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AHI JAPAN INDIAN ALUMNI REUNION SEMINAR 2011 AT CSSS P

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A REPORT ONA REPORT ONA REPORT ONA REPORT ON

ASIAN HEALTH IINSTITUTE JAPAN ASIAN HEALTH IINSTITUTE JAPAN ASIAN HEALTH IINSTITUTE JAPAN ASIAN HEALTH IINSTITUTE JAPAN �� INDIAN ALUMNI REUNION SEMINAR 2011 AT C.S.S.SINDIAN ALUMNI REUNION SEMINAR 2011 AT C.S.S.SINDIAN ALUMNI REUNION SEMINAR 2011 AT C.S.S.SINDIAN ALUMNI REUNION SEMINAR 2011 AT C.S.S.S

THEME: THE ROLE OF VO’S / NGO’S IN THE PRESENT NRH M CONTEXT

ORGANIZED BY

PATHAPATNAM, Andhrapradesh

&

, PARALAKHEMUNDI, ODISHA.

VENUE AT: VENUE AT: VENUE AT: VENUE AT: C.S.S.S. CONFERENCE HALL, PATHAPATNAM, ANDHRAPRADESHPC.S.S.S. CONFERENCE HALL, PATHAPATNAM, ANDHRAPRADESHPC.S.S.S. CONFERENCE HALL, PATHAPATNAM, ANDHRAPRADESHPC.S.S.S. CONFERENCE HALL, PATHAPATNAM, ANDHRAPRADESHP

SUPPORTED BYSUPPORTED BYSUPPORTED BYSUPPORTED BY

ASIAN HEALTH INSTITUTE (AHI), JAPAN


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Introduction Health is very important and prioritized aspect in sustainable development and livelihood promotion.

Government of India has initiated many developmental initiatives for employment, self employment

and sustainable livelihood promotion with social security schemes and provisions in urban and rural

sectors.

But the health service delivery mechanism as well as the health institutions in the rural areas are poor

and not able to reach the needy because of hilly terrain, forest and remoteness. Government of India

formulated a health policy to streamline the health service mechanism ensuring health for all initiatives.

But it was not successful in delivering the effective health services in rural areas.

National Rural Health Mission (NRHM) was intervened in the year 2005 and upto 2012 as first phase

in India. The main aim of the AHI Japan India Alumni Reunion Seminar is to focus on the role of the

NGO / VO sector in the present NRHM context.

� After AHI training, some of the participants are specialized in practicing herbal medicine in a scientific way when many rural people are using the Herbal medicine without knowing the scientific implication.

� Some of them are specialized in magnetic therapy and running a nursing home in Nalgonda

district in Andhra pradesh. Some are specialized in acupuncture and other practices which are very much useful.

The main objectives of the seminar

� Sharing the work experience of the participants and learn from each other. Since many participants are working in different parts of the country with different rural communities in different capacities in different linguistic minorities communities and downtrodden people of the society.

� To learn the present health policies of the Government and NRHM and analyze the effectiveness in the rural areas.

� To discuss the role of NGO and CBOs in addressing the real health problems in the rural

communities.

� To build up and strengthen the network of the Indian AHI alumni and in learning the people’s health movement in India.

� To analyze the achievements of Public Private Partnership in providing the health support

services in rural and remote areas in India and work with community where the effective health support services are not reaching.


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Participants in AHI Japan India Alumni Reunion Semi nar

SL.N0

NAME OF THE PARTICIPANT sex POSTAL ADDRESS ORGANIZATION

AND PLACE. CONTACT NUMBER E-Mail

PHOTO OF PARTICIPANTS

1 Padmashree Dr.H.Sudharshan

M 686,16th main , 4th T Block, Jayanagar, Bangalore-560041

Karuna trust &VGKK

9448077487 drhsudarsha

[email protected]

m

2 Dr. Jain M Nawarangpur, district nawarangpur, odisha.

9439988356

3 Dr.Surendra kumar Jena M

Chattisgarh irrigation development project,(CIDP), state data center, shiva bhavan complex, civil lines, raipur,492001.

Chattisgarh Irrigation

Development Project ( CIDP)

8827815050 [email protected]

4 Mr. Subban Veluchamy

M

Oddanchatram (Post) Dindigul District, tamilnadu, 624619

Christian fellowship hospital

09843486935 08012503464

[email protected]

5 Sr.Innocent F

Wayanad Social Service Society, Manathavady p.O, Wayanad-670645.

Wayanad Social

Service Society (WSSS)

9048527781

6 Mr.Augustine Joseph M

Ayyankanal house, kampallur po,cherupuzha via, kannur disst. Kerala.

Total Literacy Programme. 9495891841

[email protected]

7 Mr. M.Rama Raju M Lawsanway coloney,visakhapatnam, andhrapradesh.

SOMNEED 9440675544

8 Mr.P.Balaram Naidu M

Vriksha mitra bhavan ,yasodha nagar, pathapatnam, srikakulam district, andhrapradesh.

CSSS 9441853670 [email protected]

9 Mrs. P.Sarojinamma

F

Vriksha mitra bhavan ,yasodha nagar, pathapatnam, srikakulam district, andhrapradesh.

SANGHATITHA


10 Mr.A.Jaganadha Raju F

Near check post, Sridhar Nagar, Lane-1 Parlakhamundi, Gajapati District, Odisha

CCD 9437062516


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11 Ms. Malaya Mallick F

Amtala housing Complex, P.o-Kanyanagar, Dist-south 24 Parganas-743398,West Bengal, India.

SRDTC 9433395090 [email protected]

12 Dr.T.N.Manjunatha M

No-2904,2nd Main, Chamundipuram, Mysore, 570004, Karnataka.

ITIHAS 9902613543 [email protected]

13 Ms. UI Shiori F Asian health institution, (ahi) nagoya , japan

AHI 81561731950

[email protected]

14 Ms. Yoko Fukui F Asian health institution, (ahi) nagoya , japan

AHI 81561731950

[email protected]

15 Ms.Kagumi Hayashi F

Asian health institution, (ahi) nagoya , japan

AHI 81561731950

[email protected]

16 Mr. Hiroo Ishihara Ph.D M

Asian health institution, (ahi) nagoya , japan

AHI 81561731950

[email protected]

17 Mr Anant Eswar takri M

Jelc complex-1, nh-43, mission compound, jeypore-76001. District koraput, odisha.

