A national NGO based out of Delhi advocated strengthening of community involvement to attain health and well-being as envisaged in the newly released national health policy.

To prove its point, NGO Caritas India featured a host of community health volunteers (CHV) amongst several intellectuals and veterans in a two-day national meet in Delhi from March 22-23.

Dr N S Dharamshaktu,   special director general of health services in the Ministry of Health and Family Welfare, said during the inaugural function, “What is needed for achieving sustainable development goals (SDG) is primary healthcare to (reach) rural and urban areas, tribal pockets, migration population and other vulnerable population.”

Whether it is the concern of sanitation, hygiene and lack of psycho-social care during emergencies or chasing the lofty target of ending primordial diseases like tuberculosis and malaria, the role of community owned models suggest better reach, affordability and harmony.

Four proven examples, specific to HIV/AIDS and Malaria, presented at the seminar suggest that India’s solution to health and well-being are in the hands of community.

Health is not everything, but everything is nothing without good health

39 year old Pradeep Arora from Delhi is a three times suicide survivor. He was tested HIV positive in 2001. When he confessed his situation to his wife, expectedly she left for her parent’s home from where she filed for a divorce. For the next six long years, Pradeep lived in trauma and despair.

In 2006, when Pradeep was invited to work with Deepti Foundation, a partner NGO of Caritas India working for HIV positive people, he gradually got convinced of a new mission in his life.

In the last more than 11 years, Pradeep has been able to support and nurture close to 3000 positive people. Some of his works are to provide medical counselling to MSM (men having sex with men), FSW (female sex workers), transgenders and drug users who find easy to relate with and confide in him.

Pradeep’s case is a unique example that goes to state his present mental health and overall well-being which he has acquired; something that he continue to enjoy despite his physical health which is under strict regulation.

His second marriage according to Pradeep is one his biggest personal achievements. Although both he and his wife are positive, they have taken utmost care not to pass on the HIV virus to their 9 year old daughter.

“It is very important for positive couples and parents to be counselled into relationship so that they are able to take an informed choice to give as well as live a healthy life,” says Pradeep.

Community at the helm of service provision to the doorstep.

Lilawati Mohanta, community health volunteer under Intensified Malaria Control Project – 3 from a remote village in Mayurbhanj district of Odisha, where many malaria cases are seen. In her village the cost of a blood test for malaria in her village ranges from Rs.150-200. And if tested positive, the cost of the medicine can go up to Rs.1500 in the hands of private medical practitioners.

The nearest Primary Health Center is around 6 km away, which may take up to 30 minutes on foot, where a patient may or may not be lucky to be greeted by a health practitioner always. In such a scenario, many cannot hold on to their patience and choose to either neglect their health or try their belief of jadu-tona (sorcery). In this process, many succumb to malaria, she said as tears started filling her eyes as if to suggest that she has seen and borne such pain in her own life.

Since the time she volunteered with Caritas India’s Malaria project together with local partner Lepra Society in August 2016 after training, she has been administering free blood tests for malaria and if tested positive, medicines are also given free. She also is very active in community mobilization through various BCC activities.

Harmonization of service provision in the village by ASHA and Community Health Volunteer (CHV)

Chiro, another community health volunteer from Tripura said that he treats 5 to 6 malaria positive cases in a month in his village which has about 500 families, roughly 2400 people. The village also has ASHA or Accredited social health activists are community based care providers. However one difference is that ASHAs are working in different health programs while I work only for malaria, said Chiro from Tripura, the land of renowned music composer directors SD Burman and RD Burman who ruled the Bollywood music industry between 1940-1990.

Benefits of Community Health Volunteer (CHV) to the Community

Before I offered to become a CHV, I have served my neighbors in different capacities under the local village development platform of Tawipui South village, said Vanlallura from the hilly state of Mizoram, situated nearly 4000 feet above the sea level.

The 50 year old volunteer has administered tests to hundreds of patients since 2011 and treated positive cases in his village. He is available for 24 hours a day and seven days a week. This makes him a preferred choice for diagnosis and treatment in the case of malaria, he said.

Like Vanlallura, CHV Lalhma’s village in Mizoram was enrolled under the Intensified Malaria control project – 3 in September 2016. Within these 7 months, he has treated 5 malaria positive cases

According to Lalhma, there has not been a single death due to malaria in this year. 

Take Away: Health & Well-being conference

Caritas India resolved 7 broad areas of action to be pursued in collaboration with it’s NGOs fraternity. According to the Executive Director Fr. Frederick D’Souza, the learning from the conference will help Caritas in developing a health strategy plan 2019-2022 which in turn will adequately compliment India’s role as a signatory to SDG goal 3 (Good health and Well-being).

Some of the broad areas of action as declared at the valedictory ceremony are:
1. More space for community engagement,
2. Access, affordability and universal health coverage,
3. Holistic redressal of communicable and non-communicable diseases,
4. Mother & child care,
5. Malnutrition,
6. Health (including psycho-social care) in emergencies,
7. Socio-economy and geographic equities.