Monday, November 17, 2014

Finger Millet - A Disabled Friendly Crop

This is a guest post written by Ms. Rachel Belda Raj. Rachel serves as Project Manager of the project on Community Based Rehabilitation for the Disabled in NJH.

Working with vulnerable groups for their rehabilitation and empowerment is a challenging task and then there are People with Disabilities (PWDs) who often are the most vulnerable, trapped in the cycle of poverty and disability. The rehabilitation process is time consuming as it involves both helping them discover opportunities as well as facilitate a change in their thought process. In the process of our working with PWDs, disabled friendly opportunities are rare as society is a long way from main streaming. A change in attitude may occur but without the right opportunities, they are not fully rehabilitated, unless they create the opportunities themselves.

Here is an account of a created opportunity towards rehabilitation.

Like most rural communities, agriculture is the main source of income for our community part of the Community Based Rehabilitation (CBR) Project for PWDs. Unfortunately the area we work in is a drought prone area affecting the main source and for most people the only source of income or food. The PWDs also find themselves most vulnerable as their mobility impairments affect their agriculture as well. Surprisingly, this issue has been a recent one as for generations, this area has been a drought prone area but people have survived by cultivating drought resistant crops. But with the green revolution and introduction of cash crops, traditional drought resistant crops were abandoned. Now, with the climate change issues and lack of rainfall, the community finds itself vulnerable as neither they have irrigation facilities or timely rain for the cash crops nor the traditional knowledge of drought resistant crops.

The Community Based Adaptation Project had discovered the long forgotten drought resistant crops of the area especially finger millet which had been part of the community. They are now working to promote Finger Millets both for its drought resistance as well its nutritional content aiming to tackle poverty and mal nutrition.

As a spill over effect of the project work, the PWDs in the CBR Project area had also heard about the work to promote finger millet. Both out of curiosity and desperation, they enquired about finger millet. Most of them had idea as their ancestors had grown and consumed in their homes. As predicted, the lack of rain fall left most of the fields barren. Meanwhile, the CBA project had arranged a training regarding drought resistant crops at Satbarwa, the block headquarters.

The PWDs from the village Patna were encouraged to attend so they would get an idea of Finger millet and its benefits. The meeting was facilitated by Prof. Haider from Birsa Agriculture University, Ranchi. As they presented fascinating facts about Finger Millet, the PWDs were convinced to at least give it a try. As in the end of the meeting seeds were sold at nominal prices, almost 18 PWDs bought about 200gms to cultivate.

The Finger Millet was cultivated and unlike many other crops, this doesn’t need much effort or regular supervision. This was beneficial to most PWDs as they most of them had mobility impairments and were dependant on other people for agriculture. This crop reduced their dependency as there was hardly any effort involved. Of course, regular care of the crop would definitely give higher yields.

When Professor Haider visited the region last week, one of the fields he visited was that of Mr. Manoj who had done cultivation of madwa in one plot of land. He was elated on seeing the yield. In fact, Professor Haider was also taken aback at how finger millet farming has become a boon to a disabled farmer.

The team at Manoj's field . . . 

Prof. Haider interacting with Mr. Manoj . . . 
They now look forward to the harvest. Cultivation of finger millets has not only ensured them some source of food and income but also re kindled hope for the future. 

Saturday, November 15, 2014

Tale of two fields

While Professor Haider from Birsa Agriculture University visited the fields in the target villages of NJH Community Health work, we got to witness a very telling fact about millet farming.

At Patna village, we got to meet a farmer who had sown 2 adjacent fields with finger millet and rice. Our staff had not noticed it. However, when Professor Haider visited the place, he pointed the obvious difference. It did not need any explanation.

The ragi field is on the right and the rice is on the left . . .

Prof. Haider and the rest of the team walking through the rice field. 
There was not even one panicle of grain in the rice field. It was in a sorry state of affairs with yellowish dwarfed slivers of leaves. The farmer told us that he had in fact given some amount of water to the rice field. However, it did not do any good. He had not tended the madwa field much. However, it was evident that he had a better than average finger millet crop.

