In a remote part of Salumber block in rural Udaipur district, something new, but important, is happening. Two small clinics have opened, which are staffed by nurses round the clock, and visited by a doctor once or twice a week. Basic laboratory tests are also done here. The premise of these Amrit clinics (as they are called) is that access both in terms of cost and distance are huge barriers to health care, and therefore if low cost good care is provided close to the people, they will utilise the services. Charges are Rs. 50 per visit, good for a week of repeat visits, for any complaint, no matter whether it is trivial or serious.
This is coming true with a vengeance. The clinics have run now for barely three months, but have a busy time serving a range of sick patients. Diabetic keto-acidosis (caused by too much sugar in the blood), advanced leprosy and tuberculosis, cancers, hypertensive patients, severely anaemic adults and children - these are just some of the patients who are seen here. The very large number of previously treated TB patients (or those who have discontinued treatment half-way) is worrying. Antenatal clinics are held in the periphery on a fixed routine, and pregnant women are seen at the clinics as well. Having women nurses at the clinic has encouraged women to come forward with gynaecological complaints that had gone unreported earlier.
Much of the work of the initiative revolves round linking up the patients with the Government health system to access drugs and facilities as much as possible.
The initiative also trains illiterate women health workers to do growth monitoring, recognise growth faltering, and also about young child nutrition. They follow up the children in their village and hold women's meetings where cooking demonstration is done about the type and consistency of food that must be given to little children.
Most of the villages served are inhabited by Meena tribals, where the men have migrated to Gujarat to work. Women left behind to head the household and do all the work in the fields and in the home and to labour, have little time left to look after their young children. Consequently, high malnutrition rates are the norm. Adults have a low BMI (body mass index) as well, signifying undernutrition.
This is coming true with a vengeance. The clinics have run now for barely three months, but have a busy time serving a range of sick patients. Diabetic keto-acidosis (caused by too much sugar in the blood), advanced leprosy and tuberculosis, cancers, hypertensive patients, severely anaemic adults and children - these are just some of the patients who are seen here. The very large number of previously treated TB patients (or those who have discontinued treatment half-way) is worrying. Antenatal clinics are held in the periphery on a fixed routine, and pregnant women are seen at the clinics as well. Having women nurses at the clinic has encouraged women to come forward with gynaecological complaints that had gone unreported earlier.
Much of the work of the initiative revolves round linking up the patients with the Government health system to access drugs and facilities as much as possible.
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| Malnourished child with pneumonia brought to the clinic by his father. Father washes dishes in a hotel in Baroda. |
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| Swasthya Kirans (health workers) learn how to plot weights on a growth chart |
The initiative also trains illiterate women health workers to do growth monitoring, recognise growth faltering, and also about young child nutrition. They follow up the children in their village and hold women's meetings where cooking demonstration is done about the type and consistency of food that must be given to little children.
Most of the villages served are inhabited by Meena tribals, where the men have migrated to Gujarat to work. Women left behind to head the household and do all the work in the fields and in the home and to labour, have little time left to look after their young children. Consequently, high malnutrition rates are the norm. Adults have a low BMI (body mass index) as well, signifying undernutrition.
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