LEAD 9178732340 [email protected]

18 Rosamma V.J (Sr. Rose Vypana F

Bharananganam p.o, kottayam dist,kerala 686578

IHM Hospital Bharanangan

am 9447284760 rosevypana

@gmail.com

19 Vadlamudi Sujatha Kumari F

RUTH-DS,Behind govt High school, Kusumanchi, Khamam,A.P

RUTH & DS 9866916257 [email protected]

20 Sr Eliza Kuppozhackel F

AYUSHYA, Center for Healing and Inteegration.Veroor P.O, Changanacherry-68104,Kottayam Dist, Kerala

AYUSHYA Center for

Healing and Integration

9961752903 0481-2720544

[email protected]

21 Mr Anup sharmah M Karuna trust, arunachalpradesh.

KARUNA TRUST



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22 Mr P.Phalguna Rao M

PPSS, Kattragada, Kotturu village, srikakulam district

ANITRA TRUST 8500101008

23 Mr.Karre Dayanand Karanakar

M Medak 9440540988

24 D.Enoch M

Adivasi Prabhavitha Padam,Chinapalli, visakhapatnam, AP - 531111

APP 8937238275 9441210555

[email protected]

25 Mr .Venkates Rao M

Community development Center, Rambhadrapuram, Badaningi mandalvizanagaram District, Andhrapradesh

CDC 8790584279 [email protected]

26 Dr. M.Kaliratnam M ,Periyakukuppam,Tiruvallur, MG R dist.,Tamilnadu

Thiruppani Trust

Association (TTA).


27 Trilochan Padhi M

Yasodha Nagar,Pathapatnam, Pathapatnam Srikakulam district. Andhrapradesh

CSSS 9778694852 [email protected]

28 Mr. Sundram Joseph prabhu M

Association for Rural Peoples Education and Development(ARPED)

ARPED 9865606646 [email protected]

29 Mr.Narendra kumar Biswal M Deenabandhupuram

, Tamilnadu ANITRA TRUST 9786816600

30 Mr Suneel Kumar M SARDS organization, SARDS 9912340222

31 Omana Jose F Post box no-26, rayagada-765001,odisha

AKSSUS,

9437230802, 06856222683

[email protected]


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The resource persons

1. Padmashree Dr. H. Sudarshan, Director, Karuna Trust 2. Dr. Jain, Nawarangpur

Inauguration

The AHI Japan India Alumni Reunion Seminar was held from 15th – 18th June’11 at CSSS conference hall, Pathapatnam, Andhra Pradesh organized by CSSS, Pathapatnam, Andhra Pradesh and CCD, Paralakhemundi, Odisha. The inaugural function of the seminar was organized at 11.00 AM on 15th June’11 at CSSS office premises. Mr. P. Balram Naidu, President, CSSS welcomed all the participants and invited the guests to the dice. The progrmme was inaugurated by Padmashree Dr H.Sudharshan along with the AHI representatives. The guests have shared their experience and their involvement in health & rural development sectors and presented their contribution in community health services.

The guests present on the dice

1. Padmashree Dr H.Sudharshan 2. Ms. UI Shiori, AHI 3. Ms. Yoko Fuki, AHI 4. Ms. Kagumi Hayashi, AHI 5. Mr. Hiroo Ishihara, AHI 6. Mr. M. Rama Raju, SOMNEED 7. Mr. A. Jagannadha Raju, CCD 8. Mr. P. Balram Naidu, CSSS 9. Mr. Anup Sharma, Karuna Trust

Mr. P. Balram Naidu, President, CSSS and Mr. A. Jagannadha Raju, Secretary, CCD requested the guests for inauguration of the seminar. After inauguration, the participants from different regions shared their experience along with self introduction. After self introduction session, Mr. Venketes Rao, President, CDC, Rambhadrapuram has given the vote of thanks to the participants at the end of the inaugural session.


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Dr Surendra Jena was 2006 batch of AHI and he is working at Chatisgarh for promoting local governance, organizing water bodies, disseminating the information through RTI and promoting community monitoring tool for education, health, food habits and sanitation. He is working for analyzing the governance accountability between service providers and service takers. Mr. Narandra Kumar Biswal was from1988 batch of AHI and he is now emphasizing on alternative medicine for health care with homeopathy. He shared his experience that he is serving around 1000 patients in a year.

The 1st day seminar session was started at the conference hall with a warm up moment. Ms. UI Shiori has monitored the session and encouraged the participants for joining the seminar. Mutual introduction session was beginning when UI Shiori has intended to know the personal description of the participants with 3 key words. Dr. T. Manjunathan shared his experience. He was the 1987 batch of AHI. He is now focusing on oriental / community medicine. He is promoting traditional medicine and framing the policies to integrate the traditional medicine. He is emphasizing on Ayurvedic practices in schools, clubs, medicals and all department level and providing trainings at grass root level to sensitize the community on the usage of herbal practices.

Sr. Eliza Kuppozhackel has shared that she was from 1992 batch of AHI and she is now practicing integrated health in collaboration with state government.

Mr. Augustine Joseph was 1995 batch and he is a teacher. He is focusing on alternate health care and pesticides. Mr. Sunil Kumar was 1996 batch of AHI and he is now working in promoting sustainable collaborator for public private partnership and emphasizing on networking of community based organizations at grassroot level and human resource building. He is rendering the services for persons suffering with HIV.

D. Enoch was 1993 batch of AHI and working for tribals for literacy and health. He is emphasizing on promoting community organization and networking with collective health forum.


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Ms. Sujata is working as a lecturer. She has taken training at in Deenabandhu in 1983.and 1984 batch of AHI. She is conducting training for VO and NGO personnel and till now she has trained more than 500 members on on herbal practices. She is maintaining 0.50 acres of herbal garden and started an herbal clinic for past 10 years at Khamam of Andhra Pradesh. She has the ability in curing the snake bite and scorpion bite patients by providing herbal dose without any injection. Many doctors have visited the clinic and the minister has given a certificate for her excellence.

Mr. A. Jagannadha Raju, Secretary, CCD was from 1986 batch at AHI and trained at Deenabandhupuram in 1983. He has shared his long standing experience of 33 years in rural development sector. His three key wards were sustainable livelihood promotion, institutional building (CBOs) and inclusive of PWDs. Mr. Anup Sharma was 2009 batch of AHI and has expressed that he is working with partnership with Rural Development Ministry, CAPART, and Primary Health Centers of Government with PPP mode in NRHM. He has shared his experience in working with 70 PHCs in North eastern states of India.

Mr. M. Rama Raju was from 1981 batch of AHI and the 1st person in India to attend 3 months course at AHI, Japan. He has shared his long standing experience of 25 years in rural development sectors and he was associated with CSSS till 1992. After that he has started SOMNEED with Japanese collaboration. In the year 1986 he has participated in fund raising campaign at AHI, Japan and in the year 1991 he has participated as the resource person in AHI, Japan. He has shared the 3 key words i.e., women empowerment, watershed development and resource management. He has expressed that associated with health activities like organizing health campaigns to mobilize better health facilities for the rural poor communities.


