AID - HBP Newsletter January 2003

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HBP Newsletter January 2003

In this edition,
1. "if we can write the letters to the blocks that would be a great way of establishing communication and rapport with the block level folks"
2. "Arogyathukku peyar shanthi" (meaning "Health is synonymous with Shanthi").
3. Initial resistance from families of VHAs were encountered, but these have been overcome with efforts over the past few months." Hello Everyone,
Wish you a Happy, Productive and Healthy New Year.

In this edition,

1. "if we can write the letters to the blocks that would be a great way of establishing communication and rapport with the block level folks"

2. "Arogyathukku peyar shanthi" (meaning "Health is synonymous with Shanthi").

3. Initial resistance from families of VHAs were encountered, but these have been overcome with efforts over the past few months."

4. "...we found that newborn babies are laid on fresh cow dung. When I asked them why this practice is done, I learned that people believe that cow dung kills microorganisms and it is soft to suit the baby's body..."

5. Change in BGVS Patna office phone number

6. "They have also brought out an "Activist planner for 2003" booklet"

1. Summary of Call to Dinesh Prasad from Bihar

After exchanging greetings, we talked about the progress of the health campaign in Bihar blocks. Following is the summary:

* He started with a overview that the program is going on very well in all 14 blocks. (I did not ask him which the 14th block was.) All the block level co-ordinators, 6 cluster level volunteers and almost 60 village level volunteers are selected for each block. The training for the village level volunteers is over. The modules they are implementing are Child Health and Women's health. The campaign will be launched from December 1st. The resources for campaign like:

1. Campaign Guidebook
2. Child's Health Booklet
3. Woman's Helath Booklet
4. Health Register

are ready. 5 copies of the booklets are available in the AID Chennai office. He was pretty positive about the campaign and assured us that the campaign is going ahead with good speed.

* About co-ordination of the campaign, he mentioned that he is co-ordinating the campaign along with 3/4 other members. These folks are spending 15-20 days with the block level and village level people. Other resourse people for the campaign are:
Sarita Kumari: 5 blocks from central Bihar
Sadanandji: Blocks of North Bihar
Shilamuni Tuddu: She is the leader from local Tribes. She is coordinating blocks Dharbanga, Kodrama, etc.
Vinod Kumar supports the team from Patna.

* The different co-ordinators tour the blocks under them and help the campaign.

* He is planning to put together a report on the activities of the blocks with contact information etc. and present it in the AID-India (Benglore) conference in December. We asked him he can send us a list of block level co-ordinators before that so that we can start communicating with them, he did not promise anything!

* He mentioned that all the block level co-ords meet in one place once in two months. Such a conference is coming up, and if we can call during that we will get a chance to talk to all the co-ordinators. He will keep us informed about that. One suggetion he has was, if we can write the letters to the blocks that would be a great way of establishing communication and rapport with the block level folks. We told him that we sure will do that.

* He also mentioned that he read Priya's and Karunesh' report. He was asking about Priya, and infact he was expecting that Priya would be on call. We explained him why we could not get all these folks on the call. We got some contact numbers from him for the Patna office, they are: 612-684628
When he is in Jehanabd, this is the contact number: 6114-22406

* He also said that they are planning to bring all the volunteers together next year in Patna, to mark the first year of the campaign. He also have a plan to organize a health march in Patna during the same time. He also mentioned that he is planning to have AID india conference in Patna at the same time so that AID vols can have interaction with the Bihar folks.

* He gave some suggestions like Writing letters is something we can do, we can also send the New Year greeting cards along with the letters. Also we felt that to get the detailed idea of the work going on and day to day activities, etc. of the block level co-ords and village level co-ords we have to establish contact with them soon.

2. Vikatan is a prominent tamil magazine that has a large circulation. In this week's issue, there is a detailed interview with Shanthi, statewide co-ordinator for the HBP health programme.
http://www.vikatan.com/aval/2002/dec/20122002/aval0412.shtml

The title of the interview is "Arogyathukku peyar shanthi" (meaning "Health is synonymous with Shanthi"). The interview is very inspiring, her passion comes out clearly and she refers to the arogya iyakkam programme as a separate movement in itself with its own identity! Do read it if you get a chance.

