both directions, more from grass roots to global.
Then, for that the efforts will have to be always with the people and the part of the
people. So the working from grass roots level to the global. We will require building a
strong community in all positive aspects. That is required to achieve anything. For that we
will be required to build a unity on positive bases. The community may be required to
educate and empower itself or by such elements from it. It will require commitment and
skill. Commitment is based on values. Values may be based on needs, needs in turn on the
historical development and processes in the community. Quest for change- changing
unjustified socio-politico-economical structure is the most valuable fuel for your action and
movement. Along with one's situational and historical needs, these may be the real drives
that keep you on peoples' side!
So, it may require to
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Go to the people
Live with them,
Love them
Learn from them,
2.9 Why the social determinants of the health?
Hospital is a place where people come to you. In community health, as you are with the
people, participating in their education, demystifying the knowledge, breaking barriers,
learning of all to analyze inter and intra relations of living and non living things is useful.
Understanding socio-politico-economical structure of exploitation, poverty is necessary.
Making the sense of rights is basic thing. The democratic ways are inclusive. Listening
/hearing all is necessary and a part of justice, part of participation. Constant learning is
important. Strong organic link (may be restoring to the primitive one!) can be a major
goal as well as a tool.
Understanding society and individual and the surrounding also is a part of understanding
the social determinants of health. All they constitute the health of each other.
Coming together of such pro-people attitudes at Alma Ata in 1978 made a world
statement declaration stressing of the basic requirement of 'Health For Air, to be met by
year 2000AD. The Alma Ata declaration has defined the health as "a state of complete
physical, mental and social well being, not only the absence of disease or infirmity."
How much we have attained it today?
The answer is disappointing.
That is why the Peoples7 Health Charter brought up by the Peoples Health Movement says,
"We declare health as a justiciable right and demand the provision of basic health care as
a fundamental constitutional right of every one of us. We assert our right to take control of
our health in our own hands and for this the right to-a truly decentralized system of local governance vested with adequate power and
responsibilities and provided with adequate finances,
-a sustainable system of agriculture based on the principles of'land to the tiller7 linked to a
decentralized public distribution system and safe drinking water and housing and
sanitation facilities,
-a dignified and sustainable livelihood,
-a clean and sustainable environment,
-a drug industry geared to producing epidemiologically essential drugs at affordable cost,
-a healthcare system which is responsive to the peoples needs and whose control is rested
in peoples hands.
So for the health equity, the basics of life which constitute the health or determine the
health are to be considered as main fronts of action or policy
As Ravi Narayan tells about Pre Alma-Ata India and health experiences, experiments
before Alma Ata were much trying to find alternative ways for primary health care. Efforts
after Alma Ata were much inspired of Alma Ata declaration for Health for all. But later on
as globally capital started influencing; many projects supported by World Bank were
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having sectoral or limited vision. But the genuine community based and intersectoral,
people participatory efforts also went strong. A People's Health Movement took place.
The United Nations has set now the 'Millennium Development Goals'.
But it seems that the same thing is going to happen about these MDGs which happened
about the 'HFA by 2000A.D', if every thing goes in the same ways as new economic
policies did with health for all by 2000A.D. That is why there is requirement to be more
conscious and act.
Revealing the context...
3.
Through the heart of Badaami-BhoomJ
A Representative Reflection from a South Indian journey
I received an opportunity to travel through the Badaami-lands of Karnataka to
further there towards the Western Ghats in south India. The journey in that remote
interior south India was learning and memorable experience; especially the travel from
Bangalore to ManiMahadeo hills, towards the Mysore region. The land and the people
there, the life there, the forest, the hills and the trees and the children there have really
something strange to say.
That study tour revealed geographical, social, cultural and also economical factors
before us. All they are difficult to separate.
3.1 Geographical and ecological conditions:
Karnataka is a land heavily studded with diversity. The lava-mantel of the Deccan
region has a lot mega-continuous rocks here. That is a region specific characteristic. So
much meters devoid of any crack! Even their cracking tendency also cubical-angular-in
cubes, slabs or strata. That's why the rocky slabs plenty everywhere! That rock have an
effect over the art and aesthetics also, sculptures and carvings also. Mahabalipuram,
Bahubali Gomateshara aesthetics reflects that. Humpi-Badaami-Hospet has inseparable
relation with that. The rock characters are found in small stones also. This rock when
freshly cut has a gray color. If we add marble to black basalt of Maharashtra, we will get
this texture and color. The mixture of both varies with the region. Shahabaad, Manjrya,
Kota, Kadappa, Shirgola etc. are the form-diversities with some commonness. That
diversity comes from various additional minerals like calcium, iron, silicon, bauxite, etc.
Fresh cut gray rock slowly turns yellowish, then reddish. Rock is a father of the soil. So the
soil here is reddish-badaami. Like some marbles, the sand found here is also
semitransferent! The land is fertile, more so if it gets sufficient rainfall. So there are plenty
trees, semi forests and jungles, as well as agricultural usage and cultivation. The land
where there is no much raining, also have there own characteristic flora and fauna. This is
related to the economy of the society here.
The story of the actual Bangalore city and its development doesn't fit directly in
this picture. This entire situation has place at the base of this development. This
development has nothing to do with the region outside the Bangalore. In the Bangalore's
sky, every five-ten minuets a plane revolves. As we move away from Bangalore, the
picture changes. The land nearby the Bangalore is rapidly going in the hands of the land
and mine mafias. Some hills have there skin deeply taken off. These intermittent rocky
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gray patches of hills show how and at which cost the Bangalore is developing. Elsewhere,
there is a lot hope yet there. Relatively a large green heritage nearby Bangalore is still
there. Near the city the biodiversity seems to be under stress and forced to narrow.
Besides very less wild spaces, there are monotonous palmarys, eucalyptus related to
commercial plantations. A plenty resorts and careless industries!
As we move from there towards the Western Ghats, biodiversity increases. Marshy places
and lakes are plenty but local contradiction is also prominent. (This doesn't mean that it is
less in the city. The marginalized have no place there.). In rural region huts of palm
leaves, the houses of working masses go on increasing. Paddy fields are obvious where
the water is available. Sugar cane is also prominent. So a typical village picture with all its
characteristics takes place. Taluk-level semi-urban towns are also typical., with the
percolation of falsehoods of globalization., the same 'bhaigiri' on the pan stalls at square.,
the same gutkha picks and pockets.. But comparatively the fumes and fog of the bidi,
cigarette smoke is quite deep dense. Liquor shops also plenty as like stationary and
grocery stores! Average women, dried children., young people in the efforts of finding
work., those who are in work finding for a while of rest., all less or more same.
Whilst passing through the large dry-lands and planes, broad and shallow river
came across abruptly. Moonlight mixed-like frothy white water finding way through rocky
bed. When I received an information that it is a river Cauvery, I really got thrilled!., filled
so great about own myself for a while to see her!., some names come with their
personalities!
The farmyards there also provided with sericulture. The mulberry leaves add a
deep bright greenness to the surroundings. Ramangram, Chennapattan, Neerghatta,
Maddur.. as we move more and more inside towards the Mysore, the picture changes
gradually. The regions having very sparingly rains have somehow dry-xerophytes jungles.
Various acacia species (A.Catechuew, Shami, Hiver) and not-so-local but growing with
'wild'spirits- the lantana (multicolored). The Saatbhai birds there are more yellowish as
compared to grayish ones of Maharashtra. Turtle doves are a lot. The region, I think, also
can be identified as a major home to Royal Falcons. The bullocks are one of the important
animals to be considered. Here they are some how smaller ones, with parallel ante-curved
horns, seemed to be more pitiful! Just like us, every house provided with 2-3 goats. But
the number of such small packets of sheep are considerable. We have their nomadic
herds. The hutments of poor people made from the coconut leaves or to the most, of
biwinged Mangalor tiled roofs. Tiled roofs usually provided with open extensions before
and behind. That is a local style.
As we move near to the ranges of Western Ghats, we get the feel of rainshadowed
region. A picture, which is very similar to our homeland. Now where there is water, there
are a lot paddy fields (Maavali climate). The remaining one is provided with very less
rainfall, but provided with a very rich, long run arid forestry. You will not find any lamplight
throughout your visual field. No bus, transportation and connectivity very difficult. The
village huts poorly provided with electrical connection, that to limited to an exceptional
40 watt bulb! Few decades ago, what the kerosene chimney in hut did express, the same
thing we find by this dim light. Also, no sufficient voltage to run a tube light. The urban
region is provided with a lot rich continuous electricity supply- a condition much better
than Maharashtra.
Overall, the forest region has a great diversity there. And that also reflects in the
development- a very strong reflection. Even a small effort to feel the gaps of development,
even within this moribund system, could have been resulted into temporary relief to the
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toiling masses, living in such a otherwise naturally rich zone. But the reality is reality., and
that's why this forest region can also be a home to a lot like Virappan.
The diversity, to tell in detail, contains dense green forests like Satyamangala
along with the thorny dry forests. New Kamrajnagar district has been formed now out
from the old Mysore dist. But everything remains the same for common people. It is talked
that there are a lot mini Virappans now. In the conversations with the people, people told
that the common people were have nothing to do with Virappan and Virappan was having
nothing to do with common people.
The climate here has two monsoons. As pre-monsoon thunder follows the shallow
monsoon showers (mrig-rimzim), the same is true for the post-monsoon thunders (hast).
But the rain is very unpredictable and uneven. The October heat is as strong as the
summer.
In such environmental condition, there can be some relief from indigenous
development efforts. But it seems to be the total absence of the major drive i.e. the
political will. And that also seems to be purposeful. The second (and may be secondary
and obvious) major challenge is the absence of consciousness about the poverty, slavery
and the reality within the people themselves., it has assimilated in their life!
3.2 Socio- economic:
All homes are poor with certain exceptions! No major difference between the
landless and the minor 2-3 acre land holders. Here we may require to widen the concept
of land reforms. All these people have the day today important. It they get a fair rain, they
abruptly will give up the sowing raagi and turn to ground nut, sowing it with a lot dreams!
They will guard that crop from wild animals like elephants and wild pigs and crows
throughout days and night- they are to that extent hard working. Ground nut is not a crop
to eat. That is to be sold all in market (cash crop). Very often the money came through
that remains happiness of only a while! With the exceptions, all are poor, but the fangs of
caste are so sharp. The S.C. population nears about 40%. S.T. fraternity is also prominent.
The lower castes have majority of Soligas, Lambani (lamaani). The reformist and serving
societies like missionaries were worried with all the socio- economic difficulties here. But,
somehow insensitivity at higher orders in churches due to increased influence of
commercialization is a thing of worry for grassroots level devotees. The hills here are
provided with crosses equally with the temples. But there is hardly any difference in
peoples' life. It seems here that keeping the basic philosophical structure constant,
changing a religious form doesn't make much difference to the socio-economic status or
change the origin of such problems. However the counter communal forces operating at
various levels are more necessary to be taken into consideration in today's situation.
Of course, within the limitations of such conventional frame-work also, a lot can
be done for temporary relief to the sorrows and sufferings of people, as the work of Dr. Sr.
Aquenus and her dedicated staff shows there. Though we realize here that the only service
is not an ultimate answer and it hides the real focus of the problem generation, there work
shows the importance of palliative work with its limits.
As a part of fellowship studies, we visited there to the Hanur village in Kollegal
Tahasil. That village has started now growing as semi-town and market place. Very same
like ours, there also we see the primary teachers in government schools struggling against
the inadequacies. Schools have reached only to the some such developing villages. These
places also are not spared of divide and there too are now coming up some private
English-medium schools, mainly for the exceptional ones. For the remote small villages
and hut clusters, the school will be on the day when the teacher will be able to reach there
after overcoming all the obstacles. From there, we went to Koretti Hosuru- a small hut
14
cluster and also the Yarabgere. Then we also saw some 'bridge-school' efforts at other
village-Prakashpalya. Our worse education system is worse for such places. Then where do
the children here go and what do they do?
The children go or stay at the bound labor places! The bound labor has the
heritage there from the generations! It has very strongly chocked the lives there. It is
relatively prominent than the counter situation at ours. The children there also do go for
works like keeping cattle, for quarrying, mining works, or domestic work in various
villages, small towns and even cities like Bangalore, some go for vending fruits, news
papers, a lot go for cutting the sugarcane. Some go for working as collie- girls too. They
also do go for sewing- stitching works- boys too. A lot have to look after the younger
brother or sister. All this is not in much grown-up age. The age parallels to the 3rd or 4th
std.
After such a few initial steps in formal schools, there, you may say as is a trend to
go for selling toys and various articles in trains. But a majority of work is in farms and
bound to certain condition, or you may straight say, a bonded labor.
There is no end to their sufferings. A lot try to escape and run off. A lot fall pray to
malnutrition. A lot do suicide. Some people brought that little Nagendra in a vehicle and
dumped in hospital. There he came out of almost the mouth of death. During the
treatment, after taking him in trust, he told to the nursing sister that he has taken the
Roger- the deadly pesticide! His father and mother have had a debt., probably, taken for
marriage or treatment in past. The borrowing of 5-6 thousands grows over 20 thousands
within 8-10 years despite paying a lot money over all the past years, in the form of both
money and the labor. The tragedy of the poor is that he never can return all the debt or
borrowings in a single payment. That's why he remains slave of the original amount and
even the interest. Such private interest rates may be near about 60 %( or anything!). Self
help groups have somehow less rates, but that too much higher. Also the SHGs do not
stand for emergencies. The exceptional rich and those who do business at other places
lend private money lenders and exploiters. Subsidized govt, loans are mere cheating in
white clothes for such poor masses. And also they really can't solve the puzzles of the
documents and bails. The lamp in the lender's room keeps running at any odd time of the
mid night also! He takes impression and article-deposits by one hand and immediately
lends money by the other hand. A simple procedure! Debt is an impartial part of life! Very
similar to a caste, it binds and travels through the birth also! No difference in its
consequencies for younger or older. Till few days before, farm work, domestic work
succeeded to escape from child labor act. And despite some recent happenings on this
front, there is no any considerable change in the situation. 82% children are non
nourished. Their wounds get cleaned by licking by dogs, or like here, by the cows. A lot
children fall pray to addictions, mainly the liquor. Tobacco, bidi, gutkha are a common
thing. Snuffing chemicals have penetrated very meticulously to bigger villages. Younger,
older all have a great psycho-disorder index- near about 50% (Bangalore has 30%). A lot
marriages happen within very small community relations and domains of caste and blood
relations. Child marriage is a major problem. This results in physical-mental ailments and
economical crippling. The story of the women life is the most worse. Smaller the girl, less
is the dowry. Female foeticide is not much predictable- may be due to the difficulty to
reach up to reach to the prenatal sex-determination tool (or vice-a-versa), but,
Dr.Sr.Aquenus do tell that, the female infanticide is awful- say near about 140 per
thousand! As anywhere else here are also some specific practices to kill girl.