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Ms. Yoko Fukui has joined AHI in 2010 and she has shared her experience that she was working for the communities in Mongolia with democratic approaches.Yoko is now in charge of India too. Sr. Innocent was 1986 batch of AHI and she is now emphasizing on promotion of herbal medicine and focusing on herbal treatment especially for sickle cell anemia. Dr. M. Kali Ratnam was 1988 batch of AHI and 1983 batch of Deenabandu. He has shared his long standing experience of 23 years for promoting and strengthening trade union. He is expressed his three key words i.e., fight for Right, fight for Justice and fight for survival.

Mr. Sundaram Joseph Prabhu was 1989 batch of AHI and he is now working in promoting people’s movement especially Dalit movement in Tamilnadu. Mr. Subhan Veluchamy was 2001 batch of AHI and now involved in socio-economic development program, health education especially in schools and working with government as a counselor for HIV. Mr. Hiro Ishihara expressed that he has involved with AHI for last 10 years and associated with Deenabandhu for 2 years in promoting health service delivery mechanism and dissemination of health messages. Sr. Vypana was 2002 batch of AHI and she is now involved in health promotional activities, promoting herbal garden and working as PPP for NRHM.

Ms. Malayya Mallick was 1981 batch and 1980 batch at Deenabandhu. She is now working for the tribal communities in Sundarban forest areas focusing on women empowerment, reproductive child health, land rights, livelihood promotion and conducting outreach camps.


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Mr. Venketesh Rao was 1984 batch in AHI and 1983 batch in Deenabandhu. His 3 key words are educating the people to make aware, strengthen the community based organizations / people’s organizations and improving the livelihood with management of local resources. Mr. P. Phalguna Rao was 1984 batch of Deenabandhu and working for community health. He has opened a rural clinic and providing health education. He has trained around 5000 persons in 5 years regarding best health practices and dissemination health messages in grass root level.

Mr. Karre Dayanand Karanakar was 1985 batch of AHI and 1984 batch of Deenabandhu working as a medical officer in a Chemur Ayurbedic hospital, Hyderabad. His 3 key words are health and other services are “For the people, For the Church and With the people.” He has facilitated as a health trainer from 1985 to 1988 and facilitating as the resource persons in sensitizing the health practices in the schools.

Ms. P. Sorojiniamma was 1991 batch in AHI and 1983 batch in Deenabandhu. She is working for women empowerment, strengthening women groups and educating the women on herbal medicine practices. Mr. UI Shiori is working as the General Secretary of AHI since 2006 and promoting health support services in networking with VO and NGOs and strengthening the health institutions at grassroot level. Ms. Kagumi Hayashi is working since 1986 at AHI and facilitating for international networking, health & peace building. Her ideology is becoming peace mother.


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Mr. P. Balram Naidu was 1981 batch in AHI and he is working to empower the community with his 3 key words like land, water and health. He is emphasizing to educate the people for herbal medicine practices and sensitizing the community for prevention measures. The alumni members have shared about their personnel and about their organization activities in brief. At 2.00 PM lunch session was held. After the lunch session, the team has visited the office of SOMNEED on the invitation of Mr. M. Ramaraju. The seminar was started at 3.15 PM. Ms. Kagumi expressed that AHI is organizing many international courses and after the training, AHI ensures for peace building. The training courses are offered for alumni, people’s organizations and community based organizations. She has enlightened that the reunion seminar is meant for internal exchange of ideas of different people / health experts. The main aim of AHI is to streamline the health activities with the methodology of sensitizing the community on best health practices and behavioral changes. To disseminate the health messages in rural areas, AHI will support the project for initial period until big donor support available. AHI provides continuous support but not for long period. CSSS has raised hand to reactivate the partnership to get the project from AHI.

Ms. Kagumi offered that if the partner NGOs are interested to organize the reunion seminar, then AHI will support to organize the same to share the experience and to update the status of health support services as well as community behavior in health practices. Presentation was held by Mr. Narendhra Biswal with the experience and interventions of Deenabandhu medical mission,and narrated the paper presentation of Dr.Prem John on Peoples Health Movement status and its issues and challenges. Details of the paper presentation in enclosed in the annexure I Then Mr. Hiroo presented on horrific moment of Japan during Tsunami. The presentation was very much shocking and all the alumni have expressed their condolence to the citizens of Japan and encouraged and praised the delegates of AHI for supporting and participating in the seminar even though after the shocking moment.


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Mr. Sundaram Joseph Prabhu expressed that he has adopted community acceptance methodology and spreading the health education in his operational areas in Tamilnadu. He is facilitating and organizing mobile health camps to promote the health activities. He has started school literacy campaign to read and write and educate the children. He also organized environmental protection campaign and sensitized the community to avoid superstition. He has promoted self help groups to promote health education and encouraged for people’s movement and dalit movement to fight against the government for equal wages and to access the social security provisions. Since last 10 years, his organization is working to accelerate the people’s movement to get their land rights with an objective of :-

• To provide the land to the dalit community • To get common resource to the dalits from upper caste • To demand the government to file the cases as per the Atrocity Act, 1989 • To facilitate the dalits for their active involvement in the campaign. • To monitor the NREGS whether the workers are getting equal wages

He is lobbying with Tamilnadu government to solve the problems and issues of the Dalit communities. Dr. Manjunathan told that government of India has initiated a mediation center to solve the problems without going to court of law. In this process, the person would save their time and money and get immediate justice.

Dr. Manjunathan shared his long standing experience and his involvement in rural health mission, organized trainings from medical students and traditional health activities. He expressed that health care can be ensured through good habits, hygienic environment, agriculture practices and best health practices. But medical care can only cure the disease by taking the medicine. Best practices can achieve good health permanently but medicine practice in temporary. So he emphasized on prevention is the first. Therapy helps to cure the diseases. He told that drumstic chocolate can cure Anemia. He told that after working for past 32 years in advisory board of Karnataka government he observed that how Ayush works for government.

Sr. Rose Vypana shared their work in health promotional initiatives through NRHM with an objective to change the health indicators through medical camps, adolescent campaign, distribution of supplementary food, adolescent counseling and community monitoring. She has organized the vocational trainings to prepare soap medicine, herbal medicine and leaf plates. She has conducted school health programs to educate the children in RCH with the participation of government personnel to chanalize the medicines and other health support services.


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The day One session was concluded with fruitful sha ring and knowing each other.

The 2nd day session was started by 9.30 AM with a review of 1st day. Dr. Surendra Jena has presented the points of 1st days discussion.

