MAHAN Trust provides health services to tribal communities in Melghat, India. It operates a hospital and runs various community health programs. The region has high rates of malnutrition, maternal and child mortality, tuberculosis, and other diseases due to poverty, lack of education, and inadequate access to healthcare. MAHAN Trust aims to reduce these health issues and promote health and wellbeing amongst tribals through both curative and preventive services. It implements programs like home-based child care, blindness control, and sustainable nutrition initiatives.

1. By
MAHAN Trust, Melghat and Kasturba Health
Society, Sevagram

2. MAHAN Trust
About MAHAN Trust
 Meditation  Addiction
We stand for Health
AIDS
Nutrition
The only NGO in Melghat -medical care
We Are for the reduction of the malnutrition and
child deaths amongst the tribal.
We provide Tribal focused health service
through our different projects.

3. MAHAN Trust
MAHAN Trust
wanted to become the best health
Institution for tribal area of India Vision statement
with an aim to uplift the health
facet of tribal of Melghat & India.

4. MAHAN Trust
Mission statement
 Believes in core values of trust,
transparency, care and compassion .
 Principle of Service, role model
MAHAN Trust always through research and monitoring of
govt. health system.
believes in service to the last
 Strives to maintain healthy standards
tribal of Melghat with
of social governance.
dedication

6. Dr. Prakash and Dr. Manda Amte with Satav Family.

8. Motivation for Work
 My grandfather Mr. Vasantrao Bombatkar (Sarvodaya leader).
 Literature written by Mahatma Gandhi and great saint Vinoba Bhave.
 Gandhian teaching : “ Youths should go to the villages to serve as real
India is in villages”
 Tribal health projects run by Drs. Prakash and Manda Amte, Drs.
Abhay & Rani Bang, Dr. Kolhe, Dr. Sudarshan, etc. - Tribal areas need
medical facilities to a great extent.
 Guidance of Miss Joshi & Mr. Bhagwat sir.
 “Shram Sanskar Shibir” - Baba Amte
 The guidance by Dr. Ulhas Jaju, Dr. Avinash Saoji ,
Dr. Kalantri, Dr. Jalgaonkar and Dr. Mrs. Holey .

9. Preparation for future life
 During M.B.B.S. course in Government Medical College,
Nagpur, I followed simple living.
 Due to regular yoga and meditation, study of Geetai ,
“Experience with truth”, books written by Swami Vivekanand &
the book “Seven Habits of Highly Effective People” , my
mental strength is increased.
 Due to use of Gandhian principals in personnel life, the life in
Melghat has become palatable and tolerable.

10. MAHAN Trust
Home based Child Care
Program
Mortality Control Program for 16-60 years
Sustainable Nutrition
Program Counselors
Program
Our Programs
Well equipped Hospital Blindness Control Program

11. Epidemiology of Melghat
Population distribution and socioeconomic
characteristics
80
70
60 Uneducated
Tribal 50
40
30
Nontribal 20
Population below
10 powerty line.
0
Melghat INDIA
• Population is 2,50,000.

13. Epidemiology of Melghat
• Korku is the major tribe of Melghat. Most of
the tribal(>90%)are farmers or laborers, living
very hard life in huts without electricity (90%) .

14. Health Facilities Available
Very high under 5 children mortality (>100 children
deaths per 1000 live births) and very high death rate in
the age group 16-50 years.
The health facilities are worst in Melghat as compared
to rest of the Maharashtra. (50 years back)
No Gynecologist, anesthetist, surgeon, facilities for
Cesarean Section etc.

15. 150
100
50
0
NMR IMR U5MR
Developed countries India Maharashtra Melghat

16. Region NMR U5MR
IMR
Developed
5 7 8
countries
India 43.4 69 96
Maharashtra 19 31 43
Melghat
62 >75 120
(2004)
(Reference: 1,2,3) Book of Preventive & Social Medicine by Park(17th edition),
ICDS, Maharashtra & study by Dr. Satav et. al.)
(NMR= Neonatal Mortality Rate, IMR=Infant Mortality Rate, U5MR=Under-5 year children mortality rate)

17. Background of Project
Due to lack of proper medical facilities &
superstitions, tribal goes to traditional faith
healers/quacks (pujari & bhumkas) for
treatment of illness. Skin is burnt with red hot
iron rod for reducing pain known as Damma .
Moved by such things, we started the project in
Melghat in November 1997.