15
Some of such children do reside and learn at bridge-school. We saw there
tremendous cultural abilities and skills e.g. singing, dancing skills, their srishti-geet,
harvest songs, pot dance( bindige) all really unforgettable!
3.3 Health:
What to speak else than this on health as separate? It is the same situation as at
other regions. But the severity of the problem is to much higher. No much adequacies of
the govt, health service. The shortage of drugs, especially the anti-snake venom serum, is
very prominent. It's the such a place where it requires most. The same thing is about the
prophylaxis and the determinants of the health. Chickungunia, various fevers, the
mosquitoes all are in form now! People have primary support from local heath traditions,
herbs and Aayurvedic therapies, and also they have much more trust on these. There is a
combination in these service providers, some of which are genuine and some taking
advantage of peoples' situations.
When we started to back, we came across the place from where Virappan
kidnapped a minister., a huge property of long spread palm-grove and irrigated land,
estate.
.. So we have a great unity of certain things throughout the society, all the states
and the boundaries., a very sure common things!., we have a solidarity in this sense also.,
the situation is there, the situation is more or less here also., the various narrations also
are there., some broken answers are also there., and they are useful also, to some
extent., but., where is the complete solution?
4.
Some important considerations in COMMUNITY HEALTH-
The necessity ofshifting our approaches.
Medical model—to—social model
Individual—to community
Patient—to—people
Disease—to—health
Providing—to—enabling
Drug technology—to—knowledge/social process
Professional control—to—demystification
Teaching is somehow one way.
Learning is facilitation, participatory
Looking inside and outside of our self and others is required.
Step by step new journey from hospitals and institutions to community is required.
Medicine is not everything. It is a starting point.
Poor people also have something to give you.
Discussions are important
Advices as per reality
16
Every primary health care worker you will have to understand
Be a tap-turner not a floor mopper.
6.
Health/public health/primary health/community health-important happenings
Thrust to conceptsHealth(1948WHO)
Is much beyond medicine.
Public heath(1950 Social reforms and rulers in Briton.)
As a job/duty of state.
Primary health (1978 Alma Ata)
Basic, primary health
Community health concept (1980s)
Arrangements made by the community for the country.(with the help of govt, or
else.). Wider magnitude.
So building a community is important mission. Beware: community is divided.
About primary health care:
Its importance has evolved from people's experiences of
various countries. They were pre- Alma Ata, Alma Ata (1978) and post Alma Ata. The
mission health for all by 2000 underlines it.
Four major principles in health are:
Equity
Appropriate technology
Intersectoralness.
Community participation
Marketycapital has started attacking all above since 1980s investing in it being tagged as
expenditure. To resist this a global uniting is required.
7.
Health Structure, Programmes And Policies. (TN.)
Different classification methods of health sectors:
Village Town City.
Public Private
Allopathic AYUSH LHT
Historical development of health structure in our country.
Pre-independence
Post independence.
It was knowing how British rule was pro-allopathic, marginalizing Indian
systems of medicine. Even after the independence, our state continued support only to
western style of public health and health strategies. Historical development of primary
health center and accordingly higher stepwise establishment of health infrastructure
achieved.
There is a journey from Bhore committee to today's NRHM via 25 National
Programs.
17
It has got some influences: first of British colonial, then freedom struggle, then
Alma-Ata and now the corporate capital led globalization.
But also has got influence of people's movements and solidarity.
Now-a-days, following factors are important:
Budget,
Policy
Implementation and effectiveness of services
Entitlement of people's right to health.
We also discussed the today's health structure's key factors, programs and various
systems of surveys.
7.1 Important Aspects Of Globalization
It is a private corporate capitalism via international bodies and govts. A segment of global
citizens benefit.
Problems created by it:
Increased inequality, disparity
Increased unemployment.
Wars and conflicts
Loss of livelihoods
Negative health impacts.
All the determinants have got negatively influenced.
There are social crises.
There are effects on women.
Socio-politico-economical factors in community health:
A single struggle in a village for a minor thing like getting 100 Rs govt pension is
meant to involve all the determinants of health.
7.2 India's health in qeneral-the context and the happeningsWhatever may be the Definition of health, in India for the majority of toiling masses, it is
yet a delusion.
The root-causes and basic needs of health have been neglected a long time. Especially the
following sectors are now much in negative side.Food security.
Equity in health
Availability/accessibility/quality
Public health System and primary health, PHCs.
Environmental determinants and hazards
Poor environment/water supply
Treatment: commercialization
Existing health problems are getting worse, old reviving, new health problems are
evolving.
Where are we in world ranking? We have 127th rank in the Human Development index,
(unfortunately there is no 'happiness development index').
18
Health scenario
Infant mortality and maternal mortality rates, life expectancy requires to be worked on the
roots.
Constitution of India expects:
"A new social order based on liberty, fraternity, equality, justice and dignity of
individual."
Its directive principles ask for health.
WHO constitution at least on paper has some bindings of which every nation has some
responsibility.
UNDHR (1948) underlines the basics of humanity.
Alma Ata declaration is very clear thrust in direction towards the Health for All.
UN declaration- any how, is a collective responsibility for health.
All these we have either signed or bound on our self. But the goal is far away yet; in fact
the situations are worsening more and more in accordance with the global capital flows.
7.3 India's Health Policy
The global motion of the ruling forces has very close effect on Indian Health Policies'
Historical evolution.
There is a vast disparity between the kind of society we want and the society we have.
Despite the ruling classes' interests, in ancient times, Ayurveda was provided with much
positive things. The kings like Ashoka have positive history.
British attitudes worsened the conditions.
Freedom movement tried to some extent, e.g. Sokhey committee.
1946: Bhore committee came in. whose recommendations were a good push towards
health for civil masses and expanding British military medical services to all citizens.
1982: National health policy came in as a effect of Alma Ata. Till that there was no
significant policy consideration for health.
1991: Neo liberal globalization policies exaggeration started.
2002: New national health policy in that light of
Liberation, Privatization, Globalization
Various national programs got reformed.
Discussion with Dr.C.M.Fransis was informative in this subject.
Now the Millennium development goals which talk only in the language of 'halving the
populations in various diseases till 2015' are the being made as an indicator.
The major distinctive characteristics of present societal process are high rise in disparity
and inequality. The divide between the poor and the rich is becoming more and more wide
and deeper. The poor who constitute a majority of the populations are being marginalized
and simply excluding them, the rosy picture of "Super-power" is being painted. The virus
of communalism and fundamentalism is also threatening infectious disease of today's such
a vulnerable condition. Seminar at Indian Social Institute emphasized some thingsImportance of social-economic rights of minorities. Liberal democratic voices, culture
already exist. We require supporting them.
7.4 Poverty, Globalization, development and health’.
These are important determinants of health
All these determinants operate at many levels and are inter related.
Statistics many times may negative politically affected.
Health as a human right and social justice in health
WHO has formed a commission on social determinants of health.
19
8.
Rights, Human Rights and Campaigns
The concept of right (not yet well differentiated): a privilege
The base of Right to Health is a Human Rights concept.
There is no specific right to health in Indian constitution or govt.
Human rights are the basic rights inherent with birth and no one can take them
away. There is a need to be ware of this reality and work. It is a vital thing for society and
it is dangerous to be weak of human rights movement.
9.
Issue of drugs:
Discussions with Naveen Thomus, Prasanna gave valuable information on the happening
on the front of the struggle for access to essential drugs. The AIDAN Meet was also one
important meet where a lot important information about this movement got revealed.
India is a largest manufacturer of the drugs. Despite this the majority people in the
country have no access to essential medicines and the neo-economic policies are affecting
the condition very badly.
A film: Pills, Policies, and Profits revealed the ethics and evils affecting the people's access
to the essential drugs. Some important things to mention areMedicines getting out of reach of people,
No effective control of drugs
Drs being trained by drug companies.
Rational drug use and medical care.
Discussions with Dr.Prakash Rao provided some more information.
Health care already have got commercialized.
There is deep effect of globalization, liberalization and privatization.
The only motive is of profit.
There is
A lot irrationality in health care and drug practice.
Erosion of public health sector, being used by private to grow.
Necessity of ethics allover.
He also delivered a nice guideline to confront these issues related to commercialization.
It was a valuable session. It definitely provided some armory for the confrontations.
Discussions with Prasanna:
Health care is decided by market.
Creativity aligned with it gets commercialized and goes hunting for consumers and profits.
It leads over to monopoly over things like drugs or intellectual properties.
This is the challenge of globalization to health for all.
Privatization=profits=curative approach.
Historical happenings in the field of IPR/TRIPS.
Campaigns and confrontation related to it.
In some total, this joint session was also a very useful, informative and updating.
It ushered the necessity of continuous campaigning in this field of health. It gave idea of
the challenges by transnational tyrants against community health.
20
10.
Urban Health -(study with S J Chander).
Two real stories revealed the difficulties that urban poor have to face in Private as well as
Govt health facilities.
Community efforts: service providence is not enough.
Going beyond that is also not easy. Local money and muscle power gets reacted against
us.
Vicious cycle of poverty-malnutrition-illness-expenses.
Necessity of a clear policy for urban health.
11.
Child health based on Rights
Visit to ARSA (Association for Promoting Social Action.) with S J Chander.
resource: Laksha, Ravi
Intersectoral work for and mainstreaming of street children.
How the child helpline operates, supports vitally in emergencies.
Various successful training efforts.
School.
To a certain level, it seems to be a genuine effort.
12.
Determinants of health with respect to Tb/HIV/AIDS
(resources-TN)
Tb germs can be controlled, difficult to eradicate.
Historical happenings about Tb
Its association with industrial revolution, world war
Epidemic to pandemic -internationalization
India's national Tb program
Effect of patent policy on treatment
Effect of international politics on revision of NTPC to RNTPC
RNTPC- a risky battle approach
Discrimination as a challenge
Information is important.
Nobody should die of Tb today.
HIV/AIDS a new epidemic that can be reversed
Stigma and discrimination a major problem
Classical example of struggle in kerala by Sunil
Community is the learning place
HIV positive people also have a great contribution in movement.
Visit to MILANA with Sunil, resource: Jyoti., Revealed the following important aspects
that require to be urgently attendedAcceptance is important
Support group is necessary
21
Funds also have discrimination tendency
Issues about ARVT
Medical fraternity's attitude
These are the experiences of the positive women looking positively towards the life.
13.
Rights of Physically Challenged and Disabled people
Visit to MOBILITY INDIA : with NT,SJC.
We learned there how a community based rehabilitation can be set. It was a good
example of automatisation of the disabled community can take place. The products they
were producing were helpful for themselves as well as economically empowering them.
There seemed to be a less effort in advocacy or rights based broad effort.
14.
Gender and Women's empowerment. -RN/RG
Gender sensitivity starts with individual level and capacity. Gender attitudes are
very chemoflaging. A good example of this is our text-books. There are some
commissions, omissions, and mal-importances.
Try to understand from where the differences come. Mutual understanding is
important.
15.
Mental Health -by Dr.Mohan Issac.
It's an often ignored and mal-understood part of health.
Broad classification of mental disorders:
Severe, common, and substance use related personality disorders.
Mental health disorder:
"A person at ease with himself, others and environment."
A vision of training to treat/manage mental disorder at primary level is needed, because
much of it doesn't require medicines and that level is much organically suitable. That is
why some of traditional healing methods (not all-me) require to be taken into
consideration.
A visit to BASIC NEEDS INDIA which works on mental health, -with NT
Resource: Dr.Nayadu and Dr.Mani.
The dialogue with Dr.Nayadu revealed the necessities and difficulties of people
with mental disability and their family. Even the basic needs of this part of society is often
neglected and underestimated. The chemicals based conventional ways of their treatment
is also have many shortcomings. Even the traditional ways are much variable and mixed.
We have to intervene when they turn violent and torturing like beating.
Learning from groups and evolving their own model based on their needs is
valuable and viable.
For them you will know the real meaning of self help groups or SHGs.
22
Off course we realized this when we visited to the families with mentally disabled peoples!
We went to magadi road slums of Bangalore where Basic Needs India group and the APD
have became part of such families. The picture which we saw there was a bad reality.
The overall visit gave us a positive direction and lighted lamps of hope.
16.
Determinants of health with reference to
Malaria /Piarrhoea/Non-communicable diseases some important aspects:
Why social/community concept of health?
Present view is mainly -medical.
We require a Balloonist's vision.
Malaria:
Chemical- medical approach, curative and even in the name of preventive
approach requires to be changed. Relation to engineering and development should be
considered; mosquitoes are linked to development.
Diarrhea:
Biological-medical circle
Public health circle
Social circle
IHD/CVD: How it is related to modern life-style,
Addictions
Social vaccines idea
Visit to
National Institute of Malaria Research, Bangalore -with S J Chander, resourceDr.A.K.Gosh.
Malaria:
You can't control without going to the grass roots.
Implementing science for the society is necessary.
Local and folkal approach
Community also have a responsibility.
All is based on Economics.
We have good infrastructure of Panchayat Raaj
Understanding structure is important.
Emphasis should be given on vector control.