Sr. Eliza expressed that health cannot get through hospitals or taking the medicines. It can achieve through body therapy, counseling especially in schools, promoting herbal garden in the schools and backyard of the household and best health practices. Proper care can achieve good health. She emphasized that prevention is better than cure.

Mr. Heroo has enlightened on the Thermal power plants in Japan which he intended to present the economic situation of Japan even after the Tsunami. Mr. M. Rama Raju told that there are 3 power plants in Srikakulam district where the general public were involved. He also focused that SOMNEED has initiated to take up mini hydro electric plant without disturbing nature/environment for 100 households in Odisha.

Mr. Aunp Sharma shared his experience of Karuna Trust in changing the health scenario in rural areas of north eastern states through mainstreaming the PHCs. Padmashree Dr. H. Sudarshan has participated as resource person and shared on the present situation of NRHM and about Public Private Partnership. He is the executive member of NRHM and also Chair person of PPP. He presented the health initiative and services of Karuna Trust and Vivekananda Girijana Kalyan Kendra. He focused on the Soliga tribal people.


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Dr. H. Sudarshan has appealed that even after 64 years of Independence, we did not reach the goal for establishing health friendly environment because we did not focused on the following :

1. Equity issues: Class, Caste, Gender, Regional disparities, And Marginalized people: STs, Disabled people, Homeless Children and Adults etc.

2. Sustainable Development 3. Corrupted Governance system

He focused on the following points for health initiatives in tribal areas. Evaluation of tribal development

• Started Curative Health Services • Initiated Community Health with Woophing Cough epidemic • “I had no pills for poverty” - Land rights issue – Community Development • Conservation of Biodiversity and Livelihood of tribal people – Sustainable Development

Tribal Health Care

• Comprehensive Primary Health Care: Preventive, Promotive, Curative and Rehabilitative Health Care

• Understanding Traditional Health and integrating/building on it. • Empowering people to manage their health

Basic Principles of Tribal Development

• Living with the people – understanding their strengths – Traditional Knowledge • Humility to learn from people • Build on the strengths • Respect Diversity and no need to bring them to so called “National Main stream”

Traditional Knowledge System

• Living in Harmony with Nature • Knowledge of the Forests and environment • Traditional Health Practices – Herbs, delivery in squatting posture • Traditional Agriculture – organic & traditional seed varieties

Tribal Education

• Started with 6 children in a hut – 1981 • 4 of them have done Post Graduation • Jadyea has done MSc in Agriculture and completing his PhD – Asst Professor in Forestry

College – President of VGKK • 2 MSWs & 1 MSc in Botany • Residential School with 500 tribal students – Boys & Girls I to 10 the Std. • 11 & 12th (PUC) – Science & Arts • Industrial Training Institute • Forestry School • Auxiliary Nurse Midwife (ANM) School • Drama School – (Drama for Development) • IGNOU – Correspondence Courses

Innovations of Tribal Education

• The problem of thrusting main stream education of tribal people • Soliga Nudi Text book • In Soliga Dialect/language • Soliga Culture Specific • B.R.Hills Environment • Gradually merges in to Kannada


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Health profile of Tribal People

• Those living inside the Forests • Those living in the periphery • Those living in rural areas – totally alienated from Forest environment

Health activities in Vivekananda Tribal Health Cent er

• 20-bedded tribal hospital with X ray, laboratory, pharmacy providing free health care to the tribals

• Caters to over 20000 Soliga tribals and a few other forest-dwelling tribals of Chamarajanagar district

• Trained tribal youth as health workers, X ray technicians, laboratory technicians and nurses Mobile medical unit

• Doctor with a tribal health worker and driver • Carries all essential drugs • Curative services • School and Anganwadi health check-up • Community mobilization and social action • Emergency care and referral

Health Activities with Traditional knowledge

• Integration of authenticated and proven traditional practices : Delivery in sitting posture, Single herbal remedies for routine ailments

Sickle Cell Anemia Screening

• Screening and documentation of Soliga population with case records Tribal ANM Program

• Tribal girls with 7th std qualification trained as ANMs to manage sub-centres in remote forest tribal areas

School Health

• Regular school health check-ups and health education Initiatives by Karuna Trust

• Founded in 1986 • Response to high prevalence of Leprosy in Yelandur- 21.4/1000 in 1987 to 0.2/1000 in 2005 • Community based, people oriented, need based, culturally acceptable models using

appropriate technology with minimum cost to the community Public Health Challenge – Negligence of Public Heal th Centre

• Comprehensive Primary Health Care – Alma Ata Declaration – India a signatory • Poor Primary Health Care infrastructure • Non-functional PHCs - Doctor’s not willing to stay in PHCs, lack of Health workers • Non availability of Essential drugs • Poor management of PHCs


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Public Private Partnership

• Public – Government • Private – For Profit Private Sector & Not for Profit Sector ( NGOs, VOs) • Privatisation: Partnership with Not for Private Sector is not Privatisation • Partnership: It is not being “Contractors” for implementation of Government Programs.

Partnership in Policy formulation, Planning, Implementation, Monitoring, evaluation, Training & Research

Karuna Trust – PPP in India

• Karnataka State: � 26 PHCs - one in each District � 2 PHCs through other NGOs – Vivekananda Foundation & Vemana Trust � Eye Hospital – Chamarajanagar Dt. � 7 Mobile Medical Units � Help Desk at Two District Hospitals. � FRU in Santhemaranahalli CHC, Chamarjanagar Dt � District Health Management – Tumkur Dt.

• Arunachal Pradesh – 9 PHCs • Meghalaya State – 4 PHCs • Orissa State – 5 PHCs • Andhra Pradesh – Adilabad – 2 PHCs

PPP – the process

� Advocacy with respective state government � Expression of interest / direct application � Identification of PHCs – poor performance, remote / tribal areas � Dialogue with community and PRI members � Applying to ZP / state, sharing draft MoU � Finalising MoU � Recruitment and induction training � Withdrawal fo govt. staff – option for continuing at PHC � Formal takeover of the PHC from DHO

Major Achievements of Karuna Trust

• 100% headquarter stay of all staff in PHC • All buildings and equipments in place • Specialist and referral services available • 24 hour ambulance services • Women friendly PHC • Rational drug use / essential drugs available • Chronic disease prevention and treatment programme

Innovation of Karuna Trust

� Tribal ANMs program: Training tribal girls as ANMs and posting them in the Tribal Sub-centers. One year course for 7th pass not recognized by Nursing Council. Now 18 months course for 10th pass.

� Introducing Mental Health Program including Epilepsy in Primary Health Care, Low cost management of Epilepsy in PHC.

