Sunday, 28 October 2012

Story of Reshma

Here is a story of Reshma, who underwent plastic surgery in one of  surgery camps at MAHAN.

Reshma, an orphan, was Severely Malnourished & severely anemic. She was saved in MAHAN hospital. Reshma had a cleft lip also. Subsequently a plastic surgery was carried out in one of such camps at MAHAN. Now Reshma is leaving good life.
Every Year Dr. Dilip Gahankari, a renowned Plastic Surgeon from Australia, carries surgeries at MAHAN. Till date he has carried out >270 plastic surgeries (none of them are for cosmetic purpose) free of cost.  We have no words to express our gratitude towards Dr. Dilip Gahankari & his team.

Thursday, 13 September 2012

Miracle of Dedicated Scientific Efforts-Lakshmi

Lakshmi: Treatment of Severely malnourished baby by VHW

Lakshmi, a 23 months old female child was brought to our hospital by our field workers Mr. Pande and Dr. Ajay Sadanshiv. The child was very critical &suffering from worst degree of severe malnutrition &severe pneumonia. Her weight was - 5.300kg (expected – 10 kg).
We requested relatives to admit the child in the hospital for treatment. However they refused flatly, saying “she was admitted in various Govt. Hospitals including district hospital during last 2 months but she could not improve & finally sent back home” & ‘Now it is God’s will’. Lakshmi went home to her remote village in Melghat.
After 2 days when MAHAN team visited Lakshmi’s house, they found that Agarbattis (fragrant incense stick) were being burnt in the house and relatives prayed to God.  After long persuasion they agreed to accept our treatment.
Our village health worker Meerabi (7th std.) treated her at her home as per treatment guidelines developed by Dr. Dani, Mrs. Pendharkar and Dr. Satav.
Treatment of Pneumonia by giving daily Injection of Antibiotic for 9 days followed by oral antibiotic for Pneumonia  Treatment of severe malnutrition. It consisted of specially designed food as per WHO guidelines (F-75, RUTF).  The food was prepared from local produce by local tribal females under our supervision at MAHAN.
Lakshmi showed steep improvement. Her pneumonia was cured.  Her weight increased from 5.3 kg to 8.2 kg in 90 days.

           Severe malnutrition can be treated at their home by village health worker under close supervision by very carefully prepared scientific diet from locally available food material, prepared by local tribal females under strict supervision. It is safe, cost effective, acceptable, achievable, approachable and hence replicable.
We are thankful to Dr. Vibhavari Dani, Mrs. Pendharkar, Meerabi, Dr. Ajay, Pande, Caring friends  Mumbai (Ashish Kacholiya, Ramesh uncle Kacholiya, Nimeshbhai Shah) , Stitching Geron and Cordaid, the Netherlands,  Kasturba Health Society, Sevagram (Dhirubhaiji Mehta, Halbe sir)  for their full hearted support to achieve this success.

Sunday, 29 April 2012

KHS-Real Supporter

Kasturba Health Society, Sevagram is providing financial support to the Mahatma Gandhi Tribal Hospital.  Late Dr. Sushila Nayar, Hon. Dhirubhai Mehta and Hon. Halbe sir are extending their support as much as they can to Dr. Satavs for improving health status of tribal of Melghat. Their contribution is unparalleled.

Lead by Example-Beyond medical profession

A Road traffic accident:
            Once a truck carrying more than 50 passenger fallen down in river near Bihali village. More than 10 people died on spot and more than 12 were serious. No one was ready to help the serious patients. When Dr. Satav  noticed it, while passing by, he immediately stopped,  got down into the river and removed all 12 serious patients & sent them to hospitals. We could save 11 lives. Later on our team saved many lives in similar accident cases.