18. Traditional Health Care
Grade 4 Malnutrition Traditional Faith Healer Damma
(Bhumka) treating a
malnourished child.

19. Aims & Objectives Of The Project
 To provide curative & preventive health
services to people of Melghat
 Community research of diseases in tribal of
Melghat
 To provide exposure of tribal health
problems to outside world.

20. BRIEF REPORT
(Nov.1997 to March 2010)
Our base hospital is at Karmagram, Utavali
which is 140Kms from Amravati (district place).
Drainage Area: Melghat (all villages) &
surrounding Madhya Pradesh-Tribal area.

21. HEALTH PROBLEMS
HEALTH PROBLEMS
High neonatal (o-28days child death)& maternal mortality (death of mother) due to home
deliveries(>85%).

22. HEALTH PROBLEMS IN
MELGHAT- Malnutrition
*Prevalence of protein energy
malnutrition
(Grade I to IV) is 75%.
*Prevalence of severe protein
energy malnutrition
(Grade III to IV) is >10%.
Severely malnourished child.

23. HEALTH PROBLEMS IN MELGHAT
.
Tuberculosis of the spine & Skin.
Pneumonia & Tuberculosis (T.B.) are major killer of children & adults..

24. HEALTH PROBLEMS
Iron deficiency leading to Anemia & Koilonychias (Spoon shaped nail)

25. HEALTH PROBLEMS
Severe Dehydration due to diarrhoea

26. HEALTH PROBLEMS
Tobacco, Alcoholism , & Ganja addiction.
Bidiwale Baba
Woman Purchasing alcohol

27. HEALTH PROBLEMS IN MELGHAT
.
TOBACCO induced carcinoma of cheek.

28. HEALTH PROBLEMS IN
MELGHAT
 Malaria, typhoid, etc.
 Hypertension
 AIDS
 Alcoholic gastritis

29. HEALTH PROBLEMS
Bitot’s spot (Vitamin A deficiency)

30. HEALTH PROBLEMS IN MELGHAT
Rickets (Vitamin D deficiency)

31. HEALTH PROBLEMS IN MELGHAT
Goiter (Iodine deficiency)

32. HEALTH PROBLEMS IN MELGHAT
Cataract

33. Poisonous Snake Bite

34. Malnutrition status-2006
(Ref: Bhavishya Alliance, Park-PSM, Dr. Satav.)
80
70
60
50
40
30
20
10
0
INDIA Mah Mh-Ru Melghat
Severe PEM(%) PEM(%)

35. Nutrition survey
Pilot study revealed that marasmus (lack of
calories/energy) is predominant type of
malnutrition.
 24 causes of malnutrition have been detected
by our organization.

36. Causes Of Malnutrition
Poverty

37. Causes Of Malnutrition
Inadequate quantity & poor quality of food.
especially by children & pregnant mothers during last
trimester.
Lack of education(50%) & ignorance about health &
nutrition(90%).
Unapproachable villages with no proper roads(25%).

38. Causes Of Malnutrition-Big family size.
Average couple has 3-5 children. Improper spacing.

39. Causes Of Malnutrition
Improper child care
Parents go to farms & young children are taken care by 5-6 years old brothers or
sisters.

40. Causes Of Malnutrition
Unhygienic living conditions &
feeding practices (eating without hand wash)

41. Causes Of Malnutrition
 Unhygienic living conditions leading to infections.
 Delayed complementary feeding usually after one to
one & half years of age.
 Lack of proper hospital facilities.
 Early marriage age: Average age for marriage is 15-
16 years for female.
 High unemployment leading to migration.

