Chandrashekar M.N CHLP 2015-10-FR 159.pdf

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extracted text: 2015-16

Community Health Learning Programme
A Report on the Community Health Learning
Experience

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School of Public Health Equity and Action
(SOPHEA)

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building community health

Society for Community Health Awareness Research and Action

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.sockaiafctuiilcltncommunity health

MY journey in CHLP

CHANDRASHEKAR M.N
Community Health Learning Programme

August 2015 to may 2016

Mentor: Mr. Prahlad IM

School of Public Health Equity and Action (SOPHEA).

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SWAMY VIVEKANANDA YOUTH MOVEMENT (SVYM)
HISTORY:-

The year was 1984. A group of young medical students led by R. Balasubramaniam at the
Mysore Medical College (in Karnataka State, India) were starting to feel that the career in
medicine they dreamt of pursuing was very different from the practice of medicine around them.

They believed that they had in them to make a difference and make a positive impact on the lives

of the poor and the marginalized. And so, they started the Swami Vivekananda Youth Movement
(SVYM, for short), with initial assets of high ideals and all the positive benefits of inexperience.

Their initial intention was to provide rational, ethical and cost-effective medical care to the
needy. They started small - collecting physician samples of medicines and distributing them to

poor patients, organizing blood donation camps and weekly rural outreach clinics around
18

Mysore. In 1987, destiny took them to Heggadadevanakote Taluk, the home of the displaced and

dispossessed forest-based tribes. These indigenous people, belonging to five different clans Jenukuruba, Kadukuruba, Yerava, Faniya and Bunde Soliga - had been displaced twice from

their natural habitat by development projects of the Government, namely ‘Project Tiger’ and
‘Kabini Reservoir’, and were forced to live in penury on the fringes of the Bandipur National
Park.

The medicos set up a clinic at a tribal hamlet named Brahmagiri, at a distance of about 80 km

from Mysore city, with a little help from the Mysore District Administration. Realizing early that
medicare by itself is not enough and hoping education to be a panacea to the gen-next, they

opened an informal school for the tribal kids in a cow-shed in Brahmagiri. They were able to sail

through the initial days of extreme uncertainty and struggle (and even ridicule!) by pluck, some

luck and with help from unexpected quarters. As days passed, more people joined hands and the

work took a definite shape. Socio economic empowerment activities were added to health and

education, and the rural poor were also brought under the ambit - as the organization moved
from the role of a ‘provider’ to a ‘facilitator’. A 10-bed hospital was started at Kenchanahalli,
along with a host of community-based programs in Health and Education. As the medicos

returned in batches after completing their post-graduation, the multi-specialty Vivekananda
Memorial Hospital took shape at Saragur, with generous help from donors, friends and well-

wishers. The organization continued to grow and expand in the 90s, with a definite vision and

strategic direction.

Note: Events and circumstances that led to the birth of SVYM can be read on the R Balu's Blog

Vision and Mission

Our Vision:
A caring and equitable society, free of deprivation and strife

19

Our Mission:

To facilitate and develop processes that improve the quality of life of people
Our core values:

These are the driving force behind our work

1. Satya

- Truthfulness

2. Ahimsa

- Nonviolence (both in thought and deeds)

3. Seva

- Service

4. Tyaga

- Sacrifice

Health

SVYM adopts unique health care model of treatment in order to provide holistic care integrating
the best of Allopathy and Ayurveda treatment.

Key Focus- Tribal and Rural Health, Ayurveda, reproductive and child health, hygiene and
sanitation, care and control of HIV/AIDS, Tuberculosis and Disability.

Program

Vivekananda Memorial Hospital, Saragur

Inception: 1998Location: Saragur, Heggadadevana Kote taluk, Mysore District
Population of 400000 which includes tribals of H D Kote and neighbouring areas of Hunsur,
Nanjangud & Gundulpet taluk

Vivekananda Memorial Hospital is a rural multispecialty hospital providing integrated and
comprehensive health services with unique inclusive approach of Allopathy and Ayurveda,

giving its patients an opportunity to choose the best treatment for their recovery.

20

Vivekananda Memorial Hospital opened its doors 15 years ago with a purpose of adopting a
systematic approach in tackling the challenge of providing quality secondary healthcare services
to local needy rural and tribal communities.

