Jul 10, 2021

Community based program to reduce deaths of poor

Community based approach to improve health and nutritional status and to reduce deaths of tribal of Melghat, Maharashtra

                                           (Report April to June 2021)

MAHAN (Meditation, AIDS, Health, Addiction, Nutrition) is a non-government organization established in 1998 to improve health care in Melghat region. MAHAN was touched by Gandhian teaching that “youths should go to the villages to serve as real India is in villages”. Melghat is the hilly forest area in the beautiful Satpuda mountain ranges. Population is 300,000 & 75% of them are tribal. Korku is the major tribe of Melghat. Most of the tribal (>90 %) are farmers or laborer, living below poverty line (>80%) & very hard life in huts (>90%) mostly without electricity & illiterate (>50%). Medical facilities are grossly inadequate in Melghat as compared to rest of Maharashtra.  Due to lack of proper medical facilities & superstitions, tribals go to traditional faith healers/quacks (pujari & bhumkas) for treatment of illness. Skin is burnt with red hot iron rod for reducing pain known as Damma. This lead to very high under 5 children mortality (>100 per 1000 live births) especially Malnutrition related deaths and very high mortality in age group (16-60 years) & maternal mortality. Moved by such things, we started the project in Melghat in November 1997.  MAHAN Trust has dedicated its work to reduce malnutrition and mortality among under-five children, women and economically productive age group through various programs like HBCC, MCPEPAG and SAMMAN. Below is a snapshot of our achievements in these projects aided by our generous donors.

SAMMAN (Community based Management for Severely Malnourished Children)Aim of the Project

To reduce prevalence and death of severe malnutrition in under 5 children (SMC) (SUW & SAM) using local therapeutic food (LTF) distributed by Village Health Workers (VHWs).

Activities and Impact (32 Villages)

Particulars (June 2021)

Numbers

Total 0-5 years Children

2826

Anthropometry of 0-5 Year Children (measured)

2647

 

Total SMC 

316

Total Prevalence of SMC (June 2021)

11.9%

Total SMCs treated in SAMMAN

231

Case fatality rate (CFR) of Treated SMC                                                                       

0

Case fatality rate (CFR) of overall SMC                                                                       

0

     Hence, we achieved the target of prevalence of SMC <15%.

There was not a single death amongst treated SMCs and hence we could achieve WHO target of CFR of <4%.

SUCCESS STORY

SAMMAN

One 2 years 4 months of age, girl from Chaurakund village was suffering from severe malnutrition ( MAM/SUW). Her weight was 8.00 kg and height was 83 cm on 28-10-2020.  VHW treated her with local therapeutic food (LFT) for six months and after that she recovered from Severe Malnutrition. On 28-04-2021 her weight was 9.440 kg and height was 84 cm.

HBCC (HOME-BASED CHILD-CARE Program)

Aim of the Project

To reduce under 5 children mortality rate and prevalence of malnutrition.

 No. of 0-5 years patients treated by VHWs=2205

 Impact achieved

Under 5 Mortality Rate. =67.8

 Success STORY

One 4 years 2 months of age, girl from Sawarya Titamba Village was complaining of cough, fever. She was brought to village health worker (VHW) for the treatment. VHW diagnosed her as probable case of Pneumonia as temperature was 101.8 F, Respiratory Rate 45 per minutes. VHW started her with syrup Cotrimoxazole and syrup Paracetamol for five days and she recovered from the symptoms. 

MCPEPAG (Mortality control program for economically productive age group, 16-60 years)

Aim of the Project

To reduce number of deaths in 16-60 years age group from 32 villages.

Activities and Impact

This program involves treatment of patients suffering from hypertension, malaria, diarrhea, asthma and referral of patients of TB, heart diseases, etc. to hospital.

Impact achieved –

MCPEPAG population

19287

Total number of 16-60 years treated

2450

Total Behavior change communication beneficiaries

8747

Age specific mortality rate per lakh population

311.1

Success story:

1) A 50 years old male from Pohara, was suffering from hypertension since 2 years. His first Blood Pressure was 155 / 100 mm Hg as per record of VHW. After constant health education by VHW and BCC supervisor, along with medicine, Tab. Amlodipine 5mg once a day, his Blood Pressure reduced to 133/85 mmHg. Constant follow up by recording weekly blood pressure is done by VHW and medical supervisors.

