| The Conflict:
India has entered the 21st century with modern development
in the cities. Yet at our native places and villages of origin,
our people are deprived of even basic necessities! Pregnant women
carrying the future of India still answer nature’s calls in the
open, come rain or storm. How does she deliver her baby? The same
way – at nature’s mercy. The child develops advanced pneumonia as
a result with no medication to help – and remains at nature’s mercy!
These are the conditions we encountered when we ventured into remote
areas and delved deeper into the lives of our brethren there. Villages
have little potential to grow, as those with intellectual possibility
and who possess any leadership quality have to migrate to cities
for better opportunities. They leave behind their village to the
mercy of nature and the selfish local opportunist.
The Indian government and some NGO’s have expressed their concern
over this and wish to reach out and help. However, few manage to
reach out or sustain their activities. Most find themselves lonely
and short of financial resources in their struggle to manage the
expanding needs. People in cities may be surprised to learn, that
over the years of our interaction with rural communities, we have
come across many genuine and empathetic people working to build
a better community. However, since such work is in isolation, the
results are poor.
The government has realized that it cannot implement their schemes
and facilitate change on its own and are looking for partnership
with other like minded organizations.
Serious effort at a resolution:
Our organization needed to expand our definition of health care
to include individuals, the society and the environment. We needed
to approach health from all angles and find an integrated solution.
The solution we found lay in large scale cooperative efforts between
government and non-government organizations working together with
common objectives.
We had to accept that we did not have adequate financial resources
and so we had to plan multi-centric programmes and mobilize our
resources with a lot of care. These resources were the human resource
of experts and technicians, as well as material resources. Dr. ML
Dhawale had offered a possible solution:
“Primary Health care in a rural setting can be optimized through
an educative multi-centric programme. Leadership comes
from the community with guidance from health care teams, various
government agencies and non-governmental agencies working together
in the region in a massive cooperative venture.
What is called for is a planned objective, well aligned by
the nation, state and region so that wastage through needless
duplication and repetition is avoided and optimal utilization
of the sacred resources is assured.”
Perceiving Rural Health, Perceiving 1: Dr. ML Dhawale
The Multi-centric Approach
Based on Dr. Dhawale’s perception, the multi-centric approach works
through a multi-layered team working with cooperation in Curative,
Preventive and Promotive Programmes. Our experience in tribal areas
taught us that Curative programmes are successful when conducted
with survey camps followed by regular visits of the Community Health
Volunteer (CHV) and the Multipurpose Worker (MPW). The work is achieved
through a multi-disciplinary approach with due importance to homeopathy
and traditional medical sciences.
For this there a multi-layered team: The Physician, the Medical
Social Worker, the Multi-purpose Health Worker and the Community
Health Volunteer need to work together to achieve the objectives.
The physician and medical social worker make weekly visits offering
either homeopathic treatment or traditional medicine.
In the homeopathic curative programme, the CHV is appropriately
trained in first aid and the use of homeopathic first aid medicine.
The MPW should have the ability to communicate and handle difficult
medical conditions till they can be brought to the health centre.
He forms a crucial link between the sub centre and the primary health
care centre.
Preventive programmes, largely educative programs, attempt
to create awareness in the fields of hygiene and nutrition. The
management of all these programmes is with the resident leader,
called the CHV. The CHV and MPW’s make this work their full time
activity and require good incentives and salaries to encourage them
to continue to be part of local development.
In addition, an integral part of the development strategy in the
multi-centric approach is the involvement of government or NGO’s
with expertise in education, special agriculture, organic farming
etc. to pass on to the local people. They offer programmes that
train volunteers to promote these good farming practices.
Diagram of multi-centric approach:

Here you see a diagram of the Multi-centric Approach for Rural
Health Care:
At the centre is the Community Health Manager who manages the functioning
of:
-Multidisciplinary medical services
-Effective communication of health programmes
-Developing the infrastructure for Cooperative welfare living
-Making basic necessities available: Water, Food Clothing
-Mobilization of adequate resources for projects
-Providing appropriate opportunities for housing and sanitation
-Education and vocation training of rural people
Realization of our efforts:
Here is a video you could watch to see the fruit of our efforts
and the involvement of the community:
The Indian Government now has in place the National Rural Health
Mission Programme which seeks to achieve the desired objectives,
partnering with NGOs. While various agencies have come forward to
help, it is the MLD Trust and NGO organizations which have been
able to offer pioneering experiments in taking health to the rural
masses through the multi-centric approach described above, with
homeopathy as the central modality of treatment.
A lot needs to be done and this is the beginning. What is truly
exciting is that our organization functions as an NGO that is cooperating
with Government programmes with homeopathic treatment as the central
modality. Our homeopaths are trained to think beyond homeopathy
– they are trained as multi-centric homeopaths, manifesting the
values, knowledge and expertise required of multi-centric health
experts.
There is hope that slowly and surely the lifestyles at the mercy
of nature in the rural areas will change. It is the commitment and
concern put into practice by those who care, in cooperative ventures
that will make a difference.
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Dr. Manoj Patel is the Director, Smt. MK Sanghvi
Medical and Educational Complex, Vadodara.
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