With its infrastructure, facilities and its dedicated team of doctors, the 80-bed facility is offering
multi-specialty secondary care at affordable cost to the community.

Objectives:

•

To provide institution-based full time, integrated, primary level health care

(promotive,preventive, curative, rehabilitative and palliative) and periodic secondary
level care (OBG,Orthopedics, Internal Medical,Paediatric, Ayurvedic) to the community,
with focus on indigenous Tribal Population.

•

To support National Health Programs and network with government agencies and link
community with welfare programs.

Services

• 24 x 7 Emergency healthcare services are available for primary and secondary level.

• Specialist services related to Internal Medicine, Obstetrics &Gynecology, Orthopedic,
Pediatric, Diagnostics and Laboratory, Ayurveda.

• 24 hours dispensary and ambulance services.
• Networking and linkages with the community for referral and patient follow up.

• Poor Patient Fund (Yoga Kshema Samithi) for Socio- economic support of the patient to avail

appropriate secondary and tertiary health care services.
• Support to National Health Programs (NRHM, RNTCP, RCH, HIV, and NPCB) and supporting
tribal women to avail schemes like Janani Suraksha Yojane, Prasoothi arike, Madilu kit.

• Blood Storage & Transfusion Services (Recognized by NACO).

21

To Develop a Sustainable Rehabilitation program for the Identification, Management and

Prevention of Disability in H.D.Kotetaluk.The core rehab team that was formed continued to
focus on identifying disabled children and adults in the region and providing them medical care
along with facilitation of schemes available from the government.

Water Sanitation-NirmalyaVahini

NairmalyaVahini addresses the issues of Water-Sanitation-Hygiene-Environment in a holistic
manner, thro multiple activities including awareness generation, behavior change
communication, capacity building, research and development of appropriate technologies, and
advocacy.

Palliative Care

The Palliative Care program was launched in year 2011 and it takes aholistic approach to

healthcare focusing on alleviating the suffering of patientswith terminal illnesses, and was. This
program caters to five dimensions ofhuman personality viz. physical, psychological, social,

economic, and spiritual Health.
HIV/AIDS Care Control Program
Programs initiated:

PPTCT-PPP - (Prevention of Parent to Child Transmission of HIV under public Private
Partnership)
This program was conceptualized to attain zero new HIV infections among children born to HIV
Positive mothers through PPP-PPTCT services across 21 districts in Karnataka.

TI-Migrant- the Goal of this program is to reduce HIV prevalence among migrants through this
program.

TI-MSM/FSM-The project's activity is to primarily prevent and treat HIV/AIDS infected.In

connection to that it focuses on integrating prevention among Menhaving sex with Men (MSM)

23

and Female sex workers (FSW). This projectis being implemented for the benefit of the

community of FSW & MSM inHassan district.
Education:
Our education initiatives strive to provide joyful, experiential and child-centered learning focusing on values, literacy, numeracy and appropriate vocational training. The focus is on

educating children in tribal hamlets, rural areas and urban slums.

Viveka Tribal Center for Learning is a residential school for tribal children initiated in the year
1988 and is recognized by government since 1990. It is offering unique environment and
facilities to encourage education among tribal children. The school is home for about 425

students from forest based tribal communities like Jenukuruba, Kaadukuruba, Yeravas and
soliga. The aim of this institution is to impart quality education to tribal children of HD Kote

aged between 6 to 15 years.
Viveka School of Excellencewas established in 2002 in the outskirts of Saragur and is affiliated
to the Central Board of Secondary Education. The school is committed to provide child centric
quality education for 512 rural based children. The school has classes from Montessori to 10th

standard. The School has well equipped library for accessing academic books. Innovative labs
for mathematics, science and computer help students with hands on experience and joyful
learning.

With an aspiration to transform rural and tribal youth to be value based humane teachers,
Vivekananda Teacher Training and Research Center was instituted in 2006. It runs a 2 years

Diploma in Education (D.Ed.) program with an annual intake of 50 students with 20% of seats
reserved for the forest based tribes, especially girls.