He was happy to have tried finger-millet. He told us that he would have at least couple of sacks millet grain for the year. If he had put rice in both the fields, he would have lost everything.

Something was better than nothing.

I’m at anew place now. Here, finger millet is not much known. But, there are farmers who grow pearl millet (bajra). On interaction with patients from the nearby villages, it is very obvious that pearl millet farming is also on the way out. Farmers prefer to grow rice or wheat.

Bajra (pearl millet) at NJH. We had tried out a small plot this year and got a good yield
I’m sure it’s worth to look at the possibility of a program/project to promote pearl millet farming. Pearl millet also has many common features with finger millet, including the property of requiring less water than other crops. In addition, pearl millet is a rich source of Iron and maybe it could be the solution to Iron deficiency woes of the country.   

Friday, November 14, 2014

Disabled and the Church

This is a guest post by Ms. Sheron Mathew, Physiotherapist at NJH. She gives a brief description of an initiative we had with a local Catholic church in mobilizing support for parents of children with intellectual disabilities. 

Community Based Rehabilitation (CBR) project, has been working in Barwadih block, Latehar district for more than 2 years. CBR project mainly works on improving the quality of life of the Person with Disabilties (PWD), also with the stakeholders of the PWDs, which inlcudes family, local community and otherother people who are related to the PWDs.

Our networking with the Catholic Church at Barwadih helped the project to reach out to the community in many ways.  Catholic Church has been ministering among the people there for a really long time, by providing spiritual counselling, education and basic medical facilities and these had ultimately ended up with the church developing a good rapport with the local community they serve. 

With the help of Fr. Siby, CMF, vicar of the Catholic Church, Barwadih, we was able to do programme for children with intellectual disability in Gandhi Ashram, Barwadih on 11th October, 2014. When such programmes are organized, there are always major issues such as the lack of interest of the caregivers and the lack of the reach of information to those who need it. In this programme, the church played its vital role in mobilising the community as well as opening it’s doors for the children and their parents.

The turnout was really amazing. Screening was supposed to start by 8:30 in the Gandhi Ashram premises, but there were people who had already been waiting since early morning.  The project provided them with our services for free consultation for the children with disability. A total of 17 children and parents had come for the programme. Most of the children were having Cerebral Palsy or some other development delay.   Along with the screening, information was also provided to the parents on some basic exercise for their development and other necessary tips on how to take care of their child. There was also a discussion with parents on the possible levels to which their children can develop. Most of the children were below 8 years. It was really sad to see that few of them had spent a lot of money for  treatment and diagnosis, and most of the parents weren't informed about the nature of the disability in their child and their condition and what they should do and what they can expect their children to do. There were also parents who had started some therapy for their child in the beginning but later they had had stopped because they couldn't see much improvement instantly. 

After the screening of all children, the CBR team had a small discussion with the caregivers on how the project could intervene with the caregivers and their children. By proper facilitation, it was suggested by the caregiver that if the project could facilitate the availability of physiotherapist once a month, they could come together and learn from each other and ensure that they can do the maximum possible for their child in the available circumstances.

Our Co-ordinator, Satyaprakash interacting with the parents
It was encouraging to see that though the parents were sad about the condition of their children they had a smile on their face when they left. We are encouraged by the kindness of the priests and sisters at Catholic Ashram, especially Fr. Siby, the vicar of the local parish. He arranged lunch for all the people who came as well as expressed willingness to open the parish hall for use by these children with intellectual disabilities as well as their parents whenever they need it.

This program was a great learning for each of us as we learnt of a major avenue through which the church can reach out to an unreached group in the local community – children with intellectual disabilities and their parents. This is all the more significant in places such as ours where there are no facilities where such children and their caregivers can get help or support. I’m sure there are quite a number of churches who can learn from our experience.

