Sunday, 29 April 2012

‘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. }

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