Friend of Snakes:-

‘Karmgram’  is surrounded by forest & farms.  There are lot of snakes including poisonous snakes like Cobra, Krait and Vipers, etc.
There are many interactions with these snakes. Few of them are worth mentioning.
·         Once Kavita was arranging cloths. She suddenly found a snake lying on the cloths.
·         I was about to go to bed. To my surprice black cobra was near the head end of my bed as if it was welcoming me.
These interactions offered us opportunity to learn snake catching. Subsequently we became Sarpamitra (friend of snakes). Being a Sarpamitra, we don’t kill snakes but catch and release them in surrounding forest.
One day morning we found a black scorpion lying quietly on bed of our son Athang.

Social Committment won over personal life

A}  It was September 6th, of 2011, I got phone call from Kavita’s sister in law that Kavita’s father is very serious and gasping.  She asked me to inform Kavita. At that time Kavita was examining 20 school children selected from school screening. I did not inform her till she finishes the work.  Later on she requested me to accompany her to Akola to save life of her father. At that time , there was one young patient of heart attack (angiography revealed 99% block in coronary arteries done after discharge) in our hospital who was serious. We discussed and decided that this young man’s life is more precious and if I leave for Akola the young patient may  die. So Kavita alone went to Akola.  At night around 11 pm , I got the message that Kavita’s father died.  I informed to Athang who was with me. He started crying like anything.
At that time two more patients suffering from ischemic heart disease were admitted in our hospital. At the same time one more patient of heart attack who was operated few months back (bypass surgery) came to hospital at 11 pm. She was the person who provided me food for few days during our initial period of Melghat hospital. 

Athang was very nervous, I was confused whether to go to hospital or counsel Athang who was alone. Any how I requested crying Athang to be with our servant Sanjay and went to hospital to treat that patient.  I could save all three of the patients. Next day when the patients settled down and discharged then myself and Athang went for the funeral.

B}   Few months back my mother was admitted in intensive care unit of Sevagram Medical college for angina. As there were patients of heart diseases admitted in Melghat hospital, I could not go to visit my mother.

Once when I was a lecturer, I got message from Hon. Dhirubhaiji (President, K.H.S.) asking me to rush to Sevagram for appearingfor the interview for the post of university Associate professor. At that time one 30 year young poor tribal lady was admitted in our hospital in comatose condition.  She had 3-4 children. I preferred not to attend the interview and tried to save her life at cost of own professional life.

C} Once Athang had severe attack of Bronchial Asthma and I had to attend important policy level meeting in Mumbai. Kavita & I, we divided the responsibility. Kavita took care of Athang (in absence of any paediatrician in Melghat) and I attended the meetingwhere I could significantly contribute in improving the policy which resulted in saving lakhs of poor children.

Personal Memorable Life Experiences:

A} Coming out of personnel comfort zone-
       Since birth,our son, ‘Athang’,who was brought up in Melghat only,has asthma problem & use to get  severe attacks.There used to be many health problmes of Athang specially during night time, like high grade fever, Bronchial Asthma, pneumonia, rupture of ear membrane&severe ear pain etc.,As there is no pediatricians in melghat, nearest  district hospital is 150 Km away, road is through dense jungle & ghats, no ambulance, every time we had to treat him at our hospital  only. Though we could manage it successfully, we thought, we both are highly qualified doctor, still cannot provide expert pediatric facilities to our son. But then we realized that we have to come out of our own personnel comfort zone to serve the society.    

 B} Supporters helped to extend work-
      For first couple of years, I used to go to interior villages through forest either by two wheeler or by bullock cart or walking for treatment of patients and health education. Melghat is famous for wild life like tiger, leopard, wild bear, etc. So Kavita was afraid of my life. My elder brother Avinash offered his tempo trax jeep (which we  used for next 7 years) , due to which we could extend our medical relief work to most interior part of Melghat. Now due to ambulances received from Mumbai group of friends, MASTEK & govt., we are able to extend our activities to a great extent in the interior of Melghat.        


C}  Determination of Kavita-           
       In 2007-08, Kavita developed heart problem-neurocardiac syncope leading to ventricualar bigeminny, but she never thought of running away from her work or Melghat. On the contrary she has expanded her work to more than 150 villages spread across Melghat reaching more than 17000 people & operated more than 700 cases.