Kollar experiment of vector control
This was an excellent example of how govt officers can also be exceptions! How
they studied the difficulties with DDT, its effects on silkworms, necessity of finding an
alternative method of vector i.e. mosquitoes control. They went through science and found
a biological way of control in the form of Guppies or Gambuzia fish. They worked with
communities and introduced that to field and got effective results.
The increased addictions are a big problem of the lifestyle and the conditions of the people
today. SJ.Chandar put some light on this issue.
23
17.
The challenge of TOBACCO,A physical and mental challenge.
It kills.
Widespread social problem.
Portuguese introduced it in 16th century.
Tobacco market in India: more than 260mill.
Bidi and chewing is biggest part.
Govt not interested in banning.
Demand and supply both should be targeted.
The life skills are important in practically fighting against this problem.
18.
Nutrition:
Nutrition is a very crucial and vital issue. Food is a basic need. The currents global and
local policies have affected the food security and nutrition of people to great severity. The
export oriented production and the import policies have affected the food and the farmers
respectively. Our public distribution system is being eroded and the subsidies ae being
constantly attacked.
We got different technical and medical inputs from a very special day with Dr.Padmasini
Asuri. According to her.
Nutrition is fundamental even for health. Everyone should know it.
She talked about some ancient concepts and trends about aahara.
Mothers' role is important.
Some of her views were like-"Poverty existed even in puranas, besides poverty, managing
whatever you have is important." This may require to be re-analyzed.
She discussed about-What can be done to make nutrition as responsibility of community?
-Interaction and practical with food items.
-Way of cooking
-Importance of post-harvest technology,
A very memorable lunch that took us throughout all the southern Indian food traditions.
19.
ENVIRONMENT and HEALTH. (Resource-RN/RG)
Relation of environment to us and its study.
There is always a lack of certainty in environmental health.
Concept of health field.
Understanding environment.
Deep connections are important.
Finding solution is also a complex thing.
Industries are based on profits. They do not have interests in controlling pollution. Even if
they exceptionally decide to do so, there may be the chemical or pollutant not treatable.
Establishing a link between cause and effects is a main challenge community side.
24
Components of Environment, Lay Epidemiology with reference to Health. RN/Sukanya.
A film on Kasargod Endosulphan tragedy.
There are thousands of Bhopals. We know only few because only with acute
effects come in light. But the chronic effects are very difficult to come to surface. There
always remains a challenge of establishing relationship between pollutant or cause and the
effects on the health of people. The polluter industries are always against of such efforts.
The govt very often guards interests of such industries. Access to the scientific data is very
difficult. That's why there is a need of people's initiatives, such initiatives are the important
part of today's environmental movements. One such effort is CHESS-Community Health
Environmental Survey Skill Share. It is a lay epidemiology.
How this can be useful in peoples struggle is explained by three examples of
struggles. This produces valuable data that can be a strong asset in legal fighting. These
three examples explained by Sukanya were:
Kudlore(Tamilnadu): industrial chemicals
Kasargod(Kerala): Endosulphan spraying
Idduki Dist. (Kerala): Tea plucker's exposure to pesticides and its effect on
women's health.
20.
8th Sept.2006.
A seminar presentation by our self on "PEOPLE'S CHARTER FOR HEALTH"
was a good learning experience.
25
21.
Report of the studies at FRLHT,Bangalore
Fellow-Z.Harishchandra
21.1 Gross outline:
llsept2006: Knowing about FRLHT
12sept2006: Community based experiment: GMCL
13sept2006: How LABORATORY and RESEARCH helps
14sept2006: LHT, herbs in health, and nursery/herbarium
15sept2006: Community oriented DATABASE work and RITAM
21.2 Knowing about FRLHT
It is a large organized effort concerned in health situated at Bangalore. It is a
Foundation for Revitalization of Local Health Tradition supported by various concerned
people and the govt, ministry of forests. It works for the medicinal plants conservation
program.
Late 70's and early 80's can be considered as a period of increased commercial as
well as pro-people conservative approach towards plants. Both were opposite to each
other, working for respective interests. As a part of efforts of conserving Local Health
Traditions, FRLHT came into existence based on the experiences from various LHT
conservation efforts.
As its introductory leaflet suggests, its effort was revitalization of Indian Medical
Heritage and not mere study and research. Its vision in this area concentrates on three
major fields:
Conservation of the natural resources used by Indian Medical Heritage
Demonstrating the contemporary relevance of the traditional medical knowledge of
health care.
Large scale dissemination of traditional knowledge via informal, institutional and
commercial transmission process.
It works by designing and developing various efforts in these fields
Institutional Status: It is a registered public trust and charitable society. It started
its activities in March 1993.
The Ministry of Science and Technology (DSIR) recognizes FRLHT as a scientific
and research organization.
The Ministry of Environment and Forests has designated FRLHT as a National
Center of Excellence for Medicinal Plants and Traditional Knowledge.
Its various activities can be profiled from following efforts.
21.3 Conservation OfNatural Resources. In 1993 the institution primly identified the
need for conservation of intra and inter specific diversity of medicinal plants. Between
1993 and 2004in collaboration with state forest departments of Kerala, Tamilnadu,
Karnataka, Andhra Pradesh, and Maharashtra, FRLHT has conceived, designated and
technically guided a 40 crore project for the creation of 55 Forest Gene Banks (FGBs) of
200-500 hectares size each, across peninsular India. These forest gene banks have been
designated by the State Governments as permanent Medicinal Plants Conservation Areas
and they capture the gene pools of the medicinal plants diversity of the region. In 2004the
UNDP and Global Environment Facility have pledged to work with MoEF, Govt, of India to
26
expand the peninsular India program to the north-east, north-west and central India.
FRLHT has been designated as the technical resource agency for guiding this program.
Information technology and Traditional Knowledge: In 1995, FRLHT started giving
information technological strength to Traditional System of Medicine and its vast materia
medica. It was the effort towards improving access of TSM, mining its knowledge base for
variety of research base. FRLHT by 2004 has developed multi disciplinary database on
medicinal plants, covering the fields of botany, ecology, phytochemistry, pharmacology,
agriculture, and traditional knowledge.
A bridge between Traditional Knowledge and Science:
21A How laboratory and research helps in community health
FRLHT lab has been set-up in 2000. It works on epistemologically informed crosscultural research. The base of work is 'rigorous methodology for co-relating concepts,
categories and approaches of traditional knowledge systems with modern science/ It is
well prepared with standard facilities in chemistry, phytochemistry and biology, including
molecular biology and microbiology. It has done the standardization of the raw material
and process used in traditional medicine. It has developed innovative products for industry
on the consultancy basis. It has initiated research on basic concepts of Aayurvedic
pharmacology like rasa or taste and is investigating traditional methods for purifying
water.
How laboratory and research can be useful for the community health:
Discussions with Dr.Unnikrishnan revealed the important and crucial role of
laboratory in the TSM and the people's health.
It gives contributes mainly from the modern sight. It works for three important
issues: QUALITY, SAFETY, EFICACY.
Quality: standardization of any medicine or food is required to build a much
greater trust as well as effectiveness. It is the most important contributing factor for a
good medicine or food. Work of laboratory on standardization is of two major issues: one
is developing modules of standards.-standard operating processes right from collecting the
herb. It provides different biomedical values, chromatography profiles, general profiles like
total ash content etc. The other is Quality maintenance: once a norm is established, it is
required to adhere to that level. So many times, continuous testing is required.
Safety: It does watch for toxins, toxicity, pesticides, property variation, etc.
General profile also contributes for this. This includes microbial contaminations, various
bacterial, fungal counts etc.
Efficacy: all the above things are basis for an efficient medicine or food product.
Also one more important thing is botanical authenticity, proper identity. In today's
situation, anything is being sold in the name of Aayurveda. To check this and to help in
the central regulation of the happenings, the laboratory work and modules are vitally
useful.
The laboratory contributions further can be enhanced to
Product development: it has an important role in community medicine. A specific
problem wise, area wise product can be designed/developed. E.g. pregnancy related
anemia, post-partum delectation, purification methods of water, malarial regimes etc.
Market assessment also can be an extended contribution on the laboratory work
basis. It has important role in community empowerment enterprising.
'll
21.5 Scientific replenishment of Natural Resources:
It is one of the most important challenge and need of the day. Working in this field
has resulted in formation of internationally accredited herbarium of the medicinal plants of
India. At the end of 2004. the herbarium has collected over 50% of the medicinal plants of
the codified Indian Systems of Medicine. Simultaneously the herbarium is getting
digitalized. It also is expanding its scope to cover medicinal fauna and metals and
minerals.
All the above work builds community useful databases. It documents resources.
Laboratory, research can contribute to the continuously required up gradation of some
part of database, besides additions to the database. The database provides references of
already happened work and studies, uses, practices etc.
All the above efforts also generate a good environment for the propagation of
knowledge which is given in the form of training. Training in standard operating
processes, good manufacturing practices helps. Using field testing methods for quality,
safety gives positive outputs. How to develop research proposals based on quality,
standards of ayurveda, GMP, clinical studies, helps in community based enterprises. Some
of the useful services given by the laboratory are: Moisture content, total ash, Acid
insoluble ash, estimation of tannins, total alkaloid contents, bitter contents, saponin
contents, HPTLC analysis, Fat content, aflatoxin test, biological assays etc.
21.6 Revitalization of Folk healing systems and LHTs:
Froml995FRLHT is working with the network of community based organization to
revitalize the Local Health Tradition cultures for the enhancing health security of rural
communities on South India. It has standardized a method for rigorous documentation of
local health traditions as well as for participatory assessment of health practices. It has
sponsored dozens of taluka, district and state level conventions of folk healers in southern
states. For the last nine years it has also been giving annual Nati Vaidya Ratna awards to
outstanding folk healers.
A very significant program for promoting family health was initiated by FRLHT in
2000. This program was concerned with the primary health as well as innovative and very
simple method of conservation of the natural resources used in it. In association with
various groups and organizations, more than 150000 family herbal gardens have been
established across the south Indian states.
Ayurved and yoga nursing home is also serving the patients in the premises at
Bangalore. It mainly stresses on standardization in management of various health
conditions.
Dr. Unikrishnan says that, "before bringing any external knowledge to the
community, analyzing local natural, human, social, cultural resources is necessary."
The development should accept that:
There can be different culture,
There is local knowledge, tradition.
The development should be affordable, cost effective, compatible.
There should not be hierarchy between knowledge-systems.
Strengthening from within, itself is required.
Every traditional knowledge have its own understanding of environment, body.
The gaps are to be filled by complimentary views.
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21.7 Community Based Enterprise: GMCL
Herbal public limited company:
This is also a module to know how the various health concerns, conservation
efforts as well as peoples empowerments can be integrated.
In 2001 FRLHT initiated a community owned enterprise whose shareholders are
small marginal farmers and rural women. It is the Gram Mooligai Company Ltd. It is
designed like AMUL for the herbal sector. It is registered under the companies act. The
company conducts cultivation, collection and value addition of herbal products, in the last
four years the Company has achieved cumulative sales of a little over Rs.One crore. Its
annual turnover is forty lakhs and it is spread over nearabout 52 SHGs each of about 20
collectors/cultivators, mainly in Madurai dist.of Tamilnadu.
21.8 Database work:
As mentioned formerly, all the above efforts result in building a huge collection of
data and documentation resources. Also it is one of the important need of the time to build
such a database. Database documents the natural resources used in medicine. It is hugely
attached with the references where it is used, the traditions, the identification, etc.
Dr.Lokesh gave an idea of the database work. It have two major fields:
Nomenclature database and bibliographic database.
The nomenclature database (IMPD: Indian medicinal plants database) enlists the
information of about 7609 plants.
The bibliographic database records the related references of the plant.
Besides this, there is also a database of every pathy, i.e. of Aayurved, Unani, etc.
This database is made useful to the people in the form of various packages
developed, e.g. the plants of caraksamhita, etc.
21.9RITAM:
Research Initiatives on Traditional Antimalarial Methodologies
Dr.Deepak gave the idea of the above RITAM .
It was initiated by the committee of Global Initiatives for TSM.
Malaria is a major cause of the entity fever in community. The traditional, local
health measures for tackling it have a rich potential to contribute in the combat against
malaria. Various plants and activities are used at various regions to prevent or cure the
malaria or fever or jwara. Documenting, researching, strengthening these health traditions
helps in community medicine and public health.
Aims of RITAM:
Documentation of LHTs
To assess the parameters
Develop region-specific formulations and treatment packages
Promote it in community medicine and educational programs
In the overall procedure, after the documentation of formulations and practices in
local health traditions, the assessment is done. It includes activities like proper
identification, bibliographic references etc. simultaneously the data on malaria from PHCs
is collected. Though it is very often misleading, it is correlated with the village status, then
taking into consideration of the LHTs, the villages are selected for the RITAM.
In the preparation of the decoctions and the various activities the community is
involved. The decoctions are made available to drink in specific seasonal status. The
afterstudies and cohort observations are also made. Analysis done.
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Based on all this, the training modules for the Physicians and the peoples involved
are also developed and used. This perpetualness increases the effort with time.
How we can apply all this to our public health programs and development:
Dr.Unnikrishnan told that this is a big challenge. It requires to develop modules.
Purification of water, care of elderly are some important fields. In fact, documenting
people's health resources, the GMCL , RJTAM, training traditional bone setters are itself the
good examples of such efforts. Dr.Unnikrishnan also told about his experience about
allopathic drugs usage in Maharashtra villages and the experiments about giving locally
available ayurvedic alternatives to it; made by his team.
Understanding of what are the key problems and what are the key resources
available in the above context is important.
21,10 Mainstreaming ofISMs.
It is a major work and way to apply the conservation and strengthening ISMs. It is
a means of spreading the knowledge and making it useful for the society. It is one of the
way relating public health, institutions and the Folk Health Traditions. We all need to work
hard by this side.
The kind and co-operative nature of the staff like
Dr. Unnikrishnan, Dr.Gangadharan, Dr.Deepak,
Dr.Lokesh, Nandeeni madam, Shriram, etc. is appreciable.
