Ashwini community health programme to train village-level health workers (Gudalur) – Tamil Nadu

Ashwini is working closely with tribal communities in south India to help improve their social lot through participative inclusion

Deep in the misty Nilgiri hills, a quiet revolution has been taking place in Gudalur, a verdant valley nestled at the confluence of the southern states of Karnataka, Kerala and Tamil Nadu. Home to adivasis — the original inhabitants for several centuries — Gudalur has over the past three decades witnessed an inspiring story of courage, change and empowerment, played out by a handful of committed individuals and supported by adivasis determined to retain their identity and dignity in the face of rapid urbanisation and displacement.

It all started back in the eighties when Stan Thekaekara and his wife, Mari, started Action for Community Organisation, Rehabilitation and Development (Accord), an NGO in Gudalur with the objective of organising the adivasis and helping them fight their alienation, speak for their rights, fend off land grabbers and preserve their identity. Thus was born the Adivasi Munnetra Sangam (AMS), a representative organisation of the adivasis of Gudalur.

What began as a political struggle soon started moving into other areas of the adivasis’ existence, especially health. “The adivasis did not have a health-seeking behaviour. There was no concept of antenatal care, of immunisation or of seeking medical help when sick. They called their gods or lay down to die,” recalls Dr Shylaja Devi, founder member of Ashwini (Association for Health Welfare in the Nilgiris). It was, therefore, common for women to die at childbirth and for their children to suffer from illnesses like diarrhoea. There was a pressing need for some kind of intervention.

And that came in the form of a young doctor couple, Dr Narayanan Devadasan and Dr Roopa Devadasan, who joined Accord in 1987 and launched a community health programme to train village-level health workers selected from the community to prevent illnesses, provide immunisation and nutrition to pregnant women and young children, and improve general health awareness.

This effort grew into Ashwini, a charitable society established in 1990, which now runs a comprehensive health programme for the tribals of Gudalur. Ashwini also runs the Gudalur Adivasi Hospital. This time, it was another young doctor couple, Dr Shylaja Devi and Dr Nandakumar Menon, who took up the challenge of setting up the hospital and training young adivasi girls as nurses. […]

Three years ago, the Tamil Nadu government stepped in to cover the costs of in-patient care, making it unnecessary for an external insurance company to be involved in the tribal health care programme. But people favoured continuing to contribute towards health care. “So we have set up a common pool of resources, the Adivasi Community Fund, to meet other expenses like referral and emergency transport,” says Dr Shylaja Devi. “Money from the fund is used to meet health expenses not covered under the government scheme. It is a form of insurance, it is just that no external agency is involved. It is supported under the SRTT decentralisation project — the decision-making for this is at the area level, the mechanism is more decentralised.”

Quality health care for the adivasis of Gudalur has become a reality, but Ashwini doesn’t see this as the end of its journey. “The hospital recently shifted into a new building; the funding for which came mainly from friends and from a training programme that we run for medical students from overseas. Infrastructure needs to be improved; we have approached the Tata trusts for support with this,” says Dr Shylaja Devi. Ask her to name the biggest difference Ashwini has made to the lives of the adivasis, and she says: “When this question is put to the tribals, their answers have been ‘we don’t die like we used to before’ and ‘we are not afraid like we used to be before.’”

Source: Tata group | Our commitment | Tata Trusts | The wealth of wellness
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Date Visited: Sun Jun 03 2012 10:27:41 GMT+0200 (CEST)