 

 2) A 22 years poor tribal female farmer patient, from village Sawarya Titamba, complained of fever and breathlessness. She came to Village Health Worker (VHW) for treatment. VHW checked her SPO2 (98), Pulse rate (89), temperature (99.8-degree F) and respiratory rate (25 per minute). VHW diagnosed her with pneumonia, and treated her with antibiotics and tablet Paracetamol 500mg. Along with the treatment she also gave her health education on Pneumonia and basic hygiene for prevention.  She is normal now.

 

 Hospital report:-   

 

1) Hospital care Beneficiaries (OPD)=814

2) Total Hospital Inpatient Beneficiaries (IPD)=135

3) Critical Care Beneficiaries (ICU)=85

 

Success story:

 We saved very serious young poor tribal patient suffering from Covid-19 with bilateral pneumonia with ARDS with sepsis with CAD with pulmonary embolism with hypo-tension with hyponatremia with hypokalemia with anemia with severe hypoxia with encephalopathy. He was on ventilator for nearly 15 day and on high flow oxygen upto 35 L per min for another 15 days. Since one month he is normal without oxygen.  Thanks to MAHAN staff and donors. 

 

 

Expenses…Rs. 35,69,562.00..

 

Links:


Attachments:
Mar 15, 2021

Community approach to reduce deaths of poor tribal

MAHAN (Meditation, AIDS, Health, Addiction, Nutrition) is a non-government organization established in 1998 to improve health care in Melghat region. MAHAN was touched by Gandhian teaching that “youths should go to the villages to serve as real India is in villages”. Melghat is the hilly forest area in the beautiful Satpuda mountain ranges. Population is 300,000 & 75% of them are tribal. Korku is the major tribe of Melghat. Most of the tribal (>90 %) are farmers or laborer, living below poverty line (>80%) & very hard life in huts (>90%) mostly without electricity & illiterate (>50%). Medical facilities are grossly inadequate in Melghat as compared to rest of Maharashtra.  Due to lack of proper medical facilities & superstitions, tribals go to traditional faith healers/quacks (pujari & bhumkas) for treatment of illness. Skin is burnt with red hot iron rod for reducing pain known as Damma. This lead to very high under 5 children mortality (>100 per 1000 live births) especially Malnutrition related deaths and very high mortality in age group (16-60 years) & maternal mortality. Moved by such things, we started the project in Melghat in November 1997.  MAHAN Trust has dedicated its work to reduce malnutrition and mortality among under-five children, women and economically productive age group through various programs like HBCC, MCPEPAG and SAMMAN. Below is a snapshot of our achievements in these projects aided by our generous donors.

SAMMAN (Community based Management for Severely Malnourished Children)Aim of the Project

To reduce prevalence and death of severe malnutrition in under 5 children (SMC) (SUW & SAM) using local therapeutic food (LTF) distributed by Village Health Workers (VHWs).

Activities and Impact (33 Villages)

 

Total under 5 children measured February 2021

2636

Total SMCs treated in SAMMAN – January – March 2021

179

 

Case fatality rate (CFR) of Treated SMC                                                                       

0

0%

 

 

There was not a single death amongst treated SMCs and hence we could achieve WHO target of CFR of <4%.

SUCCESS STORY

SAMMAN

A girl from Ghota was severely underweight= SUW (starting weight 8600gm and Height 78 cm) on 24/07/2020. She was enrolled in SAMMAN program for 6 months. After 6 months of SAMMAN (end date 24/01/21), she came out from severe malnutrition and now she is healthy.

 

 

HBCC (HOME-BASED CHILD-CARE Program)

Aim of the Project

To reduce under 5 children mortality rate and prevalence of malnutrition.

 

33 Villages.

 

No. of 0-5 years patients treated by VHWs – January - March 2021

1441

 

 Impact achieved

Under 5 Mortality Rate.

45.87

 

Success STORY

1)    Angels of Melghat.

