Paying back after growing wings
Delhi based ‘Chaupal’ moulds Delhi medicos turn to villages; screen over six lakh people through health camps on weekends
Moved at the long queues of village patients in Delhi hospitals, Dr RS Tonk of Delhi’s Ram Manohar Lohia hospital decided to take the ‘hospital’ itself to villages. Persuading his fellow doctors and other medical professionals he started organising health camps in the villages of National Capital Region on weekends. Started in 2007 under the banner of ‘Chaupal’, the platform that he has exclusively created for this objective, he has so far screened over six lakh rural patients—thus saving the lives of thousands of patients because of timely detection of their diseases. His initiative has set a precedent, which can prove to be a big milestone in resolving the health issues of rural people. Dr Tonk is dedicated to village health so much that he says no undergraduate or MD doctor should be issued medical degree without his compulsory practice in rural areas.
In India, about 75 per cent of the health infrastructure, medical man-power and other health resources are concentrated in urban areas, where only 27 per cent of the population resides. This exposes the reality of health status in rural areas. This is the reason that the life expectancy in rural areas is just 63 years, infant mortality rate is 80/1,000 live births and maternal mortality rate is 438/100, 000 live births. It portrays very dismal image compare to the cities. In this situation the initiative by Delhi based ‘Chaupal’ involving the health professionals (both with rural and urban background) working in different reputed hospitals of Delhi, develops a fine hope.
People in rural areas continue to ignore even the minor ailments until they take a critical turn. The WHO says that 90 per cent of diseases can be prevented by public education. But we in India believe in spending huge amount of money on treatment and nothing on preventive care. “Our experience shows that public education on health can save the lives of crores of people annually. But problem is that it is the most neglected area even in health sector today,” says Dr RS Tonk, who originally belongs to Bayanpur village of Sonipat district in Haryana.
Dr Tonk strongly believes that the professionals, especially from rural background, must not forget their roots and after achieving success in professional life they must pay back to the villages. He mobilised such professionals with the motto ‘let us not forget our roots when we grow wings, hence, it is time to give back’. Later young professionals from metro cities also joined him in this initiative. Since 2007 these professionals have collectively made around six lakh people in the National Capital Region health conscious. The professionals associated with ‘Chaupal’ come from diverse fields of health, agriculture, social science, management, technology with a clear vision to make a positive difference in the lives of rural people. Not only health they also focus on many other issues which indirectly cause damage to the human health.
“Chaupal has incorporated community-building components such as health, hygiene, agriculture, veterinary and social issues like female feticide, drugs abuse, empowerment of women as well as deprived sections of the society through education and dialogue. This objective is achieved by organising camps on weekends. The professionals diagnose and treat common diseases, run campaigns to stop the spread of preventable diseases through public health education with special emphasis on national health programmes. We deliver basic preventive, promotive, curative, rehabilitative and palliative care to the vulnerable rural population,” says Dr Monika Puri, a public health specialist associated with the ‘Chaupal’.
The health camps organised by ‘Chaupal’ are basically ‘complete mobile hospitals’ as they consist of physicians, chest physicians, pediatricians, gynaecologists, psychiatrists, psychologists, eye surgeons, dental surgeons, radiologists, pharmacists, optometrists, and on the spot facility for ECG, ultrasound, pulmonary function tests, blood tests and eye refraction. “Through these camps we intentionally take the whole hospital to villages and treat majority of the ailments on the spot,” adds Dr Monika.
Apart from health camps in villages, there are many schools in rural areas. Efforts are being made to target the young minds, who hold the key to success of any health programme. “During health camps we focus more on eye check up. Around 2,000 patients with eye ailments are screened in each camp. Some who need surgery are operated at Ram Manohar Lohia or any other hospital,” points out Dr RS Tonk.
Nutrition has been found a major concern in rural areas, which otherwise are famous for surplus production of dairy and farm produces. “It’s paradoxical situation. Most of the products are sold to boost the family income leaving little protein and calories for personal consumption. Our outreach programme is a way to fight against malnutrition. The programme provides education on nutrition thereby, improving awareness about the good and balanced diet in preventing disease and to identify early signs and symptoms of malnutrition. Furthermore, patients are provided with multi-vitamins supplements apart from deworming the cohort population,” Dr Tonk added.
He feels that mental health is second most common non-communicable disease, affecting more than 20 per cent patients in the rural areas. Despite its prevalence, only a small percentage of the population has access to even the basic treatment. Untreated mental illness is a serious handicap to individuals struggling to make a living in a resource poor and challenging condition. “Our health team has number of trained and well qualified post doctoral mental health professionals who sensitise the community towards mental health issues. They examine patients, provide medication and teach skills to overcome their disability. ‘Chaupal’ thus, believes in making care accessible not only to improve the lives of those afflicted by mental illness, but also to facilitate the reintegration and stabilisation of the entire community, which is our ultimate goal,” added Dr Monika. Since smoking hukka or Indian hubble-bubble is widely prevalent in the male population of rural areas, a sustained effort is made for educating people on the harmful effects of smoking.
Agriculture and veterinary scientists provide extension services from laboratory to farms, train farmers ways to cultivate land more efficiently thereby, increasing productivity thus boosting income and improving quality of life. Dr Tonk is shortly going to establish a state-of-the-art, full-service community health centre in his ancestral village, Bayanpur in Sonipat district, within six months.
Dr Tonk is a staunch supporter of compulsory practice by medicos in rural areas. “For under graduate students it should be at least one year of service in a rural health centre, while for the MD level students it should be further one year practice. These students should be issued degree only after they complete such a practice in rural areas. Instead of holding discussions, the Government should make it mandatory by law,” opines Dr Tonk.
Nobody knows when the government would take such a decision, the initiative taken by Dr RS Tonk can definitely change the entire health scenario of rural India.
S Vijay, the 17-year-old son of a Dharmapuri farmer, saved 15,000 people in his village Pikkili, and 17 other adjoining villages from drinking toxic water. Vijay works for a firm that distributes water from a sump in Melkottai Village to 18 villages in the Panchayat. “I wasn’t well on the morning of November 9, so my mother helped me get to the sump because I had to close the valve,” Vijay says. “The smell was obnoxious near the sump.” A laboratory confirmed that a highly toxic rodenticide had been mixed in the water. Losing no time, Vijay alerted the pump operator in Thirumalvadi Village, asking him to stop distribution of water from the overhead tanks that received water from the sump. He also informed Pikkili Panchayat president Vasuki Ayyappan about the alarming discovery by calling her husband, C Ayyappan. The 2 lakh litre sump, which receives water under the Hogennakkal Water Supply and Fluorosis Mitigation Project, supplies water to 11 overhead tanks for distribution to 18 villages. The warning came just in time: The tank operators were to start distribution to street pumps in just an hour. The Panchayat resumed water supply only after the sump and overhead tanks were thoroughly cleaned. The Panchayat has lodged a complaint with the Papparapatti Police, seeking action against the culprits who poisoned the water. Tamil Nadu Chief Minister J Jayalalithaa honoured Vijay with a cash award of Rs 1 lakh.