I owe special thanks for Dr. Unnikrishnan for the
extension of very big hand of friendly help in studies and
orientation.
22.
Some Ways OfEmpowering People Possible Within The Given Condition
As community based experiments are useful to know the possibilities and also to some
extent they give immediate relief to the present day problems of the people, they need to
be taken into considered for their there outcome. Some of such productive outputs are
from BAIF. A lot practical things can be learned from these experiments, especially the
efforts in economically empowering the people.
BAIF
In 1946, Mahatma Gandhi visited Urulikanchan near Pune to establish a Nature Cure
Centre. His devoted disciple Manibhai Desai was assigned the responsibility of
management. To replicate his experiences in rural development, a Charitable Trust in
1967, named Bharatiya Agro Industries Foundation (BAIF) came in to existence. It is now
known as BAIF Development Research Foundation.
BAIF is recognized as a Research Institution by Indian Council of Agricultural Research and
Ministry of Science and Technology, Govt of India, University of Pune, and South Gujrat
University,Surat.
The BAIF mission says:
"Unemployment, underemployment and depletion of natural resources being the root
causes of rural poverty, BAIF's mission is to create opportunities of gainful self
employment for rural families especially disadvantaged sections, ensuring sustainable
30
livelihood, enriched environment, improved quality of life and good human values. BAIF is
a non-political, secular and professionally managed organization."
BAIF has a wide range of work in India. Its program based is outlined as:
*Family as a unit of development.
*Multidisciplinary program for assured livelihood.
*Blend of development with Research and Training.
*People's organization for program implementation.
*Focus on Quality of life.
*Women empowerment.
*Environmental Protection.
This approach is reflected in following major programs:
Livestock development.
Water and land development
Tribal rehabilitation
Empowerment of women
Community health
Renewable energy and environment
Training in sustainable development.
This is considered as a contribution to the Millennium Development Goals.
Thus the health of individual, family and community is seen in this entire context. It has
created a lot measurable material output.
Efforts in community health:
Health Is viewed as and integral part of better quality of life. It agrees that even after
SSyears of independence, illness is a major problem of the rural poor in India. It pursues
Bapuji's vision behind Nature Cure Center at Urulikanchan to promote community health.
Gandhiji considered simple interventions like hygine, sanitation, immunization and nutrition
as a means to reduce the incidences of illness. This is taken as the basic principle of
community health here.
Strategy:
-Health is an essential link in the poverty alleviation, sustainable development and
improved quality of life.
-Good health as a goal for development.
-Health contributes to empowerment of people and people's movements.
Community health is considered as an integral part of Wadi(orchard )development
program, training local midwives, traditional healers. VHGs create awareness, provide
primary health services, and drinking water chlorination in project villages. Local healers
have been trained in naturopathy and the have established their own centers to treat
cases from their villages and from far away places.
Following are considered to be keys to good health.• Hygiene and sanitation.
• Family planning.
• Safe motherhood: antenatal period.
• Child nutrition.
• Immunization.
• Managing common illnesses
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22.1 Approaches for community health:
*Intersectoral approachHealth promotion activities are supported by the poverty alleviation program, land
development, water resource development and people's empowerment.
* Participatory approachHealth activities are supposed to be accessible, equitable and ethical, through
planning and implementing the program through people's organizations. (However this
approach was found limited to registered organizations and not unregistered groups,
organizations or movements.)
*LinkagesNo intervention is duplicated, through linkages with the Govt./Private/Non-govt
health programs in the project areas.
* Development and ResearchBAIF considers experimentation with different approaches, wider replication of
successful experiments help them to grow with the needs. Recent efforts are in herbal
medicine, eco-system, health issues, health insurance and participatory monitoring and
evaluation.
22,2 Primary Health Care serviceIt is provided by Village Health Guides. More than 1000 VHGs are in service. A range of
allopathic and herbal medicines are used and supported by referral system.
Backyard Garden is promoted for herbal medicine and villages are taught to use them.
Sanitation is an integral part of health promotion.
Safe drinking water effort is done. For that, apart from sanitation to water conservation,
watershed area development, creation of water source etc undertaken.
Reproductive and child health (RCH), Family planning measures are the major initiatives.
Mental health is also considered. Especially in Surat and Bharuch. Documentation of
Traditional Health Practitioners of five districts in managing patients with mental illnesses
has been done-100 practitioners have been studied and they are being trained.
A child growth monitoring computer program is developed and being used in activity of
child nutrition.
22.3 Promotion ofAyurveda and Traditional system of medicineThis activity has a special place in the efforts of BAIF. It has made a considerable
achievement. It includes:
-Documentation of the existing biodiversity and its use.
-Cultivation of Medicinal Herbs and their use through Traditional Healers.
Charak Centers
A program being implemented in Maharashatra and Gujrat ;that involves THR in
Community Health activities through regular trainings in herbal medicines, naturopathy
and 'Charak Centers' in their villages. That provides herbal and nature cure services to
patients. Presently there are nearabout 55 Charak Centers. They have made spectacular
changes in the life of Traditional Healers. Nisargopchar Ashram at Urulikanchan works as
practical input center for training purposes as well as service outlet. Visit to this
Nisargopchar Ashram at Urulikanchan was pleasing experience.
All these efforts are consolidated under a brand program named 'Herbotechnik' since last
five years. It emphasizes mainly on Rural /Tribal Community health resources and Local
Health Traditions.
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Initially there was a discussion on whether to include farmers in this or not. But
the studies revealed that 70 % of population yet insists on alternative treatment which is,
mainly based on herbs and natural resources, whilst only 30 % allopathic medicines are
used. Near about 12000 herbs species used worldwide for medicinal purposes. Another
thing also was found that, specific species were cut and traded more resulting in decline.
How much herbs get consumed per year with six lakh vaidyas? So the burden on natural
resources was taken into consideration and about medicinal plant conservation, apart from
land characteristic to the trading of herb everything was well considered.
The first man who comes in contact with the herb is the traditional health
practitioner.
Traditional Health Practitioner (THP) was defined as, that person who goes In
forest, can identify the plant, collects them, makes medicines from them and can
appropriately use them.
Considering overall health scenario and its context, THPs were not considered
blindly as an entity but scientifically and socio-scientifically evaluated and graded to some
extent. (This is very important.).
THPs are surveyed and graded as:
Grade A: Fair Practitioners
Grade B: Better to some extent.
Grade C: Those who use both-plants as well as chants and irrational methods,
superstitions
Grade D: Those who use and exploit by superstitions, harmful methods etc.
After survey it was found that D category was most abundant and prevalent.
In the efforts, crude methods and practices like harmful Svedan methods filtered,
refined, appropriated and trainings are tried.
Traditional knowledge system is documented. All the activities happen at charak
centers. They serve as primary health center as well as social treatment center. Here the
word 'primary is considered important. Various forest plants are used in treatment. But it
found that every vaidya uses near about 20-30plants more often for primary health care.
On the basis of these prominent plants, herbal gardens are developed.
22A As a multidisciplinary centerThese centers serve as multiactivity center for primary health care, Self-help group
meetings and health meetings. ANN serves immunization from there. Anganvadi and child
nutrition programs are watched from there. Every month one medicinal plant is selected to
spread information about it.
One HEALTH COMMITTEE and one VILLAGE TREE COMMITTEE (Gram Vruksh
Samiti) are formed. Gram vruksha samiti has to include 10 children compulsorily-5 boys
and 5 girls. The children play effective role in spreading the message. Gram Vruksh Samiti
is joint forest committee. It promotes tree plantation in village. Every village gets some
part of jungle to protect.
The local experienced old people help in preparing plant/nursery calendar. That
helps in income management.
The plant identification boards displayed.
The herbarium sheets are prepared for training.
SHGs of Traditional Health Practitioners are formed. They run their pharmacies.
They are trained with the help of Nisargopchaar Aashram. Documentation is considered
33
important because a non-insitutional person is given RMP status by Govt, only after if he
has a record of at least 30 years of his work.
22.4 EmpowermentIt has really made a noticeable difference in life of some vaidyas(THPs).
The resource person told that if anyone raises a question, it is understood from his
side and point of view also.
These activities are made maximally for the people with their participation. They
are made self reliant.
The wife of THP is given importance and due-role. A joint account of both is made
for that Charak center. She has an important role in practice.
It is calculated that the obstacles will obviously come. They are taken as help for
further development.
I should specially mention about Dr. Sarafs thinking. I found much positive vision
in his understandings. I don't know it is theoretical or what. The philosophical interaction
with him was really a rare and precious experience for me. He was much positive about
the queries. He has faith in younger generations. Where to lead all these efforts?-he saysit depends on you the people. There he expressed the positive effort to bring new
generations in this mission. He also revealed the difficulties while working with a rational
scientific reason, especially when working at the community level. Only looking at the
goals doesn't work much. We also should be aware of the traditions. We should look at the
situation not from a frame, but from outside the frame, he says.
Though restricted to few ones, the most important thing I observed here is a vision
using two principles at a time-respect for tradition as well as the rational scientific attitude.
Even the BAIF appoints its own doctors who indirectly evaluate the work going on, give
separate visits and document the process separately. A scientific research has some place.
Can the result be generalized? Can every one become a 'Lahoo Sonar'? Though it
is better to keep the question open, Dr.Saraf says, "a proper policy by government is
required...there should be a movement!"
As a reflection of such scientific visions, there is a community health research center
(CHRC) at Urulikanchan near Pune.
It coordinates and also provides laboratory diagnostic facilities and physiotherapy
to the patients of Nature Cure Aashram there. It also conducts water and sanitation
related activities in the project area of BILT paper factory at Bhigwan in Pune dist.
however I found this vision requires to be strengthened in pro-people direction.
The wadi project also have deep impact on health and livelihood of the people. It
conducts horticultural and like activities and have created a good improvement in rural
families livelihood.
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22.5 Some reflections about the Javhar- one of the work fields of BAIF.
Javhar region is a tribal belt situated between Thane to Nashik, some 130 km from
Mumbai in Thane dist. The region is well-known for its developmental backwardness and
the so called remoteness. A lot NGOs are working here. The work of BAIF is one of the
prominent.
The major tribes are warlis to west of Vikramgarh, Thakar, Katkari, and some Mahadeo
koli east to it. Vikramgadh is a place 25km from the Javhar, the ex-capital of local
Sansthanik. The region is part of Wada area. All this area is historically well-known for the
extensive exploitation of tribal people by the feudal and landlords. Godutai Parulekar has
done a historical work to built a revolutionary change in consciousness and self confidence
in these tribes, especially the warlis. She has an immortal place in these tribes.
Chandrakant a local youth and also a social worker tells that it is now not that much easy
to exploit the tribes. But overall the system and the state economy have a restricting effect
on the development efforts of the region.
As the tribes are away from the land rights as usual, despite the scanty daily wages, their
major expenses are for daily living, marriages, health and education and also highly
expensive traveling. The sources of employment are shrinking very fast. Some people with
having minor capabilities are turning for the small businesses like brick-kilns. But the brick
kilns are also becoming the centers of exploitation as they are taking place from the
Mumbai sub-urbs up to such tribal areas. As well as they have environmental stress
a Iso. Col lection of grass through hill slopes is also one conventional prominent employment.
But the rates given to that grass by the traders are exploitative. They give near about
Rs500 for five quintals and sell that in Mumbai for near about Rs 1200 for the same! Also
as the Adivasis take advances in summer season, they have no alternative than to sale
their grass to these traders with the rate which the traders say. The same thing is about
the other means of wages- the milk production.
Although the overall environment is very reach in its ecological strength the weakness of
the development is very weak there. But there are also a very big Multinationals like
Hindustan coca-cola's bottling plant ill-famous for its environmental exploitation. Also they
have nothing to do for local employment. One thing is there. To blunt the local resistance,
they give large donations to capitalists-politically related trusts, which do minor things like
bus shelter and note-books distribution..
The local people have no land-rights as well as sufficient money to invest in the
agriculture. They also have now restrictions over the forest land use. Some struggles are
taking place for the right to forest plots. Though it was not possible to get an interaction
with the BAIF office-staff locally, the living and sharing with people revealed the local
ground realities.No one is serious about the health and empowerment related
infrastructure, except few people's representatives with transformative philosophy. Peoples
are looking at them as hopes.One another thing is that the conventional rulers have
organized their voters in the form of SHGs and through that some development models
are being set. But that remains kept restricted to certain level. The upper casts do not
allow growing the other social factors to grow beyond certain limit. Also that type of way
has some inherent restrictions. One important observation about the environment was
cutting down of branches (not main stem ) of a lot of trees, especially of Arjun-saadada (
terminalia arjuna). Here comes some question about indirect exploitation of forests by the
present developmental consequences. The branches are mainly used to burn in the paddy
fields for good harvest. But the drive is much commercial. It exceeds the peoples'
requirements.
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23.
Gender- women centered efforts
Despite being half of the humanity, the woman is the most neglected and cornered section
of the society. She contributes to near about 65 percent of the labor. But she is not given
a just place and treatment in the society. Discrimination, violence and oppression about
her is a saga of centuries in the historical development and civilization of the humanity. So
whilst traveling towards a 'gender discrimination-less' society women centered efforts is a
considerable component of the health. Positive preferential approach is required about
woman, especially women from the exploited Dalit and Minority sections of the society.
However the move requires a well conscious effort.
Gender and Women's empowerment. -RN/RG
Gender sensitivity starts with individual level and capacity. Gender attitudes are
very chemoflaging. A good example of this is our text-books. There are some
commissions, omissions, and mal-importances.
Try to understand from where the differences come. Mutual understanding is
important.
Visit to MASUM was a fair experience to explore the possibilities and necessities or
women centered vision.
MASUM
LI T
. ..
MASUM-Mahila Sarvaangin Utkarsh Mandal is a Regd. Charitable Trust Organisation
working with a women-centered vision in the arid zone of Purandar Taluka of Pune dist.
and also in Ahamadnagar, since 1987.
It evolved from the groups formed for the empowerment of in the determinants
that affect their life and to build a meaning and dignity for women's life.