  D} Life Time memory
      In 2004, MAHAN developed new hospital & residential campus. Most of the house work was executed with the help of local material & people. In rainy season while shifting the luggage, suddenly I got a severe shock. My mother who came to rescue me also got shock. Both of us were glued to electric wire.One of our staff, ‘Vitthal Pande’heard our shouting & saved us. We were unconscious for some time, but saved.


E} Baba, will you get time for me?-
            In Melghat, I have to shoulder many responsibilities in addition to a physician and the day become so busy that I couldnot spare time for Kavita and athang. For initial years, Kavita and Athang used to get irritated but now they have become habitual of the situation.  Still Athang asks me baba, will you get time for me? For what you work so hard?


Fighting with ill system for wellfare of tribal

A}Public Interest Litigation
MAHAN, KHOJ & some more NGO, together started a innovative ‘Counselor’ program. In India this may be the first innovative program of monitoring of government hospitals by voluntary organisations. This yielded very good results in terms of improving hospitalisation of patients, attendance of doctors & other staff, hygiene,availability of medicines, instruments functioning, etc. However it hurts vested interest of ill elements of system. Govt. stopped  this program. We filed a Public Interest Litigation, ‘PIL’, in Mumbai  High court.  Honorable chief justice JN Patel, Honorable  Chief Justice Mohit Shah and honorable  justice D.Y. Chandrachud ordered govt. health department to restart this program and also advised govt. of Maharashtra to replicate the model all over Maharashtra.


B}Truth can be troubled but cannot be defeated
            As we were exposing non performances, malpractices etc. in govt. health & ICDS system of Melghat, we were always made  target by ill elements insystem. Once  a  person lodged a false atrocity case agianst me and Kavita. Police tried to pressurise us for settlement saying otherwise we will be arrested. At that time Athang’swas appearing for exam. In next few days, I was supposed to go to Germany & Netherland for presenting papers in international medical conferences. But we were firm on our stand of not bowing infront of such wrong allegations and bear whatever will be the consequence. At last it was proved to be false case & we could escape the arrest.
We realised Mahatma Gandhiji’s sentence “Truth can be troubled but cannot be defeated.”

C} Set Back-
            There is a village named ‘Kharya tembhru’.In that village one child died due to negligence of a government nurse. After investingatign we got to know the truth. We also came to know that due to her, health condition in that village detoriated to great extent. But due to fear, she and some ill elements of the villages defamed us and stopped our work in the village and even tried to arrest our team. Later on we filed a PIL in Mumbai high court.


D}Story of community awakening :
            ‘Kokmar’ is the most remote & interior village of Melghat. Due to our efforts the facts about malnutrition & mortality rate in this villages was surfaced out. This exposed the grass root govt. workers. These people presurrised our Kokmar village health worker (VHW) to stop work. It was a great blow to our efforts.Myself along with Friend Aalhad kashikar & few of our staff, went to Kokmar. It was rainy season & we had to cross the dense forest and river to reach to Kokmar. People who got hurt, had told villagers that MAHAN team was defaming village by publishing name of the severely malnourished babies. So the villagers were reluctant to speak with us.
After 30 minutes, we saw a boy walking with a roti in hand. This was the same boy whowas severely malnourished 3 months back,was bed ridden, not getting proper nutrition from anganwadi. Howevere after we surfaced out his condition, he started getting benefit of special diet and health care from govt. As a result he could walk.
We explained it to the villagers. They  were  convinced with the example and started supporting like anything to us since then.

Great Work by Village Health Workers (VHW)

A}        Once a baby was suffering from birth ashphyxia. Sukrai Jambekar, 7th std. pass,  MAHAN’s tribal village health worker performedartificial respiration for 60min & saved baby. Sukrai showed her will power and dedication to save the newborn.
Sukrai was awarded ‘Jamshetji Tata National Virtual  Academy fellowship’ for Rural Prosperity

B}        Once a baby suffering from birth ashphyxia was admited to govt primary health center.  However hospital staff expressed their inability to save the baby. ‘Kantabai Wankhede’, totally uneducated village health worker of MAHAN saved a baby by artificial respiration.

