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ASHA: Delivering healthcare services to ethnic tribes in Arunachal Pradesh

An organisation saving large number of lives in Anpum forested area of Arunachal

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'ASHA' workers Source: Wikimedia Commons

Anpum (Arunachal Pradesh): Washed out bridges, absence of roads and uncertainty of reaching destinations deep in the forest, do not come in the way of ASHA workers in their effort to provide precious healthcare services to ethnic tribes in Arunachal Pradesh.

Till a decade ago, un-staffed Public Health Centers (PHCs) in this corner of India often led to the deaths of two-three tribesmen of the Adi clan every week.
Poor roads and remains of washed out bridges is what the ASHA workers have to face every time here in Arunachal Pradesh while delivering the medical services. Poor roads and remains of washed out bridges is what the ASHA workers have to face every time here in Arunachal Pradesh while delivering the medical services.

But the situation started improving after the state government handed over 11 of its PHCs to the Karuna Trust, an NGO, under the public-private partnership model to ensure better health services around six years ago.

Now, the entire task of providing healthcare at the PHCs has been entrusted to the efficient hands of trained ASHA (Accredited Social Health Activist) workers. And the results are visible.
Such has the dependence on ASHA workers grown over the years, that their absence could possibly push the tribes inhabiting the Anpum forested area of Arunachal Pradesh back to what existed earlier.

Everytime ASHA worker Kenjir Perme (name changed) is tasked with immunising children in a far off village, she prepares herself to tackle the tough hurdles she has to overcome to reach her destination.

Covering miles on foot through muddy roads that pass through deep forests full of wild animals, waiting for hours to cross a river on boat, and then uncertainty of being able to return home, is what she has to confront every time.

The presence of an ambulance at the PHC meant for taking ASHA workers to their destinations hardly matters, as often unexpected downpours play foul. Once stuck in the deep muddy roads, the ASHA workers have to wait for hours before being rescued by a tractor, a rarely available transport here.

“This is a regular phenomenon here and we are quite used to it. Just because there is virtually no mode of transportation we cannot afford to ignore the health of the vulnerable tribespersons living in this forest area, and providing them medical services on time,” Perme, who is among a few ASHA workers at the Anpum PHC operated by Karuna Trust, told the visiting IANS correspondent.
Though the PHC also has two other sub-health centers, at a distance of at least 15-20 km, the task of ASHA workers remains the same — delivering health services, including immunisation and drug delivery and reproductive and child health programmes, to all the villages in the area.
Locals say the healthcare has got a new lease of life after the PHC was handed over to the Karuna Trust.
“Earlier, our people would die of minor health problems, due to lack of medical care at the PHCs. But now, we are happy at the healthcare being provided,” Robin Tayeng, a local Adi tribesperson, told IANS.
With an area of 83,743 sq km and a population of 14 lakh, Arunachal Pradesh has one of the toughest geographical terrains in India. Even today about 70 percent of its area is inaccessible and it takes days to reach from state capital Itanagar.

In the initial years Karuna Trust also received funds from the Population Foundation of India to strengthen its medical care facilities in the PHCs.

“To reach some of our PHCs one has to trek, walk on foot for miles as no roads are available. But we have trained our ASHA workers to overcome all such hurdles,” Annop Sarmah, co-ordinator for Karuna Trust NE, said.

The state’s tribal population has benefited immensely from the handing over of the PHCs to the NGO, and they are now provided with services like family planning and immunisation. Today ASHA workers under Katuna Trust ensure that all the newborns are immunised against all major diseases.
Efforts of the ASHA workers has helped bring down the Total Fertility Rate to 2.1, from a previous high of over 3.

PN Thungon, Mission Director, National Health Mission, told IANS: “The ASHA workers are our lifeline. They have made the impossible, possible. Looking at the way Karuna Trust is training its ASHA workers to disseminate health services against all odds makes us feel that we can hand over some more government PHCs to it.” (IANS)

 

1 COMMENT

  1. This is a really good initiative. The Government should also take initiatives for the upliftment of tribal people. Social Activists like Soni Sori are fighting for a good cause.

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Zimbabwe President Robert Mugabe has been named the new Goodwill Ambassador by WHO

New WHO head Tedros Adhanom Ghebreyesus praised Zimbabwe for its commitment to public health

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Robert Mugabe
President of Zimbabwe and Chairman of the African Union Robert Mugabe. Wikimedia

United Nations, October 21, 2017 : The World Health Organization (WHO) has appointed Zimbabwe President Robert Mugabe as a goodwill ambassador to help tackle non-communicable diseases.