It takes the deprived women mainly from the marginalized castes and minorities
under its warm wings. The destitute women, the laborer women, working on daily wages
came together to support each other to solve their problems and to build a unity for their
rights.
.
,
..
The woman centered approach and trust in democratic ways may have brought
them to today's achievements.
Manisha Gupte, Dr.Ramesh Awasthi, late Tanajiappa Yadav, Nirmala Sathe are
some of the pillars of this mission run by rural lay women. Their joint co-ordination
committee including these women takes the decisions.
•
The aims and objectives can be outlined asEnabling the women for their employment and self-reliance. Providing vocational
•
training and financial loans for that.
Making them aware of their rights, constitutional rights, human rights.
•
•
•
Improving their physical and mental health.
To generate a place in society based on equity for the destitute, downtrodden,
marginalized, minor section of the society. To resist the casteism, gender biases
and religious divides.
To work for sustainable development in rural Maharashtra through peoples active
participation.
To achieve these goals, MASUM runs various programs. The healthy life of rural
women has a central place in it.
•?
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A majority of programs directly and indirectly work for its determinants. Some of them
are as following-
Lokseva Aushadhalaya (Pharmacy in the service of people.)
It makes available essential generic medicines for the people at low cost. Trained
village women run these centers. These centers are functioning since 1990.
These centers are proven to be very useful for the local population as the
commercialization of medicines, especially branded medicines is on an increase.
Feminist Health centerIt is situated at Taluka place-Saswad. It provides treatment for women's illnesses.
Both the Aayurvedic and Allopathic medicines used. Aayurvedic medicines are prepared at
the place. Antenatel care is given. But the real benefit of this center is beyond the
medicine. It provides a space to express the women their feelings, problems and
difficulties. It promotes consciousness in woman about her body as well as the mind. It
works co-coordinately with the government health services.
Sadafuli CentersThese are found at village level. It provides the medical service as well as the
health training to selfhelp in health. The training to run such center is also provided which
runs for one and half year. It provides the same space to women to express their feelings
and share the problems. It helps in self health check-ups and self-medication too. It
spreads the knowledge about health, physique, exercise, Aayurvedic treatment, etc. the
center carries various health issue based camps. Cervical carcinoma of uterus is one
important issue. For that regularly low cost Pap-smear camps are conducted. The center
provides health and physical education to the adolescent girls about their body and the
rights.
Tailoring classIt promotes self reliance in adolescent girls but is also much beyond that and
conveys the vision of MASUM, especially about their social as well as self mind and body
consciousness.
Raanpaakhare program- this can be considered as an extension of above activity. It forms
groups of boys and girls, disseminates the education of values like social awareness,
responsibility, solidarity, democracy, gender equality etc, through various plays and
medias. It tries to root out the psych of violence very from the childhood.
Samvaad-Domestic violence resistance and family guidance centerIt is run at Taluka place-Saswad. Extends health and support to women to resist
domestic violence, injustice, exploitation. It also provides legal help. It works coordinately
with other such organizations and movements.
Saathi is its same activity which works at village level. The training to local
volunteers is provided in this regard.
Antiaddiction activityIt is also taking place and de-addiction groups are being run as the issue have a great
intesectoral impact- including ill health and domestic violence.
37
Tarang CenterFor a healthy mental development as well as treatment of psychological affections,
MASUM runs Tarang center at Hadapsar with the help of specialists. It uses various
methods for the positive development of the child. Parents are also included in the
process.
All this requires a potent economic empowerment and unity of the activists,
participants and the recipient section of the society. Forming the self help groups of the
women is most important activity done. It is called as "Stridhan Vikaas Project". Near
about 4000 women have came under this activity which provides them financial selfsupports for empowerment, employment and development. They take their own decisions.
Two women organizers from every village look over the work of SHG.
All the activities are implied through this structure. Some of the important activities
are Tailoring class: as mentioned above.
Handloom center:
It is one of the spectacular activities. It is run by the women who were provided
with training and handlooms by the 'Tricem' scheme of Govt. The product is marketed by
women themselves in Pune Zilla Parishath's Savitri marketing center as well as through
various sales exhibitions.
A Krushidhan Vikaas Program is also conducted. It advocates local and improved varieties
of crops, sustainable and low-consumptive agriculture. The side occupation like poultry is
also promoted.
A special program is being conducted for the welfare of tribal communities in
Parner taluka of Ahamadnagar dist.
Rural information center at Ralegan plays a vital role in rural transformation.
Visit to MAHILA SAMAKHYA, Karnataka, Bangalore, with SJ Chander, resource: Kavita
gave some additional information regarding this. Its basic focus is on women's health
through empowerment, especially by forming the self-help groups. It is the Govts' own
effort to organize the women. It is limited to 8 states. It shows How women can be organized through self help groups
Districts like Bellari have strong paradoxes
Govt initiated efforts also have their own policy contradictions.
38
24.
Community Participation and empowerment f primary health delivery and its
aspectsCommunity participation, especially through women, with preference to oppressed classes
is important and effective. One example of such an effort is from FRCH in Purandar Taluka
of Pune Dist.
Visit to FRCH revealed that
The health is perceived as a promotive, preventive and curative entity and not only
as a medicine.
The campaigns are not like the chalo-delhi or that type, the resources say. They
are basically addressed to health, environment etc. Many times they come from the
thinking of the grass roots workers that is Tais.
No any specific determinant is stressed. Every part of health is given a reasonable
importance. Occasionally the interventions required at community level mainly at the time
of outbreaks and epidemics as like the recent epidemic of Chickengunia. Diarrhea in
summer etc.
Right to information is one of the important thrust issues.
EmpowermentThe community and the community representatives are empowered in maximum
aspects. The most important representation is trained health service provider i.e. Tais.
The peoples participation The services provided and the issues taken are generally raised by people.
It is told that, besides the health service, various activities undertaken are that the
people and the health workers are encouraged to express their feelings, ideas and
problems. For that various activities are conducted e.g. board writing.
The anganwadi-khelwadi promotes the health information and health, nutrition
messages.
The issue of addiction is taken only if it comes from the people.
Local health traditions- are actively used in health service and people are
encouraged to use them. However the use of allopathic medicines seems to be dominant
one.
A special attention is given in using local anti diarrheal herb as the problem
increases in the summer when there is scarcity of water.
Environment:
Various environmental campaigns, school campaigns are conducted. Camps at
nearby fort Purandar are arranged at which important faculties are invited to train the
participants like medicinal plants, birds, snakes, etc. Also the education of organizing a
camp is given.
The TAIs
Trained village health service provider i.e. Tai is central to all the efforts in health. It has
set a good model for the other organizations. Representatives of various organizations are
39
sponsored by their organizations to come here and learn their working and get exposure
with the overall activity. FRCH has a good history in this respect.
At Parinche, FRCH started the training of local Tais in 1995 for diagnosing and treating
common health ailments. Today the work has come to be a role-model for others. It is
now spread over three villages- Parinche, Pangare, and Kaldari. The present batch has
nearabout 40 candidate, the older one has 30 and batch before that, nearabout 10
candidates. FRCH is also have contribution in health initiatives at Ralegan Siddhi.
Criteria for selection- Semi-literate local, married, village woman who can spent some time
from her daily routine work, who is respected within their community are selected.
Purpose- is to provide diagnosis and treatment of common health disorders in the area
where they are scarce and expensive. It has now extended to the spread of message
about environment, culture and education, public information.
They carry with them the allopathic and aayurvedic medicines, dressings and
antibiotics, and primary diagnostic equipments for blood testing e.g. Hb. They also provide
veterinary healthcare.
The start-up:Dr.N.H.Antia of FRCH a personality with a great sensitivity while working as a surgeon in
Mumbai, moved at heart by the patients coming from the rural Maharashtra to Mumbai
for the treatment. So he started to work on providing some basic health service at the
grassroots level in villages like Parinche. As a part of that effort the present structure of
the village health worker-Tai came into existence. All the health initiative is a journey of
about 30years. The Parinche project has a foundation of experiences at villages like
Mandva, Uran, and Malshiras.
The key factors :Providing the right information to the people- however technical let it be and
however simple the people be- they use it with great effectiveness.
The training:It runs over near about land1/2year. Thrice a weak, trainees gather in the morning at a
convenient place like tree, temple in village etc. with their lunch and children.
Training sessions based on discussions about theory and practical. Live exposure is given
in fields.
During training they are provided with some monetary supports of Rs.20per day, 40per
day when they survey in community for FRCH. For the health services Tais provide,
community has to pay.
Tai's experiences:Learning at sessions is easy. Even diagnosing and treating after experiences is also easy.
But tackling societal problems and coping with community members and families is much
hard work and painstaking. Initially the villagers resist. As they pursue their motives, very
often the villagers and families turn friendly and responsive, especially when their much
neglected health problems get touched. Sometimes about the treatments also, initially the
people do not trust but as they experience the usefulness, they trust.
Health services are not dispensed at free of costs. A very nominal fees of Rs 5(if antibiotics
are given, RslO) is charged. The Tai provides receipt and money earned is used for the
village.
Structure:Each Tai is assigned for nearabout 50 houses near her residence. It eases the conditions.
Near about 1:3 Tais are upgraded as Sahayoginis,depending upon their experiences.
40
The activity mainly is based at Khelwadis- the informal schools for children or modified
Anganwadis.
Allied activities:There are allied activities also. Khelwadi uses various forms to spread the message. It
carries get together, festivals, cultural programs, personality development camps, etc. the
school children and teachers play an important role in assisting the Tai.
The ecogroup is not only concerned about planting the trees but the water conservation
also. Sanitization, pollution issues are also addressed.
The information service provides information to villagers about various schemes. Tais also
produce their own information leaflets.
The public bulletin board provides the space for the queries from the villagers.
Libraries at centers generate interest in reading. This service is not free. But it considers
the economic status of the local communities.
Small savings activities are conducted, collections starting from RslO. loans sanctioned as
per priority of the need.
Systematic documentation of all the work is done. It also helps in identifying demographic
trends.
Policy intervention
Apart from impact on local issues, the Tai model has provided inspiration for various other
people in community health.
Empowerment:The Tais reflect their confidence and change in their life. They have succeeded in earning
some identity. There is also an increase in the consciousness to pursue further their
education. They are now spreading their knowledge to others.
Pluralism of community health worker
As Ravi Narayan and Rakhal G. mentioned earlier with a Ppt presentation: A quick review
of CHW in India
From Bhore committee to today's ASHA, it is a journey of acceptance of 'medical assistant'
concepts and even today's acceptance of CHW beyond nurses.
Foilwing things are important about a CHWAims of CHW
They can do the complicated works also.
What is CHW?
Various perspectives at CHW-in the society
41
25.
Shelter and Housing as an important determinant of Health
The shelter is a strong influencing factor in any one's health. It is the home or
house that protects, pampers and gives a place in society for an individual. Today the
housing has become a major struggle of life for a majority of masses as the pricing of the
houses are going to touch the sky. It has become impossible for common people to have a
shelter in his life. The marginalized population in today's so called developmental and
social processes is getting thrown out of such basic needs. It influences badly the health of
an individual as well as the society as a collective. There is a strong and serious effort of
thinking and acting radically on this problem at all the levels by some movements at it is
closely related to the rights of the people.
Godutai Parulekar Mahila Vidikamgar Cooprative Housing Soc.,Shoiapur
A history happening in Pro-people Housing!
Sholapur - a major district city of Maharashtra is famous for its droughtfullness,
mills, handlooms, power looms and cottage industry. One of them being the bidi
production industry, employs lakhs of workers especially women and that to from the
backward classes of all the religions. The Sholapur are also known for their workers
martyrdom in freedom movement. Sholapur is also known for the impact on new economic
policies producing a large number of seek small scale industries.
These workers have a great impact over society here. Now they have set a directive
example in the form of Asia's probably largest cooperative housing project. It is for the
bidi-workers all own by the women.
Recently keys of 10,000 homes got handovered by the hands of Prime Minister
ManMohanSingh to their proud owners.
This project has caused positive impact not only on "shelter and housing" determinant of
healthy society but also on other determinants like social factors, solidarity, initiatives, low
cost housing, new people-accountable cooperative concept, peoples participation and a
great push ahead for social security for unorganized sector. In fact, this last is being
considered in present scenario, a major achievement because it will cause an impact on a
very large scale through a basic thrust.
The Prime Minister said, 'this project is a model for all the workers. It should be welcomed.
Due to govt's accountability to common minimum program, initiatives like National Rural
Employment act have been taken, which will soon be expanded to remaining country.' He
said, 'for the welfare of the workers, yet a lot to be done by which they will get benefited
in their illness, old age, etc.'
This 62crore Rs. Project is an ideal joint venture of workers, state govt, and center.
This 10000 houses housing project have three main clusters. A general housing unit is of
555sq.ft. Of it, 255sq.ft. is single storied R.C.C. built area. This contains a hall, kitchen
and separately toilet bathroom. 300sq.ft. area is open space (with full of dreams of flowers
and tender touching, healing plants to be brought into reality once they start living!).
The project also considers facility of hospital, school etc. And of course these
considerations are also provided with some different concepts and perspectives! Also
health hazards of tobacco and bidi are to be tackled. The govt, policy discrimination
42
between bidi and cigarette which favors more to cigarette are being fought and also a
dream of definite rehabilitative healthy employment is being struggled for.
The strong driving force behind this historical achievement is united progressive
consciousness built by citu under the leadership of people guided by Narasayya Adam
master, and a women organization called AIDWA. Adam master is himself is a son of bidi
worker woman and his father a mill worker. In fact, all these people have like a very big
'family' appearance and feel! That has also an importance in another respect as Sholapur
is very often being targeted by the communal forces.
These people have to work hard to meet their daily needs. So the dream of their own
home is really can happen only in dreams. But here the dream has came into reality and
has become a role model with a sociopolitical impact.
After this achievement, the women are concentrating over the next struggle. This
is aimed at broadening of the united march ahead in the participative and all inclusive
development of this homogeneous community, in the interest of the working people there.