C}        Doctors from subdistrict hospitalreferred a baby patient of neonatal sepsis to Amaravati. Relatives refused and took patient home. Later on , our Village health Worker,‘Sumantara Dhande’, 6th std. VHWsaved that baby by Injection Gentamicin, Cotra and proper newborn care.

D}        Sheela (Keli) and Urmila (Berdaballa) saved babies of other females,by breast feeding them.

‘Let him Die’ -Birth Story of ‘Children Mortality Control Program’:

Melghat is known for malnutrition and children mortality. As I am not pediatrician, I decided not to touch this issue. Once I was in my hut OPD, a tribal widow came with her 2 years old child who was severely malnourished and suffering from bilateral pneumonia. His chest wall was studded with rice, geru (red  liquid), feathers of hen and Damma(skin burnt with red hot iron rod) and garlic mala around neck. He was very serious and I advised the mother to admit that baby. But the mother was reluctant to admit and asked for injection. After repeated request, she denied admission. Then I used my ultimate weapon, saying that if she won’t admit him, he will die. ‘Let him die’- she respondedcoolly.‘at home,I have four more children, goats and chicken to look afterand any how he is going to die’ she continued. She went back with the child. After 3 days, I got the message that the baby died.
I realized rule of survival of fittest and thought if I would have been at her place, I might have thought similarly. But after listening repeated news of children deaths, myself and Kavita used to get anoyyed.
In 2003, five children from 2 families of 2 different villages died due to diarrhea. For two nights, Kavita did not allow me to sleep. She demanded to arrange camps in different villages to stop children deaths at cost of routine O.P.D.  In Melghat , there are 317 villages, our capacity was limited , government could not control the situation in last 10 years by mobile camp approach and whenever there is a disease in  villages , timely proper medical care cannot be made available . So I could convince Kavita that mobile clinic is not solution for reducing childhood mortality in Melghat. I was thinking of bare foot doctors.
During that time, I came across the ‘Home Based Neonatal Care’ approach developed by respected Dr. Abhay Bang, SEARCH Gadchiroli. I discussed it with Dr. Bang and realized its replicabilityand  acceptability in Melghat.
                        Our trust adopted 38 villages for this experiment(Randomised  control trial). We trained illiterate to semi-literate tribal female as Village Health Workers (VHW), for treatment of childhood illness. From May 2005, VHW from 17 villages of intervention area, started treatment of childhood illness. We could reduce the under 5 children mortality & Malnutrition by more than 60 % in those 17 villages which is cost effective and easily replicable model.

{This project received first best oral presentation in National Symposium on Tribal Health by Indian Counsel of Medical Research. I received Young Scientist Award.It was presented in 9 international medical conferences. }

Persistsance-A road to success

            In the beginning, people were suspicious whether a M.D. doctor can stay in Melghat or he will run away within months. Will tribal patient accept me (because tribal patients don’t go to doctors was a prevalent concept at that time) was itself a great challenge. In the beginning, very few tribal patients used to come to me for treatment. Many of them used to go to other unqualified doctors as I avoid unnecessary injections. But I continued my medical care without becoming depressed. People used to suspect whether a doctor living in hut, using bicycle and running hospital in hut is a really educated doctor or not. But when I treated and saved many serious cases of brain hemorrhage, heart attack, cerebral malaria and meningitis, people got confidence in me and I got recognition. Now those tribal who come to me usually become my permanent patient and I become their family doctor. Same is the story of Dr. Kavita. Initially patients were very reluctant for cataract surgery. But with great efforts, Dr. Kavita could operate upon more than 700 patients free of cost. We could influence many govt. policies.

         There are lot of obstacles, not only natural & geographical but man made also, while working in Melghat. Many elements whose vested intereste got affected continuously try to put hurdle in our ways. But now I think, these obstacles are not hurdles in the road but a challenge to test and prove ourselves. The life is like a river. The river is more beautiful when it flows through mountains, valleys, falls, etc.Many times our well wishers like various NGO, individuals, media, various professional, some govt emplyees etc. offered timely supports to strengthen our cases. We thanks all of them.

