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Health Care Programme

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The Community Fund initiative allows the community to save money and spend it in the most effective way for the community as a whole. 35 such funds have been created. Community Health Volunteers of respective areas started collecting small amounts from the community. The total collection in the Community Fund is INR 76,705 (approximately €1,279). Regular community meetings have been conducted to increase the collection and now the communities are ready to open a bank account for safety and security of the fund.


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A total of 92 public utility units were either constructed or repaired. The units have been identified by the people, community key persons, and members of the Ward-Based Health Management Committee.

These included:

• 11 new toilets were constructed and 38 were repaired. Out of 11 new toilets, 3 were constructed by Municipal Corporation due to rigorous networking and advocacy.

• 4 public bathrooms were constructed and 2 were repaired.

• 7 drainage units were constructed and 6 units were repaired

• 5 garbage vats and 3 manhole covers were also constructed.

• 6 new water supply units were constructed and 4 units were repaired. The community oversees the work of the committees. The users contribute one rupee, which goes towards cleaning and maintenance of tube wells and latrines. Every month each committee holds a meeting and informs the partner organizations on progress. Social Workers during their field visits, also visits the units for evaluation and monitoring.


EMPOWERING COMMUNITY: ENSURING BASIC ENTITLEMENTS

HOPE empowers slum communities to be the drivers of their own change, paying particular attention to the most vulnerable sectors of society - women and children. Women face daily discrimination throughout society, often deprived of healthcare, education and nutrition compared to their male counterparts, Children are also at risk of becoming ill due to their economic and environmental surroundings, with recent figures revealing that over 46% of India’s under 5 population are malnourished. The rate in West Bengal, of which Kolkata is the capital, rises to more than 52%. There are various government schemes which address the basic human rights and needs of vulnerable citizens. However through ignorance of what assistance is available or through lack of literacy skills to enable them to understand and make application for this assistance, many slum dwellers in our project area fall between the cracks. HOPE, through this programme helps the slum-dwelling population to access those schemes. Through awareness camps the community has been provided with information on different basic entitlement schemes and the process of accessing them. Social workers also help applicants avail of these entitlements through assistance with applications and interceding on their behalf with government departments to access the benefit of these schemes.

The main categories of schemes covered include:

• Below Poverty Line (BPL) Card.

• Public Distribution System (PDS) Ration Card.

• National Health Insurance Scheme.

• State Assisted Scheme of Provident Fund for Unorganised Workers (SASPFUW)

• The Jananni Suraksha Yojana Scheme (JSY).

• Other basic documentation such as birth certificates etc. Social workers with community health volunteers( CHGs) and environment volunteers( CEGs) mobilized the community people and networked with government departments to set up 3 ICDS centers, facilitate BPL( Below Poverty Line) application of 1856, where 78 BPL cards were received, also facilitated application for 1441 ration cards out of which 910 new cards were done. 615 women received benefits of JSY (Janani Suraksha Yojna- a scheme to ensure care during pregnancy and post child birth situation of mother). Facilitated application of 1087 birth Certificates, out of which 844 birth certificates were done. These processes have empowered the community to avail mainstream services, ensure their basic rights as citizen and to improve the efficiency of the mainstream services.


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The Programme looks to improve the current and long-term health status of the local communities through the treatment and provision of medical care, ensuring access to quality care services from Government Hospitals and Ward Health Units.


Ambulances take patients to government hospitals to increase accessibility of health services and also change the behavior of the slum-dwelling population. A total of 14,516 patients have been supported through government hospitals and 4,802 patients supported through Municipal Health Units/Sub Centres. 4,908 patients have been taken to government hospitals or municipal health units by the CHVs who are having a significant impact in addressing the health concerns of their own communities.


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7,640 patients received medication from government hospitals. In most cases doctors prescribe branded medicine which they couldn’t get from hospital. 9,514 patients who were treated in a government hospital but who were unable to access prescribed medicine due to either medicine shortage in the hospital or prescription of branded medicine were provided with medication by HOPE. The organization has also produced a video magazine to inform members of the community that there is a government circular requiring hospital doctors to prescribe generic drugs to patients and that when attending a government hospital they should insist on the doctors prescribing less expensive generic drugs.


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The project has conducted a prescription audit of government hospitals which is being submitted to the health department to put pressure on the hospitals to prescribe generic medicines. This will improve the accessibility of better health care facilities from government hospitals and will also reduce the cost of treatment for poor people.

