COMMUNITY HEALTH AND NUTRITION

Health and Nutrition Education

People suffer from different types of diseases due to unhygienic conditions, poverty and lack of food. They are not aware on their own health. Low production of food grains also adds to this problem. There is no accessibility for the people to go to Government . Primary Health Centre situated at Khairput Block Head Quarters which is 15 to 20 Kms away from the Bonda villages.

To provide better health facilities, the project initiated the following programmes: The staff imparts health and nutrition education on various health subjects, screening of families, treatment of patients, care of U/5 children, referring the patients to hospital, identification of chronic patients and mal-nourished children follow up, special care for U/5 children, personal hygiene, use of safe drinking water, cleanliness, immunization of children, treatment of common diseases, ORS demonstration, use of native medicines, food demonstration, nail cutting, washing clothes regular and consequences of alcohol etc.

Mobile Health Programme

As per the plan , Mobile Health Programme from Semiliguda should have visited all the 10 villages. As the Staff was not allowed to dispense the medicines by the then District Collector, the MHP was with drawn from visiting the Bonda Hills. In month of January, after a New Collector was posted at Malkengiri district the Staff met the Collector and appraised on the programmes undertaken in Bonda Villages with the support of DST. After discussion with the District Collector, the MHP work was resumed and in the last three months - January to March 2000, MHP visited four villages and treated 40 patents. Every family in these four villages was screened. Some patents were referred to hospital and ORS demonstration was carried out.

Patients Treatment Report by the Staff

The Patents treatment activity was stopped from October, 1998 under the instruction of the then District Collector of Malkengiri. Again a new Collector who was posted in 1999 asked the Project Staff to continue the patient treatment work. This activity started in the month of January 2000. Therefore the patient treatment report refers the period from January 2000 to March 2000(three months) only. As per the patients; treatment record, girls and women suffered the most particularly by malaria and worm infection.

Birth & Infant Mortality Data

In three villages, Tulaguram, Seleguda and Gopurpoda reported no infant death during the reporting period. Out of 103 Children Born, seventeen children have died due to fever and lack of milk. Male children had died more then the girl children.

Birth and Infant Mortality Rate Data - 1995 to 2000

The project began its work in Bonda Hills primarily to address the issue high rate of infant mortality. In 1994, a study revealed that the Infant Mortality rate among Bondas was very high in comparison to District State and National average. As per the report it was recorded in 1994, the IMR among Bondas was 400 infant death for every thousand children born. After five years of intensive work in five and ten villages the IMR had come down to 188 infant death for every thousand children born. Meticulous care and sustained intensive health activities like health education, under five care, pre and post natal care, kitchen garden practices, supplementary nutritious food helped the people in 10 villages to ring down the infant mortality rate. In many villages, women more motivated and educated in taking care of the children born and breast feeding was advised. The Staff and the Mobile Health programme took special care of the pregnant mothers.

01 - 5 Year Death Data

In four villages, i.e. Tuseipoda, Seleiguda, Kirsanipoda and Dantipoda there was no death from the age group one to five years. In other villages deaths was reported due to Malaria.

Death Data - 01 - 5 Year - 1995 -2000

All the deaths were reported due to Malaria, high Fever and Diarrhea. The Project stopped all the health related activates from October 1998 to December 1999 under the instruction of the then District Collector. It is noticed that boys have died more than girls. The Staff continue to fight malnutrition and other unhygienic practices which are the causes of infant mortality, under-five children, adult deaths.

Adult Death Data

In three villages no deaths were reported. Most of the death reported was due to old age and Malaria. In Dum6poda village more death was recorded due to diarrhea and one person died due to TB illness. In many villages due to lack of medicines in proper time people have died. The reports only reflects 10 villages were the Project is working. There are many more interior villages where we are unable to record the death details. The project is also planning to expand the area in the future at least to cover ten more villages Out of 32 Bonda villages the Project will try to work in 20 villages in the future.

Health Cadre

Ten health cadres were selected and trained by the project for a period of 10 days. The trained Health cadres help the staff in screening of families, treatment of patent and health related programmes. The job is to motivate their own people in the village for keeping the surrounding clean, how to care of own health and convince the patents for better treatment

Health Camp

A health camp was organised in a village to bring health consciousness among the people. The Medical officer, CHC, Khairput Medical officer, PHC, Mudulipoda. Dr Alex from Asha Kiran, CDPO from ICDS, Project leader from BDA and other Government officials were invited for the camp. All of them shared on different subjects relating to health and the health facilities available for the people from too respective departments. Nearly, 400 people participated in the camp. Patient were treated during the health camp and chronic patients were referred to hospital. ORS demonstration was part of the Camp.

Health Clinic

The staff organize clinics in ten villages. Family screening, treatment of patents and nail cutting is part of the clinical work. U/5 children screening, and special care for them was the priority.