We never felt frustrated so as to leave Melghat. This is the greatest achievement of our life.

Formation & begining of MAHAN

Due to lack of propermedical facilities & superstitions, tribal goes to traditional faithhealers / quacks (pujari & bhumkas) for treatment of illness. Skin is burnt with red hot iron rod for reducing pain known as Damma.
Moved by such things, we started the project in Melghat in November 1997.
In 1998, I resigned from the post of lecturer in the department of Medicine of M.G.I.M.S. Sevagram and registered a voluntary organization,‘MAHAN’,with the help of like minded people, and started hospital in Melghat. In the beginning, there was no financial support from anybody. During post-graduation and lecturer ship in Medical college, due to simple living especially simple court marriage, I could save some amount. I used those money for running hospital in Melghat. After 4 months, honorable Dr. Sushila Nayar who was the great supporter of the project provided financial support and since then MAHAN &Kasturba Health Society, Sevagram are running this project.

I started hospital in  four rooms rented house in Dharni. It was used for out patient department and for indoor patients in addition to my residence.

Subsequenly started OPD in a hut in one of the farms, at Kolupur. Cycle/ bullock cart/ scooter/ walking were the only options I had at that time for going to nearby villages.

In the beginning, there was no money with our MAHAN trust for purchase of land. I purchased one hector of farm near village ‘Utavali’ and leased it to MAHAN trust for 25 years without any rent. This place was named as ‘Karmagram’  subsequently. Karmgram is surrounded by jungle & farms. One side of road are farms & on other side is complete jungle. One Km from there is a water reservoir where wild animals come for drinking water.Snakes of different species like kobra, viper, krait are like pets, keep visiting Karmagram anytime. Situation forced me to learn catching the snakes. We catch the snakes & release in jungle.Now karmagram is shaping up prograssively & is permanent address of MAHAN.

Melghat at a Glance

   A] Socio-geographics-

            MELGHAT,  known to the outside world by two words “Malnutrition” and “Project Tiger’’, a hilly forest area in the Satpuda mountain ranges is habitat for Tiger, Bison, Bear, snakes and many more animals. ‘Melghat’ stands for its name, which means ‘cluster of Ghats’.
It is 150 Km away from district place  & to reach there one has to cross the forest, mountains & zigzag road(sharp Ghats) of approximately 100 Km.
In summer temperature sore to 48 Deg C.,in winter mercury goes down up to 2 Degree C&It rains heavily (up to 1500mm)  in rainy season. During rain, many times electricity, communication & transportation system collapses completely, sometimes continuously for 8-10 days.
Total 320 villages spread over the area of 4000 sq. kmare located far away from each other having population density is about 60-70 person per square kilometer. Many of these villages are with very poor or no infrastructure like connectivity, transportation, communication, electricity, basic amenitites. This area is  highly lacking with advanced education and health care facilities.
Approximately  75% of the population is tribal in which Korku is main tribe. Most of the tribal (>90 %) are farmers or labors living very hard life. Most of the tribal (>75%) are below poverty line & illiterate (>50%), living in hamlets (>90%) without electricity.

   B] Observation on Health front of Melghat during initial days.

            Main issues in Melghat were very high  child deaths, Premature adults  deaths, Maternal mortality rate, malnutrition & home deliveries (>80%.)
[Under 5 children  mortality rate >100 per 1000 live births & Infant Mortality Rate (IMR) >70 per 1000 live birth. Prevalence of sever malnutrition more than 10%.].

Malnutrition & children deaths of preschool children were burning issue.  Cataract, Addiction, AIDs, Malaria, gastro- enteritis, anemia, respiratory tract infection, hypertension are other main health related issues. In addition, animal bites, illiteracy, poverty, unawareness about farming & good food habits, child marriages, exploitation were other problem areas &needed urgent attention.