� Introducing Dental Health & Cancer Control Program in PHC – ANMs trained to take Pap Smears.

� Integration of Rehabilitation into Primary Health Care in addition to Preventive, Promotive & Curative health care.

� Addressing Specific problems : Sickle Cell Anemia & Hot Water Epilepsy. � Promotion of Traditional Medicine – 20 herbs for Primary Health Care � Integration of Ayurveda & Homeopathy (AYUSH). � Community Health Financing


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Telemedicine

• Telemedicine in all PHCs in collaboration with ISRO, NH and Amrita Inst. • Tele-health • Coronary Care Unit at Chamarajanagar District Hospital with training of MBBS doctors in

managing critical cardiac emergencies Community Health Insurance – T. Narasipur Model

• NGO & Government Collaboration • Three Levels: • Community Herbal Gardens - for common ailments • SHGs - Micro-credit for out-patient care • Pre-paid Insurance for Inpatient care - Hospitalization •

Salient features of Health Insurance

• Premium Rs.22 ( I Year Rs. 30/-) per person per year • Premium costs shared by community, Milk Co-operatives, SHGs,UNDP and GPs • No exclusions - all age groups - Hospitalization due to any illness • Rs. 50/- paid to patient for daily wages lost and Rs. 50/- to the hospital for extra drugs per day

of hospitalization Mainstreaming of traditional medicine in PHC

• Integration of single herbal remedies for routine ailments into PHCs • 3 tier system – Traditional Medicine, ANM and PHC • Involvement of SHGs, schools and Mahila Vaidya Mitras • Essential Drug List and STG for ISM PHCs • To integrate traditional medicines into PHC • To make a rapid assessment and validation of sound local practices. • To develop a cadre of Arogya mitras to cater to the preventive, promotive and curative

needs of the community • To advocate for policy on mainstreaming the traditional medicine into official primary health

care system. Mental Health

1. Mainstreaming Mental health into Primary Health Care in collaboration with NIMHANS - Management of Mental illness including Epilepsy at PHC level. Training Medical officers and Health workers.

2. MANASA – A comprehensive system of care for homeless mentally ill people

– Transit Centre, Helpline, Rehabilitation and reintegration with families, Reform of Destitute Homes in Bangalore and Mysore

Mainstreaming Eye Care into PHC

• Community Eye Care – Village blindness registry – VHSC & RKS • Training MO & PHC Staff, ANMs, MHWs, ASHAs in Community based eye care. • Vision Centers in every PHC – Ophthalmic Assistant PMOA and Optician – Vision testing and

optical dispensing at PHC Promotion of low cost generic drugs and Rational Dr ug Use

• Stocking and distribution of good quality, low cost generic drugs – LOCOST & Biocon • Biocare Pharmacies at Govt. Hospitals • Promotion of rational drug use • Essential Drug List and Standard Treatment Guidelines • Reforming the Drug Logistic Society


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ASHA Training

• Training of ASHA’a in 3 tribal Districts of Karnataka • In collaboration with NGOs in the Districts • Nearly 3000 ASHAs already training. • Supervision and Monitoring.

Community Planning & Monitoring

• Pilot of NRHM in 9 States • Karuna Trust -Nodel Agency for Karnataka • Implemented in 4 Districts in partnership with local NGOs • 49 PHCs & 562 Villages covered • VHSC & RKS capacity building • Village Health Plan and Report cards

Citizen Help Desk

• Providing Information and helping patients about facilities and services available • Monitoring the quality of Health care to OPD patients and IPD patients • Awareness programs in the areas inhabitated by poor to build confidence amongst the poor to

access services at Public hospitals. • Establish a link between service providers and users through regular feedback mechanism • Transparency and accountability in the delivery of services

PPP in District Health Management in Collaboration with other Institutions

• Capacity Building for District Health Plan • Implementation of Health programs • Monitoring & Supervision • Health Management Information System • Community health insurance • Asha training and Supervision • Community Action and Monitoring

National Health Policy – 2002

1. Introduction - 1983 Health Policy – Health For All by 2000AD 2. Current Scenerio 3. Objectives 4. NHP-2002 – POLICY PRESCRIPTIONS 5. Summation

Goals to be achieved by 2015

• Eradicate Polio and Yaws 2005 • Eliminate Leprosy 2005 • Eliminate Kala Azar 2010 • Eliminate Lymphatic Filariasis 2015 • Achieve Zero level growth of HIV/AIDS 2007 • Reduce Mortality by 50% on account of TB, Malaria and Other Vector and Water Borne

diseases 2010 • Reduce Prevalence of Blindness to 0.5% 2010 • Reduce IMR to 30/1000 And MMR to 100/Lakh 2010 • Increase utilization of public health facilities from current Level of <20 to >75% 2010 • Establish an integrated system of surveillance, National Health Accounts and Health Statistics

2005 • Increase health expenditure by Government as a % of GDP from the existing 0.9 % to 2.0%

2010 • Increase share of Central grants to constitute at least 25% of total health spending 2010


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• Increase State Sector Health spending from 5.5% to 7% of the budget 2005 , Further increase to 8% 2010

NHP – 2002 – Policy prescription

• Financial Resources • Equity • Delivery Of National Public Health Programmes • The State Of Public Health Infrastructure • Extending Public Health Services • Role Of Local Self-Government Institutions • Norms For Health Care Personnel • Education Of Health Care Professionals • Need For Specialists In ‘Public Health’ And ‘Family Medicine’ • Nursing Personnel • Use Of Generic Drugs And Vaccines • Urban Health • Mental Health • Information, Education And Communication • Health Research • Role Of The Private Sector • The Role Of Civil Society • National Disease Surveillance Network • Health Statistics • Women’s Health • Medical Ethics • Enforcement Of Quality Standards For Food And Drugs • Regulation Of Standards In Paramedical Disciplines • Environmental And Occupational Health • Providing Medical Facilities To Users From Overseas • Impact Of Globalization On The Health Sector • Summation

Major Issues of Concern to achieve the goal

1. Corruption 2. Neglect of Public 3. Distortions in Primary Health Care 4. Lack of Focus on Equity 5. Implementation Gap 6. Ethical Imperative 7. Human Resource Development 8. Cultural Gap and Medical Pluralism 9. From Exclusivism to Partnership 10. Ignoring the Political Economy of Health 11. Research 12. Growing Apathy in the System

Good Governance in Health Care

• Karnataka Lokayukta – Ombudsman Institution for control of Corruption in Public Sector • Vigilance Director for Health – Epidemic of Corruption in Health Sector • Prevention and control of corruption in Health Services.

