COMMUNITY HEALTH

Introduction

The VHS Department of Community Health (Institute of Community Health) comprises 5 Mini Health Centres (MHCs) located along the OMR and ECR. The Mini Health Centres conduct activities such as:

	Clinical services
	Community health outreach including daily house visits, medical camps, field clinics, school health visits, community group interactions and nutrition demonstrations.
	Community health training for medical, nursing, nutrition, pharmacy and other paramedical students as per the University syllabus.
	Operational research studies on community health issues.

Clinical and community health outreach is done through 10 Mini Health Centres which are located in the southern periphery of Chennai city mostly located on the ECR and OMR arterial roads. The catchment area of the Mini Health Centres covers a population of nearly one lakh for clinical services and approximately half are covered with regular outreach such as daily house visits. The Community Health outreach services are offered under the eight core activities such as Water, Sanitation, Women health, Child health, Nutrition, Communicable diseases, Non-Communicable diseases and Clinical practice. Other activities such as Nutrition Demonstration, Group health Education, Provision of Weaning Mix and School health visit are done on a regular basis.

VHS is a recipient of the ‘Father Tong Memorial Institution’ award from the Voluntary Health Association of India (VHAI) for outstanding and pioneering contributions in the field of community health and development.

Objectives

	Provide preventive, promotive and curative health care to rural and underserved populations
	Conduct training programs for doctors, interns, nurses, paramedics and health workers
	Offer field exposure placements at mini health centres to medical, nursing and nutrition students
	Undertake epidemiological, clinical and socio-economic research studies

Approach

Health Promotion and Disease Prevention

Levels of Intervention

	Basic clinical care
	Community outreach
	Training programs
	Research studies

Community Health Model

	VHS currently manages 10 Mini Health Centers offering basic clinical care and outreach services to one lakh beneficiaries living in southern peripheral communities of Chennai.
	Mini Health Centers networked with central tertiary care hospital providing preventive, promotive, curative and rehabilitative care covering major specialties and super specialties
	Mini Health Centres staffed by two trained Multi-Purpose Health Workers, backed by periodic visits by Medical Officer and Public Health Nurse
	Mini Health Centers serve patients based on clinical needs rather than their ability to pay and work towards health promotion and disease prevention
	Mini Health Centers improve access to primary health care services for poor and underserved population through trained community based health workers

Field work

The Multipurpose health workers make daily home visit as per the Fixed Tour Programme (FTP) in order to cover the entire population for every two months under each Mini Health Centre. This outreach provides basic clinical care, preventive and promotive services by medical officers along with multipurpose health workers and trainees posted at the Dept of Community Health. Cases that require specialized care are referred to the main hospital at Adyar.

Training

Training is undertaken at the Institute of Community Health at Thuraipakkam and practical postings at various mini health Centres. Trainees include CRRI posting, MD Community Medicine, M.Sc Nursing, B.Sc Nursing, Diploma in Nursing, Post Basic B.Sc Nursing and other streams such as nutrition, pharmacy etc. Non-formal training is based on request from various organisations such as Rotary Clubs, NGOs etc and is tailor made to requirements. For the reporting period a total of 333 students were trained in 84 batches.

Camps

Free medical camps are periodically conducted by VHS Mini Health Centres so that health care services reach the poor and underprivileged communities living in slums, resettlement tenements and along canal banks. Medical camps fulfil unmet health care needs of people having poor health seeking behaviours. Free medical camps organized by VHS extend quality medical care services, free medicines and health education to the needy and underserved populations living in peripheral areas surrounding Chennai.

Additional Director, Medical Officer, Public Health Nurse, Staff Nurses and Multi-Purpose Health Workers

Medical Camps Conducted

VHS conducted three free medical camps for the benefit of communities living in and around Neelangarai (20th August 2017), Thuraipakkam (3rd September 2017) and Sithalapakkam (10th September 2017).

Each of the three free medical camps was sponsored by The Oriental Insurance Company Limited (a Government of India Undertaking) under its Corporate Social Responsibility (CSR) initiatives.

Inauguration of free Medical Camps by Mr. R. Ravi Kumar, Deputy Manager, The Oriental Insurance Company Limited, Regional Office, Chennai

Statistics

A summary of key statistics from the three medical camps is given in the table below,

Camp Activities

The following activities were conducted at the free medical camps

	Registration of beneficiaries
	Monitoring of vital signs
	Examination by VHS attending doctors
	Screening for blood pressure
	Screening for diabetes
	Eye examination
	Diagnosis of common ailments
	Dispensing medicines for common ailments
	Health education
	Nutrition demonstration
	Referral to VHS Hospital for further investigations and specialist care

Health Workers checking blood pressure	Measuring height

Health Workers - assisting beneficiaries

Community Participation

Braving the searing heat from the sun, leaving behind household chores and giving up family commitments, a large number of people assembled at each of the three medical camps to avail free health care services offered by VHS with support from The Oriental Insurance Company Limited.

The community response was overwhelming with a continuous stream of people gathering throughout the day, including women, men, infants, children, adolescents, elderly, differently abled, infirm residents and people who are unable to afford quality medical care.

A total of 1,306 people (Neelangarai - 368, Thuraipakkam - 277 and Sithalapakkam - 661) in need of medical care benefitted from the camp.

Beneficiaries lining up for registration and monitoring vital signs	Mothers and children at the camp	Registration of beneficiaries and monitoring vital signs

Beneficiaries included working women and men, daily wage earners, domestic workers, casual labourers, construction workers, fisher folk, factory workers, security men, auto rickshaw drivers, loadmen, shop assistants and staff from housekeeping services.

