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QUARTERLY REPORT
JANUARY- MARCH, 2013
2
CONTENTS PAGE NUMBER
Main Events and Activities 3
Achievements 4
An Overview of New Activities and Programs 5
 Village Selection 5
 Program on Malnutrition 7
 Village Scan 9
 Vocational Training 13
 Strengthening Basic Education 13
 Bodhgaya Clean Environment Program 14
An Overview of Total Medical Activities-OPD and Mobile Clinics 16
 Medical Consultations 16
 Directly Observed Therapy (DOT) 18
 Types of Diseases Observed among Patients in OPD and
Mobile Clinics
18
 Generic Medicines 20
 Identity Cards for Medical Consultants 22
 Review, Revision and Update of the List of Medicines 22
 Refresher Training for Doctors 22
Access to Primary Healthcare in Urban Area: Shechen Medical
Centre in Bodhgaya, Bihar
23
 Outreach Patients Department (OPD) 24
 Laboratory 27
Outreach Services: Community-based Integrated Programs 28
 Mobile Clinic 29
 Medical Camps for the Poor and Needy 34
 Health Education Program (HEP) 37
 Non-Formal Education (NFE) 38
 Solar Electricity 39
Other Events, Activities and Information 40
 Recruitment of New Staff 41
 Orientation on Program Activities 41
 External Visitors 42
 Finances 42
 Upcoming Activities 44
 Our Partners 44
Annex- Success Story 45
3
MAIN EVENTS & ACTIVITIES
 A Medical Camp was organised in January and February for Monks at the
Nyingma Monastery. Total number of consultants at the camp was 748.
 A Medical Camp was organised in January and February for the poor and
needy including the Dalits. Total number of consultants at the camp was
859.
 In February Karuna-Shechen, India had the honour of welcoming several
external visitors including Chief Operating Officer, Tarek Toubale and
Director of Field Operations, Sanjeev Pradhan.
 On 5th February, training on Malnutrition was conducted by Dr. Nadine
Donnet where the entire staff of Karuna-Shechen, India participated.
 A one-day Orientation was conducted in Bodhgaya for the new staff of
Karuna-Shechen, India.
 A village scan was conducted in March in the 6 newly adopted villages.
 9 new staff members were recruited in the months of January and
February. In March 6 motivators were recruited for our six new villages.
 The existing list of medicines was revised and updated.
4
ACHIEVEMENTS
 Total number of consultants in OPD (Outreach Patients Department) and Mobile
Clinics was 7358, where number of new consultants was 4221.
 Our outreach healthcare service of Mobile Clinics was extended from 12 villages
to 18.
 Generic medicines were introduced in January 2013 and have since been
prescribed along with branded medicines. New!
 Identity Cards are issued to all Consultants at the OPD and Mobile Clinics in an
effort to keep a track of the medical history of the patients. New!
 Refresher training was given to our Doctors by Dr. Jaya Maitra from the Red
Cross Society in Jamshedpur, Jharkhand.
 Till 2012 only male doctors served the patients at the OPD and mobile clinics
but since February 2 female doctors have been working with us to better serve
the women and children who form majority of the medical consultants in
Karuna-Shechen, India.
5
Apart from its continuous dedicated efforts towards the wellbeing of the poor and
underserved communities of Bodhgaya town in Bihar and 12 surrounding villages, from
February 2013 Karuna-Shechen India has extended its outreach services to 6 more
villages with the objective of reaching out to more people suffering from the grinds of
poverty and marginalisation.
VILLAGE SELECTION
A meeting in Chando during village selection
AN OVERVIEW OF NEW ACTIVITIES
AND PROGRAMS
6
After 6 month of hard work to identify and shortlist the villages around Bodhgaya
through several village visits, village walks, formal and informal meetings and
discussions with the villagers themselves, 6 new villages were chosen for our
intervention. The various above-mentioned processes have been taken in an effort to
build a strong relationship with the beneficiaries and to incorporate and motivate them
to work together with us for their own development.
The 6 new villages are:
 Bandha
 Dema
 Nawatari / Meghuvigha
 Barsuddi
 Kadal
 Chando
Reasons for Selection of the 6 New Villages
The choice to provide services to the above-mentioned villages has been based on
several factors:
 Need based search: The villages have been selected primarily based on their
need for intervention in the areas of health, education, environment and
social factors.
 Distance: The villages are within 50 kms from our clinic in Bodhgaya.
Distance was an important criterion because we did not want travel time and
costs to obstruct our goal of providing the best possible service to the
villages.
 Creation of Village Cluster: Villages have been chosen in such a way that the
benefits of program intervention can reach the cluster of villages nearby.
Villages belonging to the same block and /or panchayat have been chosen as
we have identified the need to target the entire Panchayat. Kadal and
Barsuddi have been selected as they both belong to Bhumer Panchayat;
Chando is located in the neighbouring Panchayat. Again, Meghubigha and
Bandha belong to neighbouring Panchayats.
 Possibility of extension to Jharkhand: With the intention of extending our
programs to the neighbouring state of Jharkhand several villages near the
Bihar-Jharkhand border have been selected. Kadal and Barsuddi are 3 and 2
kms from Jharkhand border respectively.
The process of village selection and building relations with the target communities,
continuing from 2012 lasted through the month of January this year.
7
PROGRAM ON MALNUTRITION
Training on Malnutrition
8
Looking at severity of the problem of malnutrition in
India at large and Bihar in particular, Karuna-
Shechen, India decided to incorporate malnutrition as
an integral part of its health services. The groundwork
for the program started with a one-day training on
Malnutrition on 5th February this year. It was
conducted by Dr. Nadine Donnet and was attended by
the entire staff of Karuna-Shechen India, a volunteer
from France, the Program Officer of Karuna-Shechen,
Nepal, and Field Operations Director, Karuna-
Shechen, Nepal.
Dr. Donnet demonstrating MUAC measurement
The training was followed by an extensive baseline survey of our 6 newly adopted
villages where the malnutrition
program will be conducted. For the
survey the widely used and
accepted tool of measurement of
malnourishment, the MUAC (Mid-
upper Arm Circumference) was
used. The MUAC is a simple way of
determining whether or not a child
is malnourished using a coloured
plastic strip. MUAC is used on
children from the age of 12 months
up to 5 years.
MUAC measurement taken during baseline survey
9
ACM
VILLAGE SCAN
Shamsul Akhtar engaged in discussions with the people of Dema village
Keeping in tandem with Karuna-Shechen’s participatory approach towards its various
development programs, we conducted a village scan for our new villages. Our team, led
by the Director, conducted meeting with the people from each of the 6 villages. Village
Scan is the first step to identifying and implementing projects that are guided by the
specific needs and aspirations of the local communities. It will thus form the base for
determining what projects will be introduced in the villages. The programs that would
10
run in these villages will follow the ‘small money big change’ model which empowers
the target communities by facilitating their participation in community planning and
management.
The Village Scan was segregated into two distinct categories. It started with Social
Mapping and then proceeded to a discourse on the main problems confronting the
village as a whole. In the first exercise the villagers were provided with flipcharts and
coloured pens and asked to draw a map of their village demarcating the various types of
water resources, schools, roads, households etc. This fun-filled activity worked as an
ice-breaker thus forming the first step towards participatory learning. It enabled the
villagers to engage and interact with us, making them comfortable and at ease with the
entire situation. Map making was followed by an animated discussion about the
common problems facing the villagers, the probable solutions and how we could work
together to implement them. In this activity villagers were asked to state the most
crucial problems that they faced, while one amongst them volunteered to write them
down. Having done that the villagers were asked their opinions on how we could
resolve them.
