KHEJRI SARVODAYA TRUST AND HEALTH CENTRE

Annual Report April 2007 – March 2008

On 1^st April 2007 the Health Centre started functioning in the former guest rooms, consisting of 2 ½ rooms and two kitchens. The acquisition and demolition of our spacious building for the construction of a 60m highway left us with just 15% of the previous space. The ‘bonsai’ Khejri clinic shifted from a temporary shed, where we worked for 3 months into this small building. Thanks to the cooperation of the medical and supporting staff the patients were attended to throughout and their number never diminished. Still, the callousness of a bureaucracy that has no consideration for the health care of marginalized people and which demolished the Health Centre far ahead of its requirement (the road was still not constructed in March 2008! see photo back page) has left a bitter impact on the patients and the staff. “Every citizen has the right to social security and health care, especially those living closest to subsistence level, but in rural India expenditure on health is the second most common cause of debt and nearly half of the households that are in debt have done so to finance hospital expenditure. This is a vicious cycle, where expenditure on healthcare creates poverty, which contributes to malnourishment, decreases economic productivity and perpetuates further ill health”. (‘Troubled partnerships in healthcare sector”, Laura Keenan inThe Hindu, 3^rd March 2008). We still fail to understand the need to deprive the local people of the much needed space for their health care.

During the year under review we could provide medical treatment and free medicines to 41709 patients’ visits, thanks to the generous support from our donors and the dedicated work of the doctors and staff. Briefly, the statistics for 2007-08 are as follows (comparative figures refer to 2006-07) It is a happy phenomenon that in spite of the considerable reductions in space and staff members and fewer donations the number of patients attended to has remained the same. Even the ratio female: male and children seems constant.

 

 

Diseases profile:

We are a basic primary health centre still functioning in a semi-rural, but urbanizing area. The Health Centre is the first ‘port-of-call’ for people who are unwell for shorter or longer periods and for injury and accident cases. Most pregnant women have now also realized that early investigations, tetvac immunisation and pregnancy guidance are in their and the baby’s interests. Our monthly reports indicate that the majority of diseases relate to: 1) upper respiratory infections, 2) all kinds of skin diseases, 3) all kinds of eye diseases and refraction cases 4) arthralgia and arthritis, 5) amenorrhoea and other reproductive problems, 6) diarrhoea and intestinal infections, 7) major and minor injuries, 8) urinary tract infections, 9) otitis media, 10) fevers of different origins.

We attended to 330 injury cases, mainly children. UNICEF has recently identified that one of the leading child mortality causes in Asia is death by injury. We have been aware of this and in our earlier School Health Education courses we had incorporated special lessons on accident prevention, both inside and outside the home.

Special Treatment Programme Fund:

Besides regular OPD and mobile medical treatment and medicines, we provided financial assistance to patients who required specialized treatment, investigations and medication elsewhere, which otherwise they would not be able to afford. Our ‘old’ patients under this scheme are:

Vishnu, 14 years, of village Dantli, whose epileptic fits have much improved. He has recently passed his 8^th standard.

Suresh, age 27 years, of village Burthal, who has had a relapse with his tuberculosis. Was hospitalized and needs constant monitoring.

Razia, age 20 years, of Transport Nagar, who needs continuous medication after her heart operation in 2006. She remains weak, also due to insufficient nourishment at home. Razia has started taking literacy classes, joined a women’s organization and helps others to come to the Health Centre.

Tabassum, 12 years, of village Khonagoriah, urgently needed extensive dental corrections. Her teeth now have their second corrective braces and she looks beautiful.

Lada, age 67 years, of village Kundanpura, has TB and comes to the Health Centre for regular medication.

Chanda Lal, age 35 years, of village Kathipura, is a severely disabled person since he had a major accident.. His wife regularly comes for dressing material and medicines.

Lokesh, age 12 years, of village Giladia, had no external ears and is having plastic surgery for crafting of new ears. (see photo). This is a long process.

 

During the year under review we added some new patients under this Programme:

Nawal Kishore, age 40+, of Mansarovar, Jaipur, severe cancer patient, who needs regular expensive medication and palliative care.

Prahlad Meena, 35 years, of village Siroli, kidney failure, who was provided with support once for dialysis.

Asgar Khan, 30 years, of Jagatpura basti, suffers from antro verticular malformation (brain). Needs regular medication.

Salim Khan, 45 years, of Khonagoriah village, patient of cerebral bleeding (blood clot in his brain), but can not be operated. Needs regular medication and monitoring to control his blood pressure

Mohammed Salim, 17 years, of Transport Nagar, had a thyroid operation, benign goiter. We paid for the operation. He has recovered well.

Noor Allam, 40 years, of Khonagoriah, migrant labourer from Bihar, is undergoing open heart surgery at the SMS Hospital at the time of writing this report. We shared the cost of his operation.

Moreover, financial help for treatment and medicines was also provided to:

‘Taabar’ an organization working for street children found at the railway station, several children are HIV infected;

‘Shakti Stambh’, a short stay home for distressed women run by the Rajasthan University Women’s Association;

‘Positive Women Network Rajasthan’, which runs a home for children whose parents have succumbed to HIV/Aids.

The total amount spent for the patients under this Programme amounts to approximately Rs. 240.000.-

Reproductive Health, Mobile clinic, Eye Clinic, Laboratory, Immunisation, School Health and Support.