Premavidya, is a program started in 2006 with the mission of breaking the cycle of poverty for

families by improving the quality of education for their children at the school level and

encouraging students to pursue meaningful job oriented courses by providing scholarships and
innovative family saving schemes. Premavidya is spread over 7 districts of Karnataka i.e.
Bangalore, Mysore, Yadgiri, Tumkur, Hassan, Raichur and Uttar Kannada. In 2013, the program

24

reached out to 22181 students across 230 schools; 200 Kannada medium and 30 English
medium.

Vivekananda Scholar Program provides academic support to meritorious students who are

economically backward, aspiring to continue higher education. Students are offered rigorous
academic coaching through a team of dedicated tutors and volunteers. Moral support is offered
through life skills coaching, mentoring and counseling. Performance of the students is
continuously tracked through regular an assessment that helps in providing ongoing support to

meritorious students.

Vijnana Vahini - (Mobile Science Van) started in 2008 with the aim of improving scientific

temperament among the students of HD Kote Taluk. The project also aims to empower the
government and private schools to provide schools to provide quality science education to their
students and create a platform to enhance children’s interest and creativity in science.

Vijnana Vahini had setup a Centre for Innovation (Cfl) and a Resource Centre (RC) at Saragur in
order to create a platform for all students, teachers and community members with innovative

ideas which they would like to experiment or do further research on. It has three componentsScience Laboratory facilities, Exploratory Park and Research Unit. Exploratory Park have both

indoor and outdoor components focusing on the development of scientific skills like observation,

classification, measurement, making inferences etc. It is designed to have the following sections
- Light & Sound, Mechanics, Electricity & Magnetism, Chemistry, Health, Flora & Fauna, and
Patterns in nature, Astronomy, Technology around us and History of Science. A separate section
on astronomy is being created

1111 Socio Economic Empowerment Program

Location: H.D.Kote taluk and neighboring districts.

25

Reach: 2,75,000 population of H D Kote taluk including 17,000 population of tribals of
H.D.Kote & neighboring areas of Hunsur, Nanjangud & Gundlupet taluk.

SVYM’s Socio-Economic Empowerment Program was conceptualized in the year 1989 to

develop a secured, sustainable environment amongst rural and tribal community with a special

focus on youth and women empowerment. SEEP has been working across 119 hades of
H.D.Kote taluk. SEEP operates its programs through Micro level planning towards the holistic
development of tribal community. It aims in creating a permanent asset to uplift the socio

economic condition of the community.

Key activities of SEEP
•

Formation of Self Help Groups- 90 SHG’s have been formed by playing a major role in

strengthening the community.
•

Basic Infrastructure development of hades - Tribal communities are provided with basic
facilities like Biomass stove; provide drinking water facilities through bore wells & toilet

construction.
•

Creating Self-employment opportunities - Platforms are created to make the community
self reliant through many income generating activities by organizing vocational training
on bakery products making, Plumbing, Electrician training, agriculture etc.

•

Acting as a Bridge between Community & Government - SEEP collaborates with

government institutions and tries to bridge gap between these institution and the
community. Community is oriented on Public distribution system, provide information on

basic entitlements like widow pension, old age pension & about NREGA (National Rural
Employment Guarantee Act).

Janadhwani 90.8MHz

Janadhwani is a community radio station reaching over one lakh listeners across 188 villages of

H D Kote taluk run by Viveka School of Excellence (a unit of Swami Vivekananda Youth

Movement) based in Saragur, H D Kote taluk, Mysore district. Its journey has made tremendous
impact on the people across its coverage area. It has been acting as a medium by rendering voice
26

to the voiceless, power to the powerless and giving way to help rural and tribal masses in
creating awareness and to establish their right to information, development, communication,

governance, decision making, and participation, freedom of expression, employment, health,

education and security, through well designed programmes.

Training and Research
Vivekananda Institute for Leadership Development (V-LEAD)

Vivekananda Institute for Leadership Development (V-LEAD), a unit of SVYM was established
in 2002 with the aim of serving India by building the potentials of individuals and institutions for

the development sectors. The educational program is an attempt to work with individual
Education Leadership and Management capacities in the field of social development.

• The master in development management is a two year program offered by the V-LEAD in
collaboration with University of Mysore.

• Institution Based Program: IBP is an effort of VLEAD that aiming at building, strengthening

and sustaining network of partners in development of various sectors through innovative and

customized training programs and successful development models in training. It caters trainings
for Government, Youth, NGOs and Corporate sector under the supervision of skilled training
managers.