Maybe, you can very well do things similar to what the Community Based Rehabilitation team at NJH are doing through the local churches. The next meeting at Catholic Ashram, Barwadih is on Saturday, the 15th November, 2014. 

Thursday, November 13, 2014

Backyard captive poultry

It is a very well accepted fact that backyard poultry is a very rewarding pastime as well as a source of income. There is enough research which has proved that backyard poultry rearing improves household nutrition as well as empowers women.

However, there are major challenges, especially in rural areas.

As part of our Community Health project aimed at building up resilience in the local communities against Climate Change, our team was involved in exploring opportunities for income generation. One theme that was echoed across almost all sections of the society was backyard poultry. Initially, it was about vaccinating the birds from Ranikhet (Newcastle disease). We got some success by going for vaccination campaigns. But, we found out that there was couple of pertaining issues which needed to be sorted out.

The first issue was of predators which preyed on the birds when they scavenged during daytime and even at night. There were incidents of wild cats entering chicken coops made of mud and killing off entire flocks of birds. The other predators were snakes and various species of rats and mice.

The second issue was of sustained feeding of the birds. Because of irregular and erratic food availability, the birds took time to gain weight and therefore were not economically productive.

The third issue was of diseases - the main disease being Ranikhet (Newcastle disease).

We thought quite a lot about solutions. It was very obvious that with a bit of change in practices and discipline we could tackle the second and third issues without much problem. The major issue with the first issue was to make a cheap chicken coop which will keep out wild cats and snakes. There were quite a lot of designs available in the internet to make quite beautiful chicken coops. The problem was the enormous cost.

While I was in Kerala, I saw advertisements for cage like structures to keep 4-6 chickens that cost about 2500 INR (40 USD, 25 GBP, 35 Euros) to make. The monthly earning of an average family in our nearby village was hardly 2000-3000 INR. And most of the poor earned less than that.

It was obvious that we had to think of a new design. Dinesh, our maintenance manager and I ultimate came up with a design. We decided to try it out ourselves as well as among few families within the campus who consented to try it out. We had no inkling about the success.

The contraption was quite simple. We got 3 feet wide chicken mesh, which usually came in rolls of 50 feet. We made cylinder structures using these mesh with a diameter of 3 feet, height of 1.5 feet and circumference of 9.4 feet. On the top of the cylinder, an opening was made with a mesh door. There was no use of any other frame for this cage. The cost of one cage came to around 650 INR (10 USD, 7 GBP, 9 Euros). And it could comfortably house 6 chickens.

Our family has already kept 4 batches of chicken (each batch of 6 chicks) over the last 5 months. And it has been a roaring success. Many of our staff tried it and are quite happy about it. Then, we moved out from NJH to Barwadih. Quite a lot of people who saw the cages were very impressed.

And slowly people started to enquire on where to procure these cages. And we started off a small industry. The priests at the Catholic Ashram, Barwadih were very helpful. We trained few local boys to make them.

In NJH, we made about 20 cages for the staff and villagers before we moved out and at Barwadih, we made about 40 cages in 2 months time.

Few snaps of what we've doing . . . 

Sukhi - the first person who attempted our theory and succeeded. 

The initial days - one of the first cages being made at NJH

A cage kept by one of the staff at NJH

A cage in one of the nearby homes at Barwadih

The 3 cages we used to have. We used to buy 6 chicks every 2-3 weeks which meant that we had regular chicken to cut

The cages being made at Catholic Ashram, Barwadih
Chicks ready for sale

Ujwal, Amit and Manbodh . . . the first full time experts on the cage . . .

Women . . . empowered . . . 

Going home with the cages

It was not only the women . . . even the men were quite interested in the dynamics
Well, I’m sure there will be people who will be interested to do this in other places. As of now, we’ve this being made at NJH and Catholic Ashram, Barwadih. There are 3 more places where few of my friends are exploring on start promoting this. 

The challenge is to have some funds to start off and to find the right people.