An earlier Englishi interview with Shanthi can be accessed at
http://www.indiatogether.org/wehost/tnsf/tnsf-janfeb-2000.htm

3. We had a conference call with the block coordinator in Rohtash in Dec. Following is the minutes of the call ...

* On 23rd Dec, a day long training program for the VHAs in Dehri in the hall in the BGVS office (Saaksharataa Kaaryalay?).

* Of the 60 or so VHAs (all women) selected, about 40 attended (each representing a village in one of the 9 panchayaats: Baravn-Kala, Majhiyanv, Darihat (divided to 2 units due to population) , Berkup, Chakanha-Indrapuri, Bhaluaadi, Bhaisahi,
Mathuri, Jamuhaar.)

* The VHAs were primarily drawn from the Literacy movement implemented by BGVS. All the VHAs are the daughters in law of their respective villages, so that the situation of a trained VHA being married to a different village and thus the program loosing her does not arise at all.

* Initial resistance from families of VHAs were encountered, but these have been overcome with efforts over the past few months. Now the families realize the value of the work and are appreciative of the efforts.

* The attendance of the VHAs in the 23rd dec, training was not complete because of dauwni (harvest) work in the fields. The ones who missed out will be trained in the next few weeks.

* VHAs are mostly from small land holding families : typical land holding is 2-4 bighas (Note : 3 bigha ~ 1 acre ~ 0.4 hectares ~ 40m by 100m plot) and the approx. educational profile of the selected VHAs is : middle school 10, non
metric 10, matriculate 20-25, and about 2 to 3 B.A.

* Each VHA is responsible for anywhere between 100 to 200 families which would imply a population of about 1000.

* Block Resource Persons (BRPs) are 5 women, 4 of them were trained in the Jehanabad workshop in June and one in the Bhabuva workshop. They were the main instructors in the dec 23rd training for VHAs.

* The health registers were recieved on 19th and now that the VHAs have recieved a training, the next step is to start compiling the health registry. The Block Coordinator and the BRPs will tour and guide the VHAs in the initial stages.

* Transportation is a big issue and constraint as travelling by bus implies that not more than one village can be covered in a day. It was requested if a budget allocation for renting a jeep could be made so that the BRPs do not have to undergo
additional strain due to the overcrowded buses and also because their time can be better used if travel time was reduced (the block is about 21 kms wide, but bus connection to the villages are not good)

* The newly elected panchaayat office bearers are corrupt. But most of them are not brazenly corrupt, though they do belong to the 'commision' class. Some constructive work might be done, but hopes are dim. List of the panchaayat leaders with contact information will be compiled and sent over.

* The newly elected mukhiya and sarpanch were given a short training by the district authorities and Moryaji was also involved in this, but this brief training does not seem to be bearing any fruits.

* Next step is the health register work, this might be completed by about February. A training program is planned for the VHAs in January (most probably a refresher) .

* Next call is planned for sometime in mid jan so that problems being faced in the Health Registry compling work can be discussed.

* Alternate contact number is the Shaksaartha office Ph # : 251717 (P.P., office of BDO -Balkishan Munda) and in case of site visit, Priya's brother is a reliable point of contact (His name is Kumar Avimanyu or Avimanyu Singh, ph: 06184-251740)

* Documents that are promised to be passed on to Priya Ranjan's brother at the earliest -
(1) A list of participants of the Dec 23rd training(containing Name, Address, Age, Educational Qualification ... )
(2) A list of the villages in which the VHAs have been chosen (containing the panchaayat under which the village comes, the population of the village, details of the sarpanch ... ) and
(3) a copy of the district level census data available from the 2001 Census.