Corruption in India – Transparency International In dia

• Transparency International India & ORG-MARG Research Pvt Ltd - An empirical study • Covered Ten Sectors: Police, Health, Education, PDS, Land Admn., Judiciary, Taxation,

Railways, Telecom. • Most Corrupt: Police Least Corrupt: Telecom • Health: Perceived to be 2nd most corrupt sector • Payment of Money through hospital staff • Money demanded from North 25% - South 38%


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• Doctors: 77% Hospital Staff: 67% Epidemic Corruption in Drugs control departments

• 2268 samples declared “Not of standard Quality” including 126 spurious drugs – very few prosecutions

• No action initiated on those who supplied spurious drugs to Health department • Violation of DPCO – people of Karnataka have paid nearly 100 crores in excess • Complaints given by public & institutions were not attended. • Trading of blood by Unlicensed Blood Banks & chemists, HIV infected blood sold

Corruption in procurement of Drugs

• Purchase of Non Essential Drugs – Nimesulide Tabs 18% of budget • IV fluids scam – Bypassing HAL and buying from PDPL • Decentralized Corruption in Procurement of drugs by Zilla Panchayaths – buying spurious

and substandard drugs from unlicensed manufacturers – excess price. • Sigma scam – forged documents

Corruption in procurement of Equipments

• Dialysis machine worth 5 lakhs bought for 11.6 lakhs by DME and at 12.6 lakhs by KIMS – Hubli

• Equipment for removing Cholesterol was bought for 60 lakhs and used only once • Gulbarga ZP bought X-ray machines in 1992 and they were not installed till 2004. • Corruption in Indenting, specifications, not looking at market rate etc.

Corruption in Hospitals by service providers

• Ayaas/ward boys • Contract workers • Technicians • Administrative Staff • Nurses • Pharmacist • Doctors • Specialists

Corruption in hospitals for the following services

• Admission • Issuing Medical certificates • Laboratory • X-ray, Scanning • Transporting patients • Referrals • Medical & Surgical • emergency services • Elective Surgeries • Deliveries • Postmortem • Blood Transfusion

Various forms of corruptions by the Doctors and Para Medical staff

• Private practice • Nursing Homes (owned by spouses, relatives & business partners) • Referrals to Private Hospitals/Diagnostic Centers • Theft/Selling of drugs & surgical items • Misuse of User Fee • Owning Pharmacies/Blood banks • Excess of assets over income – False declaration of assets

Corruptions in Civil works


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• Construction of PHCs, CHCs, Taluka & District Hospitals and Repairs.

Corruption in Administration (at offices of Distric t Health, Directorate & Secretariat for the following) :

• Recruitment & Postings, • Transfers & Promotions • Sanctioning Leave, Medical reimbursement • Monitoring Private Practice & Absenteeism • Suspension and Reinstating

Corruption in Private Health Sectors

• Corruption in Procurement of Equipment • MNCs are also corrupt • Tax evasion and Unqualified staff • Poor quality • Commissions for diagnostics CT, MRI, Lab Investigations • Surgeries (Hysterectomies) and procedures (Angioplasty) which are not indicated

Reforms for good governance in Health Services

• Proactive Lokayukta – Ombudsman for PRI and active Monitoring – institutionalize the reforms

• Vigilance cell in Health Department – Strengthen and Capacity building – Expertise • E-Governance: HMIS – Program and HRM, computerize transfers, recruitment, promotions,

e-procurement, Web site for transparency and accountability • Integrity Pact – black listing and debarring • Effective Management and Supervision by Administrators and senior staff – Field visits

Prevention of Corruption

� Peoples Movement: bottom up process – Peoples forum to prevent and fight corruption. � Community Monitoring � Promote Values - Value based education � Awareness to make use of Right to Information Bill And Transparency Act � Whistle Blower’s protection � Strengthen Consumer Forum � Electoral Reforms � Coalition Against Corruption – NGO net work

Good Governance

• Mere Technological Packages can improve the health outcomes marginally • Good Governance can provide quantum jump in the health outcomes

Transforming India through quality leadership

• Working as a team – Net working • Living practitioners of Values – Human Resources for Development • Inner strength - Moral/Spiritual • “My life is My Message” – M K Gandhi • “They alone live who live for others; others are mo re dead than alive” – Swami

Vivekananda


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Through the above points, Padmashree Dr. H. Sudarshan invited the attention of all alumni in the seminar towards reformation of good governance to ensure the quality health services in rural and remote areas to achieve the goal of NRHM. He focused that these above points are the biggest barriers in promoting good health services.

The presentation of Dr. H. Sudarshan encouraged the AHI Japan India alumni to concentrate the matter to overcome the issues and problems to ensure quality health service delivery mechanism. After the presentation, Ms. Mallaya Mallick questioned to Dr. Sudrashan that why Karuna Trust is not working in West Bengal. But Dr. Sudrashan told that Karuna Trust is not working with their own interest. If any government invites to take over the PHCs, then Karuna Trust will enter into agreement and work in PHCs with their own infrastructure and own human resources.

Mr. Narendra Biswal expressed his view that why the demonstration of herbal medicine is not taking place in the backward of every household that can improve the knowledge of the people on herbal medicine. Question was raised that in which situation, NGO could take over the PHCs. Giving the answer, Dr. Sudrashan told that NGOs are entrusted to take over the PHCs when government is not reaching or government is not interested to work in most remote areas.

Mr. Narendra Biswal expressed his view that why the demonstration of herbal medicine is not taking place in the backward of every household that can improve the knowledge of the people on herbal medicine. Question was raised that in which situation, NGO could take over the PHCs. Giving the answer, Dr. Sudrashan told that NGOs are entrusted to take over the PHCs when government is not reaching or government is not interested to work in most remote areas.


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With the fruitful discussion on health and development, the 2nd day session was ended at 6.30 PM.