The following table shows the problems pin-pointed by the villages as those requiring
immediate action:
Table 1: Problems faced by the villages
VILLAGES PROBLEMS
Dema
 Drinking Water
 Irrigation
 Education
 Inadequate Healthcare Facilities
 Unemployment for the Youth
 Electricity
Bandha
 Women’s Education
 Lack of Adequate Hand Pumps
Kadal
 Drinking Water for Villagers
 Drinking Water for Animals/ Ponds
 Irrigation
 Roads
 Inadequate Healthcare Facilities
 Education
 Electricity
 Unemployment
 Embankment
 Bandh (Small Dam) to store water
11
Barsuddi
 Proper Roads
 Electricity
 Drinking water for Villagers
 Drinking water for animals
 Water for Irrigation
 Inadequate Ponds
 Inadequate Healthcare Facilities
 Education
Nawatari  Drinking Water
 Electricity
 Lack of Ponds
 School/Education
 Temples for Lord Shiva and a Goddess
 Panchayat Bhavan
Meghubigha
 Tubewell
 Electricity
 Temples for Lord Shiva and a Goddess
 Pond
 Sewing Machine
 Roads
 Drains
Chando
 Drinking Water
 Irrigation
 Electricity
 Unemployment of Women (insistence on requirement
for training in incense stick making)
 Land is sloped /lack of leveled land
 Inadequate Healthcare Facilities
 Increase in the Price of Diesel
The above-mentioned table clearly demonstrates lack of drinking and irrigation water,
dearth of electricity and proper education facilities as a major problem for all villages.
The villages agreed to work along with us, contributing in their own small ways,
towards the resolution of the problems.
Thus, the village scan formed the building blocks of the upcoming programs in the new
villages.
12
Women and Girls were especially encouraged to come
forward and participate in Social Mapping
Villagers engaged in noting problems and potential solutions during the session on problem discussion
Discussing problems written on flipchart by villagers Listening to the villagers
13
VOCATIONAL TRAINING
In an effort to enhance the skills, add to the livelihood and economically empower rural
poor women we will incorporate vocational training like making pickles, baskets,
poultry farming etc. in our Non-Formal Education program which will start from mid-
April in the new villages. The decision as to what type of vocational training should be
imparted will be taken in accordance with the interests and requirements of the
villagers. During our village scan in our newly adopted villages, where extensive
discussions were held with the villagers, several women demanded that they be trained
in sewing, tailoring and incense stick making. The final decision will be made after
further discussions with the villagers.
STRENGTHENING BASIC EDUCATION
We have started the process of visiting schools in various villages and talking with the
principal, faculty members, students and their parents regarding teachers’ training on
pedagogy, providing TLM (Teaching Learning Materials), forming Children’s Club, etc.
We are in the process of searching for individuals from amongst the villagers who, with
their knowledge and enthusiasm, can act as support teachers to the existing school
faculty and thereby help ameliorate education of the school-going children. We have
also started looking for suitable sites near the schools to make playground for the
children.
14
School children of Barsuddi with Director, Karuna-Shechen, India
BODHGAYA CLEAN ENVIRONMENT PROGRAM
As the first step to this project, in January this year, photographs of various localities of
Bodhgaya town were taken in order to get an idea about the level of cleanliness in the
town and to pinpoint which localities we require to work in for this project. Again, the
village coordinators have been in the process of talking to street vendors and random
local people in order to understand their stance on hygiene and clean environment.
An ill-maintained dustbin Vendor selling food open without any cover
15
Following the principle of Charity begins at Home, during the Orientation on Program
Activities in March this year, the entire staff of Karuna-Shechen India was trained in
making paper bags with the objective of discouraging the use of plastic bags and
encouraging the practice of paper recycling amongst the staff members.
Karuna-Shechen staff making paper bags Staff with their hand-made paper bags
16
MEDICAL CONSULTATIONS
The total number of Consultants availing healthcare services of our OPD (Outreach
Patients Department) in Bodhgaya and Mobile Clinic in 18 villages is 7358, wherein new
consultants constitute 4221 people (57.37% of total number of consultants).
An Overview of Medical Activities -
OPD and Mobile Clinics
Total
17
 The number of patients refered to PHC & Government Hospitals was 102
(1.14% of total consultants at OPD, Mobile Clinics and Medical Camps ).
 The total patients who were treated “Free of Cost” (Pregnant women,
children and aged people above 60 years) in the OPD Clinic and by our
Doctors were 2336 ( 13%).
 4 special cases (from poor patient fund) were treated by our doctors.
 Total money collected against registration charges was INR 84395.
Table 2: Total Number of Patients Referred to PHC and Government Hospitals
MONTH OPD MOBILE MEDICAL CAMP
FOR POOR &
NEEDY
MEDICAL CAMP FOR
MONKS
January 12 8 21 5
February 12 10 15 18
March 1 0 0 0
Total 25 18 36 23
Table 3: Total Money Collected from Registration Charges
Month Amount
January 23340
February 31640
March 29415
Total 84395
18
DIRECT OBSERVED THERAPY (DOT)
Out of 751 medical tests conducted in our pathology laboratory Sputum tests (for
Tuberculosis) constituted the highest number of tests done (168) in the first quarter of
2013. Out of these the number of people who were diagnosed with TB was 9. Currently,
the total number of TB patients undergoing treatment is 24.
Table 4: Details of DOT program
January February March Total
Number of TB patient’s started
medicine
5 4 3 12
Number of sputum test 33 47 88 168
Sputum Positive 1 5 3 9
Refer TB Patients 0 0 0 0
Completed TB Medicine 3 5 2 10
Undergoing Treatment in Mobile 5
Undergoing Treatment in OPD 19
Total Number of TB Patients currently
undergoing treatment (OPD and
Mobile)
24
TYPES OF DISEASES OBSERVED AMONG PATIENTS IN OPD AND
MOBILE CLINICS
The following table gives us information about the various types of diseases observed
among the patients in our OPD and Mobile clinics.
Table 5: Types of Diseases
Types of Diseases Total
Diarroheachildren 37
Diarrhoea / dysentery adults 66
Amoebiasis 17
Ttyphoid
0
TB
34
Gynea patient
139
Bone & joints patients
568
19
Burn patient
87
Worm manifestation
15
Skin diseases of all kinds
301
Ophthalmologic infections
23
Number of identify malnourished children
2
Cardiac Inf. 3
HTN 122
Diabetes 10
Asthma & COPD
135
Cough & Cold
476
Epilepsy 33
ENT patient
50
LYMPHadenopathy
20
I&D Dressing
21
Other patients
341
20
From the above table and graph we notice that the most common diseases observed,
both in OPD and Mobile clinics, were Skin diseases, Bone and Joint Problems and Cough
and Cold.
GENERIC MEDICINES
Till 2012 only branded medicines were given to the patients but since January 2013
generic medicines have been introduced as they are equally effective but much cheaper
than their branded counterparts. Therefore, since the beginning of this year our medical
team is providing generic medicines to the patients along with branded ones.
The following table gives a comparative study of the prices of 12 branded medicines and
their generic counterparts. These 12 medicines have been chosen as they are some of
the most widely used medicines in our healthcare services.
21
Table 6: Cost-Effectiveness of Generic Medicines
The above table shows that the substitution of these widely used branded medicines
with their equally effective generic counterparts has resulted in about 60% reduction in
the cost.