 


In the last year, a number of advocacy meetings and networking visits were held under this Community Healthcare Programme with the aim of influencing public policy to ensure that families living below the poverty-line in Kolkata received greater access to and use of quality Government services. Networking and Advocacy visits conducted in the past year can be classified in three categories:

1. Networking visits by community representatives and social workers to local municipal authorities putting forward proposals for public utility construction projects such as deep tube wells, water taps, latrines, garbage bins etc. A total of 295 visits were undertaken under this category and as a result HOPE, the Community and Municipal Authorities have together constructed latrines, water taps, garbage bins and concrete drainage facilities in many areas.

2. 5,433 networking visits and advocacy meetings were undertaken by our social workers and coordinators. These visits were made to

o Superintendant of Government Hospital,

o Councillors and Borough Chairman,

o Health Executive of Borough Health Department,

o Chief Medical Health Officer of Howrah District,

o Block Medical Health Officer of Howrah District,

o Chief Medical Officer of Health under Kolkata Municipal Corporation,

o Members of Legislative Assembly,

o Labour Commissioner,

o Labour Officers,

o Local Police Station,

o District Magistrate,

o Block Development Officers etc. These interventions resulted in better supply of medicine from government hospitals; increased supply of free medicine from government health units to poor patients; the opening of three new Integrated Child Development Services (ICDS) centres to support malnourished mothers and children under 6 years in under-provided areas, the opening of new and much-needed Directly Observed Therapy (DOT) centres for Tuberculosis patients and better supply of family planning measures.

3. A greater focus on action-based advocacy resulted in the following initiatives:

• 29 Ward Based Health Management Committees were formed

• 80 meetings were held to address different health issues and challenges faced by the staff to ensure social security and other entitlements (ration card, birth certificates, health insurance, below poverty line cards etc.) for poorly resourced people

• 12 reports to Kolkata Municipal Corporation and 12 reports to the Ministry of Health have been submitted highlighting problems faced by the poor in order to integrate population and development linkages into sub-national and sectoral policies, plans and strategies, especially to ensure that the rights of poor, disadvantaged or marginalized groups are protected. Under this project 87 cases have been filed under the Right to Information Act 2005. Very few responses have been received from government departments involved so now those cases have been filed to the first appellate authority. In many cases we are seeking pro-active disclosure of information from hospitals, police stations etc. To highlight the concerns of women, we have organized a ‘SHE is’ campaign in different pockets of Kolkata to highlight an holistic approach to the educational, nutritional and health needs of girls and young adult females. Thousands of people joined the campaign in solidarity. All the newspapers covered the campaign and one leading television channel partnered with HOPE on the campaign.


To reduce infant mortality and maternal mortality JSS project ensures full antenatal care, postnatal care, immunization of pregnant women, institutional delivery and immunization of new born child through pregnancy tracking. Individual staff visits and provides counseling support to pregnant women, husband and other family members.


847 women and infants were benefitted through JSY (Janani Suraksha Yojna) scheme and have undergone full Antenatal Care, Postnatal Care, Institutional Birth, Birth Registration and Immunization.


To reduce adolescent risk and vulnerability by increasing access to gender sensitive prevention information, skills and services JSS (Community Health care) Program focused adolescent girls, pregnant and lactating mothers due to the multi-generational nature of health. They were targeted through the awareness camps on health topics and government welfare schemes, through facilitating access to JSY and ICDS (central scheme aims to reduce maternal and infant mortality and child malnutrition) and through their involvement in the campaigns for improved government schemes, services and facilities. This year 8360 adolescent and 32998 adult females were sensitized through the awareness camps on social and health topics.


The program is targeting adolescent and adult males also through the awareness camps on social and health topics. Their inclusion is based on the often harmful practices instigated by them in Indian society including domestic violence, drug abuse, alcoholism, child marriage and child labour and their decision making power, particularly in relation to sexual and reproductive health. The program promotes the dissemination of factual information, pertinent to the above challenges, to enable informed actions and decision making by them. This year 3772 adolescent and 4493 adult males were sensitized through the awareness camps on social and health topics.


The communities with whom we work are empowered to be the drivers of their own change and take action to tackle the prominent healthcare issues arising in their own communities. Through the provision of awareness camps, awareness campaigns and CHG and CEG training programmes, the communities are trained on preventative and curative measures to prevent and halt the spread of serious health concerns.


