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.
Dr. Manoj Patel is the Director, Smt. MK Sanghvi Medical and Educational Complex, Vadodara.