The huge success in dealing with the problem of malaria in two districts in the preceding year has inspired the NERSWN to expand its area of operation and penetrate in those areas which are more susceptible to malaria. To translate the idea into action the organization had conducted a extended base line survey in four districts of¬ Bodoland Territorial Council (BTC) in month of May 2006.¬ The survey included in-depth interview with the health care provider, key persons in the community and Focus Group Discussion (FGD) with the workers of student and social organization, health care providers, community members and collection of secondary data from the health care department. The survey revealed that out of four districts under BTC, the three newly created districts viz. Baksa, Udalguri & Chirang are more vulnerable from all fronts. None of the three districts have civil hospital. There are PHCs which are functioning with single doctors. The huge inflow of patients in the PHCs makes the health care providers helpless. The pathetic road condition and lack of bridges on many rivers makes the places inaccessible from all sides. The people are poverty ridden as a result cannot afford to access better health care. There are huge bag logged posts of health workers but there has not been any initiative to fill those vacant posts. As a result the limited number of health workers can not reach out to provide basic health care to the people. As a result the limited number of health workers can not reach out to provide basic health care to the people. As a result hundreds of people die every year even due to mild health problem. The malaria is endemic to these districts. With the onset of monsoon its sweeps away hundreds of live every year. The malaria is one of the easiest diseases to cure if treated at the early stage that too without spending money. But there is very little preparedness to deal with it. The lack of government’s will and paucity of NGOs to tackle the menace of malaria has pushed the people of these districts at the periphery of their life. Therefore, with a commitment to fight a battle with the killer malaria disease the NERSWN had implemented this project in the month of June 2006.
For the smooth and effective implementation the NERSWN had setup three base camps viz. Udalguri, Tamulpur and Nikashi. Besides, project in Chirang district was monitored from the Kokrajhar office. The project was implemented with the following objectives:-
- To provide limited curative malaria care in collaboration of Government Health Care institutions during endemic season.
- To reach out to every household with the basic malaria treatment facilities in remotely located areas of Baksa and Udalguri districts of BTC.
- To make community aware of preventive measures of malaria.
- To encourage community for modern treatment of malaria disease.
- To make the public health care institutions functional through sensitization and collaboration.
Salient activities under the project:
¬ ¬ ¬ ¬ ¬ ¬ ¬ Malaria Diagnostic Labs: The project area was divided into four zones. In each zone there was one diagnostic laboratory equipped with expert Laboratory Technician. These diagnostic labs were setup at the base camps. The base camps were manned with a coordinator, two CHV, Two lab technician. The community Volunteers who collects the blood smear would transport the slides to these centers and again collect the result.
¬ ¬ ¬ ¬ ¬ ¬ ¬ Blood Smear Collection: The Community Health Volunteer (CHV) was solely engaged with the blood smear collection from the villages. Each community health volunteers were assigned with 10-15 villages. They would collect blood smears from the fever infected people and again report back to them with the results and necessary medicine. Keeping in mind the vulnerability factor the CHV would administer the Presumptive Treatment to the client as soon as the blood smears are taken. In case of any emergency, the CHVs check the patient’s blood on the spot by Rapid Diagnosis Kits and if detected as positive they administer medicine as per the requirements. Hence, the CHVs were the backbone of the project.
¬ ¬ ¬ ¬ ¬ ¬ ¬ ¬ Awareness Generation: Sustainability of any activity depends upon how well the community were informed or educated about an issue. Thus, with an idea to create mass awareness about the preventive and curative measures of Malaria, the NERSWN had published Pamphlets and distributed in the community. The coordinators and project managers hold meeting attractive ways of creating awareness was organizing street plays. The Street Theatre Team of the organization had organized Street Plays base on different aspect of malaria. The people have really enjoyed and appreciated the initiatives.
¬ ¬ ¬ ¬ ¬ ¬ ¬ ¬ Project Collaboration Centre: The project was implemented in collaboration with the Department of Health Services, BTC. Therefore, the department was also involved with the project. The PHCs were made project collaboration centre and in case of absence of PHC the base camp set up by the organization were made as collaboration centre. In case of overflow of patients in the base camps the slides were transferred to the collaboration centre where the government lab. Technician would test blood smears. At times anti-malarial drugs would fall short, and in such situation the medicine was supplied by the project collaboration centre. The patients who were in critical state and needs full time medical attention were referred to the collaboration centre.
¬ ¬ ¬ ¬ ¬ ¬ ¬ ¬ Health Committee Formation: With a view to empower the community, the organization had formed health committees in each and every village which are covered under the project. The health committees were provided with the necessary stuffs like proceeding book, register book, stationary etc. They were entrusted with the task to inform the health workers about the health crisis in their respective villages. They were also imparted basic training and education on their human rights. They were also familiarized with the causes of several killer and common diseases. The health committees were informed about the available health care source in their locality and outside the locality.
The management staff of the organization had put their best effort to implement the project successfully. In spite of the hurdles all the project staffs have been able¬ to reach out to each and every household of the project area. They didn’t left any stone unturned in order to provide anti-malaria services to cross section of populace. Community members in all the project places have expressed that if the project had not been implemented hundreds of people would have died due to malaria. The achievements of the project have been highlighted below in both qualitative and quantitative form:-
- The project has covered total village of 369 in three districts which was distributed in four zones.
- Each and every household of the 369 villages were visited by the community health workers on every alternate day with the purpose to collect blood smears from the fever suffered people.
- Formed 369 health village health committees.
- Through the project 41 young men and women were trained to deal with the malaria and were engaged with the project.
- In¬ four zones a total of 19,438 fever related blood smears were collected.
- Out of the total blood smear collection a total of 8,279 cases were detected as positive.
- Out of the total positive 6,353 cases were found to be Plasmodium Falciparum Malaria. 1,890 cases were detected as Plasmodium Vivax and only 5 cases were detected as mixed infection.
- The total percentage of positive cases out of the total blood smear collected stands up to 42.60 percent which is quite high.
- Keeping in view with the epidemiology and inaccessibility of the project area¬ health workers had of organization had administered WHO recommended Presumptive Treatment to all the clients who have volunteered for testing their blood.
- The 8,279 positive people were treated with the WHO recommended Radical Pattern of Treatment and all of them were treated successfully.
- The workers have learned about the physical and social environment of the project areas.
- The local people who were trained and absorbed with the project have become a readymade manpower to carry out any kinds of developmental activities in those areas.
- The workers got oriented with the common health care problems of those areas.
- The issues of inaccessibility, un-affordability, unavailablity etc. have been identified by the workers.
- Through the project the organization has earned community acceptance and appreciation.
- The necessary skill to work in a team or in a group as well as individually have been learned by the workers.
- By being part of team, workers have imbibed a sense of belongingness to each other also with the organization.
- Workers from top to bottom hierarchy have gained experience of working with poorest of poor people.
- The project workers have been also enhanced their ability to adapt to different condition and environment.
- The rural dynamics or the hurdles which comes on the path to working in a rural condition have been identified by the project staff.