4. AROGYA IYAKKAM [REPORT BY SHANTHI AND PRIYA]

* Shanthi, a state resource person for Arogya Iyakkam, and Priya, state full-timer for Arogya Iyakkam have prepared this report. Along with Pragnya and Virginia, AID volunteers, went for a 10 day visit to Cuddalore and Virudhunagar Districts. This trip was from 11 NOV 2002 to 19 NOV 2002

CUDDALORE:

* It takes about 4 to 41/2 hours to reach Cuddalore from Chennai . Cuddalore District has 3 blocks: Bhuvanagiri, Parangipettai and Keerapalayam.

* Bhuvanagiri block is an old block, consisting of 40 villages. Mr. K.P. Narayanan is the district secretary, Lakshmi is the district coordinator, and Seenasigamani is the part-time block resource person. Shakila, Punita, Anbarasi, and Lakshmi are the full-timers. Health and savings group programs were started in Bhuvanagiri in May of 1999. Because the block is old, both programs are well-established and operating well. There are currently 29 self-help groups. The volunteers and full-timers are supportive, dedicated, and well-trained, and we expect this program to become even better.

* Parangipettai and Keerapalayam are new blocks, each covering 40 villages. Mythili, Mahalakshmi, Bathurubi, and Palaniyammal are the full-timers for Parangipettai. Rani, Palaniyammal, Kalaiselvi, Jansi, are the full-timers for Keerapalayam block.

* Health and self-help group programs were started this May (2002). Since these are newly formed blocks, health and savings group programs are still small. The volunteers and full-timers in these blocks are currently being trained. Volunteers need to be more supportive to TNSF and the health program.

* A 2-day training camp was held in Bhuvanagiri for Parangipettai and Keerapalayam blocks. 38 new volunteers from 32 villages attended this camp. A detailed review meeting for all three blocks was also held.

VIRUDHUNAGAR

* It takes about 11 hours to reach Virudhunagar from Chennai. Virudhunagar District consists of 8 blocks, each covering about 30 villages. Out of these 8 blocks, 3 are old (Thiruchuli, Karriyapatti, and Watrap), and 5 are new (Sivakasi, Virudhunagar, Vembakkottai, Srivilliputtur, and Rajapalayam). Health program and savings groups in the old blocks were established in May 1999. In these blocks, self help groups are thriving, while health programs have lost momentum due
to the lack of regular visits by the state. In our visit to the old blocks, we saw how health registers are maintained, as well as how they do in child health care, mother health care, and utilization register consolidation.

* In Sivakasi, a one day training camp was held by the full-timers. 37 volunteers attended from 18 villages. We observed the camp and gave them some suggestions about how to increase the number of self-help groups and about child health and mother health.

BLOCK-WISE REPORT

CUDDALORE DISTRICT

* BHUVANAGIRI: We held a 2 day camp at Bhuvanagiri to train volunteers for Keerapalayam and Paragipettai blocks. The full-timers also took classes about women's health, pregnancy care, coughs and colds, immunization and vaccination, and the importance of breast-feeding, as well as how to fill out health and utilization registers. Shanti gave an introduction to adolescent girls' classes. We had a detailed review meeting for all the blocks. Almost all villages have health committees.
Health registers are maintained in 40 villages. 11 utilization registers are consolidated.

* KEERAPALAYAM AND PARANGIPETTAI: There are 4 full-timers in each block, covering about 40 villages. In Keerapalayam, 12 health registers and 4 utilization registers are consolidated. There are 4 health committees and 2 self help groups have been formed. In Parangipettai, there are 16 health committees, 16 health registers are maintained, and 16 utilization reports are consolidated. One self help group has been formed.

VIRUDHUNAGAR DISTRICT

* THIRUCHULI: From the Thiruchuli office we first visited a village called Udayanampatti. There we found that the volunteers maintain the health registers well, and the health program is strong. In Udayanampatti we also met with 8 Thuligal groups. They had a number of questions about financial assistance, loans, and business plans, which indicated a need for more guidance from the district level.