New WHO head Tedros Adhanom Ghebreyesus praised Zimbabwe for its commitment to public health, BBC reported on Saturday.

But critics say Zimbabwe’s health care system has collapsed, with the president and many of his senior ministers going abroad for treatment.

They say that staff are often unpaid and medicines are in short supply.

Tedros, who is Ethiopian, is the first African to lead the WHO and replaced Margaret Chan, who stepped down from her 10-year post in June.

He was elected with a mandate to tackle perceived politicisation in the organisation.

The WHO head praised Zimbabwe as “a country that places universal health coverage and health promotion at the centre of its policies to provide health care to all”.

But US-based campaign group Human Rights Watch said it was an embarrassment to give the ambassador role to Mugabe given his record on human rights.

“If you look at Zimbabwe, Mugabe’s corruption, his utter mismanagement of the economy has devastated health services there,” said executive director Kenneth Roth.

“Indeed, you know, Mugabe himself travels abroad for his health care. He’s been to Singapore three times this year already. His senior officials go to South Africa for their health care.

“When you go to Zimbabwean hospitals, they lack the most basic necessities.”

The idea of hailing Mr Robert Mugabe “as any kind of example of positive contribution to health care is absolutely absurd”, he added.

President Robert Mugabe heard about the award while attending a conference held by the WHO, a UN agency, on non-communicable diseases (NCDs) in Montevideo.

He told delegates how his country had adopted several strategies to combat the challenges presented by NCDs, which the WHO says kill about 40 million people a year and include cancers, respiratory diseases and diabetes.

“Zimbabwe has developed a national NCD policy, a palliative care policy, and has engaged United Nations agencies working in the country, to assist in the development of a cervical cancer prevention and control strategy,” Mugabe was reported by the state-run Zimbabwe Herald newspaper as saying.

ALSO READ Countries with best Health Care in the world

But the President admitted that Zimbabwe was similar to other developing countries in that it was “hamstrung by a lack of adequate resources for executing programmes aimed at reducing NCDs and other health conditions afflicting the people”.

Zimbabwe’s main MDC opposition party also strongly criticised the WHO move.

“The Zimbabwe health delivery system is in a shambolic state, it is an insult,” said spokesman Obert Gutu.

“Robert Mugabe trashed our health delivery system. He and his family go outside of the country for treatment in Singapore after he allowed our public hospitals to collapse.” (IANS)

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Integrate National Plans to Eliminate TB by 2030: WHO

The WHO South East Asia Region includes India, Bangladesh, Bhutan, North Korea, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste

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India TB Outreach Work
A TB patient hopeful of being cured in India. Wikimedia

New Delhi, Sep 11, 2017: The World Health Organisation (WHO) has told the South East Asian countries to integrate their national plans and mobilise and utilise resources efficiently to reach the Tuberculosis elimination target of 2030, a statement said on Sunday.

The WHO South East Asia Region includes India, Bangladesh, Bhutan, North Korea, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste.

Also Read: Malnutrition makes children susceptible to Tuberculosis: Experts 

The global health body said that there is a need for countries to identify the package of interventions best suited to their challenges — whether that means focusing on strengthening TB services, accelerating case detection or investing in research and development.

“All countries face unique challenges, meaning they should each adapt the regional and global strategies to their context,” said a statement issued by the WHO’s South East Asia Region Office.

“We must avoid taking one-size-fits-all approach, and must instead seek out and embrace tailored solutions that meet specific needs and challenges.”

The five-day 70th Regional Committee Session of WHO South East Asia Region concluded in Male on Sunday.

According to the global health body, by planning effectively and making smart, high-impact interventions, countries across the Southeast Asia Region can lift TB’s significant burden and end the disease as a public health threat once and for all.

Although the region accounts for approximately one quarter of the world’s population, it has nearly half the number of new TB cases and close to 40 per cent of TB deaths globally.