Composition Medicine Name Price
Rate
Generic
Medicine
Name
Price
Rate
% of
reduction
in Price
Rate of
Generic
Medicines
Compared
to
Branded
ones
Calcium Tab Calcium 500mg 2.4 Tab Cachacal
500mg
0.33 86
Paracetamol Tab Calpol 500mg 1.06 Tab Pyrakem
500mg
0.30 72
Cefexime Tab CEFOCEF O 100
tab
3.98 Tab O-
Powercef DT
100mg
2.25 43
Clobetasol propionate
sulphate &
Miconazole nitrate
Cream Cosvate-GM 8.43 Cream
Clobikem-GM
8.00 5
Anticold, anticough Sy Lemolinctus 27.69 Sy New Nano
Cold
10.00 64
Levofloxa Tab Ovil 500mg Tab 5 Tab Levowok
500mg
2.45 51
Ofloxa+ ornidazole Tab O-Cebran Oz 5.2 Tab Oflowock
OZ
1.60 69
Anticough (Dry cough) Sy Samdex 38.8 Sy Tordex 17.50 55
Anticough Sy Samdryl 28.6 Sy Kemodaryl 8.50 70
Aceclofenac+paracetamol+
serrataiopetidase
Tab Speeder SP 4.18 Tab
Acceclowoc SP
1.30 69
Aceclofenac+paracetamol Tab Speeder-Plus 1.98 Tab
Acceclowoc-P
0.54 73
Levo-Cetrizine Tab 1 Al 1.26 Tab lovozine 0.4 68
22
IDENTITY CARDS FOR MEDICAL CONSULTANTS
In order to keep track of the medical history of each patient identity cards are issued to
every individual seeking medical help from us. These cards cost a mere INR 5 and
should be brought along in every visit to the OPD or Mobile clinics.
REVIEW, REVISION AND UPDATE OF THE LIST OF MEDICINES
The list of medicines existing in 2012 was reviewed, revised and updated to better serve
the target population.
REFRESHER TRAINING FOR DOCTORS
Refresher Training was imparted to our doctors by Dr. Jaya Maitra of the Red Cross
Society, Jamshedpur.
23
Patients waiting for check-up in OPD Patients queuing in front of the Pharmacy
OUTREACH PATIENTS DEPARTMENT (OPD)
The total number of people who came to the Medical centre in Bodhgaya for
Consultations in the first quarter of 2013 was 3834. Out of this total 2410 were new
consultants, representing 62.86% of total consultations in OPD.
ACCESS TO PRIMARY HEALTHCARE
IN URBAN AREA: SHECHEN
MEDICAL CENTRE IN BODHGAYA,
BIHAR
24
Table 7: Number of Consultants in OPD
JANUARY FEBRUARY MARCH TOTAL
TOTAL NUMBER OF
CONSULTANTS
1360 1321 1153 3834
TOTAL NUMBER OF
NEW CONSULTANTS
872 864 674 2410
MEN 420 431 310 1161
WOMEN 585 552 515 1652
CHILDREN 355 338 328 1021
PATIENTS FREE OF
REGISTRATION
CHARGE
485 478 461 1424
25
The total patients who were treated Free of Registration Cost (Pregnant women,
children and aged people above 60 years) in the OPD was 1424, representing 37.14% of
the total consultants.
26
From the above pie-chart we can see that women and children constitute the majority of
the consultants (70%) in OPD.
LABORATORY
Total number of patients who came in the first quarter of 2013 (January-March) for
different medical tests were 237 and total anaysis done was 751. The number of
patients and tests are different because one patient may go for several tests. Total
money collected from these tests was INR 7210.
27
 From the above pie-chart we can see that the more frequent tests were Sputum
test (for tuberculosis), ESR and TC/DC ( Blood tests for infection, allergy and
red blood cells) and less frequent test were ASO (for throat infection), Titer and
VDRL.
 Patients tested free of registration charge (pregnant women, children and
people above 60 years of age) were 38 (16. 03%) out of 237 people
undergoing medical tests.
28
Apart from the medical clinic situated in the town of Bodhgaya Karuna Shechen
provides several outreach services to the poor and marginalised population in the
surrounding villages. The Community-based integrated programs run by Karuna
Shechen India are:
 Mobile Clinic
 Health Education Program (HEP)
 Health and Hygiene
 Reproductive and Child Health (RCH)
 Non-Formal Education (NFE)
 Solar Electricity
OUTREACH SERVICES:
COMMUNITY-BASED INTEGRATED
PROGRAMS
29
MOBILE CLINIC
Inaugration of Mobile Clinic in Chando village
Inaugration of Mobile Clinic in Bandha village
Till January 2013 Karuna-Shechen India provided medical care to the rural population
through the services of a mobile clinic that functioned 6 days a week.
With the objective of providing
comprehensive healthcare to a larger number of the rural poor our organisation has
expanded its mobile health services to 6 new villages since February 2013 by launching
a second Mobile clinic. The new villages have been selected on the basis of the cluster
model so that the services of the mobile clinics are not confined to the population of
these villages alone but are also extended to the people of 3-5 satellite villages.
 In the first quarter of 2013 (January-March), the number of patients who
came for the consultations in mobile clinic from 18 village were 3524, out
of this 1811 were new patients representing 51.39% .
 Number of consultants from the satellites villages around our 18 adopted
villages who sought medical help from our mobile clinic services is 1474.
 The total patients who were treated for Free of Registration Charge
(Pregnant women, children and aged people above 60 years) in the
Mobile Clinic was 1918 (54.43% of the total consultants at mobile
clinics).
30
Table 8: Details of Consultants going to Mobile Clinics
MOBILE CLINIC JANUARY FEBRUARY MARCH TOTAL
TOTAL NUMBER OF
CONSULTANTS
632 1511 1381 3524
TOTAL NUMBER OF
NEW CONSULTANTS
237 915 659 1811
MEN 172 426 409 1007
WOMEN 283 774 652 1709
CHILDREN 177 311 320 808
PATIENTS TREATED
FREE OF
REGISTRATION
CHARGE
336 769 813 1918
31
From the above table and graph we can see that the number of consultants at the mobile
clinics in the month of January is much less compared to February and March. This is
because the mobile healthcare services were extended to the 6 new villages from
February, i.e., till January mobile clinics served 12 villages but since February it has
been covering 18 villages.
1918 patients out of a total of 3524 consultants visiting the mobile clinics were treated
free of cost by our doctors.
32
Just like in the OPD, women and children constitute the majority of consultants in the
Mobile Clinics (73%).
33
Villagers waiting for their turn for check-up
34
MEDICAL CAMPS FOR THE POOR AND NEEDY
In addition to the mobile clinic Karuna-Shechen makes an effort to extend its outreach
healthcare services to the poor and needy groups like the Dalits (low-caste Hindus who
constitute a poor and underserved community) and the Buddhist Monks through
medical camps.
In the months of January and February a medical camp was organized for the poor and
needy in general and another camp specifically for the Monks at Nyingma monastery
during the auspicious occasion of Nima pooja.
Medical Camp for poor and needy
Medical Camp at Nyingma Monastry
Table 9: Total Number of Consultants and Refer Patients at the Medical Camps
Month No. of
Consultants at
Medical Camp
for Poor &
Needy
No. of Consultants
at Nyingma camp
No. of Refer
Patients at Medical
Camp for Poor &
Needy
No. of Refer
Patients at
Nyingma camp
January 500 148 21 5
February 359 600 15 18
March 0 0 0 0
Total 859 748 36 23
35
36
HEALTH EDUCATION PROGRAM (HEP)
Health Education Program (HEP), which was introduced in our 12 villages in 2010,
continues to run smoothly. Currently there are 87 health groups with 534 members
under HEP.