Care of U/5 Children

During the MHP visit to the villages, U/5 clinics were organised to screen the children. By MHP, 270 children were screened (Male - 150 and Female 120). To, all the children de-worming was done and the Staff advised the parents to take care of their own children.

Immunization

The pulse polio programme was organised in 10 villages along with government Doctors and ANMs. AU the children below 6 years were immunized under pulse polio programme. So far 326 (156 male and 170 female children) were immunized.

Training of TBAs

10 TBAs under went training for a period of 5 days on Safe delivery system, how the TBA in the village can attend all types of delivery. They never use to contact the local PHC Doctor or health worker, after training the TBAs realized how important to contact the health staff. Al to 10 TBAs were provided with TBA Kits. They were informed to contact the project staff for information on the birth and infant death.

VNDs Training

The VNDs training was organised for 10 persons from 5 villages. They undergone training for a period of 3 days. Different types of new plants/medicines used by other VNDs was discussed in the training. A herbal garden in each village was proposed.

Herbal Garden

In 2 of the villages as proposed herbal gardens were raised. The VNDs from 2 villages, started the herbal garden and nearly 50 varieties of plants in each village were planted. All the medicines are for cuts and wounds, stomach pain, fever, toothache, diarrhea, headache, nasal problems and snake bite etc.

Chronic Patients

Chronic patents were identified in 10 villages and were referred to hospital. The patents suffered from T.B, Cancer, Leprosy and Chronic Ulcer. Other patents who suffered from tooth ache, gastric and colic pain were also referred to local PHC for better treatment Total 21 chronic patents from 1 0 villages were identified and care was taken.

Kitchen Garden

To avoid mal-nourishment and provide nutritious and fresh vegetables to the families, for the ante-natal mother and 1-5 years age of children who am mal-nourished the kitchen garden programme was initiated. In Bonda villages, the following nutritional disorders were identified among the children and adults: 1) Anemic, 2) Goiter, 3) Berry berry, 4) Marasmus, 5) Night blindness and 6) Kwashiorkor. 300 families from 1 0 villages were provided the following vegetable seeds to raise in their Kitchen garden - Greens, Bottle gourd, Ridge gourd, Cucumber (big and small), French beans, Brinjal, Cluster beans, Tomato, Chillies, Bitter gourd, Ladies finger and Turli.

Care of Malnourished Children

Special care was taken to all U/5 children from ten villages. During the screening, the 4th grade malnourished children families were identified and they were provided with Vitamin tonic, Mebex syrup and iron tablets. Mixed was provided for the malnourished U/5 children numbering 103 Children (Male 48 Female 55).

Pre and Post-natal Care

This is the most important activity in the Community health programme. Special care for U/5 children, pm-natal mother and post-natal mother is part of the programme. Iron tablet and fortified tablets, TT injection, Vitamin tablets and syrup were provided to all the pre-natal and post-natal Mothers. As of today, nearly 180 pm-natal mother and 145 post-natal mother care was taken in all the 10 villages. Some critical delivery cases have been referred to the nearby hospitals for safe delivery.

Sanitation

Compost pits were dug in all the 1 0 villages. AJI the dirty things around the village was dumped in to the compost pit.

Statistical Data on Community Health Programme

Programmes	Male	Female	Total	Villages
No. Of Villages Health education imparted	1235	1375	2610	10
No. Of Persons in the Families screened	420	515	1020	10
No. Of Persons Nail cutting done	1020	1215	2235	10
No. Of U/5 children screened	150	120	270	10
No. Of Patients treated by the MHP	21	19	40	3
No. Of U/5 Patents treated by the MHP	4	3	7	3
No. Of U/5 Children treated by staff	60	77	137	10
No. Of Patents treated by the staff	143	195	338	10
No. Of Patients referred to hospital	7	3	10	5
No. Of Chronic Patients identified and follow up	12	9	21	10
No. Of TBA trained		10	10	5
No. Of VND trained	10		10	5
No. Of Persons selected and trained as a Health Volunteers	10		10	10
No. Of Children immunized under Pulse polio	156	170	326	10
No. Of Mal-nourished Children mixed food provided	48	55	103	5
No. Of Families supplied Kitchen garden seeds				137
No. Of Villages Herbal Garden raised				2
No. Of Herbal Plants planted in each village				50
No. Of Pre-natal mother care taken		180	180	180
No. Of Post-natal care taken		145	145	145
No. Of Villages cleaning done				10
No. Of Villages Compost pit done				2
No. Of Health camp organised	130	270	400	1
No. Of Children Born in 1 0 villages	53	50	103	10
No. Of Infant death	11	6	17	7
No. Of 1-5 years children death	9	3	12	6
No. of Adult Death	22	16	38	7