In recognition of TB’s outsized burden, accelerating progress towards the 2030 target — which requires a 90 per cent reduction in TB deaths and 80 per cent decrease in TB incidence — is now one of WHO South-East Asia Region’s flagship priority areas of work. (IANS)

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Banning E-Cigarettes Deprives Indian Smokers of a Less Harmful Alternative: Experts

The government is allowing the sales of lethal nicotine-containing products while banning a substantially less harmful alternative

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e-cigarettes
Ban on e-cigarettes, Pixabay

Sep 02, 2017: Banning e-cigarettes may deprive Indian smokers of a substantially less harmful alternative, which can be against public health and can result in adverse consequences, experts have warned.

Some states in India, including Jammu and Kashmir, Karnataka, Punjab, Maharashtra and Kerala, have prohibited sales of e-cigarettes, while tobacco cigarettes remain legal.

According to media reports, the Union Health Ministry has recently ruled out acceptability of e-cigarettes in the light of research findings by experts who concluded that they have cancer-causing properties, are highly addictive, and do not offer a safer alternative to tobacco-based smoking products.

However, health experts argued that such decision creates a paradox. The government is allowing the sales of lethal nicotine-containing products — tobacco cigarettes — while banning a substantially less harmful alternative.

“In my opinion, banning e-cigarettes is against public health. I think it’s going to have an impending adverse consequence, because the ban will deprive Indian smokers of a substantially less harmful alternative,” Konstantinos E. Farsalinos a research fellow at the Onassis Cardiac Surgery Centre in Athens, Greece, told IANS in an interview.

Also Read: E-Cigarettes loaded with nicotine-based liquid may be as Harmful as Smoking, Says Research

“Banning is a hasty decision and can be counter-productive, because we are not aware of the extent of e-cigarette use or its harm in India,” added R.N. Sharan, Professor at North-Eastern Hill University in Shillong, Meghalaya.

An e-cigarette is a battery-operated device that uses a liquid “e-liquid” that may contain nicotine, as well as varying compositions of flavourings, propylene glycol, vegetable glycerin, and other ingredients.

In tobacco cigarette, there is combustion, a burning of an organic material, which generates temperature up to 900 degree Celsius, and thus produces all the harmful material.

Whereas, in e-cigarettes there is neither combustion nor tobacco. There is only the burning of the liquid, made up of ingredients approved for food and contains minimal burning, which is 100-1000 times lower compared to tobacco cigarette.

A study published in the journal The Lancet showed that India has 11·2 per cent of the world’s total smokers. Over 11 per cent of 6.4 million deaths worldwide was caused by smoking in 2015 and 52.2 per cent of them took place in China, India, Russia, and the US, the report said.

Further, the experts contented that banning e-cigarettes is contrary to worldwide trends.

Various studies conducted in the US, UK and other countries in the European Union, have shown that e-cigarettes have resulted in a significant decline in smoking rates.

Several countries like Switzerland, Belgium, New Zealand, Canada and the US, which were formerly advocating for bans, are now moving towards lifting the bans on e-cigarettes, Farsalinos said.

“Earlier in July, the US FDA cancelled the intended regulation saying that e-cigarettes may probably help a substantial proportion of smokers to quit smoking and switch to less harmful alternative,” Farsalinos said.

“The UK’s Royal College of Physicians recently advised the UK Government to promote the use of e-cigarettes (along with conventional nicotine replacement methods) as widely as possible as a substitute for smoking,” Farsalinos stated.

A survey of over 27,000 participants all over Europe, published in Eurobarometer in 2016, showed that more than one-third of e-cigarette users polled reported smoking cessation and reduction.

“With India being devoid of good monitoring systems and rich data of research, it should take cue from these countries. Ignoring the evidence from other countries, while the country doesn’t have much of its own, and deciding on bans, can be a bad idea,” Farsalinos said.

Importantly, e-cigarettes appear to be effective when used by smokers as an aid to quitting smoking.

The hazard to health arising from long-term vapour inhalation from the e-cigarettes is unlikely to exceed five per cent of the harm from smoking tobacco, the experts said.

“While, its not absolutely safe, it is 95 per cent less harmful than tobacco cigarette,” Farsalinos said, adding: “We don’t recommend it to a non-smoker. We always say it’s a product for smokers, and should be used as a smoking substitute.”

However, it is best to quit smoking without use of any alternative.

Farsalinos said that although marketing for e-cigarettes is essential, it needs to be done with strict regulation.

There is also an urgent need to create a competitive environment between a less harmful product and tobacco cigarette, which includes accessibility and price, the experts said. (IANS)