Advocacy . . . Empowering the poor

This is part of a series of posts on other things we do in addition to clinical care.

Over the last week, one of our colleagues from EHA Central Office had come over to Ranchi to help us facilitate an advocacy workshop.

Mark Delaney has been in India for the last 17 years and since couple of years, he had been preparing Advocacy Manuals for Indian States. So far, manuals for the following Indian states have been prepared - West Bengal, Uttar Pradesh, Delhi, Madhya Pradesh and Jharkhand. Soft copy of the manuals for each of the states in Hindi and English is available in the EHA website. For West Bengal, the copy is available in Bangla too. 

Now, what is an Advocacy Manual? It is a document that facilitates to help the poor to access facilities which otherwise may be unknown to the public. In addition to a compilation of all the government programmes, there are sections on advice about how to go about submitting applications, copies of application forms etcetera.

So, we facilitated the organising of a workshop on the advocacy manual along with few likeminded organisations including churches.

Mark was quite brilliant in his presentations and communicated quite well on how this can be well used for the emancipation of the poor and marginalised in the society. Below are few snaps of the whole program.

Participative sessions . . .

Role play . . . 

Game on team building

A section of the participants

Another view of the sessions

Game on group dynamics

Another game . . . 

And the press reported us . . . 

All the organisations who participated took a unanimous decision to organise a forum to take this forward and take the responsibility of updating it on a regular basis. 

And before I sign off - a selection of verses from the Bible on caring for the poor . . . 

Matt 5: 13-16 

Matt 7: 12

Matt 22: 30-40

Mark 1: 40-42

Mark 8: 1-10

John 13: 34-35

James 2: 14-17 . . .

1 John 3: 16-18

Water . . . Water . . . Digging borewells

This post is part of the series of posts on what else we've tried to do in addition to clinical care which brings about a change in the villages around us.

Over the last 3 years, many of our surrounding villages suffered from severe drought and one of the major challenges was the availability of potable water all over the region..

It was quite a blessing to know about ‘Sampurn Development India’, who facilitated us to dig borewells and install handpumps in few of surrounding villages especially those hamlets who had to walk quite a long way to fetch water. Over the last month, 5 borewells were dug and handpumps installed in 5 villages. Our plan is to facilitate doing this over the next 3 years. I understand that the parent funding comes from ‘Living Water International’.

Below are few snaps of the process including the inauguration of the handpumps. We praise God that we came to know about the work that ‘SDI’ has been facilitating in providing potable water to rural India. 

Other things we do . . . Linking up development to health. . .

It has been quite a long time since I’ve posted something on development activities that we do in addition to clinical work. To be very frank, I prefer that we do more of health education, community development and empowerment which brings about more transformation. Otherwise we would end up doing more rupture uteruses and seeing complicated and late presentation of simple diseases like malaria and tuberculosis because of poor and un-empowered communities.

Over the last 2 weeks, we have been part of couple of major programmes which should go a long way in achieving the objective of transforming communities.

The first one we had about a week back.


Community Health and Development Project of Nav Jivan Hospital has been serving in 33 villages of Satbarwa block since 2011. Over the years, we formed 29 SHGs from our target villages. These SHGs have reached at the functional stage with a total funds of about 500,000 INR. During the year we organized trainings and workshops for strengthening these groups. As per the project plan we have been trying to link these SHGs with the government DRDA programmes. In the first process we put forward an application to DRDA for linkages. However, the authorities directed our team to hold a workshop of these SHGs at Nav Jivan Hospital. Eventually a date was fixed to organize the workshop. 

The chief guest of the day was Mr. Awdhesh Upadhyay (DDC, Daltonganj). Other invited guests were Mr. Anil Singh (Account Officer, DRDA), Subhash Kumar (District Welfare Officer, DRDA), Jyoti mala (Project Officer, DRDA), Renu Rashmi (Technical Assistant, DRDA), Madhu Kumari (Technical Assistance, DRDA), Anu Priya (APO, DRDA), Vidyavati Akhori (Ladies Extension Officer) Block Office Satbarwa.

There was good interaction between the 300 odd members of the 29 SHGs and our learning points were -

· Knowledge about the governmentt schemes for the SHGs

· Inter loaning in the group is the basis for obtaining loan from the bank

· The new SHGs are eager to learn and develop the group further

· The wrong practices of the SHG members came to our knowledge: One of the major problems that we find in SHG movements in multiple SHG memberships that one person holds.