Question was raised that how to ensure good governance to prevent the corruption in health sector / PHCs. Dr. Sudrashan expressed that if we empower the people through Gram Sabha, empower the village health & sanitation committee and empower the people, then we can get the success upto a greater extent in preventing the corruption. Question was raised that how to coordinate to ensure good health mechanism. Dr. Sudarshan told that it is the corporate social responsibility. Every state has to contribute the share more for NRHM. Spend more money on health and in result it can support for growth of the economy. Mr. A. Jagannadha Raju, Secretary, CCD has invited the concentration of all alumni that how we can achieve the goal of NRHM / good health support services with Dr. Sudarshan’s

Dr Jain was introduced and was requested to share his experience with NRHM being in the Govt sector as well as a NGO who was running an Organization advocating for community Health. Dr. Jain, one of the resource persons shared his experience in health and development sector. He shared his long standing experience and started his work from 1981 from NGO. He was involved in comprehensive health works, promotion of SHGs since last 25 years. After joining into Govt Healthl sector he has expressed that first time in Odisha, he has started the SHG revolution. He elaborated the role of ASHA, role of Anganwadi, role of GKS at village level, role of RKS at PHC level and role of BLAC at Block level and importance of VHND to achieve the safe motherhood. He concentrated on early detection of pregnancy, timely diagnosis which will save from more complicacy. If any risk cases will refer to a Doctor in the last time, then doctor cannot save the life of the mother. So he emphasized on proper training of ASHA, AWW and village level health service providers to render their service with more effectively and sincerely. He has expressed the mindset and the behaviors of the doctors, health personnel and of the higher authorities who are not serious and don’t like to take the risk for a better cause where by the policies and schemes are not working. He advocates to take up the programme of NRHM in a positive way and mobilize the community and the key stakeholders for the successful results.

Ms. Sujata drew the attention of alumni towards the inability of government personnel towards streamlining the schools. She told that till now around 100 government schools are closed because of poor monitoring and lack of human resources. But with her commitment and zeal to work with community, she was able to establish 20 Ashram schools in her region. She is focusing on girl child education and also imparting the importance of health/ medicine. She has presented a herbal leaf namely “AMRITA” which is very much useful for any kind of fever.


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On 17th June’11, all members had been to Public Health Centre at Gumma of Gajapati District, Odisha. Before visit to PHC, the alumni have visited CCD office and a small dialogue was done in the office premises. Secretary, CCD explained the management system and exhibited different photographs of ongoing projects. The AHI Japan India alumni have visited the PHC and observed the available health facilities, infrastructure and services by the health service providers. Individual interaction was done with Pharmacist, Block program organizer, nurse and Ayush doctor regarding the services and facilities. A meeting was organized at PHC conference hall where Medical Officer, Ayush doctor, BPO and pharmacist have expressed their view in rendering the services inside the PHCs and community level services by ASHA. They expressed that ASHA is playing important role in bridging the gap between community and PHC in providing health services. Dr. Manjunathan asked the PHC personnel that whether they are satisfied with the support services and facilities provided by NRHM. The PHC personnel have happy to share their experience that they are rendering their services to the tribals and reaching the health services in remote and hill areas. The Medical officer is female and Ayush doctor is male. Considering the gender perspective, Dr. Manjunathan asked that if any patient come to the PHC, then how he / she prefer to go to the Medical officer or Ayush doctor. In

After the discussion, Dr. Manjunathan suggested the Ayush Doctor regarding the importance of Ayurbedic medicine. He encouraged the Ayush doctor to widespread the usage of herbal medicine and prepare a herbal garden inside the boundary of the PHC. Dr. Manjunathan has given his personnel address and contact number and encouraged the Ayush doctor to take suggestion and guidance whenever necessary regarding herbal medicine.

The members visited to Jangjanglo hill top village of Gumma Block around 8 km distance from Gumma PHC to have a observation on the health, sanitation and livelihood of the tribal community. The tribals of Jangjanglo have received the members with their traditional culture. A mass meeting was organized at the village. The ASHA has shared the health services and facilities available by the PHC. The SHG members and other villagers also shared their livelihood options, education of their children, water and sanitation facilities provided by government and maintenance by the village community. The villagers have expressed that CCD has organized many sensitization programs, awareness camps, health camps, trainings on livelihood generation, savings and credit management etc and the villagers are living in good condition as since many years they had not suffered in serious health problem like malaria, diarrhea or any financial problem.


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At 7.00 PM the team has returned to CSSS office and shared the learnings and observations on village visit and PHC visit.

During return, the team has visited the low cost innovative cashew processing unit at Tohojung village of Gumma Block. The team has appreciated the interventions of CCD in establishing the cashew processing unit which is maintaining by the women SHG members. The women members have shared that the cashew processing unit is enhanced their income options through value addition process. The team members have purchased the cashew from the SHG members.

The team has returned to CSSS at 2.30 PM and after lunch, the team have visited to PHC at Baidalapuram of Andhra Pradesh around 25 Km from CSSS. The team has interacted with the PHC personnel about the services and facilities by NRHM. As per the discussion, the PHC personnel shared their problem that there is no medical officer. The PHC is running by only one Nurse and a Pharmacist. After several complaints to the administration, there is no result. But the alumni team has suggested that village people are more powerful and we have to motivate them to raise their voice. People’s movement can solve the problem. The team has suggested that without medical officer, the health services will be not much effective.

After two hours discussion, the team has visited to SODHA village to meet with the village community. A village meeting was organized and the SHG members along with villagers have shared about their village and their livelihood. They have shared that CSSS has first entered into their village and promoted the community based organizations, Self help groups and initiative livelihood generation activities.


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The feedback was come up from the members :-

� PHC visit are good, educative, informative and touching.

� Role of NGO is visualized and it was a new learning

� People are enthusiastic to hear and learn

� People’s participation is visible in the village

� There is a need of effective documentation of developmental activities at village level

� There is a need of NGO support to improve the facilities in PHCs

� Two model villages were seen and people are very much interested to take up new initiatives

� Interaction with villagers and their opinion was very encouraging

� Village culture is continuing and villager’s believe on traditional healers

� There is a need to advocate the problems of the villagers and the people has to advocate

their own problem

� Arrangements by the organizers for the exposure visit are good

� Utilization of local resources is visible

� Food security has to ensured, strengthened and sustainability of micro enterprises

� Waste land can be utilized

� Mainstream the Ayush in NRHM as the Ayush doctor is sitting idle

� Promote herbal garden in PHCs with collaboration of forest department

� Role of NGOs to motivate and train local practitioners

� Circulate the guidelines of NRHM in PHCs

� Transparency at office level was good

� NGO should promote herbal medicine in all villages to ensure community health

� Promote healing system in promoting younger generation

� Development cannot ensure by NGO rather than strengthening of the local governance

system

� PHC is the basic infrastructure of Nation and should know by all villagers / stakeholders

After the feedback session, the 3rd day session was ended at 9.30 PM and there was a break for dinner.


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The 4th day session was started at 9.30 AM. The members have shared the experience and learning of 3 days session.