The eye over the building of a health service infrastructure, as a part of it, here is also not
only being visioned as mere a chemical-medical model or all burdened on this community
only. Besides efforts for building hospital as a health facility there, it is being considered
much beyond that.
A lot such visions are behind building such a unique model colony. That's why it was
appreciated as wonderful in Geneva international convention of labor organizations. The
project is being discussed in every country now.
The project is also a unique and important example of the pro-people elaboration of the
govt, by working people's initiatives. It is not a thing under the name of alternative being
imposed on working class totally to rise, but a good and balanced summation of overall
social responsibility. Of course it is a part of such initiative. The struggle for social security
for the unorganized sector is main key issue presently. What to say about medical
security? Presently after contributing 50 Rs.as premium, the state and center contributes
50 and 100 Rs each to it and through it, an insurance of Rs llakh for accidental death, 25
thousand Rs for expenditure of wounded person is being given. But all this is too much
away from realities due to various obstacles and also very inadequate. So it is a major
struggle being fought.
The women's collective leadership like this is being considered as an alternative for
the pro-people rehabilitation projects like that of earth-quake victims. Technological cost
effectiveness achieved by dedicated building firm of Anil Pandhe is being considered.
Various 'constructive' capacities are being hoped and identified by social and socioscientific personalities like Arun Deshpande. It is obvious and necessary to make an
exception of people like Adam master to individualism, as he is the 'rock wall' behind the
young bloods hard working for such a human achievement. The organizational force of
AIDWA has put the 'different' social dimensions in this project, moving it to be a
movement.
The shelter has a deep impact over social and individual health. It is a major determinant
of health. In a vicious cycle, it has a dual role- a cause as well as an effect.
The shelter is a basic need of civilized humans, the common people. But as like the
other needs, its fulfillment has became worst today, very similar to other things, due to
43
the highly commercialization and market based economy. The resources with respect to
«<=
of
income in making a home. All this have very negative effect on health. It is a major part
the peoples struggle for living and livelihood.
This example from Maharashatra has brought a light of hope in the eyes of crores of
workers, especially the unorganized ones and those moving from rural to urban slums.
This example is a solidarity beyond religion and achievement beyond god!
These really sweet cooperative homes have chosen their name as 'Godutai Paru ekar
Mahila Vidi Kamgar Sahakari Gruh-nirman Sanstha'-the name Godutai is a er a a e
veteran lady who devoted her life for building a strong movement and consciousness in
extremely exploited Warlis -theAadivasi peasants and landless bound-laborers. A lady t a
raised a movement of farmers and that too aadivasis, 60 years before with her husband
Shamrao Parulekar!
Today once again the same spark of hope has glowed in the eyes of the workers.
The reason on mentioning this work here is due to two thingsOne is that it has made a great impact on the lives of bidi workers. This project is no
considering housing as a 'totally people's responsibility that is to be met via the mark^/
but also the state responsibility and people participation in decision making. Another thing
is that it is considering health as its major part of the movement, but not deviating from its
very basic determinants.
One thing I can not resist to mention. That Jimmy Carter, the ex-president of US came to
India. With the help of the some national and international NGOs and celebrities, recently
he constructed some 100 houses for poor in village Malavali, near Pune. A vast media
coverage was given and even being given to that thing. It is the same country-US whose
strategies allover the world has resulted in the homelessness for millions! Their bombs and
warheads destruct a vast sweet homes in the world, for ex. in Palestine. There is no any
consideration in media about the Solapur people's efforts. Both these examples are worth
to compare to find the 'tendencies' of the happenings!
44
26.
Some aspects in understanding the SOCIETY:
It functions like our body. Distinct parts but no part separable.
There are six main organs of society.
Social. Economic. Political. Religion. Culture, Ideology,
Dams, flyovers all are for Brahmins, kshatriya, vaisyas; not for shudras.
LESSER HUMANS: a documentary shows a very realistic picturization of scavenger castes.
It reveals the situation, reactions and emotions of a community for which the society has
denied even humanhood.
Article 21 of Indian constitution asks for a right to life with human dignity. Where
is it ?
Social exclusion in India and the inclusion policy.
k lecture delivered by Dr. Sukhdeo Thorat at Pune on 19th Nov, 2006.
The citizens from pune decided to honor Dr. Sukhdeo Thorat for his selection as a
Chairman of UGC. But on the background of Khairianji incidence in Maharashtra, he
decided not to accept the honor but to deliver the lecture in the same ceremony on the
social exclusion and caste system in India.
He said, "Khairianji is a tendency. Near about 23to 24thousand atrocities occur every year
in India against dalits. Also the thing is that not all cases get registered. Caste related
inequality is yet there. The exclusion and untouchability has taken new forms. The
question is why it is there?"
Then he gave some brief information about Dr.B.R.Ambedkar's chronological analysis
about caste. "Why the violence against dalits exists? Though there is a legal way to
register a complaint or case against a individual, the direct violent mass attacks on dalits
are rising on. The analysis of this tendency is necessary. There is constitutional equality for
dalits and equal rights for dalits. Although it is so, they are restricted from using these
rights. A difference is made in the temples, working places, wages, and the all society.
Why it is so?"
Then he gave some characteristic of caste with references from Dr.B.R.Ambedkar's work.
1) It divides people in groups.
It divides people's rights.
2) It divides rights unequally.
It divides rights hierarchally
3) Caste provides mechanism to enforce the caste.
Use of violence is justified.
4) Don't blame people, blame religion.
He told how these characteristics are necessary to be taken into consideration to fight
against the caste (rooting out the caste.).The remedy should base on this
"Gandhi did say that, untouchability has no relation with religion. But Ambedkar denied it
and firmly pointed out its structural base in religion. Caste system has its base on social
ideology and also some elements of the religious ideology like 'karmasiddhant. Also we
45
will have to be aware that the analysis by Dr.Ambedkar is based on the politics of that
time. The thinking on social exclusions came in economics in near about 1960 and even
more lately to here. Babasaheb advocated the principal of individual equality/liberty in
western culture. But that requires some legal safeguards (state). Here British made various
laws also but in social life dalits found no rights. That's why Ambedkar required doing the
Mahad satyagrah. As the law alone cant do every thing,(here comes the place of
reservation also, it gives due share.) the social education is required- education not of
dalits, but of higher castes.
Protection against discrimination and protection against economic exploitation is required.
For the latter socialism is the answer. For its safeguards, state is required.(State
socialism). But alone one sided struggle will not solve the problem of discrimination. As
social and cultural behavior of people is dependent of caste, even violence is being used
for that, so these cultural rules will be required to replace. Mao also was aware of this
thing that, cultural norms change very slowly. We thought reservation will do everything.
Reform of Hindu society is necessary. State will have to do this. Along with economic
struggle, this will also have to be done. We require social engineering. Destroy believe in
inequality!"
27.
2nd World Ayurved Congress-2006, Pune
Mere commercialization- in the name of Ayurved Propagation
*
The 2nd World Ayurved Congress (WAC)-2006 happened at Pune University. People from
all over came their in the hopes for propagation of Ayurveda and the Indian systems of
medicine. But the picture there happed quite different despite the large coming together of
people. There was a very shameless hijacking of the govt, and people's efforts by certain
powers included. In exhibition section nearly 170 companies and aspired-to-be companies
participated.
The section of the free lectures was open to all but lectures arranged there were only like
false analytical pravachans and all the Pravachankars were prominent personalities related
only to the parent organization. These lectures were organized in the main huge and
expensive, glamorous pavilion specially erected.
The inauguration ceremony of exhibition happened with the hands of Health Minister
Dr.Ambumony Romdoss.
The important announcements he made there were-announcement of compilation (?) of
TKDL (Traditional Knowledge Database Library), proposed formation of special planting
zones for medicinal plants (very similar in all aspects with total-private-controlled s.e.z.s!
Who will benefit?-only mega companies and not common people or even Ayurvedicians.).
He also revealed the necessity of some scientific work for the new age. The publication of
Ayusoft was suspended at eleventh hour- the conspiracy yet unfolded. The reason given
after was that the fear that what to do if any one arises the objection based on patents
issue. This is either ridiculous or it reveals the lack of confidence of organizers in fight in
this field due to distance from the people or a conspiracy which the organizers or the
46
developers- CDac may know. But the same software was made available in the exhibition
pandal.
One prominent physician, who propagates theist ideology and Ram but having a large
corporate attitudes delivered his lecture.
On the next day (6th Nov.), St. Shankar Abhyankar delivered main lecture. He is one of
the new generation's babas. In his speech he was not concerned with common people's
ailments. He was much concerned about those who are getting food then the need. He
was not concerned about those who were not getting food even once in the day. His
deferring 'greed' for money also included 'need' for money. Vijnana Bharati secretary was
the chair person.
All are worried about the tensions and ill health created by the diseases, as they have to
encash it. But no one has to do anything about those who has lost even their livelihood in
this speculative capital-led globalization. The same high class worry was found in the chief
lecture of the next day (7th Nov.) delivered by Rajeev Dixit of Azadi Bachao Andolan.
His another important failure was falls-analysis of the Darwin! So these are the
Indian followers of the non-realistic American creationists. He put himself above the
Darwin. How can we go for a change in people's status without accepting the process and
possibility of change? There is a major contradiction that they have to be with these new
winds of scientificity but at the same time they do not want major changes as then the
change in monopoly will be obvious. Also then the very basis of their considerations and
arguments and will be routed out.
On the same day there was the farmers meet. It also was have to do nothing with
the suicides of the farmers. The prominent presence was of the leadership of higher class.
No common peasant seen any where, only some 'aspired' cash croppers, irrigated big
land-holders were seen.
On the next day (8th Nov.), one good thing was that Prof. Edwin Cooper (kuper) revealed
the necessity of scientific basis to publish Ayurvedic literatures in international journals. He
is from the Oxford University's Publication dept.
The main lecture was delivered by a well established saint Swami Swarupanand. Nothing
new, as usual, he hammered the same propaganda- science can not deliver the peace,
only (their) spirituality and peace of mind is the way for psychological health. His subject
was 'Ayurved and psychological health'. All the prominent trading personalities in this field
accompanied. They damned all the 'expectations' (basic needs included!) and as usual,
blamed them the cause of sorrow.
The chief lecture of the next day (9th Nov) was delivered by Dr. H.V. Sardesai, one of the
glamorous physicians, who gives examples from Manusmruti, repetitively and projected by
corporate media here. Being a doctor, his lecture was to some extent, relatively better.
On the next day, (10th Nov.) conference started formally.
One important session of the WAC started with, Dr. Raghunath Mashelkar, stressed on the
necessity of scientific methods in Ayurveda. He outlined the govt, efforts in this field. Work
on the issue is gathering speed in 6 National Laboratories. He expressed the need of
studying Ayurved in biological form and identifying its strong points. He was accompanied
by some computer specialists, who has a major influence in the corporate and commercial
field. After using science (rather, his own selective techno-stream), to climb a higher
47
position in society, he is now advocating the theist spirituality. Now-a-days he is getting
purposefully projected in Medias. Also persons coming from the toiling masses seen
captured by the conservatives and now they have nothing to do with the real 'movement',
as they do enjoy the position given by the present system controllers. Such personalities
need to be analyzed and mentioned here because they make major effect on the policy.
This important session concerned about three main issues- Traditional Knowledge and the
novelty, Intellectual Property, and Integrated Treatment.
The Energy and Higher Education Minister of Maharashtra, Mr.Dilip Valse-Patil announced
that the separate private university of Ayurveda will come into existence after the 'Bill for
Private Universities' gets passed in coming session of State Assembly (All the pro-people
progressive movements are opposing this bill as it is charter for further commercialization
of education.).
The common people on that day got burst on the bad and chaotic functioning of the
management of the event. Media also required considering this.
One important seminar on 'Ayurved in 11th plan' and 'predetermined' Lokadalat was there.
On the day, also the subject 'Ayurved- curse or boon' got discussed. That is actually to
establish it either black or white- totally! All the discussions were going in a certain
direction. The output remained questionable.
The next day (11th Nov.) was important. Two important sessions require to be mentioned
are, one-Science initiatives in Ayurveda' and the other a seminar (one by one
presentation) on 'Integrative medicine' were there. Both of these were having deep
shadow of commercial and negative conventional forces. Various patrons from bigger
Aayur-pharma companies and allied institutions were there in session on science initiatives
in Ayurveda.
Overall, there is a quest (mainly based on necessity) to give scientific exploration for
Ayurvedic processes. (It can be there, it is nothing much wrong, in fact the pro-people
developmental cults in Ayurveda were trying for the save, but they were getting heavily
criticized even 10 years before. Also being a Medical Science and based on matter and
material body Ayurveda has very good possibility for that, truly speaking it is Aayurveda's
nature by default!). But near about every presenter was found to be only changing the
external form and language of the subject, within some given arbitrary philosophical
limitations. The presenters selected seemed to be much planned to this 'limited outlook',
ultimately supporting the conventional rigidity and interests of super-naturalists. This great
contradiction is there while going scientific.
The concepts which can be and required to be expressed in scientific language is the
victory of science first, and the scientific ancient efforts in Ayurveda and not that of ruling
super-naturalists considerations.
Influential individuals with such irrational mixture strongly advocated to bring 'Neotheological' trends in Ayurveda! (in the sense according to them, just externally changing
the appearance). One multi-patents holder personality and CEO of a big pharma strongly
advocated individualization of research work and condemned the research in public sector
and govt, laboratories and institutions tagging it as institutionalization of Ayurveda(
another meaning!)!
At the session on integrative medicine, the previously mentioned 'mix' personality told to
integrate Ayurveda to big instruments used in hospitals, as people are crazy for it!( This
explains his corporate orientation as well as real 'spirit' also).
48
The mega-lecture series got concluded with long lecture of K.S.Sudarshan, introduced as
chief patron of Vijnana Bharati- the convener. Very intelligently he propelled his ideologies.