Table 10: Some Important Data on HEP
Total
Total Number of Home Visits by Village Coordinators 689
Total Number of Home Visits by Motivators 1515
No. of Families who Received the Message regarding
Health & Hygiene
1078
Number of Hand pumps Repaired 32
Number of Soak pits created 0
Total No of Meetings 83
Table 11: Some Important Data on Reproductive and Child Health (RCH)
Total
Identified New pregnant Women 55
Total Pregnant Women 140
Total Pregnant Women immunized with T.T1 31
Total Pregnant Women immunized with T.T2 98
Total Pregnant Women not immunized 11
Total Deliveries 52
Delivery at PHC 35
Delivery at HOME 17
Total No of Miscarriages 3
Number of Pregnant Women Followed-up by
Motivators and Village Coordinators
140
37
Total Newborn Children 52
Total Neo-natal Deaths 4
Maternal death at child birth 0
New born child Immunized 34
Training for birth attendants 0
Meeting up Mother and Child by Village Coordinators 63
The above table shows that among the 52 child deliveries that took place in the first
three months of 2013 35 were institutional deliveries (67.31 % of total deliveries). The
remarkable number of women opting for institutional deliveries shows the increased
health awareness through HEP. Again, the number of neo-natal deaths has been very
less (4 children); only 7.69 % of total newborn children and there are no recorded cases
of maternal deaths.
Health and Hygiene- Women collecting drinking Mothers with their Children
water from Tubewell
38
NON-FORMAL EDUCATION (NFE)
NFE classes were started in August 2011 in 6 villages namely, Banahi, J.P Nagar,
Karhara, Kharati, Gopalkhera and Trilokapur with the objective of expanding and
improving basic education of the poor illiterate rural women. However, NFE classes
have been temporarily stalled due to poor attendance of the students in all 6 villages
where the program was running. Currently we are in the process of evaluating the
reasons for the large-scale absenteeism of the women enrolled in NFE classes. One of
the reasons for the above-mentioned problem has been the teacher’s incapability of
inducing interest among the students about studies. Teachers seem to have failed to
connect with the students due to the former’s inability to explain things properly, their
unapproachable attitude and their irregularity. On the other hand, the students are
faced with certain socio-economic impediments to their non-formal education such as
resistance from and reluctance of the family members, no time for classes during the
harvesting season, etc.
While the process of intensive evaluation of the NFE program in the existing villages is
going on, our meetings and discussions with the new villages (during village scan) is
evoking a lot of interest among their population regarding the above-mentioned
program. So, with the objective of restarting our NFE program in the 6 existing villages
where classes have been temporarily stopped and with the intention of extending the
program to our new villages in response to their demand we are working extensively on
resolving the problems and modifying the program to provide optimum benefit to the
target population. Therefore, we have already started searching for appropriate
teachers who are passionate about bringing about positive change in the lives of their
students by imparting knowledge to them. Besides, we are in the process of revising the
syllabus and modifying the methods of teaching to make the program efficacious for the
rural illiterate women.
As mentioned earlier in this report, we will be incorporating vocational training in our
NFE classes and have already taken the first step towards it through our meetings and
discussions with the villagers.
NFE program will be commencing in the new villages and re-starting in the existing
ones from mid-April, 2013.
39
SOLAR ELECTRICITY
Children studying under Solar light
Our Solar electricity program continues to run in all 3 villages. However, over the past
several months we have noticed a decreasing sense of responsibility of the beneficiaries
in terms of monthly payment towards maintenance and replacement of batteries. In an
attempt to understand the reason for such a trend and to better serve the people we
have prepared a comprehensive questionnaire for the existing and potential users of
solar lights. It has been designed as a tool for impact evaluation of the existing solar
program and as a feasibility study for the program in new villages.
During our village scan 3 villages (Kadal, Barsuddi and Chando) have shown a keen
interest in our solar program. As per the discussions held during the village scan, 10
men and women from Kadal were taken to J. P. Nagar, one of our existing solar villages,
to give them a vivid idea about solar lights and their use. Karuna-Shechen arranged for
and bore the cost of their travelling, food and lodging. We intend to provide the same
opportunity to people from the other two villages.
In the 3 villages where solar lights will be installed, we are in the process of searching
for young, illiterate mothers and grandmothers who will be interested in undertaking
training for Solar Engineering at Barefoot College in Tilonia, Rajasthan.
Later this year Karuna-Shechen plans to send more young grandmothers for training,
bringing light to even more families.
40
OTHER EVENTS, ACTIVITIES &
INFORMATION
RECRUITMENT OF NEW STAFF
With the starting of a host of new activities since February 2013 and with the extension
of the organization’s existing programs from 12 villages to 18, Karuna-Shechen India
team has expanded to incorporate nine new staff members, including 2 female and 1
male doctor, 1 laboratory technician, 2 nurses, 1 pharmacist, 1 driver and 1 research
and documentation officer.
With over 75% of our patients being women and children recruitment of female doctors
has been a great step towards the provision of better healthcare services in our OPD
and Mobile clinics.
In addition to these 9 new staff members 6 village motivators were hired in March to
work in our new villages.
41
0RIENTATION ON PROGRAM ACTIVITIES
Entire staff of Karuna-Shechen, India at the Orientation
On 2nd March, 2013, after a month of working with the new members, a one-day
training was organized in Bodhgaya as an orientation session. The entire Karuna-
Shechen India team was present as participants while our Director, Shamsul Akhtar,
played the role of the facilitator.
Objectives of the Training
 To give a clearer understanding about the organization
 To give a clearer understanding of the program activities
 To make all new colleagues feel as part of the team and enable them to do their
best to help the organization achieve its goals.
42
EXTERNAL VISITORS
In February Karuna-Shechen, India had the honour of welcoming several external
visitors including Karuna-Shechen’s Chief Operating Officer, Tarek Toubal;, Director of
Field Operations, Sanjeev Pradhan; Alexandra Brun, Project Officer for Karuna-Shechen,
Nepal; Nadine Donnet, ex-Field Operations Director; Rafaele Demandre, Field
Coordinator for Karuna-Shechen, Tibet, Dr. Jaya Maitra from the Red Cross Society,
Jamshedpur; and two international volunteers.
FINANCES
The budget and expenses for the first quarter of 2013 are presented below:
Table 12: Budget and Expenses
Budget in
USD($1=50 INR)
Expenses in
USD($1=50 INR)
Administration, transportation and
functioning cost
14,271 12,302
OPD direct benefit to population in
Bodhgaya town and close surroundings
18,465 15,730
Mobile clinic benefit to population in 18
villages
27,329 14,503
Education direct benefit to population in
18 villages
15,710 4,497
Environmental Program 3,155 502
Social Program 11,780 2,367
Program Support 8,030 806
Investment: Equipment 17,450 21,269
Contingencies 5,810 627
Total 1,22,000 72,603
43
44
UPCOMING ACTIVITIES
 Non-Formal Education will commence in the 6 new villages and re-started in the
existing villages from mid-April.
 Household Survey in the 6 new villages.
 A Purchasing Committee will be functional from April.
OUR PARTNERS
Current Partner: Barefoot College in Tilonia, Rajasthan
Prospective Partner: Centre for Science and Environment, New Delhi.
45
A six year old girl called Anchal Kumari came to the OPD in February this year to treat
her severely burnt hand. Her hand had been burnt two days before but due to their poor
economic condition the girl’s family could not afford to take her to the government
hospital in Gaya. Instead they sought local medical help in their village which, due to
wrong treatment, resulted in worsening of the wound. Then one of the villagers
suggested they approach the Shechen Clinic where treatment and medication are
available free of cost, with only a nominal registration fee.