• Community Based Programs: The objective is to develop and monitor developmental activities
which will enable sustainable interventions and make a positive impact in the community.

• Samartha Project: The goal of the project is to develop and monitor a community led process,
where community will plan, implement and monitor development activities which will enable
sustainable intervention and make a positive impact in the community. Program is specially

designed to empower street vendors and to create less dependency on money lenders. The
program aims to ignite a spark among the street vendors to be responsible citizen and to lead a

dignified life.

• Education Leadership Management (ELM): SVYM with collaboration with Ajim Premji
Foundation started this initiative to develop school leaders in 3 education blocks of Mysore

27

District. A sustained people development approach adopted and program address the attitudes,
perspectives, skills and knowledge of the school leaders.
• Lake Conservation Campaign: Recognizing the importance of lakes, VLEAD has formed a

group ‘MYTRF which comprises of numerous members from varied sectors of the society.
Vivekananda Institute of Indian Studies (VIIS)
Vivekananda Institute of Indian Studies (VIIS) was established in 2008 for promoting and

facilitating the study, research, development and dissemination of Indian culture, spirituality,
dance, music, art and philosophy. University students across the globe participate in various

customized courses to have a slice of the rich Indian tradition. VIIS is also a single window for
the volunteers, Medical student Electives and interns interested in working on various projects of
SVYM. VIIS offers a unique course called ‘India Immersion’ focuses on culture and civilization,
gender in society, sustainable development, environment and health in modern India, Indian
women and tradition.

Field visit 1

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facilitator,RCH person and materials and equipment’s stationeries, registers IEC materials and

other water food medicines list all tacking to going to the visit and conducted the camp

28

General health cap, paediatric camp, diabetes camps, asthma camp, dental camp, cancer
detection camp, Tuberculosis screening camp
I visited the General health camp

235 peoples was attend the camp doctor staff nurse,
driver SVYM staffs kenchan halli Ayurveda doctor
yoga trainer attend the camp was successfully that

day observation that camp

Reproductive & Child Health- VatsalyaVahini
VatsalyaVahini was worked for 5 area PHC B. matkere, Dadada Halli, N belthuru, D.B.
Kuppe, Bdgalapura Cavard the RCHfield work

ANGANAWADI

No of Tribal

Tribal

villages

population

B MATAKERE

12

1750

19

DADADA HALL1

5

765

14

BADAGALAPURA

12

1200

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DB KUPPE

10

2150

14

N BELTHURU

18

4523

44

PHCs

Pregnantwomen:-even tt 4 weeks apart whiner pregnancy

Invest getion

1. HB%, urine examination
2. blood group including rh factor
29

3. RPR/vdrl HBsAg, hiv screening
4. RDK test for malaria (in endemic areas)
Information for give the pregnant woman and family
Encourage institutional delivery /ensure delivery by identification of SB I

Explain entitlement under jssk/jsy
Identify the nearest functional PHC/FRU for delivery
High risk pregnancy to be attended in direct hospital and medical college

Pre-identification of referral transport and blood donor

108 ambulance service use to the free service
mother

children
adolescent

•

eligiblecupules
chronic illness

SVYM given the RCH field workers awareness
1. Group discussion

2. Mother meeting
3. Promotermeeting
4. Villagemeeting

5. self-helpgroup discussion
6. school visit
7. Aganavadi visit

8. PHC visit
9. ANC/PNC flow up and new ANC delivers
10. House visit
11. TB patientsflow up

30

•

Ivisited the promotermeeting at SVYM, Dadada Haiti B Mattkere ,MC TholaluWe had

discussion with the mother, children adolescent eligiblecapfuls couples

•

RCH field worker given awareness and had discussion with the mother, children

adolescent,eligible couples,chronic illness TB breast feeding and whom do you
working in the field, prepairng action plan monthly ANC/PNC children mother taking

The plan who to reach that day the work and explain the workers asking the data

collection

Community based Rehabilitation of disabled-ChaithanyaVahini: What is cerebral palsy?

Cerebral palsy is considered a neurological disorder caused by a non-progressive brain injury or

malformation that occurs while the child’s brain is under development Cerebral palsy primarily
affects body movement and muscle coordination.