298 awareness camps were organized on health issues throughout the year, with a participation of 30,138 individuals in total. 353 awareness camps were organized on environment issues with a participation of 19,485 individuals. These camps provided the communities with information regarding issues such as:

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• health and hygiene,

• malnutrition and home based nutritional food,

• water borne and vector borne diseases,

• pregnancy care,

• new born child care,

• exclusive breast feeding practice,

• institutional delivery,

• immunization of pregnant mothers and new born children,

• reproductive sexual health,

• family planning,

• geriatric health care,

• HIV/AIDS,

• Environment & Pollution,

• Pollution Control & Garbage Disposal

• Accessing schemes and benefits like Ration Card, Below Poverty Line People’s Card, Janani Suraksha Yojona, Birth Certificate, Voter Identity Card etc.


117 community events and campaigns were held in the communities, which gave the 11,964 people an opportunity to learn about the most pressing health concerns and methods of prevention.

Two Community Video Units (CVUs) have been formed consisting of 24 community producers; they have produced twelve news video magazines on the subjects of:

• Anti Trafficking,

• Children dropping out from school,

• Ration Card,

• Environment and pollution,

• Vocational training to fight against unemployment,

• Drug abuse,

• New born care,

• Branded and generic medicine,

• Girl child labour,

• Micro credit and self- help groups for women and how it economically empowers poor women,

• Mentally ill and homeless people and

• Problems of people staying in Port Area.


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In Hope Hospital during last year 9478 Patients were treated in OPD, total 4557 patient went for different kinds of pathological tests including blood tests, 1581 patients went for X-Ray ,535 went for E.C.G, 542 went for U.S.G, 80 went for Echocardiography and 23 went for Color Doppler . 290 Children were immunized. In Hope Hospital 622 patients were admitted and 159 patients went for surgery.
Out of all the patients received support from Hope Hospital , 236 patients were referred by the Partner Organizations of The Hope Foundation and hope’s projects, 187 patients referred by the other NGO’s, 69 patients were referred by the Hope’s volunteers, and 132 patients were referred by other sources to the Hope Hospital.

During last year 3 patients were rehabilitated to Missionaries of Charity (Premdan & Dayadaan and Asansol, Bardwan District, West Bengal) after treatment in Hope Hospital who was transferred from M. R. Bangur Hospital to Hope Hospital by Hope Volunteer, Ireland as they were left unattended and uncared by the Hospital.

Hope Hospital has established links with different organizations which visited the hospital and a fruitful discussion on future partnership has been held with an USA based NGO named Calcutta Kids. Mutual sharing of facilities allows more complete care and rehabilitation of the poor patients who are homeless.


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Hope Hospital has made a tie up with St. Peter Church Nursing Training Institution under Diocese of Calcutta, who is sending their students in Hope Hospital for practical training. In this process we are getting some extra nursing hands in free of cost. After their practical training for six months in Hope Hospital we will give them a certificate so that they can get jobs in other Hospital.
Hope Hospital has created a link with an NGO named Inter religious Centre of Development. Mutual sharing of facilities allows more complete care and rehabilitation of the poor patient who are homeless. This organization has given a shelter of five boys & girls who were in Crisis Intervention Centre of Hope Foundation. One boy from this organization is now getting treatment in Hope Hospital.

Hope foundation while addressing the overall health aspect of the community( in slums of Kolkata and Howrah) from under privileged area, the need for addressing mental health aspect were also emerged . While addressing that ‘The hope foundation’ decided to start with address 2 most vulnerable sections of people, among them a section of ‘homeless mentally ill’( HMI) patient who found maximum neglected and deprived from basic treatment and care, and those children specially girls who comes under child in need care and protection and are highly traumatised (CNCP), compelled to spend their quality time of their life within shelter home, - though they are not literally mentally ill, their trauma and other forms life experiences make them susceptible to express various kinds of behavior which in reality found abnormal and require psychosocial intervention or counseling or other forms of care to ensure successful rehabilitation.

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HOPE supports the project named ‘NAYA DAUR’, which aims to identify the patients who are homeless mentally ill, categorizing them according to their mental/physical health status and providing appropriate care and treatment. It has also sought to restore patients back into their homes of origin or provided shelter through its referral network. The project activities have been also geared to spreading awareness in the community and raising the involvement of stakeholders for the cause of the homeless mentally ill. The intervention areas has been restricted under Kolkata municipal corporation i.e. Tollyganj, Lake adjoining areas, Khiddirpore, Wattgunj, Hestings, Dhakuria, Rajabazar, Majherhaat, Sealdah, Keoratola, Beniapukur,- The intervention also aims to develop various innovative models of rehabilitation through vocational training and to prepare patients for resettlement which would include family and community psycho-education about the concept of psychiatric rehabilitation and resettlement.