Ms. UI Shiori has monitored the session and given the following points to the discussed:-

� Key learnings

� Feedback on Reunion

o Content

o Process

o Logistic

� Future action plan

� Suggestion to AHI

As per the points the members have given their opin ion of key learnings :-

Dr. Surendra Jena :- 1. Promoting local self governance 2. Promoting community health through local self governance

Ms. Rosamma :- 1. Dr. Sudarshan’s health model is a good learning 2. Journey to hill areas are encouraging 3. Alternative medicine practices

Mr. Anup Sharma :- 1. Mixed experience and field visit encouraged for experience 2. Effective implementation ensure with people’s movement

Ms. Mallaya Mallick :- 1. Renewal of knowledge, experience 2. New learning is much aggressive 3. Tribal culture, work and development can be ensure through

NGOs.

Ms. Sujata :- 1. Reunion seminar is boosted a lot 2. Follow up of the seminar is good 3. Linkages with government through PHCs

Mr. Venketesh Rao :- 1. Role of PHC in people’s health management

Mr. A. J. Raju :- 1. The seminar helped a lot to chalk out action plan for effective health promotion 2. It is necessary to revive the alternative medicine / health 3. Learning from resource person was very fruitful

Ms. Eliza :- 1. Apart from AHI newsletter, it is good to learn from other during interaction.

Ms. Kagumi San :- 1. The year 1998 was the last visit to India and observed the changing the challenges 2. Organizing the people for tangible health activities 3. Traditional medicine in India is the important in future

Ms. Yoko Fukui :- 1. Role of NRHM was unknown before the seminar 2. Awareness and motivation to the people by NGO is

Encouraging 3. Partnership with Government

Mr. Hiroo :- 1. It is necessary to summarize the write up to discuss on the

Effectiveness


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Feedback – Contents Mr. Narendra Biswal :- 1. NRHM topic 2. Health practices Dr. Surendra :- 1. Written experience is needed 2. Group discussion is needed 3. Documentation in a specific format to give better feedback Mr. Kaliratnam :- 1. Regional wise discussion is very important 2. Good discussion is create competition to share the knowledge

and experience Mr. Augustine :- 1. Logistic was good 2. Due to shortage of time, the sharing of experience was not

fulfilled. Mr. Anup Sharma :- 1. As a social worker, we have to accept the problem i.e., logistic,

time frame and other problems Ms. Sujata :- 1. Lack of group discussion the sharing was not effective 2. Logistic was excellent Mr. Ananta :- 1. Status of NRHM is not clear 2. Need of powerful resource persons 3. Need of data / findings to know more 4. Group discussion is needed Sr. Innocent :- 1. All process is excellent 2. Dr. Sudarshan’s presentation was good 3. It was a good platform to meet with old friends 4. The seminar helped a lot to understand about health Mr. Ui Shiori :- 1. Need of background paper to review and ask questions to

learn more 2. It is unique of joint organization of the seminar

Sr. Eliza :- 1. Background paper on NRHM is essential to discuss 2. Group discussion was essential 3. Region wise interaction was needed Sr. Rosamma :- 1. Interaction with health worker was good 2. Logistic was good Ms. Mallaya :- 1. To get idea on PHC before entering into PHC Mr. Prabhu :- 1. It was good sharing in the seminar to know more on NRHM 2. Health activists are taking the lead role 3. Logistic was good 4. CSSS family is very cooperative in hospitality Mr. A. J. Raju :- 1. If the place of seminar and accommodation was one, then the

would have been get more time for discussion Mr. P. B. Naidu :- 1. It is first time to organize the seminar and got good experience Dr. Manjunathan :- 1. Distribute the responsibility for effective management


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Future plan

1. To form a committee of AHU Alumni

2. Dr. Sudarshan’s help in initiating the health initatives

3. Region wise Committee formation

4. Organize the seminar in a year / six months for sharing

5. Grievance for local governance on behalf of AHI Alumni

6. Public Hearing

7. Incorporate the NRHM concerns in development initiatives

8. Share the interactions in the news letter of AHI

9. Promotion of herbal garden in all villages

10. Regularization of health workers / doctors

11. Sharing of all ideas / thrust areas into incorporation / compilation

12. Circulate through e-mail / group accounts about the daily achievements

13. Letter to ministry / state government about dis-functioning of PHCs

14. Collect correct data from field about IMR and MMR

15. Organize community health workers and impart training at Karuna Trust for more effective

16. Collect the information on herbs and train the youth on traditional herbal medicine

17. Learn more things on health and institutions

18. Revive the data on NRHM for effective monitoring of PHCs

19. Take one PHC as a challenge and time to time take the guidance of resource persons for

better operation of the PHCs

20. Follow up activities of seminar to revitalize the experience and knowledge

21. Document on local health practitioners / practices

22. Organize ASHA training for better performance

23. Orient the Doctors / health service providers

24. Provide health education to all stakeholders

25. Continue oriental medicine course


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Suggestion to AHI Mr. A. J. Raju :- 1. Information of members has be updated 2. Reunion should be continued 3. Circulate articles for AHI news letter 4. Intra exposure to the field of Alumni 5. Alumni members to be the resource person at AHI Dr. Manjunathan :- 1. Organize reunion seminar once in 2 years. 2. Meet once in a year among the alumni members without AHI P.B.Naidu :- 1. Support the alumni members for organizing health activities ‘ Narendra :- 1. To start fund raising from India Dr. Surendra :- 1. Presentation on the theme 2. Update ILDC 3. Reunion should be continued 4. AHI news letter should continue 5. Respond to AHI news letters Veluchamy :- 1. List of AHI staff for birth day presentation Sr. Rosamma :- 1. Celebration with birthday card and rapport building with AHI Mr. Venketesh 1. Continue the AHI news letters Mr. Ananta :- 1. Organize the seminar with special / global issue as a theme 2. Annual membership fees to be collected by Indian Alumni Ms. Sujata :- 1. Continue the reunion seminar 2. ILDC trainings 3. Update information on alumni 4. Regular respond from AHI Mr. Anup :- 1. Case studies of individual ILDC members to collect for good

practice Ms. Yoko :- 1. Send the correct address of alumni members Mr. Hiroo :- 1. Organize India Alumni and invite AHI Ms. Kagumi :- 1. Focus on responsibility sharing 2. Focus on specific theme 3. Leadership training


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The forth day session was concluded at 1.30 PM for

lunch break. After the lunch, the alumni have visited

Gandahati Waterfall in CCDs project area of Odisha

which is 27 KM from the conference venue. The

alumni have enjoyed the natural beauty of the site

and get refreshed from the 4 days conference.

After returning from the water fall, the alumni have

visited to Gajapati Women Self Help Cooperative ltd

at Paralakhemundi promoted by CCD which is self-

sufficient. The Cooperative is a confederation of 9000

women self help group members and they are

independently operating the unit as a women bank

and accessing the micro credit for their business

development and utilizing in productive purposes.

The alumni members have encouraged the staff,

management and board members for their

endeavours for women development aspects.

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