* We also visited 5 other villages: Tamilpadi, Melakandamakulam, Chitthalakundu, P.N. Putthupatti, and Krishnapuram. We found that only in Krishnapuram were the registers maintained well, whereas in the other four villages, health registers were not well maintained and there were no records of vital events for the past 6-9 months. This is basically due to a lack of attention to the new blocks from the state level, but this can be solved quickly. We have decided to visit them
monthly, in order to guide health volunteers and reinforce the importance of the health program.

* The health program is going on well in 29 villages in Thiruchuli block. 15 health committees have been formed, and their progress is quite good. Health registers are maintained in 19 villages. Utilization register consolidation has not been started yet. 79 self-help groups have been formed. Out of these, 12 are new.

KARIYAPATTI:

* Though we did not go for a field visit, we had a detailed review meeting with their full timers at the kariyapatti office. We learned that Thuligal is going well, with about 225 self-help groups already formed. However, Palanivel was a bit rude. They had not focussed on the health program for sometime and were not ready for this palanivel told us that we should not come here to see the program .I (Shanthi) was very upset and the next day Palanivel tried to console me and asked me to come for a field visit .The district need to look in to this issue and make sure along with savings every block also does health work

SIVAKASI:

* Though Sivakasi is a new block, much progress has been made here. During our visit, the full-timers held a training camp, conducting classes about women's health, child health care, pregnancy care, how to fill out health registers, and utilization register consolidation. 37 volunteers from 18 villages attended. We observed the training camp and offered advice about how to increase the number of self-help groups and gave them their action plan.

We then went to a village called Ramachandrapuram and met with the health activist. The health committees have been formed and surveys are being done. While analyzing the health problems, we found that newborn babies are laid on fresh cow dung. When I asked them why this practice is done, I learned that people believe that cow dung kills microorganisms and it is soft to suit the baby's body. I told them that this is a harmful practice and can cause infection. After some argument, the villagers accepted my advice, and promised they would stop this practice. We also met a mother who had a one-and-a-half year old child who suffered from malnutrition so severe that her hair color had changed. In addition, we learned that the mother was 8 months pregnant. I advised her that both she and the child should eat leafy vegetables, eggs, milk, and other nutritious foods, and the mother should take the iron tablets given by the VHN. We believe that if they follow the advice we gave them, their condition will improve within 6-8 months. We found that this village needs tremendous attention from both the state and district levels.

In Sivakasi block we also went to another village called M. Puttupatti. We met with the self-help groups and gave them advice about how to improve their program, and about the importance of the group. We also discussed the health problems and gave them necessary advice.

WATRAP:

We had a review meeting where we learned that registers are not maintained, with only 6 villages having up-to-date registers. We found that this block needs more attention from both the state and district full-timers, and decided to recommend monthly visits to this block. We visited 2 villages, Matthur and Kumapatti. In Matthur, we ment with Velankanni, the health volunteer, and found that the health registers are maintained well. Child health care, mother health care, and pregnancy care are all running well. Most of the children were found to be healthy. In Kumapatti, we attended a self-help group meeting with 8 Thuligal groups and one Vanavill group. The health program is also running well there.

VEMBAKOTTAI:

Though we did not go for a field visit, we had a review meeting with Angammal, the block coordinator. Vembakottai is a new block, but the volunteers are enthusiastic and well-trained, so good progress is being made. 27 health committees have been formed, 17 health registers opened, and 31 utilization registers have been consolidated. 63 self-help groups have been started and are thriving.

[REPORT BY KAVITHA]

I am Kavita, one of the state resource persons for Arogya Iyakkam; Prem, an AID volunteer, and Latha, the block coordinator; went to Thiruvallur district to visit a training camp.

