Background
Lady Willingdon Hospital (LWH) has a clinic in Madgram, led for the last two years by Drs. Jeph and Kaaren Mathias from New Zealand. Through 2009 and 2010 the hospital has built up its knowledge of and contacts in the area as well as carried out the first Udaipur block school health mela (festival). This was highly successful and also helped pull together a team and extended their relationship with the primary education department. Drs Jeph and Kaaren Mathias have been based at Papamiya in 2009 and 2010 and although they are starting a new job in neighbouring state, Uttaranchal, they plan to remain in close contact with Papamiya project and to return for June and July each year.
This year we would like to focus on oral health promotion messages and to implement discreet medical interventions, targeted to community needs. Strategically, LWH as an non-government organisation can provide its skilled and committed human resources and can organise quickly and without weighty bureaucracy. The Hospital will thus collaborate with education and health departments, use their infrastructure, involve their staff and on behalf of our patients to access the medicines and screening services to which they are legally entitled. In a sense, these projects are to provide services now — as the Hospital achieved in 2010 — and to involve government so that these services can be sustainably provided in the future.
Each of the interventions we consider to be beneficial to school children in this area with its chronic stunting and undernutrition, high rates of dental caries and endemic lack of Vitamin A.
Proposal One – School Health Mela 2010
The objective is to target 50 primary schools and 15 middle schools in Udaipur block – with a total population of approximately 1000 children — for preventive health measures with a focus on oral health.
Operate from eleven school centres (Tindi, Salgram, Kurcherd, Madgram, Udaipur, Kukumseri, Hinsar, Kishori, Thirot, Chamrat and Tingret) over seven days.
Team – Jeph, Kaaren, Pushpa, Savita, Sam, Usha, Lalita, Nirmala, and hopefully Bimla and Sonam and or Deepak if they are here.
Duration – 7 days (Monday to Saturday)
Timing – mid June 2011
Interventions
- Health check of all children – screening for anaemia, TB and general health
- Vision and hearing screening and treatment as indicated (in association with with non-government organisation DIET
- Putatively use government-provided supply of free glasses and hearing aids but a backup supply will be provided by LWH staff
- Dental screening and treatment as indicated
- Recording weight for age and height for age and screening all children with -3 Z scores of stunting or under-weight.
- Vitamin A supplement
- Deworming
- Toothbrush supplied for each child
- Drama focusing on oral health
- Screen for significant disabilities and refer as indicated
- Health promotion play/puppet show
- Medical follow up as required
Budget
Transport of children and mela team – Rs500 /school x 50 Rs25000
Stipends for local young people (drama and administration etc.)
Rs150/day x 4 x 8 days Rs4800
Staff – Project leader (four weeks work) (setting up, meetings, school visits, team training etc)
Rs15000
Two support staff (cook/ logistics) Rs 6000
Eye technician – time, transport Rs5000
Dentist from LWH, Manali – Transport/ time Rs5000
Medicines as required for mela Rs8000
Lunch for working team Rs30 x 10 x 6 Rs1800
Toothbrush for each child Rs10 x 1000 Rs10000
Albendazole Rs2.80 x 1000 Rs2800
Vitamin A Rs3 x 1000 Rs3000
Followup of medical problems identified
(transport, referral, glasses etc) Rs5000
Overheads (electricity, computer, pamphlets, internet etc) Rs10 000
________
TOTAL Rs101 400 (about $2500 AUD)
Proposal Two – Medical Camps – Tindi and upper Miyar valley
Tindi and Miyar Valleys are remote settlements in Western Lahaul where there are very few medical services. After many years of work in Lahaul, and a base clinic in Madgram, LWH has a strong relationship with communities in both these areas. In 2010, Lahaul’s Chief Medical Officer specifically requested the Hospita to provide a medical camp in Tindi. Last year the Hospital had hoped to be supplied medicines from the Government but this was not possible. This year we therefore have budgeted in medicine costs.
In this proposal, the hopsital would run a one day medical camp in each location which would be open to all comers. Consultation, ultrasound and medicines would be provided free, hoping for some collaboration with Government services. Ancillary services including eye testing, refraction and physiotherapy we hope can also be possible.
Based on other camps we would expect to see 120 patients in a day. The camps will be timed so that surgical cases identified can be operated by Dr Laji in the Madgram clinic.. This will save patients the time and expense of travel over Rohtang pass. We would expect to identify cholycystectomies, hysterectomies for prolapsed uterus and hernia operations- chronic and debilitating conditions that patients simply put up with. More complicated cases may be referred to Manali.
Location – Tindi Primary health centre and Tingret or Khanjar Primary Sub-centre
Staff:
- Drs Laji, Jeph, Kaaren.
- Sonam and Vimla for nursing.. Sam.
- Jasmine from Manali to refract.
- Ancillary staff Suresh, Nitesh, Sam and Deepak
- Anticipate involvement of doctor+ nurse from Government posts
Equipment: Ultrasound machine and refraction equipment from LWH. No charge
Costs:
Doctors (Rs1500 x 3 x 2) Rs9000
Nurses / pharmacy (Rs750 x2x2) Rs3000
Surgical subsidy for cases identified (at Madgram or LWH)
(Estimate 6 cases @Rs1000 each) Rs6000
Transport (from Manali – one vehicle) and around Lahaul Rs6000
Overheads (Pamphlets, electricity, phone, internet etc) Rs1000
Medicines Rs20 000
TOTAL Rs44,000 ($1050 AUD)