Due to lack of proper medical facilities (hospitals, Doctors, staff, medicines, instruments etc) at local level & superstitions among tribals, tribal used to go to traditional faith healers /quacks (Pujari & Bhumka) for illness. ‘Damma’ a method to treat patient by burning skin by red hot iron was widely followed.
Average distance of District hospital is 150 km.

Wednesday, 28 March 2012


It would have been impossible without the kind support of our well-wishers. ‘Caring Friends’ is one of those. For sustenance of social work, it needs support on various aspects like Financial, Guidance, Motivation, Networking & Parental care. ‘Caring Friends’ is providing all of them.
Ramesh uncle Kacholiyaji and Nimeshbhai are instrumental behind this & like parent as well.The entire team of CARING FRIENDS is our strongest supporter

Financial Support
It is very difficult to carry on & progress the social work without financial support (for project expenses & corpus). CARING FRIENDS is the main donor agency of MAHAN. More than 50% financial requirements of MAHAN have been fulfilled by the donations through CARING FRIENDS.MAHAN has more than 115 staff members. More than 35 staff members have been provided residential facilities in campus itself, supported by CARING FRIENDS

In addition to finance, timely guidance is one more requirement for continuous progress &sustainanceof work. Honorable Kacholiyaji Uncle and Honorable Nimeshbhai are one of the main guides for MAHAN. Many times we discuss the issues, improvements with them & jointly come up with solution.

Systematic Approach
Community work of MAHAN is spreading potentially in recent years. A proper system to handle these wide spread work is the very importantotherwise it may go haywire.The visits and follow up work by caring friend teamensures that systems are in place for proper & smooth workflow.

Today MAHAN has a huge network of supporters and well-wishers. Thanks to the team of CARING FRIENDS, which always try to introduce like-minded people to MAHAN.Many times when we faced problem or needed a help for improvement, this networking (ex. legal, media, administrative, professionals etc) helped a lot.

Parental Care
Although cash and kind are the two types of donation, CARING FRIENDS surpasses all of these by bestowing lots of love, affection, faith and parental care on the team of MAHAN. Entire team of CARING FRIENDS is like a family member of MAHAN.

Sunday, 11 March 2012

Dr Kavita's experiences at Melgaht

In the words of Dr Ashish:

Dr.Kavitha cooking with a Choola

Cataract of a tiger

A}       After 2 yearsof starting MAHAN, Istarted eye hospital in Dharni. For first year, there was no financial support for her work. There used to be very few patients for initial one to two years. Due to superstitions, it was very difficult to convince patients for cataract surgery in Melghat.As most of the tribal patients in Melghat are very poor, they can not afford charges of operation for cataract. So many times, Iused toget depressed. ‘Probably I will have to operate cataract of a tiger’, I used to say sarcastically.
We used to live very simple life so that we could save a substantial amount of money and after few months we purchased operating microscope worth Rs.2,00,000. Mr. Prabhakar Palaskar (retired engineer, P.W.D.),one of our closed well wisher from Nagpur donated some amount. Kavita operated upon 10 cataract patients from that donation. And there after gradually we received more financial support for our eye hospital from Kasturba Health Society(Patron respected Dhirubhai Mehta), Sight Savers International, , Caring  friends, Mumbai, etc. Till now, I had operated more that 700  eye patients including  cataract patients successfully including Intra-ocular lens implantation free of cost.

Worship the patient is real worship to God

B}        For one year, I visited more than 50 villages in Melghat and conducted door to door screening and treatment of patients. Going to weekly Bazar was one of the options to reach the masses, overcoming the problem of commute. Our son, Athang was 4 months old. I used to keep him in cradle(zoli) made by tying a cloth between 2 branches of a tree and manage  the patients. I used to bring patients for surgery in our own vehicle. Many times I used to come at night from villages and prepare food for the blind patients and feed them. Also wash their clothes. It reminds “Patient is God and to worship the patient is real worship to god”.