THIRUVALLUR:

Thiruvallur is about 84 kilometers from Chennai and it takes about 3 hours to reach Thiruvallur. Thiruvallur district has one block, Thiruthani. The health program and savings group were started in May 2002. Mr. Palani is the district secretary, Mrs. Latha is the district coordinator. The volunteers and full-timers are very supportive. Lalitha, Vijaya, Mala, and Selvi are the full-timers. The full-timer team needs more training. I spent around 6 days and visited about 10 villages with Prem and Latha accompanying me for one day. I spent a day training volunteers who did not attend the previous training
sessions. The full-timers also took an active role in it. Classes were taught on child health care, mother's health care, pregnancy care, and how to fill out health registers and utilization registers. I also taught an adolescent girls' class that 20 girls attended. We also met with self-help groups in 3 villages. We were able to find out that they don't meet regularly and there were many problems with loans.

THIRUTHANNI:
Kavitha, Latha, and Prem went for a field visit to 2 villages called Suryanagaram and Ellampalli. They met with a self-help group and found that the volunteers did not know how to fill out the registers correctly. Prem and Latha spoke with the self-help group members, who asked for funding from TNSF. They conducted a training camp with 20 volunteers from 6 villages. The training classes were taught by the full-timers and the block coordinator on various topics like health care, child health, pregnancy, immunization and vaccination, cough and cold, diarrhea, the importance of breast-feeding, and how to fill out the health and utilization registers. All of us went to Periyakadampur colony and MGR Nagar with all the full-timers. Health seems to be good here and the health registers and utilization registers are all up-to-date. We met with some mothers of children ages 0-5. We found that they had some incorrect beliefs about food for their children, namely that eggs cause babies to develop jaundice, and that bananas give children indigestion. We advised them that these beliefs are false, and also advised them to feed babies at least 6 times each day, in order to assure correct nutrition.
We went to Ackor and Natham. Here we found that almost all the children are healthy, and the health program is going well. Health and utilization registers are well maintained. Most of the children have cows milk as supplemental food also.

We went to Sathirajayapuram for a field visit. We met with some mothers and gave nutrition advice. In one house, we saw a baby lying in a basket of straw. When we asked the mother about it, she said that after they bathe the child, they place it in a basket of straw in the sun. When Kavitha picked up the baby, it was covered in ants. Kavitha advised the parents that they should not keep the baby in straw baskets, as it will get bitten, and may get infections. The parents promised to stop this practice.

We had a review meeting with all the full-timers. At the review we found out that surveys have been completed in 29 villages. In 3 villages, these have been kept in register format, while in all other villages, records are kept on rough paper. Health committees have been formed in 21 villages, and utilization registers have been filled. Nine self-help groups have been formed, and they meet weekly. Kavitha taught the full-timers how to weigh children using a scale, and gave the
action plans for the coming months.

ACTION PLANS

* Health registers should be completed by the end of November;
* Volunteers should be well-trained;
* Utilization registers should be maintained and a consolidated report should be submitted;
* Increase the number of self-help groups by one group per week; Weight should be taken for all children between the ages of 0 and 5 by the end of December;
* Full-timers should go for regular visits to the field and train health activists to talk about mothers' health care, child health, pregnancy care, etc.

5. The BGVS Patna office phone number has changed. The new number is: 91-612-2684628

6. The presentation about HBP went very well at the aidindia conference. Balaji gave an overview of the health programme in TN and Bihar. Dineshji from Bihar gave an update on the activities in Bihar. Then, Shanthi and other activists from TNSF did an interesting role-play on how a typical village health activist would approach a mother and what
kind of advice she would give. Aid-India has come out with a detailed report on Arogya iyakkam as well as the Makkal Palli Iyakkam programmes with a lot of photographs. Balaji will also be sending a detailed report on the Bihar activities, similar to the Taminadu one which we received earlier. The second installment of funding for the health programme is due now and we will be sending it shortly.

They have also brought out an "Activist planner for 2003" booklet. It is a very useful booklet that has all the contact information for the HBP districts/blocks in Tamilnadu and Bihar. And also the phone numbers for key people involved in various activities in each district, state-level resource people etc. Pretty much everyone you'd ever want to contact in AIPSN!

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