A girl of age 2 years and 4 months, from the village Pankhalya, had symptoms of cough, cold and fever for 4 days. When Village Health Worker (VHW) examined her, she had temperature of 102-degree F and respiratory rate 45 per min. She was diagnosed as Pneumonia by VHW. VHW started treatment with Syrup Cotrimoxazole and Syrup paracetamol. After 2 days of treatment, medical supervisor followed up the case and the patient was normal.

   

MCPEPAG (Mortality control program for economically productive age group, 16-60 years)

Aim of the Project

To reduce number of deaths in 16-60 years age group from 33 villages.

Activities and Impact

Total Behavior change communication beneficiaries in

 33 Villages

=7400

This program involves treatment of patients suffering from hypertension, malaria, diarrhea, asthma and referral of patients of TB, heart diseases, anemia, etc. to hospital.

 

Intervention Area

Impact achieved – 

Total number of 16-60 years treated

2008

 

 

Age specific mortality rate per lakh population

41.5

 

4) Bare foot doctors are real heroes of tribal areas.

A 20 years aged male, tribal farmer patient, from village Gobarkahu had loose stools and severe dehydration. He came to VHW for treatment. VHW diagnosed him with severe diarrhea and treated him with ORS and Tab. Norfolk 400 mg. She also gave him health education on Diarrhea and basic hygiene so that he can prevent further episodes of severe diarrhea. After few days, the patient became normal.

 

Hospital report:-   

1.  Hospital care Beneficiaries (OPD)=821

2.  Total Hospital Inpatient Beneficiaries (IPD)=108

3. Critical Care Beneficiaries (ICU)=70

 

1)    When there is will, there is way. : 

One 54 years old poor tribal male was admitted in serious condition in our infectious Intensive care unit. His diagnosis was Severe COVID 19, ARDS, Sepsis, Hepatitis, Hypoxia, Encephalopathy.  He was put on oxygen and ventilator ( non invasive) for 3 to 5 days and was given anti viral drug Remdesivir, Enoxaparin and steroid. Our staff  treated with care, compassion and love for more than one week . There was danger of transmission of infection from the patient to staff. But no body refused to treat the patient. Due to dedicated efforts of our staff, the patient became normal.   It would have cost more than 100000 Rs. In city. But we treated him in Rs. 500 because of donor like Mastek foundation etc.

 

 

 

Expenses (INR)

40,00,000

Links:


Attachments:
Nov 16, 2020

Reduce Malnutrition & Death of 2000 Tribal People

 

 MAHAN (Meditation, AIDS, Health, Addiction, Nutrition) is a non-government organization established in 1998 to improve health care in Melghat region. MAHAN was touched by Gandhian teaching that “youths should go to the villages to serve as real India is in villages”. Melghat is the hilly forest area in the beautiful Satpuda mountain ranges. Population is 300,000 & 75% of them are tribal. Korku is the major tribe of Melghat. Most of the tribal (>90 %) are farmers or laborer, living below poverty line (>80%) & very hard life in huts (>90%) mostly without electricity & illiterate (>50%). Medical facilities are grossly inadequate in Melghat as compared to rest of Maharashtra. Due to lack of proper medical facilities & superstitions, tribals go to traditional faith healers/quacks (pujari & bhumkas) for treatment of illness. Skin is burnt with red hot iron rod for reducing pain known as Damma. This lead to very high under 5 children mortality (>100 per 1000 live births) especially Malnutrition related deaths and very high mortality in age group (16-60 years) & maternal mortality. Moved by such things, we started the project in Melghat in November 1997. MAHAN Trust has dedicated its work to reduce malnutrition and mortality among under-five children, women and economically productive age group through various programs like HBCC, MCPEPAG and SAMMAN. Below is a snapshot of our achievements in these projects aided by our generous donors.


SAMMAN (Community based Management for Severely Malnourished Children)Aim of the Project

To reduce prevalence and death of severe malnutrition in under 5 children (SMC) (SUW & SAM) using local therapeutic food (LTF) distributed by Village Health Workers (VHWs).

Activities and Impact (33 Villages)

Total Severe Malnourished Children- treated in SAMMAN – 263

 Case fatality rate (CFR) of Treated SMC       =0

 

There was not a single death amongst treated SMCs and hence we could achieve WHO target of CFR of <4%.