42. Strength of Melghat
Healthy & pure atmosphere, forest & nature.
Fertile land
Heavy rains
Environment suitable for various cropping
pattern
 Mentally strong people
 Less gender bias

43. Mahatma Gandhi Tribal Hospital
Entrance- Muthava Baba

44. Curative Activities
OPD in the beginning
More than 46,493 patients have been treated till now.

45. Serious patient of Brain Hemorrhage.

46. Waiting Room

47. Curative Activities
Indoor Hospital (>2800 patients have been treated.)
(till June 2007)

48. New Hospital

49. Operation Theatre

50. Curative Activities Indoor.
Treatment of Serious patient of heart attack (Myocardial Infarction).
Only hospital for treatment of serious patients in Melghat. (>800)serious patients like
MI, Brain Haemorrhage , Cerebral Malaria, Meningitis, Tetanus etc. and saved
hundreds of precious lives in our hospital.

51. Curative Activities Indoor.
Treatment of serious patient of Viral Encephalitis ( Swine flue) with Brain stem involvement with
on Ventilator.
ARDS with Renal Failure with GI bleed with Coma –

52. A patient of respiratory failure was saved due to oxygen
concentrator. (Donated by Caring friends).

53. Curative Activities
Surgical camps
a. Operated more than 692 cases with Ophthalmic
problems especially cataract (intraocular lens
implantation-IOL) free of cost.
b. Plastic surgery camp: Operated 158 cases free of cost.
c. Ten cases of Rheumatic valvular heart disease detected
in our camp were operated free of cost by G-66 Heart
foundation.

55. Plastic Surgery Camp
Cleft lip & palate
Before operation.
Intra-Operative After operation

56. Plastic Surgery Camp
Post Burn Contracture
Before operation After Operation

59. Door to door Eye
check up

60. 1 2
1. Bilaterally blind patients at home.
3
2. Health worker motivating
blind patient for eye surgery.
3. Health worker bringing bilaterally blind Patient
for surgery.

61. A-Scan (for Intra-ocular lens power calculation).

62. Intraocular Lens Implantation Surgery by
Dr. Kavita Satav

63. Independent life after IOL Surgery

64. Eye Injury
After Surgery.

65. Spectacle preparation (Donated by Caring friends,
Mumbai.)
More than 4000 villagers & students were given spectacles.

66. Happy Tribal with spectacles

67. Surgery after Bear bite.

68. Field OPD (door to door)
Ground as examination table.
More than 12587 patients have been treated.

69. Curative Activities
Specialty Camps
More than 16,000 patients have been treated.
Gynaecology & Obstetrics camp.
Paediatrics.
De-addiction camp :The first effort in history of Melghat.
Surgical camps : Surgery for Rheumatic heart diseases.
 E. N. T. camp.
 HIV & AIDS detection camp.
 Life style modification camp.
Sickle cell & Anemia detection camp.
 Tuberculosis detection camp.

70. Specialty Eye - Camp

71. Specialty Camps
Pathologist (Dr. Gahukar) examining blood

72. Specialty Camps
Fine Needle Aspiration Cytology

73. Curative Activities
Specialty Camps
Detection of malarial parasites positive patients
in the camps activated the government system
to start malaria control program on massive
scale in Melghat during 2001.

74. Ultra - sono graphy in camp

75. Specialty Camps
Ear, Nose & Throat Surgeon treating patient in field

76. Gynecology & Obstetrics camp
(Dr. Kuthe)

77. Pediatrician Dr. Tiwari examining severely
malnourished child.

78. Road Traffic Accident.
We saved lives of around 29 seriously injured
persons in road traffic accident by rescuing them
from accident site.

79. Ambulance for transport of patients(Donated
by caring friends).

80. Blind School eye check-up.
More than 14,216 students form more than 102 schools were examined
and more than 200 students were given spectacles free of cost.

81. ANGANWADI CHILDREN
HEALTH CHECK UP by child specialist (Dr. Bharadwaj &
Dr. Yavalkar. )

82. Home Based Child Care Program
Village Health Worker Care
We trained 17 village health workers (VHW)
for treatment of under 5 children. More than
70,437 individuals were treated free of cost in
the villages itself from May 1st 2005.
Due to it, we could reduce under 5 children
mortality by 60% & mortality in productive age
group (16-60 years) by 18% over a period of
five years which is a cost effective, acceptable
and replicable model.