Reproductive Health Care under the direction of Dr. Bharti Bajaj covers the largest number of our women patients. More than 1047 antenatal cases were attended to in the morning clinic and the mobile clinic. Women with amenorrhoea, pelvic inflammatory diseases (PID/RTI), fibroids, ovarian cysts, polyps, cervicitis are receiving treatment. Primary and secondary sterility cases are helped with counseling and treatment, which has been rather successful. Sonography could be restarted only from August 2007, since renewed permission from the authorities was needed due to the shifting. 274 sonographies were performed in the last 8 months. Sister Prasanna assists for this service to the women on Thursdays. We are not charging any fees for this facility since January.

Mobile Clinic continued its daily service in the evenings five days a week to villages at near and distant locations. Dr. Aruna Kanwar, Dr. C.L. Gupta, Rajendran, Sreeja and Gopinathan cheerfully attended to 10270 patients, including antenatal, pregnancy tests, vaccinations and other services. For more detailed examinations patients are encouraged to come to the Centre.

The Eye Clinic works on Sundays under the professional care of Dr. A.C. Bhargava, senior ophthalmologist, assisted by Ranveer Sharma, refractionist. A total of 2207patients were attended to and 68 underwent free cataract operations with intra-ocular lenses. Detection camps were held in Khonagoriah and Jagatpura basti. We again received funds this year from the Foundation Lions Workgroup for the Blind, The Netherlands for the eye clinic and the operations.

The Laboratory continued its functioning in a much reduced space, but Babu Raj, our efficient technician, conducts thrice a week all basic pathological and bio-chemical tests. During this year these amounted to 1926 tests. More advanced investigations take place at B.Lal’s Diagnostic Clinic, for which the Centre pays in case patients can not afford the fees.

Immunisation was ably done by Sister Sreeja, who tried to convince parents of the need for complete coverage. Since the drop-out rate both here and everywhere is most discouraging, we have started offering a monetary incentive to mothers. This seems to work, because now more children receive the complete immunization for DPT/polio, etc. We fully vaccinated 932 children, both in the morning OPD and the mobile clinic. Vaccines are bought with assistance from the Jasper Fund, The Netherlands for medicines for children. All vaccinations are given free of charge, including DPT, Polio, Hepatitis B, TT, DT, Measles and the Boosters.

School Health and Support: Although we had to discontinue our outreach programmes for school medical examinations and health education, over one hundred school children come to the Health Centre each month for treatment on reference from the schools we have been working with earlier. Thanks to the support from Foundation St. Theresia, The Netherlands we again have been able to help less privileged children to attend school through payment of fees, books and clothing.

Staff:

Doctors: Dr. Hanuman Singh (director-physician), Dr. Bharti Bajaj (gynaecologist), Dr. Aruna Kumari Kanwar (gynaecologist, mobile clinic), Dr. C.L. Gupta (physician, mobile clinic since September), Dr. A.C. Bhargava (ophthalmologist, Sunday clinic), Dr. M.Jansen (physician and founder Trustee – several weeks).

Para-medical and supporting staff (full-and part-time): Rajendran Nair, Sreeja Pillai, Annamma K.M., Prasanna Shivan (Thursdays only for sonography), Rekha Pillai, Ramchandran Pillai, Shafally Berry (Wednesdays only w.e.f. January), Bhasi M.K., Gopinathan Nair, Zaida Bano, Kamlesh and Gogaram.

There were regular staff meetings during the year to discuss the functioning of the Health Centre, its various programmes and staff welfare.

Visitors:

We had the pleasure to receive donors and many visitors from Jaipur and other places of Rajasthan, Delhi, and from abroad during the year. All expressed their anguish about the injustice done to the Health Centre with the destruction of the main building and appreciated our efforts to continue serving the community.

Khejri Sarvodaya Trust:

The Trust meeting took place on 9^th and 10^th August 2007, in which the functioning of the Health Centre since the demolition of the main building and its future beyond 2008 were discussed. The members were informed about the follow-up of the decisions taken in November 2006, the present financial situation, staff pattern and patients’ treatment. An informal meeting took place on 1^st January 2008 in which earlier decisions were discussed and reconfirmed.

Trust members attending the meetings are indicated with an *: Prof. T.K.N. Unnithan – president*, Prof. H.G. Jansen – vice-president*, Dr. M. Jansen – founder Trust member*, Gerda J. Unnithan – managing trustee*, Dr. M. Unnithan*, Dr. S.Kumar*, Dr. V.Unnithan*, Nicole Unnithan-Brauch*, Jessica Jansen, Dr. J.O. Jansen, Dr. A. Jansen.

Finances:

The accounts for this year have been audited by Sareen Satish &Co., Jaipur and detailed statements are available on request. Income tax returns and the FCRA – Govt. of India formalities have been completed.

The Trust’s income was approx. Rs. 410,000,- from local donors and registration fees; approx. Rs.1,450,000.- from foreign donors and as interest on fixed deposits and bank accounts.

The expenditure from the local account was approx. Rs.610,000. – and Rs. 2,173,000.- from the foreign donations.

Our bank accounts are at the State Bank of India, Malviya Nagar, Jaipur-302017, India in the name of Khejri Sarvodaya Trust: account no. 10054351928 for foreign donations and account no,. 10054351973 for local income. The UK bank account has been closed. FCRA registration no. is 1125560111.

(the road for which our building was destroyed in December 2006 is still under construction)

Khejri Sarvodaya Trust
Todiramzanipura, Jagatpura, Jaipur-302025, India
Tel. (91)-(141)-2750047/2750134/2752246
e-mail: see contact page