When the girl was brought to the clinic she was running fever and her hand was
infected, badly swollen and severely paining. After taking her medical history her
treatment commenced with dressing and medication. Just two days after her fever was
gone and swelling and pain of the burnt hand had subsided. After a week of treatment
her wound was healed and healthy skin appeared.
Her family was relieved and very thankful to the clinic.
Anchal Kumari, when she came to Shechen Clinic for treatment
1 week after treatment
ANNEX- SUCCESS STORY

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Karuna-Shechen First Quaterly Report of 2013

  • 2. 2 CONTENTS PAGE NUMBER Main Events and Activities 3 Achievements 4 An Overview of New Activities and Programs 5  Village Selection 5  Program on Malnutrition 7  Village Scan 9  Vocational Training 13  Strengthening Basic Education 13  Bodhgaya Clean Environment Program 14 An Overview of Total Medical Activities-OPD and Mobile Clinics 16  Medical Consultations 16  Directly Observed Therapy (DOT) 18  Types of Diseases Observed among Patients in OPD and Mobile Clinics 18  Generic Medicines 20  Identity Cards for Medical Consultants 22  Review, Revision and Update of the List of Medicines 22  Refresher Training for Doctors 22 Access to Primary Healthcare in Urban Area: Shechen Medical Centre in Bodhgaya, Bihar 23  Outreach Patients Department (OPD) 24  Laboratory 27 Outreach Services: Community-based Integrated Programs 28  Mobile Clinic 29  Medical Camps for the Poor and Needy 34  Health Education Program (HEP) 37  Non-Formal Education (NFE) 38  Solar Electricity 39 Other Events, Activities and Information 40  Recruitment of New Staff 41  Orientation on Program Activities 41  External Visitors 42  Finances 42  Upcoming Activities 44  Our Partners 44 Annex- Success Story 45
  • 3. 3 MAIN EVENTS & ACTIVITIES  A Medical Camp was organised in January and February for Monks at the Nyingma Monastery. Total number of consultants at the camp was 748.  A Medical Camp was organised in January and February for the poor and needy including the Dalits. Total number of consultants at the camp was 859.  In February Karuna-Shechen, India had the honour of welcoming several external visitors including Chief Operating Officer, Tarek Toubale and Director of Field Operations, Sanjeev Pradhan.  On 5th February, training on Malnutrition was conducted by Dr. Nadine Donnet where the entire staff of Karuna-Shechen, India participated.  A one-day Orientation was conducted in Bodhgaya for the new staff of Karuna-Shechen, India.  A village scan was conducted in March in the 6 newly adopted villages.  9 new staff members were recruited in the months of January and February. In March 6 motivators were recruited for our six new villages.  The existing list of medicines was revised and updated.
  • 4. 4 ACHIEVEMENTS  Total number of consultants in OPD (Outreach Patients Department) and Mobile Clinics was 7358, where number of new consultants was 4221.  Our outreach healthcare service of Mobile Clinics was extended from 12 villages to 18.  Generic medicines were introduced in January 2013 and have since been prescribed along with branded medicines. New!  Identity Cards are issued to all Consultants at the OPD and Mobile Clinics in an effort to keep a track of the medical history of the patients. New!  Refresher training was given to our Doctors by Dr. Jaya Maitra from the Red Cross Society in Jamshedpur, Jharkhand.  Till 2012 only male doctors served the patients at the OPD and mobile clinics but since February 2 female doctors have been working with us to better serve the women and children who form majority of the medical consultants in Karuna-Shechen, India.
  • 5. 5 Apart from its continuous dedicated efforts towards the wellbeing of the poor and underserved communities of Bodhgaya town in Bihar and 12 surrounding villages, from February 2013 Karuna-Shechen India has extended its outreach services to 6 more villages with the objective of reaching out to more people suffering from the grinds of poverty and marginalisation. VILLAGE SELECTION A meeting in Chando during village selection AN OVERVIEW OF NEW ACTIVITIES AND PROGRAMS
  • 6. 6 After 6 month of hard work to identify and shortlist the villages around Bodhgaya through several village visits, village walks, formal and informal meetings and discussions with the villagers themselves, 6 new villages were chosen for our intervention. The various above-mentioned processes have been taken in an effort to build a strong relationship with the beneficiaries and to incorporate and motivate them to work together with us for their own development. The 6 new villages are:  Bandha  Dema  Nawatari / Meghuvigha  Barsuddi  Kadal  Chando Reasons for Selection of the 6 New Villages The choice to provide services to the above-mentioned villages has been based on several factors:  Need based search: The villages have been selected primarily based on their need for intervention in the areas of health, education, environment and social factors.  Distance: The villages are within 50 kms from our clinic in Bodhgaya. Distance was an important criterion because we did not want travel time and costs to obstruct our goal of providing the best possible service to the villages.  Creation of Village Cluster: Villages have been chosen in such a way that the benefits of program intervention can reach the cluster of villages nearby. Villages belonging to the same block and /or panchayat have been chosen as we have identified the need to target the entire Panchayat. Kadal and Barsuddi have been selected as they both belong to Bhumer Panchayat; Chando is located in the neighbouring Panchayat. Again, Meghubigha and Bandha belong to neighbouring Panchayats.  Possibility of extension to Jharkhand: With the intention of extending our programs to the neighbouring state of Jharkhand several villages near the Bihar-Jharkhand border have been selected. Kadal and Barsuddi are 3 and 2 kms from Jharkhand border respectively. The process of village selection and building relations with the target communities, continuing from 2012 lasted through the month of January this year.
  • 8. 8 Looking at severity of the problem of malnutrition in India at large and Bihar in particular, Karuna- Shechen, India decided to incorporate malnutrition as an integral part of its health services. The groundwork for the program started with a one-day training on Malnutrition on 5th February this year. It was conducted by Dr. Nadine Donnet and was attended by the entire staff of Karuna-Shechen India, a volunteer from France, the Program Officer of Karuna-Shechen, Nepal, and Field Operations Director, Karuna- Shechen, Nepal. Dr. Donnet demonstrating MUAC measurement The training was followed by an extensive baseline survey of our 6 newly adopted villages where the malnutrition program will be conducted. For the survey the widely used and accepted tool of measurement of malnourishment, the MUAC (Mid- upper Arm Circumference) was used. The MUAC is a simple way of determining whether or not a child is malnourished using a coloured plastic strip. MUAC is used on children from the age of 12 months up to 5 years. MUAC measurement taken during baseline survey
  • 9. 9 ACM VILLAGE SCAN Shamsul Akhtar engaged in discussions with the people of Dema village Keeping in tandem with Karuna-Shechen’s participatory approach towards its various development programs, we conducted a village scan for our new villages. Our team, led by the Director, conducted meeting with the people from each of the 6 villages. Village Scan is the first step to identifying and implementing projects that are guided by the specific needs and aspirations of the local communities. It will thus form the base for determining what projects will be introduced in the villages. The programs that would
  • 10. 10 run in these villages will follow the ‘small money big change’ model which empowers the target communities by facilitating their participation in community planning and management. The Village Scan was segregated into two distinct categories. It started with Social Mapping and then proceeded to a discourse on the main problems confronting the village as a whole. In the first exercise the villagers were provided with flipcharts and coloured pens and asked to draw a map of their village demarcating the various types of water resources, schools, roads, households etc. This fun-filled activity worked as an ice-breaker thus forming the first step towards participatory learning. It enabled the villagers to engage and interact with us, making them comfortable and at ease with the entire situation. Map making was followed by an animated discussion about the common problems facing the villagers, the probable solutions and how we could work together to implement them. In this activity villagers were asked to state the most crucial problems that they faced, while one amongst them volunteered to write them down. Having done that the villagers were asked their opinions on how we could resolve them. The following table shows the problems pin-pointed by the villages as those requiring immediate action: Table 1: Problems faced by the villages VILLAGES PROBLEMS Dema  Drinking Water  Irrigation  Education  Inadequate Healthcare Facilities  Unemployment for the Youth  Electricity Bandha  Women’s Education  Lack of Adequate Hand Pumps Kadal  Drinking Water for Villagers  Drinking Water for Animals/ Ponds  Irrigation  Roads  Inadequate Healthcare Facilities  Education  Electricity  Unemployment  Embankment  Bandh (Small Dam) to store water
  • 11. 11 Barsuddi  Proper Roads  Electricity  Drinking water for Villagers  Drinking water for animals  Water for Irrigation  Inadequate Ponds  Inadequate Healthcare Facilities  Education Nawatari  Drinking Water  Electricity  Lack of Ponds  School/Education  Temples for Lord Shiva and a Goddess  Panchayat Bhavan Meghubigha  Tubewell  Electricity  Temples for Lord Shiva and a Goddess  Pond  Sewing Machine  Roads  Drains Chando  Drinking Water  Irrigation  Electricity  Unemployment of Women (insistence on requirement for training in incense stick making)  Land is sloped /lack of leveled land  Inadequate Healthcare Facilities  Increase in the Price of Diesel The above-mentioned table clearly demonstrates lack of drinking and irrigation water, dearth of electricity and proper education facilities as a major problem for all villages. The villages agreed to work along with us, contributing in their own small ways, towards the resolution of the problems. Thus, the village scan formed the building blocks of the upcoming programs in the new villages.