Milk Brothers

C}        Once a pregnant lady was about to deliver the baby. However there was a problem in baby coming fully out of her body. Her relatives were persistently asking Kavita to conduct the delivery. Kavita on reaching to patient’s home found that her condition was very critical.There were no equipment which are required for delivery. Most importantly it was not hospital but patient’s house. Again same question ‘to be or not to be’. If Kavita does not operate, one of them will die.However kavita performed delivery successfully.
However the baby had birth ashphyxia . Kavita treated the baby and saved her life .
Next problem was - mother could not secrete  breast milk for her baby. At that time, our son, ‘Athang’ was six months young. Kavita used to send half of her milk to that newborn baby and keep half for Athang. Today that milk brother of Athang is living normal life. Now many of our village health workers & team of supervisors have motivated many tribal female leading by examples  to breast feedother babies whose mother had lactation problem. Many children were saved this way.

A face to face with calf& Snake

D}        Once I went to a village as usual for supervision of field activities. As there was no return bus from the village I preferred to stay in the village in night. I slept outside the hut of a tribal. (Few days before this a tiger had attacked that village). At around 5a.m., I realized that somebody had put leg on my abdomen(belly), I frightened thinking that probably it is the tiger and shouted. And when I open my eyes I saw a calf had kept his one leg over me and was ready to put other leg. But due to shouting, that calf ran away.
            In the next morning, I went to the forest for defecation,(as there is no latrine in most of the villages). Within fraction of seconds, I listened rustling sound of leaves.I was horrified to see a black cobra snake near by me. Somehow I could escape from that.

Obstacles converted to opportunity

There were a lot of obstacles while working in Melghat since beginning. But now I think, these obstacles are not hurdles in the road but a challenge to test and prove ourselves. The life is like a river. The river is more beautiful when it flows through mountains,valleys,falls,etc.

In 1998, I resigned from the post of lecturer in the department of Medicine of
M.G.I.M.S. Sevagram and registered a voluntary organization named MAHAN and started hospital in Melghat. In the beginning, there was no financial support from anybody. While during post-graduation and lecturer ship in Medical college, I was living a simple life due to which I could save around Rs.1,00,000 . I used that money for running hospital in Melghat. After 4 months, honorable Dr.Sushila Nayar who was the great supporter of the project provided financial support and since then MAHAN is running this project with the partnership Kasturba Health Society, Sevagram.

For the last 20 years (since 1998), not a single new M.B.B.S. doctor started non
governmental hospital in Dharni. So most of the people could not believe that I can be a M.B.B.S., We started our OPD in a hut at Kolupur and then hospital in a small (four rooms) rented house in Dharni. It was used for out patient department and for indoor patients. In the same house, patients use to vomit etc. and just nearby to it, was my dinning room and bed room. When I was in Government Medical College, Nagpur, I was habitual of working in a big hospital. But in Melghat, while treating the serious patients of brain hemorrhage, heart attack, etc., we faced lot of problems in the same small hospital. But I could manage successfully lot of serious patients.

Followings are few incidences worth mentioning it-
Critical Care Management
A}                    Once, at around 12 midnight a patient of serious heart attack was admitted in government hospital. As there was not a single physician, I was called to treat that patient. I had carried one E.C.G. machine,injection Streptokinase and unqualified attendant along with me. There was no cardiac monitor or defibrillator. It  was my first experience to treat such patient in Dharni with such minimum facilities. If I treat the patient and if he succumbs, then people will not believe me and I might have to leave Dharni. But then I realized that, if I treat that patient, there is 90% chance that he will survive. But if not treated, there is 100% chance of death.  So my strong will power forced me to start the treatment.  I was treating that patient until 4  a.m. . The patient was out of danger at around 4  a.m. and I was relaxed.
But after then, till now, I have successfully treated more than 800 serious patients with whatever available infrastructure .
B}                    Once a fifty years old male patient of brain hemorrhage (7cm in parietal lobe and 1cm in Thalamus) was admitted in comatose condition in our small hospital. He was advised by doctors from Amaravati & Indore that he could not be saved and hence should not be hospitalized. For 7 days, I was treating the patient in my hospital with available equipment. I was assisted by one 9th standard passed local male. 30 to 40 people were accompanying patient on daily basis. That was mounitng pressure.  On 8th day, that patient started walking and I was relaxed. From that day, people realized that I am a good qualified doctor and I got acceptance & publicity in Melghat.

