1. TRIBAL HEALTH INITIATIVE
helping tribals heal themselves…….
Experiments in community health
care

2. Tribals are the indigenous people of India
Red Indians of the Americas
Aborigines of Australia

3. Invocation
To the tribal Gods who protect our people

4. Some information about India
 4 of the 10 richest men live here
 46 dollar billionaires
 100 people in Fortune 500
 Fast growing middle class
 IT ‘super power’
 Moon mission

5. Some facts about ‘Bharat’
 60 – 70% population live in villages
 Medical expenses form 58% of total income
 Medical care is the 2nd most common cause
of rural debt
 24% of rural population don’t seek health care
because they can’t afford it
 40% borrow heavily for sickness
 16% fall below poverty line
 Health expenditure is 0.9% of GDP
Source: 2007 National Sample Survey

6. VISION
Attainment of the highest
possible level of health for the
people of Sittilingi valley

7. The Need for Today
Health Care
available
Affordable
acceptable

8. Sittilingi Valley …..enveloped by the
Kalvarayan and Sitheri hill ranges

9. Sittilingi and the Avalur valleys have 21 hamlets
which are home to about 10,000 people of whom
95% are tribals

10. A small beginning…..
In 1993 Tribal Health Initiative started off in a small hut
…team of 4 people

11. The Base Hospital
The Base Hospital now
has 24 beds with about
1200 admissions a year

12. Seeing patients in our OP
In 2007 we
provided service
to 17660 people
Out patients are seen 3 days a week . About 100 – 130
patients use the facility daily of whom more than 70%
are tribals.

13. Diagnostic Facilities
X-rays, ECGs & ultrasound
All Lab investigations including
Biochemistry
In partnership with the Government
Center for Tuberculosis
Counseling and testing center for HIV
Leprosy treatment Center

14. Deliveries & Neonatal Care
Advanced Neonatal care
Ante,Intra & Post Natal care.
About 30 deliveries a
month and 3 - 4 for
neonatal care per month

15. Surgical Work
About 20–30 surgeries every month including emergencies
Government recognized center for family planning
surgeries

16. Go to the people, live with them, begin with
what they know, build with what they have.
And when you have completed your work, the
people will say they have done it themselves
Lao Tse

17. Health Worker (HW) Training
Training in progress
Training is residential for 1 ½ years and open to only
tribal girls. 5 batches of 6 girls each have been trained.
6th batch of training going on

18. HWs’ manage most of the Hospital
In the Wards Dispensing in the OPD
•See Out patients 3 days a week
•Conduct deliveries and assist surgeries
•Manage Ward, Lab, Xray/ECG

19. Health Worker – Advanced Training
Health Workers also do minor surgical
procedures and anesthesia

20. Health Auxiliary (HA) training
Learning to count respiration
Learning to weigh
HA training had been for 1 ½ years, for 2 days every
fortnight. They still come back every month for 2 days to
refresh and share knowledge and data.

21. Community Health – 1st Tier
•Weighing babies in the field
•Teaching oral dehydration
•Discussing community problems

22. Community Health – 2nd Tier
Health Workers now
plan, implement and
follow up the
Community Health
Program

23. Health at the doorstep
Field Clinics on 2 days a week.
Pregnant mothers & young children seen
Health Education is the focus
All newborns are seen within one week

24. HIV prevention work
Street plays HIV education in schools
Started Education on HIV
HIV Counseling & Testing
Treatment of secondary infections
Ready for HIV deliveries

25. Achievements
 No mothers died in child birth – 5 years
 Infant deaths – from 147/1000 to 32/1000
 Malnutrition – down by 50 %
 Pregnant mothers check up – from 11%
to 95 %
 Almost 100% completion of treatment
in tuberculosis

26. That formal education is mandatory to do
health care is a myth
Help people heal themselves…..

27. There is enough in our world for everyone’s need, but
not for anyone’s greed
Mahatma Gandhi
 Stabilised Mud Blocks for Buildings
 Solar Water Heating
 Solar Lighting & Water Pumping
 Biogas from Kitchen & Hospital Waste
 Drip Irrigation & Rain Water Collection
 Minimising Disposable materials

28. Freedom to learn
Thulir – the educational initiative runs a Resource Center
for children
Basic Skills course for school dropouts

29. Back to Roots
In 2003 , after a 10 year evaluation
we decided to go back to the people

30. Farming Initiative
•15 Farmers groups [men & women]
•From 4 to 80 organic farmers in 3 years
•Collective selling and buying
•Exposure visits & classes from experts

31. Women
entrepreneurs
Shirts with Sittilingi cotton

32. Marketing
organically grown by traditional methods
1. ragi 13. ground nut
2. ragi powder 14. rice [red]
3. sprouted ragi powder 15. coconut oil
4. millet mix 16. sunflower oil
5. bajra 17. jaggery
6. bajra powder 18. coriander
7. little millet [samai] 19. coriander powder
8. bengal gram 20. turmeric
9. black gram 21. turmeric powder
10. horse gram 22. chilly
11. field bean 23. chilly powder
12. tur dhal 24. maize
25. foxtail millet

33. Craft Initiative
Porgai …….. sharing pride
Trade agreement
with Fairgrounds UK

35. Community Initiatives
 Community certificates
 Mullikadu dam
Secretary for Rural
Anti-plastic rally
Development meets
villagers

36. Future Plans
 Start work in the Kalrayan Hills
 Training more Health Workers
 More farmers groups
 Organic Certification
 Local markets for Porgai

37. THANK YOU