Residents of resettlement colonies, people living along the canal banks and workers from the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS) for poor households also availed the free medical services.

Health Care Providers

Free medical care, services, and health education were offered by a panel comprising VHS Medical Officer, Attending Doctors, Public Health Nurse, Optometrist, Staff Nurses (Ophthalmology) and Multi-Purpose Health Workers. Urban Health Nurses from the Corporation of Chennai also provided assistance during the medical camp.

Eye examination by Staff Nurse, Department of Ophthalmology	Medical Officer examining beneficiaries and prescribing medicines	Eye examination by Dr. S. Parthasarathy, Head of Department of Ophthalmology, VHS

Dr. S. Parthasarathy, Head of Department of Ophthalmology at VHS and his team carried out eye examinations and referred cases to VHS hospital for further investigation, prescription glasses, cataract surgery and follow-up care.

Doctors examining beneficiaries

The team of Attending Doctors, Nurses and Health Workers were supervised and managed by Dr. A. Kalaiselvan, Medical Officer, Department of Community Health, VHS.

The team worked under the overall leadership and guidance of Dr. Joseph D. Williams, Director Projects and Additional Director, Department of Community Health, VHS.

Health Education

The free services provided included monitoring of vital signs (height, weight, pulse, temperature, and respiratory rate), checking of blood pressure, and blood sugar test for detecting diabetes, eye examination, clinical examination, and diagnosis of common ailments, distribution of free medicines, health education and nutrition demonstration.

Some of the frequently reported symptoms during the camp were common cold, fever, cough, wheezing, body pain, joint pain, knee pain, muscle pain, headache, eye problem, white discharge, anaemia, arthritis, allergy, itching, skin infections, gastritis, hypertension, diabetes and vitamin deficiencies.

Eye examination	Dispensing free medicines

Doctors attending on beneficiaries listened to the complaints and symptoms, undertook clinical examination, diagnosed the cause, gave advice and prescribed medicines to treat the illnesses.

Beneficiaries with risk factors for developing diabetes, such as age (over 40 years), family history, overweight, obesity, lack of physical activity and high blood pressure, were screened. Upon recommendation by the Medical Officer and attending Doctors, a total of 274 beneficiaries were screened for diabetes.

Public Health Nurse and Health Worker dispensing free	Optometrist conducting eye examination	Health Worker advising beneficiary

Eye examinations were conducted and cases were referred to VHS hospital for follow-up care. Refractive errors, cataract, retinal problem, itching, eye pain and headache were some of the eye related conditions reported during the camp.

Free medicines were dispensed to beneficiaries in branded medicine covers. The most commonly prescribed medicines during the camp included antibiotic, analgesic, broncho dilator/asthmatic, gastric, anti-emetic, anti-allergic, anti-spasmodic, anti-diarrheal, anti-helminthic, anti-amoebic, ointment and vitamin supplement.

Follow-Up

Beneficiaries requiring specialized medical care were referred to VHS Hospital for further investigation and treatment.

Beneficiaries were also advised to visit the Mini Health Centre for follow-up consultations and medicines.

During scheduled house visits, Health Workers will meet beneficiaries to monitor their health condition and provide follow-up care.

Voices of Beneficiaries

The community responded positively to the medical camps by turning out in significant numbers to avail free health care services and medicines. Beneficiaries expressed their gratitude for the free examinations, tests, consultations, health education, nutrition demonstrations and medicines. The thoughts and feelings shared by a select few beneficiaries are noted below.

Neelangarai

“I am from Kerala and was passing by when I noticed the banner outside the Mini Health Centre. Normally I have doubts about free medical camps and hesitate going to such camps. However, after attending this free camp and consulting doctors and Health Workers from VHS, my opinion has changed. I am impressed to see and experience the quality health care you are giving. Your service is excellent. VHS is helping the poor people living in this community.” - Male, 60 years.

“Neelangarai Mini Health Centre has been my saviour. Without services of this centre and Health Workers, I will not be alive today. Thank you for the camp and free medicines.” - Male, 65 years.

Thuraipakkam

“Doctors and Health Workers were helpful, listened to our complaints, understood our health condition and gave us free medicines, thank you” expressed another beneficiary.

“It feels like you did this camp just for poor people like us, thank you” stated a family of husband, wife and two children. They also expressed satisfaction with the arrangements and thanked VHS and the sponsor.

Sithalapakkam

“We came as a family for undergoing check-ups and to see a doctor. My daughter is having cold, chest congestion, fever and breathing problem and we needed medicines. We are satisfied with the services and medicines received at the camp. Thank you for organizing this camp for us.” A 55-year-old woman engaged in household work.

“I am suffering from cold, cough and drowsiness. The doctor understood my condition, made me comfortable and took good care of me. Thank you for the free medicines.” A 75-year-old man who used to pull a rickshaw to earn a living.

CM Insurance Scheme

	Chief Minister’s Comprehensive Health Insurance Scheme (CHCHIS)
	A total of 222 beneficiaries were provided free medical services.
	Monthly camps are conducted by the volunteers of Sathya Sai and the Dept of Ophthalmology VHS. For the period of reporting a total of 11 camps were conducted with a total of 2,462 patients examined.

Sathya Sai Monthly Camps at Sirudhavoor

Monthly camps are conducted by the volunteers of Sathya Sai and the Dept of Ophthalmology VHS, for the period of reporting a total of 11 camps were conducted with a total of 2462 patients seen.