83. Changes in mortality rates(0-5 years
children) in intervention area
160
140
120
100
U5MR
80 IMR
NMR
60 SBR
40
20
0
2004 2005 2005- 2006 2006- 2007 2007 to 2008 2008 to 2009.

84. Village Health Worker Care Kangaroo
Mother Care (KMC)

85. Village Health Worker Care
Home Based Neonatal Care-Vitamin K injection by VHW

86. Village Health Worker Care
Home Based Neonatal (0-28 days) Care

87. Village Health Worker Care
Treatment of patients(>70,437)

88.  Exposure of problem - Our data collection during last 3 years
revealed the actual mortality status of Melghat. Government
accepted the fact now.
 Rajmata Jijau mother and children health & nutrition mission of
the Maharashtra government & UNICEF verified our findings,
accepted the facts and started action to control the situation.
Similar study by mission in other tribal blocks of Maharashtra.
 Dr. L. P. Mishra, IAS (National Human Rights Commission)
was convinced with our report & asked govt. to formed vigilance
committee.
 Dr. Shanti Sinha, Chairperson, National Child-right protection
committee, was convinced with reality and assured to improve
the situation.

89. • Acceptance of prevalence of severe malnutrition in children is very high in all
tribal parts of Maharashtra similar to our findings in Melghat.
• Acceptance of the concept of Village Child Developmental Centers (VCDC) or
home based feeding as state wide policy by Rajmata Jijau Mission of Govt. of
Maharashtra . We are the part of planning policy committee for the VCDC for
the entire state of Maharashtra.
• We were made part of Bhavishya Alliance, an international tri-sectorial
partnership for preparation of policy for reducing malnutrition in backward
part of Maharashtra.
• Development of innovative counselor program for improving govt. hospitals of
Melghat and for increasing hospitalization of tribal.

90. Mobilization of the government , N.G.Os. and social
minded people.
Most of the severely malnourished babies are now
getting supplementary nutrition and many deaths due
to malnutrition were prevented.

91. ANGANWADI CHILDREN
HEALTH CHECK UP
More than 9000 pre-school children from 37 villages
were examined & needy were treated.
Provided nutritious food to more than 300
malnourished babies and mothers for 3 months.
Many deaths due to malnutrition were prevented.

92. Weighing of Anganwadi Inmates by Village
Health Workers (>7000)
Sukarai received Jamshetji Tata
National Virtual Academy fellowship
for Rural Prosperity.

93. Food distribution to malnourished
children.

94. Iron Pan distribution to malnourished children

95. Preventive Activities
Health education programme.
More than 3732 health education programs for
more than 55,911 people. Prepared CD & flipchart.

96. V. H. W. Training programme

97. Trainer’s training for malnutrition

98. Nutrition demonstration education
(Mrs. Pendharkar)

99. Demonstration Health education
ORS (Oral Rehydration Solution) preparation

100. Flipchart on Nutrition, Malnutrition
(Donated by Caring Friends)

101. Mass Health Education-Audio-Visual Show

103. Farmer’s Training
for low cost sustainable agriculture

104. Youth dialogue & Health training program
Awareness is the key. Due to our continued effort, the government was mobilized to
conduct mutation of land on mass scale and many poor farmers became legal land
owners.

105. Community Meeting
As community participation is very important, we arranged
regular gramsabha for various community activities.

106. Impact of Government-NGOs coordination :
 Improvement in the Govt. hospitals of
Melghat.
 Improvement in services provided in ICDS
centers (Anganwadi centers) .

108. Results Figures
Percentages of patients hospitalized due to counselors in all PHCs and SDHs 13.01794454
Total Admissions of severe malnourished children by counselors in all PHCs and SDHs. 113
Counseling of patients by counselors through Flipchart in all PHCs and SDHs 4213
Total Stay of malnourished children for more than 3 days due to efforts of counselors in all
PHCs and SDHs
180
No. of patients referred by counselors in all PHCs and SDHs 819
No. of referred patients accompanied by counselors in all PHCs and SDHs 197
Total no. of pregnant ladies in OPD in all PHCs and SDHs 2315
No. of ladies hospitalized for delivery from home by counselors in all PHCs and SDHs. 165
Total no. of MCP sessions attended by all counselors in all PHCs and SDHs. 265
Quality of the meal served to the severe malnourished children as per the observations by
the counselors of all PHCs and SDHs.
Good
How many percentages of ambulances of PHCs and SDHs are in working condition since last
six months?
86%
How many percentages of patients were attended by the doctors of all PHCs and SDHs since
last six months?
100% (all)
How many hospitalized malnourished children were came out of grade III and IV to
II/I/normal?
84
Hygiene of all the PHCs and SDHs at satisfactory level All