In this year 2012-13, medical team visited the patients in the abovementioned communities for 134 times. A total of 112 new homeless mentally ill patients have been identified and total 701 check-ups done by doctor in the respective communities. A total of 711 community volunteers have given their feedback on the improvement status of the Homeless mentally ill (HMI) patients. 7 HMI patients have been restored to their families and 5 HMI patients has been rehabilitated in different organization. 78 HMI patients have been engaged in sustained employment in Tea stalls, Dhaba, Hotels, Grocery shops etc. in the above mentioned project areas. 112 patients have referred to the hospital and out of which 108 patients have referred to Govt. Hospital and 4 patients referred to the Private Hospitals. During this year 832 nutrition support has been provided to the HMI patients in the community and as good nutrition, 749 times counseling support was provided to the Homeless Mentally Ill patients in the respective community by the Counselor. 526 nos. of clothing has been provided to the HMI patients and 948 nos. of hygiene support have been provided to the HMI patients. This year 1 advocacy meeting has been organized with Ms. Mita Banerjee, Disability Commissioner, Government of West Bengal, Mr. Sachchidananda Sarkar, Deputy Secretary, Department of Health, Govt. of West Bengal, Mr. Prakash Upadhya, Councillor, ward no.29 , Kolkata Corporation, Ms. Sushmita Bhowmik, Assistant Super, Barasat Government Hospital on 25th April, 2012 on “Disability benefits for the mentally ill”. One Psychiatric Health Check-up camp was organized with the initiative of community people of Watgunge area on 23rd January’13. 22 patients received hygiene care, food and health check-ups. Dr. Abhiruchi Chatterjee, Dr. Ranadip Ranjan Ghosh Roy, Dr. Mamimohan Bhattacharya were present in the camp. Total 24 awareness Camps organized in the communities, schools, colleges. 733 participants from the community have participated in the Awareness camps. The activities of Iswar sankalpa on mental health in the community and Procedure to reach patients in the community and provides treat service has been discussed, the difference between ‘Mental Health’ and ‘Mental Illness’ , its Causes, Facilities available at govt. hospitals for mentally ill patients were shared and explained. Role of community people, students, i.e. how they can contribute in providing care and support to the homeless mentally ill person were discussed.

Dance Therapy or Dance Movement Therapy (DMT) is the psychotherapeutic use of movement and dance for emotional, cognitive, social, behavioral and physical conditions. As a form of expressive therapy, DMT is founded on the basis that movement and emotion are directly related. The ultimate purpose of DMT is to find a healthy balance and sense of wholeness.


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The Juvenile Justice Board through the Children’s Welfare Committee have been sending lost, stray, abandoned children through the court to All Bengal women’s union’s shelter home. Many of these children suffer from severe trauma, a substantial number are mentally challenged while several require psychiatric treatment. This growing number of children was not in a position of traditional counselling. They do not have the ability to understand or benefit from Counselor’s talking to them as they lack the ability to reason. Therefore some alternative support has to be provided. Experts decided that non-traditional forms of counselling must be provided for such children. Dance therapy is a method to counsel the special children who are unable to follow the regular counselling.Dance therapy is an alternative method of therapy for counselling of such children who were not able to express their difficulties nor able to follow the advice of the counsellors and caregivers. The therapy aims to help them gain confidence to be able to interact with other residents of the Home and elsewhere on an equal plane.The project aims to use dance movement for expression, build confidence and as therapy, Advocacy through performance. Facilitate the integration of the vulnerable sections with the main stream society and Improve leadership skills among the girls.


In the year 2012-13 a total of 70 Dance Therapy classes were held. Initially the focus was on learning different manners of dancing, improvement of balance, fun dance, and free dance etc – all these activities being followed by discussions on how the sessions were enjoyed. At a later stage focus was on expressions of different emotions through walking, theme based improvisation, activity on movements by using Indian percussion – to enable the participants to develop their energy level. In the third and fourth quarters focus was on training of trainers.2 girls of Dance Therapy Project participated in a programme in Asansole, Bardwan District, West Bengal under the guidance of renowned performing artist Pandit Tanmoy Bose. Beneficiaries of Dance Therapy Classes have been facilitated with an exposure visit to ‘Darpana Performing Arts Academy’, Ahmedabad, during the month September’12. 7 girls were enrolled for the ‘Kolkata Sanved’ Training of Trainer (TOT) program on 2013.Six girls from Dance therapy classes have been selected as trainer.