RF_DM-3_GUJ-2_SUDHA.pdf
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[GUJARAT EARTHQUAKE : HEALING THE WOUND'
■ OXFAM INDIA’S INTERVENTIONS!
“A mission to put people back on their feet”:
Community Based Rehabilitation of physically challenged / disabled people.
Introduction:
The devastating earthquake in Gujarat in
January 2001 is one of the worst disasters in
India’s history. Many were left injured
critically and “disabled". With spine, pelvic
and lower limb injuries dominating incidents
of fracture and a sizeable number of
amputees and paraplegics, it is a daunting
task to provide care and assistance at the
community level.
Oxfam India's innovative response to
Gujarat earthquake has been operational
from March third week onwards to reach out
to the people at their doorstep.
In
collaboration with the Indian Association of
Physiotherapists and other collaborating
agencies
and
mostly,
the
affected
community, three base stations (to cover
around 200villages) have been establishedat Anjar, Bhuj and Morbi. There is a team of
two physiotherapists, a social worker and
other logisticians at each of these centres. In
addition to this, four experienced and senior
physiotherapists are coming from Bombay
for 3 days a week. Community helpers from
the community are currently being recruited.
Oxfam India believes that “this is a mission
to put people back on their feet". A visionary
approach- the programme aims primarily to
reach out to the community and the affected
disabled people at their door step, keeping
in mind that these are people who are no
longer in a position to move around, most of
them having multiple fractures, mainly of the
lower limb, pelvis and spine. Lack of medical
records in many places is hampering follow
up care. To correct the situation, Oxfam
India has pressed the services of a mobile X
ray unit for, mainly for the villages were it is
working, but also will be available for other
patients and organisations. The model that
Oxfam India has developed with LAP. is
replicable,
and
some
agencies
are
considering this model that will be taken up
in other villages. Advocacy and lobbying,
both with policy makers and in the media
continue. Realising the fact that disability is
a missing agenda in disaster situations
today, lobbying and advocacy work to place
this as an agenda will continue.
The financial support for this programme
comes from the employees of WIPRO.
Oxfam India
Oxfam India
“ Vijaya Shree", 4th A Main
Near Baptist Hospital
Off Hebbal, Bangalore-24, INDIA
Ph: 91 (80) 363 2964 & 363 3274
Fax: 91 (80) 391 4508 (PP)
E-mail: oxfamindiap.vsnl.com
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Oxfam India
TMiTHia re awovgm povarvl
Gujarat Earthquake Field Office
I Floor, Manav Chambers,
(Opp) Kenia Hospital, Varsamedi Road
Anjar- 370 110; Gujarat, INDIA
Ph: 91 (2836) 45798
Mobile: 91 (0) 98251 90583
Fax: 91 (2836) 43008 (pp)
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0.N UPDATE on activities (9th July, 2001)
(1) Project survey to identify the cases and analyse the situation has been completed way
back in April last week. This was happening simultaneously along with the intervention
that was happening in some villages. Over 1256 individual cases, including around 60
paraplegics, have been identified in over 200 villages through this process and
subsequent field visits.
Future action: The survey report will be cross-checked during the mid term review.
(2)
Co-ordination office and Base stations to implement this programme and field
based activities: One multi-purpose office that will serve as a co-ordination office for the
entire programme as well as a base station has been operational at Anjar from mid
March onwards. Another base station has been set up at Bhuj from April mid onwards.
We also have arrangements at Morbi to carryout the activities in and around Morbi. We
are reaching out to the people in over 200 villages through this intervention. We have
been providing community based services to 1256 survivors out of which 833 people
don’t need intensive care any more. There are over 36 paraplegics who are receiving our
services.
HR / TEAM : In each of these base stations, we have a team comprising of two
physiotherapists, one social worker, driver/s, logisticians and care takers. There is one xray technician to take care of the mobile x-ray unit. (Volunteers that Oxfam India
mobilised have also been supporting the intervention). Moreover, every week fora period
of three days, a team of 3 to 5 experienced and senior physiotherapists are coming from
various hospitals in Bombay and Gujarat. This team has been mobilised by the Indian
Association of Physiotherapists who has an “exclusive*4 understanding with Oxfam India.
Moreover, around 30 people have been identified through community meetings from the
villages where we are working. Some of these community helpers are working full time
and some of them part-time, in villages to do the follow-up work. It may be noted here
that these people come from various background and their skills are being synergised for
the best results.
Oxfam India’s professionals from the head office at Bangalore continue to direct the
programme and make periodic visits to the area. The last visit was undertaken from July
2nd to 8th.
Infrastructure: The field offices also have communication and computing facilities. There
is a jeep (one Tata Sumo I one Toyota Qualis) and other logistical and infrastructural
arrangements in each of these field offices. Needless to say, as this Community Based
Programme actually takes place in the villages, the professional team sets off to the
villages by morning and come back late in the evening/ night depending upon the case
load.
Future action: The programme will continue as scheduled and village visits will take
place uninterrupted.
(3)
Mobile X- Ray, Ambulance unit and corrective surgery: The mobile X-ray unit was
launched on May 13th at Sukhpar, a village near Bhuj by Dr. D. Dastoor, President of
Indian Association of Physiotherapists. The mobile X-Ray unit is located in a Tempo
Traveller that also serves as an ambulance. It is in this ambulance patients (referral) are
often taken to hospitals for a detailed medical check-up, screening for surgery, corrective
surgical operations and to fix artificial limbs. This ambulance has also been used to
transport patients (not earthquake related) in emergency cases to ICU units located in
nearby towns.
