Community Health

From End Of Poverty

6. Community Health:

Community Health has been one of the sectors identified as most problematic one in the target areas. Poor sanitary conditions, improper drainage system, lack of safe water and unhygienic conditions are visible in almost all the villages. ASSIST strongly believes it is necessary that people realise these problems at first before proceeding further to improve the situation. The past experience in this region has taught us that “lack of individual sanitary latrines in a village might be noticed as a problem by an outsider, but for a villager living in a community it is not seen as a problem”. Hence the major task on ASSIST staff is to make the people realise the problems they are living in and to prepare them to have a dialogue to find solutions on the specific problems after prioritising them. The initial data reveals the need to organise special camps to address the needy people to improve their living conditions. Accordingly, the massive health check-up camps will be organised in the remote areas where the people cannot dream of seeing a specialist such as ophthalmologist, gynaecologist, cardiologist, orthopaedic, etc. The common people from these areas cannot afford to go near the door steps of these specialists living in urban agglomerations.

Second activity proposed is the primary health care through intensive health education and promoting values to attain positive health in these communities. Particular focus is put on women in the reproductive age group and under fives and achievement targets will be studied from the changes taking place in this most vulnerable sector. The following items are covered in community health programme of ASSIST:

• Family welfare; • Environmental sanitation and personal hygiene; • Mother and child care; • Immunisation; • Drinking water; • Nutrition; • Care of handicapped; • Patient care

Kitchen gardens and backyard poultries are promoted in order to improve the nutritional status of rural poor living in these communities. The target families will be motivated to raise kitchen gardens and improve backyard poultries. In addition high yielding varieties of pulses are also being proposed so that each family can grow its own pulses in the backyards.

HIV/AIDS Education / Care Centres:

As the HIV/AIDS cases are very much prevalent in part of our working areas, five HIV/AIDS Education-cum care centres are established in the project area to provide counselling, medical aid and community-based rehabilitation.

While discussing with the representatives of these People’s Organisations, the following strategy was suggested to combat the problem of HIV/AIDS for which they are committed to work:

• Raising public awareness and social consciousness on the problem of HIV/AIDS infection among the inhabitants. • Organise High Risk Groups (HRGs) and ensure that they practice preventive measures so that there is no spread of HIV/AIDS infection to others. • Establish an Education Centre on HIV/AIDS and provide screening opportunities for the High Risk Groups (HRGs). • Rehabilitate sexual workers through the provision of alternate employment opportunity by setting up Revolving Fund owned, managed and controlled by the Association of High Risk Groups.

The strategy adopted in four phases:

 Education Phase: Primary task should be to bring sufficient awareness and consciousness among the target population on the problem of HIV/AIDS. The target population should realise the consequences the society at large is going to face if the alarming situation of HIV/AIDS infection spread continues. It is immaterial which method is followed to achieve the public awareness but without achieving this any amount of investment on preventive measures, screening measures and rehabilitation measures will be in vain.

 Prevention Phase: Once the target population realise the problem of HIV/AIDS, the next phase would be to ensure High Risk Groups practice preventive measures. In order to make it possible, High Risk Groups need to be organised and they have to be educated in groups instead of ones or twos. It is understandable that in the Indian standards these High Risk Groups do not want to be recognised as High Risk Groups in the eyes of public. As such, they have to be organised into groups and a system has to be developed within the groups that they follow preventive measures so that HIV/AIDS infection does not spread to others.

 Establishing Education Centre on HIV/AIDS with screening provision: It is necessary to screen the High Risk Groups for Human Immunodeficiency Virus infection. Once the awareness is brought among these groups, they could be motivated for screening tests so that necessary precautions can be taken to control the spread of HIV/AIDS infection to others. Lack of this facility at present is one of the bottlenecks to enable the High Risk Groups to follow preventive measures.

 Rehabilitation Phase: The last phase would be after successful awareness and prevention programme rehabilitating the adolescents from the families of High Risk Groups by providing alternative employment opportunities. This would only be possible if the earlier programmes succeed. The phase aims at setting up revolving fund with the High Risk Groups once they are organised into an association. It will be taken up after attaining the necessary attitudinal change among the High Risk Groups so that their next generation should have better future and they should go into different vocation.