(An incident that highlights the fact that despite initial resistance to accepting the need for a Community Health Worker in a village, a single incident can bring about lasting attitudinal changes)
Domburudhar Pujari, a Community Health Organizer (CHO), a resident of Komel village was woken up one night at 2:30 a.m. by the frantic knocking on the door of his hut. Two villagers from a village called Kanchana, which is about ten kilometres away, had cycled to his village to seek his help.
The matter of concern was twenty year old Debaki Golory, wife of Jaganath Golory who was in labour for almost two days. They wanted assistance in calling for the ambulance from Asha Kiran Hospital. Meanwhile, the witch doctors had done all they could to save the patient but were unsuccessful. The ambulance reached the village and there was a big commotion as a large number of people tried to accompany the patient with a view to assist in transporting her dead body back to the village. The CHO managed to convince them that only five persons could accompany the patient. She was admitted in the hospital and by God’s grace had a normal delivery. Unfortunately the baby died after an hour of birth but the mother’s life was saved. She returned to her village after three days.
After this incident, the villagers realised the importance of having a Community Health Worker (CHW) in their village. They called for a village meeting and selected a lady who would be sent to the hospital for training. Now they have a CHW in their village who caters to their primary health care needs and refers cases to the hospital as and when required.
The Community Health Programme
The Community based Primary Health Care Project was implemented from June 1995 to December 1998, which was funded by a grant from DANIDA. The project aimed improved health status of the population in Lamtaput block through the primary health care approach with the following objectives.
At the end of this intensive health intervention a participatory appraisal of the felt needs of the community was undertaken in 1998, which gave a direction to the team to incorporate community development along with the community health programme. Hence the programme aimed to strengthen the network of CHWs, HDCs and CDOs in the block to improve the health status of the block.
Over the years the community health programmes brought about awareness on the primary level preventable diseases and gradually the medical seeking behaviour has been changing positively. Furthermore in 2003 the project adopted the focus village approach to impact in the qualitative change of the community life and living. Therefore along with the wider network of the CHWs, HDCs and CDOs the project selected 19 villages from 15 gram panchayats as focus or model villages with the emphasis of mother and child care along with primary health care, which was funded by MCC till March 2006.
In 2004, along with the above mentioned programmes another programme was initiated (funded by SSI) to address eye care with the aim to ensure provision of Comprehensive Eye Services in Lamtaput and adjacent blocks by establishing new eye care centres, strengthening the existing eye care delivery system, which is accessible, acceptable and affordable to everyone including the poor and tribal communities. This programme has increased the awareness on eye care and gives a ray of hope to the senior citizens of this community after Cataract surgeries.
In 2006, with the help of external expert’s the project team looked into the past interventions and future direction of the project, as such the MCC funding had come to an end. The team felt the necessity of continuing the same work with cluster approach and establishing a health outpost in the cut-off area of Lamtaput block. So that the focus will be further empowering the community for health and reduce IMR and MMR in the block.