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Logistics support for Health Care access

Our experience of working in remote and poor tribal villages in Madhya Pradesh has highlighted the dismal condition of people with chronic diseases or disabilities. Due to poverty, lack of access to good hospitals/doctors, lack of awareness about government schemes, they suffer from the diseases that impact their entire lifetime with little expectation that they will have access to treatments

We have named this initiative Swasthya Setu Prakalapa. Operational in all 70 or so Seva Kutir villages of Karahal block of Sheopur district, and soon to be extended to Khakwa block in Khandwa and àTamia block in Chhindwara (highly inaccessible)

Need identification by the Seva Kutir Platform :

Parivaar’s team in these villages proactively surveys and identifies people in need. Once the case is identified, our team meets the patient and her/his family and tries to understand the ailment, for how long he/she is suffering etc. Then, our team approaches the nearest health centre, which is the Community Health Centre (CHC), Karahal. Mostly, the cases are not treatable here and are referred to the District Hospital, Sheopur for further diagnosis and treatment. We then take the patients to the District Hospital and get them treated there. If the treatment cannot be done at District Hospital Sheopur, then it is referred to Medical College, Gwalior. In some cases when treatment cannot be done even at Gwalior, then these patients are referred to AIIMS Delhi or even to Government hospital in Jaipur (Rajasthan)

Logistics & post early diagnosis steps:

Parivaar’s team takes care of all the costs for transportation, lodging and food. The treatment at the government hospital is free, however in some cases we have to bear the costs of medicines and tests (sometimes done at private labs due to lack of facilities at the government set-up)

Initially, the doctors in government hospitals were a little surprised by the sudden increase in the number of patients coming to see them. Some of them were less cooperative and were apathetic towards the patients. However, they came around after we explained the level of support from the block and district level government authorities. They have also started inviting us to district level meetings presided by the Collector, on health and related issues where the Collector, CMHO (Chief Health and Medical Officer) and other health officials closely interact with us, seek our help in identifying such cases and also offer us help.

Our Sheopur District Resource Person Aamir Khan handles this entire work along with the overall guidance of our District Anchor for Sheopur Rinkesh Karochi and support from the Sheopur District team.

Some use cases below:

1. Pari Adiwasi, 15 years, Village – Bhurwada:  November 2020, her dupatta got stuck on a farming machine, and she was strangled. Her parents went to Kota where tracheostomy was done and a pipe was fixed in her throat for breathing. However, her condition had not improved and from Kota she was referred to Jaipur government hospital, but her parents could not take her there due to financial constraints. Parivaar Seva Kutir identified this need and took her immediately to Jaipur. The doctor prescribed blood tests, created a treatment plan and she now needs to return for further examination after mid -April

2. Reena Adiwasi, 8 years, Village – Madanpur: Reena suffers from a rare form of brittle bone condition, suspected as Osteogenesis Imperfecta (OI). We found her at Sheopur district hospital where she had for consultation. Per her parents, they had been passed around by the Karahal community center and now this current hospital at sheopur district was referring her to Gwalior. They could not afford the trip and the treatment. The Seva Kutir team took on the case and took her to Gwalior, but they could not treat her and have referred her to AIMS Delhi. The team is working on taking her there

3. Saksham Adiwasi, 9 years, Village – Premnagar: Saksham suffers from partial paralysis of the left side of the body. We took him to Karahal CHC, then to Sheopur District Hospital and then to Gwalior Medical College. His MRI was done to diagnose/confirm the condition. Physiotherapy and medicines for one year have been prescribed

4. Reshma Adiwasi, 13 years, Village – Bargawa: This case was identified by the government health team- needing plastic surgery as she lost her nose to an infection due to nose piercing. She was referred to Gwalior Medical College from Sheopur District Hospital, but the family could not afford to go there.  Parivaar’s team counseled her parents and promised support and then took them to Gwalior. However, before surgery she got diagnosed with Tuberculosis. So we returned the next day. She is now taking medicines for treatment of TB and her surgery has been delayed by around 6 months

5. Virendra Adiwasi, 8 years, Village – Patonda – A foreign substance (seed of Imli) had got stuck in his ear. We took him to Sheopur district hospital and the seed was removed there. He is now fine

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