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Over 60 x-rays were taken initially. The X-ray reports have been helpful to identify those
who need corrective surgery. A leading Radiologist from Mumbai has examined these xrays in July first week. Some need repetition.
2 people have been taken for corrective surgery till July first week.
Future action: The mobile x-ray unit and the ambulance will continue to be used for
follow-up examination. X-rays those need repitition will be updated by July second week
to enable the orthopaedic surgeons to conduct a diagnostic camp. The orthopaedic camp
is scheduled tentatively for the third week of July.
Moreover, this unit will be made available to other agencies working in other affected
villages. NGOs working on public health issues have found high prevalence of
tuberculosis amongst the survivors (need not necessarily be earthquake induced) in
certain pockets. They are organising a health camp and thereafter a health programme to
address this issue. The mobile x-ray unit may be used for the screening programme and
this may be done without hampering our prime activity.
(4)
Provision of artificial limbs, equipments like crutches and wheel chairs :
These needs are met on a case-to-case basis and as per the felt need. Altogether, over
25 people have been provided with artificial limbs, over 5 people have been given
crutches and other mobility appliances, 2 were given wheel chairs and tricycles. This
activity is undertaken in collaboration with PNR society, specialist agency based in
Gujarat.
Future action: We may continue this as and where it is required.
(5)
Health care center for paraplegics:
The onset of monsoon has thrown us a challenge- the bedsore that is bothering
paraplegics is a pressing concern. We are just setting up a temporary health care center
for paraplegics where over 20 paraplegics, who have shown interest, will be moved for
advanced medical/ health care for the next 3 to 9 months.
Future action: The long-term plight of the paraplegics is a major concern. Oxfam India
is committed to respond to their needs. We are putting a multidisciplinary team that
comprises of rehabilitation specialists, physiotherapists and livelihood/income generation
programme people to make a realistic assessment and suggest long term rehabilitation
plans. The team may conduct field visit and feasibility study in August/ September.
(6) Documentation: A professional documentationalist, with periodic support from students
and other volunteers, have been documenting the intervention process and the external
environment from April onwards. (Please see annexure for the documentation on the
paraplegics). A video camera has been placed in the area and efforts are going on to
document the intervention, the improvement in patients etc. This footage may facilitate
documentaries on this issue. “ The news you missed”, a compilation of press clippings
of the first three months, is being published in collaboration with the development
resource Centre, Mumbai and Institute of Social Research and Development,
Ahmedabad and has been circulated. Photo documentation also continues.
Future action: The documentation work will continue on a regular basis. The compilation
of press clippings also will continue.
(7) Printing of records and education materials : Records have been printed. Educational
materials, especially focusing the care of paraplegics and amputees is under production.
It will be ready by July last week.
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Future action: The educational materials to sensitise the families and orient the
practitioners and planners will be circulated widely from July onwards. Efforts will be put
to place it in local newspapers and other periodicals. We may put efforts to hold a photo
exhibition in January 2002.
(8) Co-ordination and networking with local, national level and international agencies
and the government: Oxfam India has left its footprint on the larger canvas. The
organization is in regular touch with local community based organizations and national
agencies. We are also very much in touch with the government, academic institutions,
the media and international agencies. The Tata Institute of Social Sciences, Mumbai has
collaborated and it may be continued in future as well. Some of our updates, newsletter
and other communication material have been circulated through national and
international e-groups, United Nations and other international web sites.
Future action: This will intensify in the coming months.
(9) Advocacy, lobbying and policy making work: Efforts have been put to advocate
rational policies, lobby this theme at the parliament and policy making level. Numerous
interviews were given to the general media and special health/ medical/ corporate
magazines like the Lancet, Reuters Health, Overseas Development Agency Newsletter,
CIO etc. Oxfam’s opinions have been highlighted widely in the TV and electronic media
as well. A 24-minute interview in a leading Indian TV Channel on the Gujarat intervention
in specific and humanitarian issues in general have been telecasted in May 2001.
We have lobbied to place physical disability as an agenda for the Indian People’s
Tribunal who is expected to visit Gujarat in August second week.
Future action: Efforts are made to publish scientific papers in academic journals and
present papers in national and international seminars. Dr. Dastoor, President of Indian
Association of Physiotherapists will be highlighting the details of this intervention at the
Asia Pacific conference of physiotherapists at Singapore in July last week. Papers about
our intervention and their results will be presented in other seminars as well.
An international workshop is scheduled between Jan and May 2002. Opinion articles are
expected to appear in leading newspapers and TV networks in the coming days.
(10)Advisory committee, mid term review and evaluation: The suggested advisory
committee includes eminent persons like David Werner, Prof. Ali Baquer, Dr. CM Francis
etc. However, apart from individual consultations, the committee has not attained a
formal structure yet. A review is suggested in October. The advisory team is likely to give
a critique of the programme after this. Evaluation is planned in March 2002.
Future action: We will be putting efforts to energise and formalise this committee.
Apart from the physical disability intervention, Oxfam India’s interventions to
respond to the psychosocial needs (undertaken in collaboration with the
National Institute of Mental Health and Neuro Sciences, Bangalore and Basic
Rights Programmefundertaken in collaboration with Indian Centre for Human
R/'ghte, Mumbai).-.am! other agencies is picking up momentum;
unni/ 9 july 2001/
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