  • 12. 12 Women and Girls were especially encouraged to come forward and participate in Social Mapping Villagers engaged in noting problems and potential solutions during the session on problem discussion Discussing problems written on flipchart by villagers Listening to the villagers
  • 13. 13 VOCATIONAL TRAINING In an effort to enhance the skills, add to the livelihood and economically empower rural poor women we will incorporate vocational training like making pickles, baskets, poultry farming etc. in our Non-Formal Education program which will start from mid- April in the new villages. The decision as to what type of vocational training should be imparted will be taken in accordance with the interests and requirements of the villagers. During our village scan in our newly adopted villages, where extensive discussions were held with the villagers, several women demanded that they be trained in sewing, tailoring and incense stick making. The final decision will be made after further discussions with the villagers. STRENGTHENING BASIC EDUCATION We have started the process of visiting schools in various villages and talking with the principal, faculty members, students and their parents regarding teachers’ training on pedagogy, providing TLM (Teaching Learning Materials), forming Children’s Club, etc. We are in the process of searching for individuals from amongst the villagers who, with their knowledge and enthusiasm, can act as support teachers to the existing school faculty and thereby help ameliorate education of the school-going children. We have also started looking for suitable sites near the schools to make playground for the children.
  • 14. 14 School children of Barsuddi with Director, Karuna-Shechen, India BODHGAYA CLEAN ENVIRONMENT PROGRAM As the first step to this project, in January this year, photographs of various localities of Bodhgaya town were taken in order to get an idea about the level of cleanliness in the town and to pinpoint which localities we require to work in for this project. Again, the village coordinators have been in the process of talking to street vendors and random local people in order to understand their stance on hygiene and clean environment. An ill-maintained dustbin Vendor selling food open without any cover
  • 15. 15 Following the principle of Charity begins at Home, during the Orientation on Program Activities in March this year, the entire staff of Karuna-Shechen India was trained in making paper bags with the objective of discouraging the use of plastic bags and encouraging the practice of paper recycling amongst the staff members. Karuna-Shechen staff making paper bags Staff with their hand-made paper bags
  • 16. 16 MEDICAL CONSULTATIONS The total number of Consultants availing healthcare services of our OPD (Outreach Patients Department) in Bodhgaya and Mobile Clinic in 18 villages is 7358, wherein new consultants constitute 4221 people (57.37% of total number of consultants). An Overview of Medical Activities - OPD and Mobile Clinics Total
  • 17. 17  The number of patients refered to PHC & Government Hospitals was 102 (1.14% of total consultants at OPD, Mobile Clinics and Medical Camps ).  The total patients who were treated “Free of Cost” (Pregnant women, children and aged people above 60 years) in the OPD Clinic and by our Doctors were 2336 ( 13%).  4 special cases (from poor patient fund) were treated by our doctors.  Total money collected against registration charges was INR 84395. Table 2: Total Number of Patients Referred to PHC and Government Hospitals MONTH OPD MOBILE MEDICAL CAMP FOR POOR & NEEDY MEDICAL CAMP FOR MONKS January 12 8 21 5 February 12 10 15 18 March 1 0 0 0 Total 25 18 36 23 Table 3: Total Money Collected from Registration Charges Month Amount January 23340 February 31640 March 29415 Total 84395
  • 18. 18 DIRECT OBSERVED THERAPY (DOT) Out of 751 medical tests conducted in our pathology laboratory Sputum tests (for Tuberculosis) constituted the highest number of tests done (168) in the first quarter of 2013. Out of these the number of people who were diagnosed with TB was 9. Currently, the total number of TB patients undergoing treatment is 24. Table 4: Details of DOT program January February March Total Number of TB patient’s started medicine 5 4 3 12 Number of sputum test 33 47 88 168 Sputum Positive 1 5 3 9 Refer TB Patients 0 0 0 0 Completed TB Medicine 3 5 2 10 Undergoing Treatment in Mobile 5 Undergoing Treatment in OPD 19 Total Number of TB Patients currently undergoing treatment (OPD and Mobile) 24 TYPES OF DISEASES OBSERVED AMONG PATIENTS IN OPD AND MOBILE CLINICS The following table gives us information about the various types of diseases observed among the patients in our OPD and Mobile clinics. Table 5: Types of Diseases Types of Diseases Total Diarroheachildren 37 Diarrhoea / dysentery adults 66 Amoebiasis 17 Ttyphoid 0 TB 34 Gynea patient 139 Bone & joints patients 568
  • 19. 19 Burn patient 87 Worm manifestation 15 Skin diseases of all kinds 301 Ophthalmologic infections 23 Number of identify malnourished children 2 Cardiac Inf. 3 HTN 122 Diabetes 10 Asthma & COPD 135 Cough & Cold 476 Epilepsy 33 ENT patient 50 LYMPHadenopathy 20 I&D Dressing 21 Other patients 341
  • 20. 20 From the above table and graph we notice that the most common diseases observed, both in OPD and Mobile clinics, were Skin diseases, Bone and Joint Problems and Cough and Cold. GENERIC MEDICINES Till 2012 only branded medicines were given to the patients but since January 2013 generic medicines have been introduced as they are equally effective but much cheaper than their branded counterparts. Therefore, since the beginning of this year our medical team is providing generic medicines to the patients along with branded ones. The following table gives a comparative study of the prices of 12 branded medicines and their generic counterparts. These 12 medicines have been chosen as they are some of the most widely used medicines in our healthcare services.