Spastic

Leg crossed like scissors
Muscles appear stiff and tight

Spasticity only occurs in relation to voluntary movant
Disturbance of the stretch reflex
Athetoid

31

Body parts are in constant motion

Involuntary, purposeless, relatively slow repeated movement that interferes with steadiness

accuracy and control of one or more body parts

Ataxic
Poor balance and lack of coordination
Wide-based gait

Tendency to fall and stumble

Inability to walk straight line
Least common 5-10%of case

That all of information collect the risors person was explain to the mother disability children who

to care the this problem the child .the one child problem was different problem the resors person

was given the methodsessaysmussels thatched active that tell to the mother

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33

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the village

165 house total population 755 man 419 girls 336

aoboa 100

house total population 394 man 140 girl 174 tribal’s men 38 girl 42 cast system tribal

(JK,S,BK.Y)Other SC, ST Nayakru, income was coming agriculture laborer land leader
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36

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NHM SCHEMES:-

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(STI)

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J New bam and child health
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S Family planning
S Addressing the declining sex ratio
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37

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45

SVYM arranging the world cerebral palsy day 2015

Gests Dr. Ravikumar (Thaluku health officer)
Kumara Swami (child development officer)
Mohan (layan’s club)
Panduranga rao (CEOSmpritha organization & e was cerebral palsy)

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48

Research

An exploratory study on “physical, social, mental and economic impact of alcohol

consumption on tribal community” from N Belthuru in HD Kote Block, Mysore District

1. Basic Data

1.1.

Project Supervisor Address:

Mr. Prahlad IM (mentor)

School Of Public Health Equity and Action (SOPHEA).
No. 359, 1st Main, 1st Block, Koramangala,
Bangalore - 560 034 Karnataka, India.

1.2.

Principal investigator

Chandrashekar MN
Fellow, Community Health learning program,

School Of Public Health Equity and Action (SOPHEA)

No. 359, 1st Main, 1st Block, Koramangala,

Bangalore - 560 034 Karnataka, India.

1.3.

Site contact details

Dr. Manohar Prasad (Mentor)
SwamyVivekananda Youth Movement (SVYM), Mysore.

B MatkereVillage,
H D KoteTaluk,
Mysore District,
Karnataka,

49

1. Introduction

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hypertension

51

saSegrt^o ^o^£>^o^cS (4).

References

1. Alcohol and its social consequences-the forgotten dimension by herald kilingemann
word health organization regional office for Europe 2001

http://www.unicri.it/min.san.bollettino/dati/E76235.pdf
2. Community health approach to tackle alcohol related problems (CHATA) by
sowbhagyasomanadhan documentation april -2004

3. Global status report on alcohol and health World Health Organization 2011
http://www.who.int/substance_abuse/publications/global_alcohol_report/msbgsruprofiles

.pdf

4. Alcohol its health and social impact in India Subir Kumar Das v, Balakrishnan, D.M
Vasudevan

http.7/www.nmji.in/archives/Volume 19 2 March April2006/Medicine and Society/Al
cohol.htm

52

2,

2.1.

Title Aim and Objectives

Title

An exploratory study on “physical, social, mental and economic impact of alcohol
consumption on tribal community from N Belthuru in HD Kote Block, Mysore District

2.2.

Aim:

An exploratory study on “physical, social, mental and economic impact of alcohol

consumption on tribal community from N Belthuru”

2.3.

Objectives

To identify the physical, mental, social and Economical issues faced by families due to

consumption of alcohol
To understand the community’s perception social economical, and political impact of

alcohol.

3.

3.1.

Methodology

Study Design:

Qualitative methods One FGD and five in-depth interview is being adopted along with
interview guidelines to “An exploratory study on “health impact of alcohol consumption

on tribal community”
3.2.

Study area and study duration:

The study will be conducted in N Belthuru Village of Mysore District .duration is from 23ndFeb
to 10lh April.

3.3.Sample size:

53

One Focused group Discussion with SVYM Self-help groups and 5 house hold level in

depth interview conducted

3.4.Data Collection technique and tools

Data Collections technique: in depth interview and focused group discussion

Data Collection tools: in-depth interview guideline, focus group discussion guide.