However, the major achievement was the assurance from all the government leaders to support in whatever way they can to develop the capacities of the groups.

I hope and pray that we would make a difference . . . There would be at least couple of more posts on similar work that we do . . . 

Nursing . . . An Invitation . . .

Over the last couple of months, there has been quite a hue and cry in my homestate, Kerala about working conditions of nurses as well as the compensation packages being given in private hospitals. There has been violence in one of the well known superspeciality hosptials. Conditions in many of the private hospitals around the country are also not much different. I recently found out that it has affected one of the hospitals under my church. 

I do have relatives who serve in the nursing services in private as well as government hospitals. One of my cousins who is a BSc Nurse, quite a smart chap and popular with patients gets a take home salary of about 6000 INR and works a 10-12 hour shift. Mr. Selvin who joined us about 6 months back also tells us about similar conditions in hospital he worked in before he joined us. He was getting about 5000 INR and living in a single room along with 4 of his colleagues.

I’ve been telling quite a number of my friends and relatives about the much superior working conditions and staying facilities that EHA units such as ours offers to nursing staff. I had been keeping myself away from putting this up for quite a long time till I discovered that the problems continue to remain in spite of umpteen number of agitations etc.

There is a dire need for qualified nurses and nurse leaders within the organisation. The major deterrent to people coming to organisations such as EHA is the remoteness of the places where most of our hospitals are. However, there are quite a lot of nursing staff from India who go all the way to t he Gulf, US or UK. And with the arrival of technology such as skype and faster travel, it is not that difficult to be in regular touch with relatives and friends.

One more major deterrent is the much needed experience that many of them need in super-speciality hospitals so as to make a career in countries abroad. However, I feel that this can be offered in few of our hospitals too.

Well, ultimately you may need to know how much we offer. I do not want to outrightly put it here, but what I need to tell you is that a newly joining ANM in EHA gets almost the same salary as that of a BSc Nurse in Kerala/Tamil Nadu.

And before I sign out, I need to put the fact that we are a bit choosy with selections as we need to ensure that prospective staff would be in line with the mission and vision of the organisation . . .

But for the bottomline, more than the superior working conditions or the better stay facilities, it is the opportunity to serve some of the most poor communities in the world and to become part of a movement that looks at transforming and strengthening such communities that drew me to join EHA. And of course, we pray that the Lord will give you a burden for such an effort and for joining institutions/organisations such as ours . . .

Chest tubes . . . Respiratory Medicine . . .

One of the most favorite of all my posts has been about the sort of X-Rays that we find at NJH. And to a certain extent it gives you an idea about the burden of respiratory symptoms that we have to deal with at NJH.

Last week, was a bit extra busy with respiratory medicine – we had 3 patients in the wards at the same time with chest tube in situ.

The first to come in was a 70 year old lady with history of pain abdomen for about 6 months with on and off fever. He was being managed elsewhere as cholelithiasis. It was only when one of our doctors wanted to check out her abdomen that he realised that she was becoming breathless. And a cursory examination was enough to come to a conclusion that there was pleural effusion. And it was massive. She made a fast recovery. We removed about 8 litres of fluid. Thankfully, it was clear.

The next one was a young man who had come couple of weeks back and we had diagnosed hydropneumothorax. We had told him about the need for admission and a chest tube insertion. Unfortunately he did not agree immediately. However, he came back after 2 weeks. He’s also made a remarkable recovery.

The third patient was a young unmarried lady who had been sick for about 10 days and was being treated at many places by all sorts of people. Here, it was pus which we drained on putting the chest tube. She has also made a remarkable recovery.

All the three patients have been started on antituberculosis treatment.

Talking about antituberculosis treatment, I just cannot stop talking about the danger of multidrug resistant tuberculosis that is lurking in almost all third world countries. Yesterday, we had a middle aged man with history of treatment with anti-tuberculosis drugs for five times over his lifetime and this was his X-Ray Chest. He was so sick… and terribly breathless.

When I write about Respiratory Medicine, I always think about a bronchoscope that lies unused in our hospital. I pray that we would have a Respiratory Medicine specialist who would be able to strengthen our services and take the hospital to greater heights.

I end this post with this X-Ray which shows a homogenous opacity in a 80 year old lady. We’ve sent her for a CT Scan . . .