  • 21. 21 Table 6: Cost-Effectiveness of Generic Medicines The above table shows that the substitution of these widely used branded medicines with their equally effective generic counterparts has resulted in about 60% reduction in the cost. Composition Medicine Name Price Rate Generic Medicine Name Price Rate % of reduction in Price Rate of Generic Medicines Compared to Branded ones Calcium Tab Calcium 500mg 2.4 Tab Cachacal 500mg 0.33 86 Paracetamol Tab Calpol 500mg 1.06 Tab Pyrakem 500mg 0.30 72 Cefexime Tab CEFOCEF O 100 tab 3.98 Tab O- Powercef DT 100mg 2.25 43 Clobetasol propionate sulphate & Miconazole nitrate Cream Cosvate-GM 8.43 Cream Clobikem-GM 8.00 5 Anticold, anticough Sy Lemolinctus 27.69 Sy New Nano Cold 10.00 64 Levofloxa Tab Ovil 500mg Tab 5 Tab Levowok 500mg 2.45 51 Ofloxa+ ornidazole Tab O-Cebran Oz 5.2 Tab Oflowock OZ 1.60 69 Anticough (Dry cough) Sy Samdex 38.8 Sy Tordex 17.50 55 Anticough Sy Samdryl 28.6 Sy Kemodaryl 8.50 70 Aceclofenac+paracetamol+ serrataiopetidase Tab Speeder SP 4.18 Tab Acceclowoc SP 1.30 69 Aceclofenac+paracetamol Tab Speeder-Plus 1.98 Tab Acceclowoc-P 0.54 73 Levo-Cetrizine Tab 1 Al 1.26 Tab lovozine 0.4 68
  • 22. 22 IDENTITY CARDS FOR MEDICAL CONSULTANTS In order to keep track of the medical history of each patient identity cards are issued to every individual seeking medical help from us. These cards cost a mere INR 5 and should be brought along in every visit to the OPD or Mobile clinics. REVIEW, REVISION AND UPDATE OF THE LIST OF MEDICINES The list of medicines existing in 2012 was reviewed, revised and updated to better serve the target population. REFRESHER TRAINING FOR DOCTORS Refresher Training was imparted to our doctors by Dr. Jaya Maitra of the Red Cross Society, Jamshedpur.
  • 23. 23 Patients waiting for check-up in OPD Patients queuing in front of the Pharmacy OUTREACH PATIENTS DEPARTMENT (OPD) The total number of people who came to the Medical centre in Bodhgaya for Consultations in the first quarter of 2013 was 3834. Out of this total 2410 were new consultants, representing 62.86% of total consultations in OPD. ACCESS TO PRIMARY HEALTHCARE IN URBAN AREA: SHECHEN MEDICAL CENTRE IN BODHGAYA, BIHAR
  • 24. 24 Table 7: Number of Consultants in OPD JANUARY FEBRUARY MARCH TOTAL TOTAL NUMBER OF CONSULTANTS 1360 1321 1153 3834 TOTAL NUMBER OF NEW CONSULTANTS 872 864 674 2410 MEN 420 431 310 1161 WOMEN 585 552 515 1652 CHILDREN 355 338 328 1021 PATIENTS FREE OF REGISTRATION CHARGE 485 478 461 1424
  • 25. 25 The total patients who were treated Free of Registration Cost (Pregnant women, children and aged people above 60 years) in the OPD was 1424, representing 37.14% of the total consultants.
  • 26. 26 From the above pie-chart we can see that women and children constitute the majority of the consultants (70%) in OPD. LABORATORY Total number of patients who came in the first quarter of 2013 (January-March) for different medical tests were 237 and total anaysis done was 751. The number of patients and tests are different because one patient may go for several tests. Total money collected from these tests was INR 7210.
  • 27. 27  From the above pie-chart we can see that the more frequent tests were Sputum test (for tuberculosis), ESR and TC/DC ( Blood tests for infection, allergy and red blood cells) and less frequent test were ASO (for throat infection), Titer and VDRL.  Patients tested free of registration charge (pregnant women, children and people above 60 years of age) were 38 (16. 03%) out of 237 people undergoing medical tests.
  • 28. 28 Apart from the medical clinic situated in the town of Bodhgaya Karuna Shechen provides several outreach services to the poor and marginalised population in the surrounding villages. The Community-based integrated programs run by Karuna Shechen India are:  Mobile Clinic  Health Education Program (HEP)  Health and Hygiene  Reproductive and Child Health (RCH)  Non-Formal Education (NFE)  Solar Electricity OUTREACH SERVICES: COMMUNITY-BASED INTEGRATED PROGRAMS
  • 29. 29 MOBILE CLINIC Inaugration of Mobile Clinic in Chando village Inaugration of Mobile Clinic in Bandha village Till January 2013 Karuna-Shechen India provided medical care to the rural population through the services of a mobile clinic that functioned 6 days a week. With the objective of providing comprehensive healthcare to a larger number of the rural poor our organisation has expanded its mobile health services to 6 new villages since February 2013 by launching a second Mobile clinic. The new villages have been selected on the basis of the cluster model so that the services of the mobile clinics are not confined to the population of these villages alone but are also extended to the people of 3-5 satellite villages.  In the first quarter of 2013 (January-March), the number of patients who came for the consultations in mobile clinic from 18 village were 3524, out of this 1811 were new patients representing 51.39% .  Number of consultants from the satellites villages around our 18 adopted villages who sought medical help from our mobile clinic services is 1474.  The total patients who were treated for Free of Registration Charge (Pregnant women, children and aged people above 60 years) in the Mobile Clinic was 1918 (54.43% of the total consultants at mobile clinics).
  • 30. 30 Table 8: Details of Consultants going to Mobile Clinics MOBILE CLINIC JANUARY FEBRUARY MARCH TOTAL TOTAL NUMBER OF CONSULTANTS 632 1511 1381 3524 TOTAL NUMBER OF NEW CONSULTANTS 237 915 659 1811 MEN 172 426 409 1007 WOMEN 283 774 652 1709 CHILDREN 177 311 320 808 PATIENTS TREATED FREE OF REGISTRATION CHARGE 336 769 813 1918
  • 31. 31 From the above table and graph we can see that the number of consultants at the mobile clinics in the month of January is much less compared to February and March. This is because the mobile healthcare services were extended to the 6 new villages from February, i.e., till January mobile clinics served 12 villages but since February it has been covering 18 villages. 1918 patients out of a total of 3524 consultants visiting the mobile clinics were treated free of cost by our doctors.
  • 32. 32 Just like in the OPD, women and children constitute the majority of consultants in the Mobile Clinics (73%).
