POST-GRADUATE RESIDENTS TAKING HOMOEOPATHY INTO THE PUBLIC HEALTH SPHERE:
RIDING PIGGY-BACK ON THE ATAL AROGYA MAHASHIBIR IN PALGHAR DISTRICT
Dr Jitesh Thakur, MD (Hom)
Medical Officer, Rural Homoeopathic Hospital, Palghar
A rare clinical opportunity smiled on the Dr M. L. Dhawale Memorial Homoeopathic Institute (MLDMHI), Palghar, when the Government of Maharashtra decided to organize the ATAL AROGYA MAHASHIBIR in Palghar district from 20th February to 3rd March 2019 and requested the Maharashtra University of Health Sciences (MUHS), Nashik, and its affiliated colleges, to participate in the programme. The objective was to ensure that all sections of the population, especially the unreached, get an opportunity to undergo a primary health screening, seek consultations from experts, and be referred to higher centres if needed.
The programme was scheduled in 3 stages:
Stage 1: Door-to-door screening of patients in every village
Stage 2: Screening of patients at rural hospitals and primary health centres across the district
Stage 3: Mega camp at Atal Maidan, Palghar, with participation of 2000+ doctors and 1 lakh+ patients
Participation of the MLDMHI
As we are an affiliated college, the MUHS required our full participation. The participation details were elaborated in a meeting at the Collector’s office on the 13th of Feb ’19, which was attended by our Medical Social Worker (MSW) – Mrs. Vidya Patil. The plan of deployment of Post Graduate residents in the different stages was outlined and the co-ordinators for the different regions were asked to take charge.
Dr Jitesh Thakur, Medical Officer, RHH was appointed as the programme co-ordinator for the camp. Approximately 25 – 30 PG Residents were to be deployed per day in different villages of Palghar Taluka. Daily reporting was done by the PG residents.
Stage 1: From 20th Feb- 25th Feb 2019.
Door-to-door screening of 6000 patients was done by 55 residents of MLDMHI in numerous villages in the Palghar district, including Saphale, Tandulwadi, Nandore, Nandgaon, Umroli, Katkarpada, Murbhe, Navapur, Chahade, Maswan, Penand, and Manor. The commonly seen clinical conditions included HTN, DM type 2, Degenerative bone diseases, Cataract, Goitre, and Varicose veins. The camp volunteers appreciated that the PG residents put in full efforts despite the lack of instrumentation/medical facilities. The local government bodies provided good hospitality for the PG residents.
Stage 2: From 26th Feb to 2nd March 2019. PG Residents were posted for all 6 days at the Rural Hospital (RH), Vikramgad, and the PHCs located at Kurunze, Talwada, Malwada, and Bhatane. Here, 1200 patients were screened by a team of 13 residents.
The residents faced difficulties in terms of lack of infrastructure for their stay. This was managed by the institute by providing residence at the Dr M. L. Dhawale Memorial Trust’s Bhopoli Tribal Cottage Hospital. Some residents were more fortunate; e.g., Dr Chandrabhan Sharma and team were deployed at PHC Malwada and their experience was brimming with positivity. Dr Chandrabhan reported: “The smiles and innocence of these children made us happy; we thought, how can these children be so happy with so few resources? We went for the 2nd camp in the next village, Gavitpada, and reached at 3 pm where people were already waiting for us. It was also a PHC where resources were scarce, but the staff was very active and well-behaved. We saw almost 50 cases. Most of the cases were very complex and really needed intervention. We discovered that in this village, with a population of 2025, there was no medical health worker and half the population had complex diseases! Their financial status was also not good. But when we interacted with these people, we felt very happy with them. They taught us the real nature of life, which is making the best of one’s circumstances.”
Stage 3: 3rd March 2019.
A mega camp was arranged at Atal Maidan, next to the proposed Prant office near the RHH campus. Two days before the camp, the MUHS officials visited MLDMHI for allotment of an office to carry out their technical work, to which the administration responded promptly. The team of MUHS officials, headed by Dr Arun Chitte, were surprised to know that MLDMHI only has a PG course despite various facilities being available.
In all, 40 residents were posted with 2 Medical Officers and 1 Homoeopathic consultant in the AYUSH OPD. More than 400 patients received Homoeopathic Rx that day.
Patients from all over Palghar district were benefitted by this camp.
The patients screened at Stage 2 were identified and were recommended for further management at tertiary care centres. These patients were transported to and from their respective PHCs / RH by government services to the camp site.
Dr S. Karthikeyan, Head, Department of Community Medicine, Rajiv Gandhi Medical College, Thane, who also has a presence at the MCI, NAAC, and MUHS, made a visit to RHH, Palghar, during the camp. He was impressed by the holistic approach towards patient-care taken up by the RHH. He appreciated the Vision and Mission statement of RHH being followed effectively.
Dr Anand Kapse, Director of RHH, was felicitated by Hon. Chief Minister of Maharashtra, Shri Devendra Fadnavis ji, for the support and motivation provided for the programme through the residents.
Gains for the Community
The WHO theme for 2019 focuses on Universal Health Coverage and this was a programme which attempted to do things in the right direction. All people and communities can use the promotive, preventive, curative, rehabilitative, and palliative health services they need, while ensuring that the use of these services does not expose the user to financial hardship.
Many patients seeking Homoeopathic treatment were referred to the RHH, Palghar, and the Bhopoli centre. Several patients then visited RHH. The programme co-ordinators and MUHS officials appreciated the work done by PG residents and had preferred MLDMHI residents over those of other colleges on other days as well.
Among the cases screened, some required surgical interventions. Many cases, especially the chronic ones, were resolved with Homoeopathic treatment.
Take-Home Lessons from the Programme
- A programme of this magnitude and public outreach needs excellent planning and execution. Bold leadership is needed for the work at the grassroots level for the objectives to get completely achieved.
- The logistics and planning with regards to stay facilities, food and water, and medical equipment and supplies needs to be done thoroughly, as at times, the absence of basic amenities can hamper the quality of clinical work carried out by the physicians.
- In developing countries like ours, the government set-ups are likely to achieve only partial fulfilment of such programmes. PG residents need to build resilience to be able to face the tough times often encountered in the field and learn to work in situations where resources are scarce.
Way forward to reach the unreached
Many such programmes can be implemented on a regular basis for the community. The government of Maharashtra, with the MUHS in collaboration, could provide funding to local trusts and NGOs to come together for this noble cause. Our RHH, Palghar, can be a place where such facilities can be provided. This will reduce the patients’ need to travel to larger cities like Mumbai for medical intervention.