He told a story in which he told that Shahjahan was provided with one English physician,
who applied Vaseline( ? it is a trade name) to burnt skin of Shahjahan's daughter and gave
relief to her. Happy Shahjahan told that doctor to ask for anything. He in turn asked for
permissions and subsidies to british to trade here, and Shahjahan gave that! (We don't
know what happened to Vasco-da-Gama!) Whether this is true or falls is a subject of
Historians. But K.S.Sudarshan projected this 'Muslim' king and british allopath purposefully.
Next, he gave in brief the development of science in west. He projected that
development 'against the church', (ok, it may be, but he stressed it with a different
meaning- very intelligently! What a duality with same purpose! And who were here against
scientists and medical scientists here in ancient India? Who did boycott physicians due to
their mixing in all type of people? Who established a Dharmasutra here that 'puyam
chikitsakasy annam'- food of physician as impure? Who killed the scientific progress in
India? Who tortured Aaryabhatta?.. a lot.). He said that all western science based on the
consideration that there is no necessity of god and ultimately these science people are
now saying that mind and body are interconnected. (Then what is wrong? This proves
mind's material basis. Your precedents were saying that mind and body are separate! Body
is 'paarthiv'-material (that even Maya!) and mind-'ncnmaterial-spiritual'. He was having
some major contradiction in his talk.
He also projected that herbal medicine is an obstacle in progress of Ayurveda, as
according to him, Chinese medicines are based on active ingredients. (Recently a new cult
of say is there, which tries to distinguish herbal different from Ayurvedic. Those
preparations that use active ingredients of plants specifically are being tagged as herbal
and differed from Ayurvedic. Actually the issue is not established scientifically yet, and
there is a mixture of advances in benefits, rise in risk, and specificity, and efficacy etc. It
also provides some definition of standards and scientificity. It is yet to weighed against the
'biological form' of medicine. Biological form itself has yet to be clear concept. But this
concept also has some genuine experiences, simplicity etc. So the difference is not that
much philosophical difference. What he is projecting from behind this is a different thing.
Also we can not rise by showing others inferior.).
He appreciated India's geographical variety and diversity. (Then, why not to accept
people's diversity and unity from within ? Why to press upon them certain vertical
uniformity?)
The reason of bias over division of health budget on allopathy and Ayurveda, he
told was the Health ministers this country got like Rajkumary Kaur- who was a Christian,
Maulana Azad- who was a Muslim. (He specifically and clearly spoke this). (Then what they
did in their rule? Who augmented the MNCs and finance capital to flow in?).
According to him the beurocracy is a major obstacle in progress of Ayurveda.
He calculated out 2011 A.D. as year of India's victory in world. (What happened to
Nostradamus? And what to do with farmer's suicides?, people dying of medicine, food,
unemployment?, getting vanished from this rosy frame of superpower India?).
Thus direct-indirectly he revealed all the attitudes behind happenings.
The last day of the congress (12th Nov.) gave concrete basis and outputs to Vijnana
Bharati and its 'owners'.
Along with all the leaders projected in the World Ayurved Congress, on the
conclusion ceremony social welfare minister of Rajasthan Madan Dhilawal and Gujarat's
Health minister were present. Pune Resolution got passed.
49
From the finance collected, a 'Dhanvantary Bhavan' will be erected in Pune
University. In that building a regional office of Vijnana Bharati will be started. This office
will regulate and plan the Ayurved movement. To control all the work there will be joint
advisory committee of Pune University and Vijnana Bharati. Next world Ayurved congress
will be organized in 'Rajasthan' in Nov.2008.
And thus happened theWAC-2006.
After coming out of the hangover of the glamorous treat a large number of Ayurvedicians
are now asking ..Who benefited? Wasn't it mere commercialization of Ayurveda? Does
Ayurveda mean only big Pharma Company and export? When Ayurveda was so narrow
minded about people's religions? Ayurveda or any material medicine is basically based on
humanity beyond all the borders. Introduction of certain narrow and fanatic tendencies in
such a new era have really shocked the medical fraternity.
Who is responsible for this?
Clearly the rulers are responsible for this. So openly the govt's good idea of
nurturing Indian System of Medicine got hijacked and it actually nurtured different things.
The AYUSH dept, got employed for strengthening different bodies, rather than nourishing
the AYUSH! The fight of pro-people movements resulted in increase in health budget from
six year before's 0.9% to present goal of 2 to 3 % till 2009. This money has got such a
misuse in the name of Ayurveda; cheating Ayurveda's philosophical principals. Not a single
word has come here against this type of process even in pro-govt, media also. Are the
rulers really unconscious about this? Why they kept eyes closed? This good event also
could have been arranged in real favor of Ayurveda besides such people. Besides them,
there are really the movements and organizations in this country working on Health since
a long history, which have made historical differences.
28.
Visit to CHRD
[Community Health Research and Development]
It is unfortunate not to find any opportunity of an interaction with Dr.Mutatkar.
Dr.P.M.Unnikrishnan from FRLHT insisted to meet me to him. I indirectly have found and
learned to some extent about what CHRD efforts in community health.. But I was and is
much willing to get interaction with such an organization. I tried a lot, but failed to get an
opportunity to get introduced with them.
29.
Rural health: current dilemmas
A discussion. At:
Indian School Of Political Economy ( Bharatiya Arthvidnyanvardhini).,Pune.
Dt. 6th November,2006
Discussant- Dr.V.Sitaramam, M.B.B.S. Ph d. (C.M.C. Vellor.)
Preparation with: T.Krishnakumar. Ph d.IIM, Bangalore, N.J.Rao,M.Tech,Bangalor.
Rajaratnam Abel, M.B.B.S. Ph d. Vellor.
50
The extract of proposed discussion (as circulated before), was"The rural Indians with increasing income incur out of pocket expenditures related
to health twice compared to the urban, while the incidence of disease is comparable. This
phenomenon could indicate, worldwide, health expenses as a major threat to people at
limiting incomes. The hierarchy inherent to expenditures alone did not explain the higher
degree of rural expenditure on health. The phenomenon is consistent with social
exploitative origins. There is an urgent need to control the number as well as quality of
medical practitioners on one hand and empowerment of women in managing household
expenditures on the other."
Response:
There was no clear revealing of relations with the determinants which he just
mentioned i.e. exploitative origins and empowerment of women. It seemed to be just a
'conventional' or 'traditional' mentioning of these things. The time was too much short and
the queries a lot. The discussion was restricted to a very restricted sector.i.e. the
expenditure by rural population. No its connectivity to policy or all the structure. The
considerations seemed to be much vague. The presentation was so much fast that even its
strong arguments also were difficult to identify and catch. Of course that may be our
shortcoming. It looked lost in complex graphical and equational presentation of even
simple thing (overinstitutionalization?). I got no clear vision of what he said. There was
one debate whether to take the latest round of NSS as the foundation or the trend from
some of the last rounds. (It was not based on actual field work). I personally think that
there is certainly difference when you show the actual mean figure in Rs or you mention it
in 'percentage'. Both have their own importance in their own circumstances. When we use
percentage to show the expenditure, then it has really good expression; because it gives
comparison with whole or some other either expenditure or income.
There are various possibilities- If there are no public health facilities available, people will
obviously have to spend more on health.
It also is related to the quantity of income.
It there is no money in the peoples' pocket then they can not spend more despite of all
the things.
Some put forth the necessity of non-governmental organizations now onwards to
implement health facility.
I tried to put some dimensions on social determinants of health and the responsibility of
state, people's participation in the decision making and elaboration.
I thought the presentation was only having look and form of'scholar'. My own perception
is that, the health expenditure is also a major secondary contributing factor to increase the
farmers' suicides.
Our selected work should also reflect our broader perspectives.
30.
Informative inputs received from AIDANr MFC Meets and the PreNHA -2
preparatory meet. These events were coming together of various health activists, health professionals. It was
a revealing of past present and future happenings about the health.
The AIDAAN meet (National Tb Inst.,Bangalore) was most useful as far as a view action is
concerned because it addressed a very key issue from the people's immediate point of
view- the access to essential drugs and drug policies.
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**
Similarly the PreNHA-2(BGVS office, Bhopal) preparatory workshop was useful for the
understanding of the context for peoples planning of the health and the Jan Swasthya
Abhiayan's responsibilities.
31.
13-15 December 2006
Traditional Medicine & Right to Health For AH
South Asian Regional Conference, Bangalore.
The three days' South Asian Meet on Traditional System of Medicine at Hot.
Monarch, Bangalore was really a memorable and learning experience. Participants from
various countries were working with different aspects and sectors in Indigenous Medicine
and Traditional Systems of Medicines. They came together despite there levels of working
for the welfare of the TSM and for the interest of community health.
As they shared their knowledge and work experiences and the problems, the Meet
formed really kolas of the cultures and the closely associated TSM throughout various SA
Countries.
The important thing to note here is that it was not only coming together and
sharing concerns in TSM, but it also tried to build a great feeling of solidarity and
confidence as well as pro-people consciousness in the TSM fraternity.
However the meet found to be much packed with the fast moving power-point
presentations and the deep discussions on single issue up to certain level of consciousness
found not that much just time. This appeared to be somehow lost in marathon. A lot
issues got only superficial touch and mere mention, e.g. the evaluation of safety and
efficacy of traditional medicine, the directions methods and bibliography of research,
research methods and ways in TSM in today's context etc. Effort to coming to conclusion
and upholding a draft of concerns also seemed to be very fast and unsatisfactory for
some. Over prominence of allied activities may have added the effect.
However this can be considered obvious due to shortage of time. Despite these
few shortcomings, the overall effect of the TSM meet was very encouraging as it assured a
possibility of considerations for contribution by TSM for community health in new contexts.
It also created a ray of hope to fight against the new commercialization like
invasions on TSM as an effect of speculative capitalist globalization. In this case this
requires very well differed from the recent World Ayurved Congress. But at the same time
some threatening threads may also make appearance here also, which are actually a
mainstream there.
The meet was to be replicated in various other South Asian countries.
In the inaugural session, the experts like E.Pupulin, Maria Pia, Anu Dhindwa, Mr.
Jose gave valuable inputs and guidelines for the conference and the work in future.
Then there was a session on revealing the condition and status of TSM in various
South Asian countries -mainly Bangladesh, Bhutan, Nepal, S.Lanka and India.
Then was a session on
Role of TM in promoting wellbeing- views from grassroots.
This roundtable put forth the actual happening in TSM field on the front of mitigating the
needs of community health.
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Then four roundtables on four major issues happened.
1. Achievements and challenges in networking across the domains on TM in SE
Asia. There was a good discussion on this issue.
2. Biodiversity and sustainability issues in communities.
3. Conducting research on safety and efficacy of different TM therapies.
This roundtable discussion was quite useful, especially the unique effort made by Dr.
Tannaz and her team in showing the seasonal variation in efficacy of plants. Such scientific
efforts-despite controversies are the necessities of the time for TSM. Dr. Shankaran also
revealed some key issues about the trade and FDA role in relation with the subject. That
requires to be taken seriously for the international campaigns.
4. Role of TM in the strategy of "Health for All"- this roundtable discussion shared
the experiences and achievements and challenges. This session can be considered as the
most useful. This roundtable discussed the actual application of the discussion to the
welfare of the society by means of the strategy of "Health for All".
The concluding session tried to formulate the draft of voices and activities.
Dr. S.Deepak who with his team took a great pain to make this conference take place,
cheered the participants of the TSM fraternity for their solidarity towards the Health for All.
Visit to Govt. Ayurved Medical College, Bangalore:
All the team that participated in the TSM Conference visited the Govt. Ayurved Medical
College. The students and teaches were so glad to arrange this part of conference there in
campus. They gave a grand welcome for us. It was a nice experience to share the
feelings, happenings and dreams of past, present and future.
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32.
A vertical decision found useful for people in Tamilnadu.
Visit to Dr.Girija's Sanjivani Ayurved Clinic, Adyar, Chennai.
It was a very useful visit. Discussions with Dr. Girija. revealed some important information
about a govt, initiative to include indigenous medicines in primary health. Such an activity
has taken place in Tamilnadu regarding the mainstreaming and use of AYUSH in Public
Health. Govt, has taken a decision to include some 50 ayurvedic drugs to supply to the
people through village health workers at sub-centers.
The decision is being implemented and the activity has already taken place.
Some 10000 VHWs are provided with training and a kit of drugs. Near about 50%of these
drugs are ayurvedic and 50% siddha.
These drugs mainly focus on maternal and child health and the minor ailments routinely
found.
Tamilnadu health secretary Smt. Sheela J. took the decision to include such drugs in
primary health. Then she consulted the consultants like Dr. Girija and after some
discussion the list of drugs was finalized.
The process took 10 years to come into existence.
Now the state govt, is procuring the drugs from a company called TAMCOLD.
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There was no prominent demand or a movement from people to do such.
Despite this, people are finding these drugs useful and they have welcomed the
indigenous drugs. Now the people are much satisfactory about these drugs. Some Tailam,
Saubhagya shunthi are some of the drugs which are getting a very good response from
people.
Some queries
No doubt the activity is benefiting a large people, but some questions still do arise.
1. The decision was much personal and top down, involving less people.
2. Despite this it has created a good impact which requires to taken into consideration for
further policies.
3. It has very much similarity like the immunization program, in having a large parentage
of good as well risk factors.
4. The module is much therapeutic and chemical-technical type. It doesnt think about any
community at any level or at a larger domain, the importance of prevention.
5. The nature of the drugs seems much to be requiring theoretical examination and
prakriti of patient etc.i.e. not easy and simple medications. The peoples related to this
effort were having some of them very or totally negative about the allopathy.
6. The distribution of drug may produce some concerns about the VHWs which have a
right to keep and distribute such drugs in village.
7. The procurement of drug doesn't involve any community or SHG-like or co-operative-
like people's participation.
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33.
The practical efforts of conservation and revival of indigenous health traditions
and organic components in farming.