  • 33. 33 Villagers waiting for their turn for check-up
  • 34. 34 MEDICAL CAMPS FOR THE POOR AND NEEDY In addition to the mobile clinic Karuna-Shechen makes an effort to extend its outreach healthcare services to the poor and needy groups like the Dalits (low-caste Hindus who constitute a poor and underserved community) and the Buddhist Monks through medical camps. In the months of January and February a medical camp was organized for the poor and needy in general and another camp specifically for the Monks at Nyingma monastery during the auspicious occasion of Nima pooja. Medical Camp for poor and needy Medical Camp at Nyingma Monastry Table 9: Total Number of Consultants and Refer Patients at the Medical Camps Month No. of Consultants at Medical Camp for Poor & Needy No. of Consultants at Nyingma camp No. of Refer Patients at Medical Camp for Poor & Needy No. of Refer Patients at Nyingma camp January 500 148 21 5 February 359 600 15 18 March 0 0 0 0 Total 859 748 36 23
  • 35. 35
  • 36. 36 HEALTH EDUCATION PROGRAM (HEP) Health Education Program (HEP), which was introduced in our 12 villages in 2010, continues to run smoothly. Currently there are 87 health groups with 534 members under HEP. Table 10: Some Important Data on HEP Total Total Number of Home Visits by Village Coordinators 689 Total Number of Home Visits by Motivators 1515 No. of Families who Received the Message regarding Health & Hygiene 1078 Number of Hand pumps Repaired 32 Number of Soak pits created 0 Total No of Meetings 83 Table 11: Some Important Data on Reproductive and Child Health (RCH) Total Identified New pregnant Women 55 Total Pregnant Women 140 Total Pregnant Women immunized with T.T1 31 Total Pregnant Women immunized with T.T2 98 Total Pregnant Women not immunized 11 Total Deliveries 52 Delivery at PHC 35 Delivery at HOME 17 Total No of Miscarriages 3 Number of Pregnant Women Followed-up by Motivators and Village Coordinators 140
  • 37. 37 Total Newborn Children 52 Total Neo-natal Deaths 4 Maternal death at child birth 0 New born child Immunized 34 Training for birth attendants 0 Meeting up Mother and Child by Village Coordinators 63 The above table shows that among the 52 child deliveries that took place in the first three months of 2013 35 were institutional deliveries (67.31 % of total deliveries). The remarkable number of women opting for institutional deliveries shows the increased health awareness through HEP. Again, the number of neo-natal deaths has been very less (4 children); only 7.69 % of total newborn children and there are no recorded cases of maternal deaths. Health and Hygiene- Women collecting drinking Mothers with their Children water from Tubewell
  • 38. 38 NON-FORMAL EDUCATION (NFE) NFE classes were started in August 2011 in 6 villages namely, Banahi, J.P Nagar, Karhara, Kharati, Gopalkhera and Trilokapur with the objective of expanding and improving basic education of the poor illiterate rural women. However, NFE classes have been temporarily stalled due to poor attendance of the students in all 6 villages where the program was running. Currently we are in the process of evaluating the reasons for the large-scale absenteeism of the women enrolled in NFE classes. One of the reasons for the above-mentioned problem has been the teacher’s incapability of inducing interest among the students about studies. Teachers seem to have failed to connect with the students due to the former’s inability to explain things properly, their unapproachable attitude and their irregularity. On the other hand, the students are faced with certain socio-economic impediments to their non-formal education such as resistance from and reluctance of the family members, no time for classes during the harvesting season, etc. While the process of intensive evaluation of the NFE program in the existing villages is going on, our meetings and discussions with the new villages (during village scan) is evoking a lot of interest among their population regarding the above-mentioned program. So, with the objective of restarting our NFE program in the 6 existing villages where classes have been temporarily stopped and with the intention of extending the program to our new villages in response to their demand we are working extensively on resolving the problems and modifying the program to provide optimum benefit to the target population. Therefore, we have already started searching for appropriate teachers who are passionate about bringing about positive change in the lives of their students by imparting knowledge to them. Besides, we are in the process of revising the syllabus and modifying the methods of teaching to make the program efficacious for the rural illiterate women. As mentioned earlier in this report, we will be incorporating vocational training in our NFE classes and have already taken the first step towards it through our meetings and discussions with the villagers. NFE program will be commencing in the new villages and re-starting in the existing ones from mid-April, 2013.
  • 39. 39 SOLAR ELECTRICITY Children studying under Solar light Our Solar electricity program continues to run in all 3 villages. However, over the past several months we have noticed a decreasing sense of responsibility of the beneficiaries in terms of monthly payment towards maintenance and replacement of batteries. In an attempt to understand the reason for such a trend and to better serve the people we have prepared a comprehensive questionnaire for the existing and potential users of solar lights. It has been designed as a tool for impact evaluation of the existing solar program and as a feasibility study for the program in new villages. During our village scan 3 villages (Kadal, Barsuddi and Chando) have shown a keen interest in our solar program. As per the discussions held during the village scan, 10 men and women from Kadal were taken to J. P. Nagar, one of our existing solar villages, to give them a vivid idea about solar lights and their use. Karuna-Shechen arranged for and bore the cost of their travelling, food and lodging. We intend to provide the same opportunity to people from the other two villages. In the 3 villages where solar lights will be installed, we are in the process of searching for young, illiterate mothers and grandmothers who will be interested in undertaking training for Solar Engineering at Barefoot College in Tilonia, Rajasthan. Later this year Karuna-Shechen plans to send more young grandmothers for training, bringing light to even more families.
  • 40. 40 OTHER EVENTS, ACTIVITIES & INFORMATION RECRUITMENT OF NEW STAFF With the starting of a host of new activities since February 2013 and with the extension of the organization’s existing programs from 12 villages to 18, Karuna-Shechen India team has expanded to incorporate nine new staff members, including 2 female and 1 male doctor, 1 laboratory technician, 2 nurses, 1 pharmacist, 1 driver and 1 research and documentation officer. With over 75% of our patients being women and children recruitment of female doctors has been a great step towards the provision of better healthcare services in our OPD and Mobile clinics. In addition to these 9 new staff members 6 village motivators were hired in March to work in our new villages.
  • 41. 41 0RIENTATION ON PROGRAM ACTIVITIES Entire staff of Karuna-Shechen, India at the Orientation On 2nd March, 2013, after a month of working with the new members, a one-day training was organized in Bodhgaya as an orientation session. The entire Karuna- Shechen India team was present as participants while our Director, Shamsul Akhtar, played the role of the facilitator. Objectives of the Training  To give a clearer understanding about the organization  To give a clearer understanding of the program activities  To make all new colleagues feel as part of the team and enable them to do their best to help the organization achieve its goals.
  • 42. 42 EXTERNAL VISITORS In February Karuna-Shechen, India had the honour of welcoming several external visitors including Karuna-Shechen’s Chief Operating Officer, Tarek Toubal;, Director of Field Operations, Sanjeev Pradhan; Alexandra Brun, Project Officer for Karuna-Shechen, Nepal; Nadine Donnet, ex-Field Operations Director; Rafaele Demandre, Field Coordinator for Karuna-Shechen, Tibet, Dr. Jaya Maitra from the Red Cross Society, Jamshedpur; and two international volunteers. FINANCES The budget and expenses for the first quarter of 2013 are presented below: Table 12: Budget and Expenses Budget in USD($1=50 INR) Expenses in USD($1=50 INR) Administration, transportation and functioning cost 14,271 12,302 OPD direct benefit to population in Bodhgaya town and close surroundings 18,465 15,730 Mobile clinic benefit to population in 18 villages 27,329 14,503 Education direct benefit to population in 18 villages 15,710 4,497 Environmental Program 3,155 502 Social Program 11,780 2,367 Program Support 8,030 806 Investment: Equipment 17,450 21,269 Contingencies 5,810 627 Total 1,22,000 72,603
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  • 44. 44 UPCOMING ACTIVITIES  Non-Formal Education will commence in the 6 new villages and re-started in the existing villages from mid-April.  Household Survey in the 6 new villages.  A Purchasing Committee will be functional from April. OUR PARTNERS Current Partner: Barefoot College in Tilonia, Rajasthan Prospective Partner: Centre for Science and Environment, New Delhi.
  • 45. 45 A six year old girl called Anchal Kumari came to the OPD in February this year to treat her severely burnt hand. Her hand had been burnt two days before but due to their poor economic condition the girl’s family could not afford to take her to the government hospital in Gaya. Instead they sought local medical help in their village which, due to wrong treatment, resulted in worsening of the wound. Then one of the villagers suggested they approach the Shechen Clinic where treatment and medication are available free of cost, with only a nominal registration fee. When the girl was brought to the clinic she was running fever and her hand was infected, badly swollen and severely paining. After taking her medical history her treatment commenced with dressing and medication. Just two days after her fever was gone and swelling and pain of the burnt hand had subsided. After a week of treatment her wound was healed and healthy skin appeared. Her family was relieved and very thankful to the clinic. Anchal Kumari, when she came to Shechen Clinic for treatment 1 week after treatment ANNEX- SUCCESS STORY