109. 109

110. Monitoring of ICDS Center

111. Many volunteers & patients trained and treated
by us stopped alcohol drinking and smoking.

112. Monitoring & Evaluation
Hospital –No. of patients treated, operation conducted
& feedback from patients.
 Home based care -Vital statistics e.g. IMR,
malnutrition prevalence.
 Internal regular monitoring and periodic evaluation
system.
 External monitoring.

113. Socio-economic development
activities
• Various socio-economic status up-liftment activities like
Employment guarantee scheme, Water supply schemes, repairing of roads
of few villages and S.T. Bus facilities have been started in many villages of
Melghat by the Government due to our regular follow up. Admission of
many students to schools was facilitated by us.
• Bicycle distribution : 100 bicycles were distributed by Caring
Friends , Mumbai to the needy poor tribal people. It made them self
sustainable and got easy means of transport for education and earning.
• Student education fund: We provided financial support to many
students for education. (Donated by Caring Friends , Mumbai). One poor
student got admission for medical course this year.

114. Bicycle Distribution
(Donated by Caring Friends)

115. Cloth Distribution

116. Paper presentation in conferences
International symposium on child health at Hamburg
Germany organized by European Society of Pediatric
Research.
International symposium on “From Research to
Improved Practice & Policy in International Health” in
The Netherlands.
International Symposium on tribal health by Indian
Counsil of Medical Research.
3rd Congress of the European Academy of Paediatric
Societies, EAPS, Denmark.

117. Paper presentation in conferences
International symposium on child health at Hamburg
Germany organized by European Society of Pediatric
Research.
International symposium on “From Research to
Improved Practice & Policy in International Health” in
The Netherlands.
International Symposium on tribal health by Indian
Counsil of Medical Research.
3rd Congress of the European Academy of Paediatric
Societies, EAPS, Denmark.

118. • National symposium on Tribal Health by ICMR –
received best 1st oral paper presentation .
International workshop on tribal health by medical
school of UK.
Interviewed by Jagtik Marathi Academy and Shivaji
University, Kolhapur.
National conference in AIIMS, New Delhi.
Dr. Ashish Satav was invited as an expert on Mumbai
Doordarshan for a program “Malnutrition problem”
under the program Sapat Mahacharcha.
Interview on ETV Marathi- for Samvad program,
SAAM TV, NDTV and IBN Lokmat for project
activities and on many presentations on ETV and news
papers.

119. Awards
Young scientist award to Dr. Ashish Satav in national
symposium on tribal health organized by Indian
Council of Medical Research.
Lifebuoy National Child Health Award for Nutrition
to MAHAN trust.
Yuva-unmesh Puraskar (state level) to Dr. Ashish &
Dr. Kavita Satav.
M.B. Gandhi award to Dr. Ashish & Dr. Kavita Satav.
Dr. V.N. Vankar award for “Health & Hygiene” by
Indian Medical Association to Dr. Ashish Satav
Comred Godavari Parulekar Smruti Award to Dr.
Ashish & Dr. Kavita Satav .

120. Awards
 Dr. Dwarkanath Kotnis Health National award to Dr. Ashish
satav
 Savitribai Fuley State Award to Dr. Kavita Satav
 Swatyantravir Savarkar pratishthan - Social equality award to Dr.
Ashish & Dr. Kavita Satav.
 Karyanishtha Gaurav Puraskar to Dr. Ashish Satav.
 Vocational award by Rotary club of Gandhi city.
 Sevankur Idol.
 Vishesh Karyagaurav Sanstha Puraskar.
 Felicitation by SAAM TV and Babasaheb Purandare.
 Felicitation by Rashtrasant Tukadoji Maharaj Samiti wardha .

