Health Initiatives in Collaboration with People’s Organizations –
In collaboration with the Kashtakari Sanghatana in Dahanu-Jawhar area of Thane district, Shramik Mukti Dal in Aajara block of Kolhapur district, Jagrit Adivasi Dalit Sangathan (JADS) in Pati block and Advasi Mukti Sangathan in Sendhwa block of Barwani district in MP, SATHI team has been involved in Community Health Action. This two-pronged work is composed of -
i) A Village Health Worker (VHW) based Primary Health Care Programme consisting of providing training and certain ongoing technical support to women Village Health Workers (‘Aarogya Sathis’ or ‘Swasthya Sathis’). These Health Workers provide First Contact Care for common simple ailments like simple diarrhoea, fever, cough, anaemia, minor wounds etc. The specificity of this collaborative work is that VHWs and other activists of the People’s Organization work as volun-teers for the health work without any external honorarium; expenses for village level activities, including the training camps are borne locally. By merely using 8-10 drugs, these nearly 100 VHWs working in various remote, mostly tribal and hilly areas have, during the last 6 years, treated thousands of patients in their own hamlets. Timely care in their own hamlet for these medically deprived people means a very valuable service, which has saved not only lakhs of rupees for these cash-starved sections but also spared them from loss of working days and from complications arising out of delayed treatment. The VHWs have also been doing related health educational work, patiently explaining health topics to the people in the local language and idiom.
Since as a policy only women have been selected as Health Workers in this collaborative programme, (a skilled and socially somewhat prestigious work) it has helped women’s empowerment. Secondly, this health work has helped to broaden the social base and support of the people’s organizations, whose main work has been to lead the struggle of the labouring people on their livelihood issues.
Attempts have been made to get wider social sanction for these CHWs. The SNDT University, Mumbai, has recognized the "Village Health Worker" training course prepared by the SATHI team. In three batches from different areas, nearly one hundred health workers have so far received certificates from the SNDT University after successfully appearing for an examination based on this course.
We believe that First Contact Care, like other levels of health care, must be pro-vided for through public funds. Hence continuous attempts have been made to get honorarium for these Aarogya Sathis, along with accessing medicines for free use for the patients from the public health system. Thanks to intensive advocacy, a few of the Aarogya Sathis in our programme in Dahanu area have now been selected as Pada Health Workers in the Maharashtra government’s Navjeevan Sanjeevani Yojana and have been receiving monthly honorarium and free supply of a few medicines.
Advocacy to mainstream this work of the Aarogya Sathis is being done so that there would be a publicly funded, well-trained VHW in every habitation in Ma-harashtra and MP. One step in this direction has been the pilot project in Dahanu area in which 45 women Pada Health Workers working in the Pada Swayam Sevak (PSS) Scheme of the Maharashtra government received upgraded training for First Contact Care from the SATHI team, and successfully appeared for the SNDT University’s examination mentioned above. Thanks to our intervention in an ongoing Mumbai High Court Case, the Maharashtra government has given a commitment to the Mumbai High Court that it would give upgraded training to Pada Swayam Sevaks throughout tribal areas of the state.
The SATHI team has given training and other inputs to other NGOs like MASUM ins Pune district, Ashagram Trust and Sampark in Barwani district for their VHW based programmes.
ii) Local advocacy for improving the functioning of Rural Health Services so that they become sensitive to the needs of the marginalized, labouring population. Such advocacy in collaboration with the four People’s Organizations has involved a range of initiatives, ranging from taking a delegation to the concerned health officials to organizing protest marches and public hearings. There have been ‘health dialogue sessions’ with the local health officials to press for demands concerning regular presence of doctors in the clinics; end to the arrogant behav-iour by some doctors / staff with ordinary people, especially the tribals; regular and adequate supply of medicines etc.
Advocacy activities are often preceded by health awareness campaigns, which explain various health issues to the people so that people can take initiative in health matters. For example, a Swasthya Yatra (Health procession) was arranged in each of the field areas for increasing health awareness and for raising the issue of health rights. In this Yatra a team of health activists moved from village to village with a range of exhibits, including human organs, a microscope, video programmes, slide shows and pictorial poster exhibitions.