The impact of present days so called development is worse on the environment and
agriculture. There is immense exploitation of the natural resources as well as at the same
time there is strong invasion of polluting and harmful substances in virgin healthy and
natural life. Such healthy and organic, near to nature traditions are now under great threat
of either getting exploited, destroyed or polluted dangerously. That's why there is a
necessity to work on this dimension for a healthy society. It is an individual as well as a
collective responsibility. But considering the strength of the invading exploitative
processes, it is required to be a strong people's movement and a part of every people's
movement.
Heart-warming visit toCenter for Indian knowledge systems (CIKS)
Kotturpuram, Chennai
CIKS is located at Kotturpuram in Chennai. This office has crated a great awareness about
strengths of indigenous knowledge.
The center is not only concerned about the theory but also the practice to produce
effective results.
The talk with the experienced personality, Dr. Balsubramanyam was very memorable and
a friendly learning experience. He has a well and good consciousness of all the aspects of
this important task, and also very frankly he passes all these values to the others.
This institution explores and develops contemporary relevance and applications of
traditional Indian and Indian sub continental knowledge systems.
Some of its active initiatives include1. Research, training and development in organic farming.
2. Work on traditional plant science i.e. vrukshaurveda.
3. Encouraging and assisting farmers for going organic and developing market for
it. Efforts also concentrate over working as resource center. It also takes a lot pains on
conservation of traditional varieties of various crops and creating gene banks of such
useful varieties.
4. Active propagation of traditional systems of medication and health.
5. All above fields are supported with training programs and valuable literature,
developing various instrumentations, etc.
»
This institute I found is one of the few institutes which are much 'user-friendly' and
welcoming the beneficiary to participate in running the module, without any superiority or
egoistic approach. Also the approach to the issue and concern seemed to be much
multilateral.
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34.
20-25 December 2006
Sittlingi Tribal Initiatives
At.post.-Sittlingi, Tal-Harur, Dist-Dharmapuri, Tamilnadu.
Waiting for a bus for hours., holding a dead baby in hands., can you feel pains of such a
mother..? That is what the rural and tribal, remote interior India's reality is.
Sittlingi post, Tal.Harur, Dist.Dharmapuri is one of such areas from interiors of Tamilnadu
state of India. Situated between chitteri and kalreyan hills -eastern extension of western
ghat hill, it has near about 25 villages around.
The reality of the remote Indian health is not only the peculiarity of Sittlingi. It is equally
important for local peoples' efforts against these adverse situations. You will have to
believe that 8th std pass village girl can give spinal anesthesia, the other can conduct a
delivery and even take easily episiotomy and suture it, that too with the sense of when to
do it and when not to do it!
Off course these efforts have a good guarded guidance and initiative taken by Dr.Regie
and Dr.Lalita. Near to 1993 both decided to work here after one years scanning traveling
throughout the country. They started with a hut-OPD on waste-land. Now it has got
developed to a 20-bed Tribal Hospital with a operation theater. It's real asset is it's staff's
capacities, who now requires very little help of these senior doctors to run this service.
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34.1 The structureIt works in a command area of near about 21 villages around.
There are 24 Health Auxiliaries (all women) working with base in their respective villages.
These function to provide remedies for common ailments. They are provided with some 5
allopathic drugs. They also work for timely referral of a patient to hospital. Besides this,
they monitor the growth and vaccination of the children.
There is one Rural Hospital with above doctors.
This hospital is provided with 14 Health workers. 13 of them are Tribal\local and having
education near about 8/9th standards. But these are the main work force. They conduct
the hospital as well as go regularly and scheduled visits in surrounding villages.
ORD in hospital takes place 3 days per week.
The health auxiliaries and health assistance are salaried as per the capacitance of the
hospital.
34.2 Health educationOne round in six weeks covers all villages and besides providing service, it also provides
the health education, topic-wise.
Every month staff meets. HW talk and training goes.
Database formation initiatives are going on. Data of every citizen is being formed. It is a
social mapping activity.
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34.3 Their opinions about Govt. PHC nearbyThey are only target oriented. Too much beurocratic. The staff gets indulged in
reports, paper-work, meetings and unnecessary disease trainings.
This hospital is being asked to take over that PHC, but to shortage of staff, it is not
being accepted by this tribal hospital. (Also very negative aspect about govt, beurocracy
seems a major reason not to go for it.). However since last few days a local youth has
become a doctor and got appointed to this PHC. He is much sensitive and resides in PHC.
Also this hospital is giving guidance to him and a lot people have again started to go there.
Sittlingi tribal hospital co-works with govt, only on immunization program and feels
better to be away from the beurocratic ways.
b
34.4 Basic ideoiogyConversations with Dr.Regie and his colleagues like Dr.Ravikumar. revealed the
basic ideology behind such effort. The main motive is "to share knowledge with people".
About the policy interventions in peoples' sufferings, he told that, it is not possible.
Why? -two things he considers.
One is that this Govt, machinery has failed and we must have some, at least IAS
level officers to intervene. But., even the interventions and initiatives taken at such a level
may be defeated at micro-level by the beurocratic and clerical officials and their
inconstancy on the posts (effects of transfers).
Second thing he says that, to make any difference at such a policy level is hopeless
because for that you will require some great mass-based influence to do the intervention,
like Aruna Roy or Med ha Patkar.
He feels that it is not my work. He says, "Though at micro level and scale, here I
can implement ideas and see the results, and also can change them if required."
Besides these health initiatives, some other people have joined him there to take other
initiative.
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34.5 Experiments in EducationAnu and Krishna is an architect duo who has started to reside there in Sittlingi village.
They stress on local resources based architectural initiatives. Also their experiments involve
low-cost housing efforts. The dry toilet the constructed has become a subject of discussion
and guidance.
The major thing is that all this is a part of innovative and practical, application
based education to village students. They have started a get-together, playful school here.
After the school times, the children and adolescent youth get hanged to this are in doing
various experiments like making bamboo works, construction techniques etc. The most
important thing is the rich library to which children get easy access.
The main drive behind this is that, today's formal education takes away youth from
their conventional livelihoods and cultures and also fails to give other employment. So
such types of practically useful education experiments are being done.
Clay modeling, bee-keeping, soap-making, chair-making, news reading and discussion are
some of the other "young" activities going on here. They are basically building confidence
in children and the youth.
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One other such initiative is making embroidery works. As a major community
around is Lambadi (Lamaani) community- a nomadic tribal community migrated from
Marwar long generations before. They were provided with rich artistic dressing tradition.
This tradition however, now becoming obsolete. So to revive it and also to generate a
income source, Embroidary initiatives are being taken. This is found vary useful for the
women.
One another important effort is in Farming. Organic farming experiments are being
carried. Also the marketing efforts are being done. One important thing is that, farmers
their own asked to do something for the farming as it is becoming day-by-day
unaffordable. So some science based initiatives are being done.
34.6 Socio-economic structure-
The ecosystem is rich in resources. But the poverty is prevalent.
The 90% community is tribal, but a lot of them provided with some 2-3 acres piece of land
received after the farm-workers act. Lambadi and Malayai communities are major.
The people are very simple and easily get cheated by the urban non-tribals. They have a
decided a rule not to sell the land to non-tribals.
The main source of livelihood is farming and farm-work. And as part of whole nation's
agricultural disaster, it has become unaffordable.
Debts are there.. Exploitation by urban, semi-urban landlords is there..
Vattamtala, a herbal plant is famous there as a suicide plant of Tamilnadu.. I think, this
Tribal Hospital Initiative is doing a small effort in a majority aspects to save the lives from
such sufferings..,though it needs some more philosophical broader views!
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35.
Whilst contributing to the community moving towards health equityFew things to note:
Assess our inside.
Get normal!
Be democratic, listen to others
Don't raise expectations
Good qualities are not sufficient. Be skillful.
"Goodwill is not enough"
36.
Skills, and values.. An exploration
What are we doing? Why are we doing this? What is driving us? The answers make us
aware of the situation and the requirements of the situation.
Values and skills required/expectedOrganization skills
Democratic ways
Constant learning
Seeing beyond the obvious
i.e. optimizing differences with peoples.
Session by Ravi on theories of psychology was a good session.
Life Skills is a newer concept in this field. Conversations with Shekhar Seshadri from
NIMHANS, Bangalore and Dr.Ravi Narayan gave valuable information about this new
concept. It involves understanding a context and the importance of knowledge as well as
human psychological factors, Back-ground and history. Developments in history and
humanity construct life skills.
Methodology:
Information based to experimental
Dealing with contexts and the contents
Generating reflections
Listing method, creativity
These life skills are not only important for one, but are major tool to fight addictions like
tobacco, gutkha, alcohol etc.
They constitute a major approach to deliver a value-education and adolescent's
unconscious counseling
In people's crises, disasters,
Look at peoples not as victims, treat as their right.
Local culture and psychology to be taken into consideration
Involve community, its right to decide/manage-plan/idea.
Learn from mistakes and achievements also.
Celebrate tremendous generosity and solidarity extended by others.
Land rights protection
Decentralized disaster alerting system
Experiences of grassroots level activists are important.
so, such rigorous inside and outside learning and active movement is required to achieve
the goal of Health Equity.
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37.
Community health fellowship-
«
Why?
To know more about the society, the health analogy of the society
ObjectivesTo study/to learn:
Some healthcare-primary healthcare community based experiments, with
reference toHealth initiatives, determinants tressed,
Empowerment,-health economics
Organization-networking-policy intervention
Health administration, structure, vision
Pleural medicine- Biodiversity- Conservation
Learning objectives at FRLHTGovernment's efforts in mainstreaming of ISM, Policy
Organizational working methods
Empowerment, Co-operative expt, Micro-economics .
How doneI visited various organizations, movements concerned and talked to the activists, staff,
working people, the beneficiaries and saw the actual work going on. I went through a range of
such efforts. I tried to find out the meaning, reality and necessities of health through the
different perspectives of health in accordance with the related determinant or influential factor.
1
LearningsThe journey through the community health fellowship was an excellent experience; especially
the informative inputs were the most valuable among them.
The fellowship catalyzes process of socialization with outer community as well as within ourself.
I tried to find out the meaning, reality and necessities of health through the different
perspectives of health in accordance with the related determinant or influential factor like,
Community building and empowerment, Gender, Social justice, Environmental, Housing,
Cultural- local health traditions/indigenous medicine etc.
The Primary health was at the central to the consideration. In this respect, I evaluated my
visits to various organizations.
In fact my objective to visit such organizations or institutions was not to evaluate them but to
pick-up positive points from there. The only criterion I tried for evaluation to some extent was
just to note how they treat a new comer lay person coming to them. Efforts in primary health,
Biodiversity and conservation and the Biological Medicine for masses were important
considerations looked for. Of course the criteria were kept relevant to and flexible to the
focused work field.
It was good to know various practical possibilities and the field techniques.
-The major strength of these different efforts is the empowerment of the community,
-Despite all the difficulties, the achievement of the goal in near about every organization was
considerable.
-Some of these may not be that much directly conscious about their contribution to 'health' but
I studied them to know about that aspect of health and its impact on health.
-Learning from others experiments is a thing of joy and a means of finding different
possibilities at peripheral efforts.
-It definitely puts additional confidence and sharpens your database.
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-The destinations as well as the means o the effort to mobilize the community found varied.
-Despite the variation, the commonalities found were something like mainly service based.
aL^d^eren/thG consciousness about the motive ar,d perspective within the organization were
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Organizations, Institutes visited6th Aug2006 to 7th Sept2006- Orientation Program, discussions and local visits
10th Sept2006 to 17th Sept 2007- studies at FRLHT, Bangalore
18th Sept2007 onwards- visits to various organizations, eventsOrganizations visited in Maharashtra-BAIF
-FRCH (Foundation for Research in Community Health)
-MASUM (Mahila Sarvangin Utkarsha Mandal)
-Godutai Parulekar Mahila Vidi Kamgar Sahakaari Gruhanirmaan Sanstha,Solapur.
-Ralegan Siddhi
-Dr.Sukhdeo Thorat on Social and Caste issues
-2nd World Ayurved Congress,Pune
13th Dec 2006 to 15th Dec 2006-South Asian Meet on Traditional Systems of Medicine, Bangalore.
16th Dec 2006 to 25th Dec 2006- Studies in Tamilnaadu- Organizations visited-Sanjeevan foundation- Dr.Girija, Chennai
-CIKS-Center for Indian Knowledge Systems
-CMC, Chennai
-Sittalingi Tribal Initiatives
27th Dec 2006 All India Drug Action Network (AIDAN) Annual Meet, Bangalore
28th Dec 2006 to 30th Dec 2006- MFC Meet, National Tb Inst. Bangalore.
4th Jan 2007 to 6th Jan 2007- Pre-NHA2 National Co-ord. Committee Meet and workshop- BGVS
office, Bhopal
8th Jan 2007 to 31st Jan- contd. Writings and studies in Maharashtra
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1st Feb 2007 to 6th Feb 2007- Debriefing and concluding sessions at CMC, Bangalore,
submission of Studies reports.
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*
Other activities donePublication of issues of bulletin (RayatRaaj) on various important Health topics, in
Marathi Oct 2006- Peoples Health CharterAn issue that includes People's Charter for Health- translated to Marathi. It also
contains various allied writings.
Nov2006- Medicinal Plants in Primary Health CareThis issue contains an easy to use information on easily available medicinal
herbs in Maharashtra, especially focused on the primary health care.
Dec2006 about N.R.H.M
An issue giving idea about the National Rural Health Mission- it's bad and good
possibilities and the responsibility of watching it as well as deviating it towards
the people's needs and interests.
Jan2007- the Addictions problem
This issue covers important topic of the severe problem of addictions like
tobacco, gutkha etc. This is a collection of translations of articles from the
booklet published by the Consortium on Tobacco Free Karnataka.
Feb2007-Whither Health
The issue lines out the current situation of health scenario. It is focused on
making common people aware of the happening about there health at various
levels.
Future Plans-Study
-Compensating and surviving the bulletin
-Work for PHM, JSA and other Philanthropic efforts.
-Working on Traditional Systems of Medicine,
-Biodiversity and conservations of natural and social resources.
-Spreading the knowledge and information- to newer ones.
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