 

SUCCESS STORY

1)    A 10 months girl child from Melghat was born on 30th December 2020. The baby was 1.5kg at birth. Her parents were separated after this child was born, her mother also had postpartum depression and couldn’t give proper attention to the child. She had very poor weight gain over the first 6 months. We enrolled her to SAMMAN on 1st of August 2020, at enrollment her weight was 2.7kg, height was 54cm and (MUAC)mid arm circumference was 8cm, head circumference was 37cm. She was severe acute malnourished and severe underweight (SAM+SUW) as per WHO gradation. Her recent anthropometry on 29/9/2020 was 4kg, height 57cm and MUAC was 10cm head circumference was 38cm. She has gained 1.3kg over the period of 2 month and has now recovered from SAM. She will be continued to fed till January 2021.

     

 

HBCC (HOME-BASED CHILD-CARE Program)

Aim of the Project

To reduce under 5 children mortality rate and prevalence of malnutrition.

 

No. of 0-5 years patients treated by VHWs – 2903

 Impact achieved

Under 5 Mortality Rate.  =60.60

(We achieved the target of reduction of U5MR to less than 70)

 Success STORY

1)    A women from Melghat, delivered on 25th July 2020. The baby’s birth weight was 2.190 kg. Our medical supervisor provided the mother, Kangaroo mother care (KMC) blouse, warm bag and baby blanket. Our supervisor intensively counselled the mother on importance of using KMC and exclusive breast feeding. The mother has regularly used KMC and our VHW have also given regular home visits to the child. At the end of 28 days, the baby had good weight gain 2.725kg and is well and healthy.

 2)    A 1 year 6 months girl child, from Melghat village had complaints of watery stool. The mother brought the child to VHW, on examination it was found that the child had acute diarrhoea with signs of mild dehydration. The VHW treated the child with ORS, Norfloxacin for 3 days, the child got cured and is fine now.

 

MCPEPAG (Mortality control program for economically productive age group, 16-60 years)

Aim of the Project

To reduce number of deaths in 16-60 years age group from 34 villages.

Activities and Impact

Total Behavior change communication beneficiaries in 34 Villages:  5390

This program involves treatment of patients suffering from hypertension, malaria, diarrhea, asthma and referral of patients of TB, heart diseases, anemia, etc. to hospital.

 

Intervention Area

Impact achieved –  

Total number of 16-60 years illness episodes treated by VHW:      3629

 Age specific mortality rate per lakh population :  245.80

Maternal mortality rate was zero.

So we could achieve target of ASMR and MMR.

Success Story

 

A 24 years woman from Melghat village, had fever – 102.20 F. She had body ache and chills. She approached our VHW for treatment. The VHW used rapid malaria test and she was tested positive for malaria; she was started on Tab. Chloroquine for 3 days and Tab. Paracetamol. After treatment now she is fine and has no other problem.

 

 Hospital REPORT: -  July - September 2020

Hospital care Beneficiaries (OPD) :  1659

Total Hospital Inpatient Beneficiaries (IPD) 170

Critical Care Beneficiaries (ICU): 118

 Success story: One 68 years old poor tribal female patient was admitted in our intensive care unit. She was in comatose condition and was diagnosed as case of Diabetes mellitus with severe hypertension with COVID 19 with diabetic ketoacidosis with urosepsis with salt loosing nephropathy (? Acute tubular necrosis) with Hypokalemia with Hyponatremia with severe Anemia with hypoxia with encephalopathy with quadriparesis. She was very serious and was treated with oxygen, Insulin, antihypertensive drugs, IV Fluids, antibiotics, Potassium and sodium, Iron and other supportive management. She was admitted in our hospital for one month. Due to poverty, her relatives did not take her to city for higher investigations and requested us to manage clinically in our hospital only. We accepted the great challenge and due to very meticulous treatment, she recovered and was discharged. The patient was treated at highly subsidized concessional rates and her life was saved in our tribal hospital in Melghat. We treated her for one month though there was high risk of infection transmission to our team.

Expenses…..

 Hospital care, HBCC, SAMMAN, MCPEPAG : 1,00,00,000

Links:


Attachments:
 
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