121. Young scientist award to Dr. Ashish Satav in national
symposium on tribal health organized by ICMR

122. MAHAN Trust
* Acknowledgements
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Your Satav family on doing of the ,
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The flipchart inspire me greatly.
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children Hospital, Hospital ,
Nagpur.
Ohio, USA.

123. Approach/Intervention
 Why the particular approach?
Hospital -intensive care unit.- As there was no
hospital to treat critical patients.
 Eye hospital –As no eye surgeon who treat curable
blindness.
 Home based care -High child deaths with no
paediatrician.
 Govt. System mobilisation-As poor working govt.
staff

124. Obstacles in work
Lot of obstacles. But these obstacles are not hurdles in the road but a
challenge to test and prove ourselves. Example of river through
mountains.
 Management of patient of brain hemorrhage (7cm in parietal lobe
and 1cm in Thalamus).
 Experience of Kavita – Conducting delivery and milk brother of
Athang. Replication by VHW.
 Athang, son –health problems- self treatment.

125. Obstacles converted to opportunity.
The key learnings /challenges/risks from the initial
interventions?
 Tribals not admitting serious children- Home based child care program-
Counselor program-success in reducing child deaths and malnutrition.
Trained tribal semi literate female village health workers can save lives.
 Critical patients can be managed and cataract surgeries can be done even
in remote backward forest areas.
 Exposure of health problems- government worker –misleading
community – solution by Vinoba Bhave way- community participation-
government system mobilization.
 Achievable, acceptable, approachable, affordable & Safe. Hence
replicable.

126. A case study
 Problem/Context
•Child died due to refusal of hospitalization of serious
malnourished and pneumonia baby by his mother .
 Solution
• Home based child care program.
• Counselor program for government hospitals.
• Nutrition farm/Kitchen garden.
 Implementation Outcome
• Reduced child deaths by more than 60%.
• Increased hospitalization of severely malnourished
children.
•Long term sustainable nutrition source.

127. A case study2
 Problem/Context
• 40 year man died of heart attack due to lack of critical
care hospital.
 Solution
• Well equipped intensive care unit.
• Community study of heart attack.
• Behaviour change communication.
 Implementation Outcome
• Saved hundreds of serious patients.
• High prevalence of hypertension & causes of heart
attack detected .
• Treatment seeking behaviour of tribals improved .

128. Solution to health problems
Where there is will , there is a way.

129. Future plans.
Behaviour Change Communication programs.
Mortality control program for economically productive
age group.
 De-addiction through meditation.
 Replication of our program throughout India and
developing countries.

130. Requirement:
• Financial:
1. Mortality control program for economically
productive age group
2. Home based child care & Malnutrition
reduction program
3. Corpus funds
4. Construction
• Man Power: Doctors, volunteers, experts.

131. Pillars of project:
• 1. Caring friends, Mumbai especially Rameshbhai
Kacholiya, Nimeshbhai Sumati, etc.
• 2. Late Dr. Sushila Nayar, Mr. Dhirubhai Mehta.
• 3. Nico Nobel & Stichting Geron , the Netherlands.
• 4. Dr. Abhijit Bharadwaj, Dr. Gahukar.
• 5. Mrs. Jayashri Pendharkar.
• 6. Vijay Kaore.
• 7. Palaskar family.
• 8. Varangaonkar, Kashikar.
• 9. Satav, Renge & Manekar family.
• 10. Dr. Gahankari, Dr. Bapat.

132. MAHAN Trust
our eminent Partners
Kasturba Health Society ,
Sevagram.
Caring Friends Stichting Geron, The Netherlands.
Mumbai
Arpan
Foundation USA.
Individual Donors

135. MAHAN Trust
Contact Us Address
Dr. Ashish Satav (M.B.B.S., M.D.)
Dr. Kavita Satav (M.B.B.S., M.S.)
Mahatma Gandhi Tribal Hospital
Karmagram, Utavali, Tah. Dharni, Distt.
Amravati 444 702.
Phone no : 07226-202291, 202793
9423118877, 09325094780
drsatav@rediffmail.com