Objetive-1

Objective -2

Data collection technique: In-depth

Data collection technique:

Interview

Focus Group Discussion

Areas to be covered in the interview

Areas to be covered in FGD

guidelines

guideline

N Belthuru village

N Belthuru village

3.5.Ethical Clearance: Ethical clearance will be sought from SOCHARA Institutional,
Scientific and Ethical Research committee, Bangalore.

3.6. Data collection time period: 24"dFebto 09'"April.

3.7. Inclusion Criteria:

Only people belonging to N Belthuru HD Kote Taluk Village selected.

3.8. Data analysis:

Qualitative data will also be analyzed manually using the principle of qualitative software.

54

4. Risks and Benefits
Study is going to be conducted to determine the gap between the actual no risk for my study and

required, to maintain health, no financial, mental risk involved, if any risk identified during the

study it will be addressed in order to protect the right of the respondent.

Help/support will be taken in conducting the research from SVYM Organisation as they are
working in this area. Confidentiality will be maintained and will be addressed with the informed
consent and participatory information sheet.

If there is any risk for the researcher it will be addressed to the local NGO.

No immediate benefits are involved for the respondents as it is a descriptive study to determine
the gap, long term benefits are there for the respondent as awareness will be spread about health

during the study and it will help to improve their health status.

4.1.Consent:

This study doesn’t have any immediate benefits for the respondents, the motive of this
information is to assess the health problems, and same will be informed to each and every

respondent and a written consent will be taken on consent form, and objective of the study will
be explained to respondent and oral consent will be taken or written consent will be obtained

from subjects.

4.2.Confidentiality

Confidentiality is a right of every respondent and will be protected during study and even after
the study .The data will be kept confidential and anonymity will be maintained during sharing of
the data with internal and external agencies.

The participant also asked to maintain the confidentiality after the SHG group discussion.

55

4.3.Dissemination
A final report will help the respondent and organization because to improve health status and to

provide health services.

5. Documents attached:
1. Tools for data collection
2. Informed consent form
3. Participants information sheet

56

An exploratory study on “physical, social, mental and economic impact of alcohol

consumption on tribal community” from N Belthuru in HD Kote Block, Mysore District

Participant’s information sheet

SOCHARA is an independent organization situated in Bangalore which offers Community

Health Learning Program (CHLP) fellowship through its SCHOOL OF PUBLIC HEALTH
EQUITY AND ACTION (SOPHEA).
Mr. Chandrashekar M N is a fellow of CHLP and going to conduct “An exploratory study on

“Health impact of alcohol consumption on tribal community” from N Belthuru in HD Kote
Block, Mysore District” under the assistance of S VYM Organization as a part of her fellowship
learning process. The purpose of study is learning and as well the finding will be used by SVYM

whenever necessary. To inform about any adverse effect in connection to this study, you may

contact to the person who’s contact details are given below.

S J Chander
Programme Officer

SCHOOL OF PUBLIC HEALTH EQUITY AND ACTION (SOPHEA)
No. 359, 1st Main, 1st Block, Koramangala,
Bengaluru - 560 034 Karnataka, India

Email: chc@sochara.org

Phone: +91-80-25531518, 25525372

Web: www.sochara.org

57

Consent Form

The Principal Investigator Mr. Chandrasekar M N has informed me about the study An
exploratory study on “physical, social, mental and economic impact of alcohol consumption

on tribal community” from N Belthuru in HD Kote Block, Mysore District. It’s objective,
risk and benefits and also assured me that all the information shared by me will be kept

confidential and will not be disclosed to anyone without my consent. She has also informed me
that this study will be for the learning and findings which will help SVYM to initiate action

whenever necessary. I am giving my consent to participate in study and also agree to provide

information in form of Audio Recording, Video Recording and Photographs.
Name:

Signature or Left Thumb Impression

Date:
Place:.

58

Questions

In-depth interview guidelines
1.

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59

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60

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Particulars

HD KOTE

Population

270,000

Literacy status

54.06%

% below poverty line

60%

Tribal Population

17,000

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Community Health Learning Programme is the third phase
of the Community Health Fellowship Scheme (2012-2015)

and is supported by the Sir Ratan Tata Trust, Mumbai and
International Development Research Centre, Canada.

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School of Public Health, Equity and Action (SOPHEA)
SOCHARA
# 359, 1st Main,
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Bengaluru - 560034
Tel: 080-25531518; www .sochara.org
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