Michael graduated from Indooroopilly State High School in 2005. He completed a Bachelor of Sciences majoring in Biological Chemistry at UQ and entered the university’s medical program this year. Having witnessed personally the social inequalities that plague places like Manali during his travels throughout India and Nepal in 2009, Michael is eager to return and lend a helping hand within the community.

Mikaela grew up in New York and graduated from University of Vermont in 2008 where she studied biology and anthropology, After working as a researcher for a year at Massachusetts General Hospital, she moved to Brisbane to undertake her Masters in International Public Health at UQ. In 2011, she began studying medicine at UQ and is excited to leave the classroom and gain some first hand experience in global health.

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)

This May a school health camp was run in Jibhi, a small rural community. It was the first time that the school health camp was run as part of the improvements to rural community health in the region. A team of two doctors and several assistants travelled through the region and checked the pre-school children – approximately 700, attending 52 different schools. For more information, see the School Health Camp Report or the report from My Himachal, a non-government organisation working with Lady Willingdon Hospital.