You can contact me at or call me at 8986725933 for more details. 

Tuesday, November 11, 2014

The Lord Cares . . .

For Angel and me, the call to be in a remote mission setting has been a definitive call. It is not uncommon that we get questions about our saneness. The questions have increased proportionately with the increase in our number of kids. Some of the recent ones have been like – ‘4 kids and living in a place where the nearest pediatrician is 120 kilometers away’, ‘how do you manage without an outing to a mall’, ‘3 days to go home and meet your parents, are you nuts?’  

Of course, it’s not uncommon that we look at adverse possibilities.

Exactly a month back, we faced such a situation. Our younger daughter, Hesed, aged 2 years old and the most active of our four children took a jump from the upper deck of our double-deck cot and landed on her right forearm. The hand took quite an impact. She was not allowing us to touch her right elbow.

And we were at Barwadih. The nearest help was about 30 kilometers away and we knew very well that the orthopedician did not deal with such injuries. We had a plan to visit Ranchi the next day. Thankfully, there was no swelling of the elbow although there appeared to be some pain.

Overnight, Hesed did fine. However, the next day as we travelled to Ranchi, we realized that there was a bit of a swelling of the right elbow. It was difficult to find out if there was much of a problem as Hesed was a left hander.

As we travelled, the first thought that came to me was to call up our friend orthopedician, Dr. Kenny David at CMC, Vellore. To our amazement, he was at a place near to Ranchi and was on his way to Ranchi airport to catch a flight.

It was amazing - - - looking from a point of chance. The number of times, we visit Ranchi as a family is only once in 3-4 months. The number of times that Dr. Kenny David will come down to Ranchi is maybe once a year. The chance of one of our children getting an elbow injury is maybe once in a generation. And to have all of them together in such a way that Hesed gets consultation from the pediatric orthopedician of a premier healthcare institute of the country when we are stationed at a remote corner of the country.

Don’t you think this is amazing? We are definite that the Lord was in control and took care of Hesed’s elbow.

Dr. Kenny saw Hesed at Ranchi. We got her X-Ray and then put her on a slab. The X-rays got reviewed by the pediatric orthopedician at Vellore. 

Today, it is one month since the incident.

Hesed is doing well. We thank God . . .

We learnt that how much precious we are for the Lord.

Back to square one

Over the last 2 weeks, we were on the move once again and are now based at a small mofussil town in Eastern Uttar Pradesh, about 300 kilometers from Palamu region. We’re not quite sure about the future, but for now, we would be based at Kachhwa Christian Hospital, Kacchwa, Mirzapur District.
We are about 50 kilometers from Varanasi or Banaras. In fact, the river Ganges is just 2 kilometers from where we are now.

Coming to the hospital, it serves the small town of Kachhwa. I shall write about the place in a later post. The best part of my first week was a 30 year of mother of two who was brought in gasping after she got bitten by an unknown snake. She was almost dead.

Our team got her intubated and resuscitated in no time. Considering that she did not have swelling over her bite site, we were quite sure that it was a krait bite. We had ASV pumping into her veins in no time. And what did we have for the mechanical ventilation?

I could not believe my eyes when I saw the machine. It was the same one; the war horse we had at NJH when we reached there in 2010.

The Newmon ventilator did a wonderful job for about 24 hours before she ran out of steam.  The relatives did manual ventilation for about 8 hours before the machine started to work again.

Thankfully, the lady could be weaned from the ventilator by 48 hours. Unfortunately, we discovered that she had some amount of brain damage, which may have occurred during the period of cardiac arrest (We do not know on how long she had not been breathing. The relatives told that she stopped to breathe about 5 minutes before we intervened.).

Our patients would definitely benefit if we had one more Newmon ventilator. It costs about 80,000 INR now (1350 USD, 820 GBPs, 1050 Euros) and the people here know where the machine can be purchased.

More on the clinical exploits at Kachhwa and about the place in a later post . . .