C}                    I do remember a story of 5 years young girl patient suffering from  cerebral malaria with coma with decerebrate posture with convulsions. There was no pediatrician in surrounding locality. Myself not being a pediatrician, thought a  lot, whether to treat her or not.  But if I do not treat her, she will not survive at all.  Hence ,I decided to use my all knowledge and courage to treat the child and could successfully save her. It increased my confidence that I can manage serious children also though I am not a pediatrician.

Sometimes I am also surprised that, I could have successfully managed serious patients in such difficult circumstances.

MAHAN Success Story in Dr Satav's words.

1) During last 5 years, the village health workers treated more than 75000 patients. The concept of bare foot doctors is now gaining good result. Our project received Young Scientist Award and first best oral presentation in National Symposium on Tribal Health by Indian Counsil of Medical Research . Our research work has been accepted in many international conferences. Now Maharashtra government has decided to replicate our home based child care program in whole Melghat.
2)  Due to our advocacy over malnutrition and children mortality, Rajmata Jijau Mother and children Health & Nutrition mission(RJMCHNM) of government of Maharashtra along with UNICEF verified our survey reports, accepted the findings and started measures to control the situation. After our confirmation, RJMCHNM conducted similar survey in other tribal areas of Maharashtra and found very high prevalance of severe malnutrition. So our study exposed the situation of severe malnutrition in all tribal areas of Maharashtra. Our NGO has been included in Bhavishya Alliance (international trisectorial partnership) for deciding policies for malnutrition reduction in Maharashtra. This is our great success.
3)  In 2004, during winter season, we supplied nutritious food to 300 severely malnourished children from 38 villages of Melghat for 100 days and saved many lives. Most of the severely malnourished babies are getting food from AWW due to our monitoring. We analysed around 20 locally available food and found that many are nutrtionaly good. We prepared many dishes during the nutrition demonstration and trained many tribals from 17 villages for home based feeding & hygeiene . In our HBCC we could reduce malnutrition and child mortality significantly.  Due to our this experience , we mobilised local govt. health department to start village based feeding centers in 39 villages of Melghat. They got good result and then from this lesson, (RJMCHNM) conducted similar experiment in other part of Maharasthra. Now it is state level policy of VCDC. The root lies in our experiment of 38 villages.
4)  During camps we exposed problem of Malaria. D.M.O. pressurised us not to expose. We did not bow . Collector accepted the fact and ordered the government machinery to start malaria control program on massive scale.
5)  Socioeconomic development especially public Satbara reading. Initially in Melghat most of the tribals were working on the fields given by government to their ancestors. But the were not legal heir of the lands and hence were not getting benefits of government schemes. We with the help of villagers could pressurise government to start mutation and open satbara reading on mass scale. Due to which many tribals are benefitted to great extent.
6)  Story of community awakening : Village Kokmar- 1. Motivation of people for accepting facts of malnutrition : Due to exposure of reality of malnutrition in Melghat, the grass root govt. workers along with some notorious people presurrised Kokmar village health worker (VHW) to stop work. It was a great blow to me , as it was my dream to reduce deaths in very interior village like Kokmar. Then myself with my friends esp. Alhad Kashikar and our staff went to the village in rainy season thorough very dense forest on bikes. The villagers were reluctant to
speak as they were told that we are defaming their village by publishing name  of the severely malnourished babies. After 30 minutes, we saw a thin boy walking with a roti in hand. He was severely malnourished 3 months back and bed ridden & was not getting proper nutrition from anganwadi. Due to exposure of his name in news paper by us, he was getting benefit of special diet and health care from govt. So now he is able to walk. We explained it to the villagers. They were convinced with the example and started supporting like anything to us since then. We have now full support in the village. The VHW restarted her work.