[COMPANY NAME]

Reported by:

ADRRN Fellowship Program INDIA

Hosted by Doctors For You (DFY) FOR

Coordination of Humanitarian Assistance (CHA)

Period: 06-25 Sept, 2015

Dr.Zarjan Zahid

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Table of Contents

Introduction ................................................................................................................................................. 1

ADRRN ....................................................................................................................................................... 2

DFY ........................................................................................................................................................ 2

CHA ....................................................................................................................................................... 3

Fellow ship program achievements ............................................................................................................. 4

Bihar state .............................................................................................................................................. 4

Maharashtra state ................................................................................................................................... 6

Jamu Kashmir ........................................................................................................................................... 7

Lesson learn ............................................................................................................................................ 8

Recommendations .................................................................................................................................. 8

Conclusion .............................................................................................................................................. 8

Acknowledgements: I would like to thank the management staff of DFY organization for coordination, cooperation and hospitality. I would also like to thank the office staff of SEEDs organization, special thanks to Mr. Mihir Joshi (Head of Department (Networks and Partnerships) for their endless support to fellowship program.

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Introduction:

Under the fellow ship program of ADRRN, CHA Afghanistan one of network members was hosted by DFY

India and I had obtained an opportunity to participate in the fellowship program from 06 – 25

September, 2015 in India.

The fellowship program was hosted by DFY to Srinagar but the plan changed due security reason to

Bihar, Maharashtra and then Jamu Kashmir states of India to exchange and build capacities through

skills, expertise, experience and innovations.

Facilitating Network ADRRN Secretariat: The Asian Disaster Reduction & Response Network (ADRRN)

is a network consists of 52 national NGOs from 20 countries

across the Asia-Pacific region. With a strong footprint in the

region, the network members are constantly engaged with

local communities strengthening their ability to combat

disasters, providing humanitarian aid like food, water,

shelter and health care, protecting critical facilities like

schools and hospitals, creating awareness, advocating for

policy changes and improving the capacity of community

based organizations. One of major activities of network is

providing learning opportunities through the exchange

the expertise and knowledge sharing among its members.

The secretariat is based at Kuala Lumpur, Malaysia.

Host organization DFY:

DOCTORS FOR YOU (DFY) formed by doctors, medical students

and like-minded people, is a humanitarian organization based in

India. Since its inception in 2007, the organization has been

working extensively with vulnerable communities in six states of

India providing efficient, effective and equitable distribution of

health care for all. So far Doctors for You has provided its

humanitarian aid and response in catastrophic event that

astounded the country like Mumbai floods 2005, Bihar floods

2008, Andhra Pradesh-Karnataka floods 2009, Orissa floods

2011, and Assam ethnic violence 2012.

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Sending organization CHA: Coordination of Humanitarian Assistance is a non-profit making, non-sectarian and non- political

humanitarian organization that was created in 1987 by a team of educated and experienced Afghan

volunteers.

CHA is a multi-sectoral organization working in Health, Education, Community development, Agriculture,

DRR and Engineering sectors. CHA has furnished and equipped field offices in 15 provinces of Afghanistan:

Kabul, Kandahar, Farah, Balkh, Herat, Helmand, Ghor, Sare-Pul, Samangan, Jawzjan, kapesa, Nanagarhar,

Parwan, Panjsher and Faryab provinces. CHA is working in various projects focused mainly in rural areas.

In addition, for the better implementation of projects and programs, CHA has established finance, logistic,

inventory, admin and human resource departments in each field offices, all mentioned departments has

its own policy and procedure and is functioning accordingly.

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Fellowship program achievements:

The fellowship program was hosted by Doctors for You (DFY) organization in Bihar, Maharashtra and

Jamu Kashmir states of India to exchange and enhance the knowledge.

To participate Fellowship Program I Arrived at Delhi at 6:00 pm on 06 September 2015 and After a night stay in Delhi, the travel plan changed to Bihar state Patna city instead of Srinagar due the security reason on that time.

Bihar state:

On 07 September at 3: 45 pm I have received to Patna city and reached to

hosted DFY organization sub office at Patna city.

Meetings and experience sharing:

1- Meeting with DFY staff: I had an introduction meeting in DFY office

with DFY staff and Budhrani charitable trust organization colleague.

In this meeting introduced and presented the CHA organization

vision, mission, core values and thematic areas with physical

locations. Experience shared regarding health and nutrition

sector programs as well as presented the basic information for

DFY organization programs and shared the information on

emergency response programs together .in addition I

participated meeting with public health executive director of

Bihar state, meeting with Goonji organization sub office in

Patna city as well.

2- Field visits: DFY had plan to establish a primary health center at MASARHI village for around

11000 population with poor access to primary health cares.

Therefore visited the MASARHI communities , meeting their community development council,

elders and house by house visits conducted for understanding real health and nutrition status of

under five children and pregnant , lactating women in that communities.

During visits cleared that the rural communities of Bihar state are the poorest don’t have adequate

access to primary health cares and outlined the below health related problems.

- The personal and environmental hygiene were worse with open defecation.

- No hand washing behavior with soap by caregivers’ and children prior to food preparation and

eating.

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- Serving foods immediately after preparation.

- Using feeding bottles were common.

- Limited access of pregnant women to sufficient quality and

quantity food including during pregnancy and lactation.

- No iron folic acid supplementation to pregnant woman and

breastfeeding mother to prevent anemia.

- Due Vitamin A and iron, folic acid deficiency among the

under-five age children and women night blind ness and anemia seen.

- The women don’t have any knowledge about importance of breastfeeding within one hour of

birth; exclusive breastfeeding for the first six months and continued breastfeeding for two

years or more.

- Complementary foods starting at 6 months of age behavior were poor.

- Several cases of malnutrition among under five children seen.

So considering to that worse situation for building the capacity of DFY Patna staff on rapid nutrition

assessment and anthropometric measurement the theory presentation and practical field test

fulfilled.

3- Presentation on Rapid nutrition assessment and practical field test: for collecting quick

information on concerned nutrition situation and risk of malnutrition among under five age children

in MUSARHI village made decision to train the DFY Patna team on the methodology how to conduct

rapid nutrition assessment. So theoretical they received training on

- Nutrition and malnutrition basic knowledge.

- MUAC measurement and detection of nutritional

bilateral oedema.

- Interpretation of the indicators and detection of

malnutrition.

- Referral system for children detected as malnourished.

- Introduction amongst community;

- Selection of households and map drawing; This includes

the use of random table;

- Conduction of individual interviews;

- Filling of the questionnaire sheets and daily reports;

- Conduction of focus group discussion if sessions are planned to be conducted during the

assessment

As well as field test conducted to evaluate the level of understanding and knowledge of the people

trained.

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Maharashtra state:

On 16 September, 2015 I have reached to hosted DFY organization main

office at Mumbai city.

Meetings and experience sharing:

1- Visit of DFY office and two health centers:

The DFY Mumbai office visited and exchanged the information on

program management. As well as two health centers based at Natwar

Parikh Compound and Lallubhai compound visited. Through these health center DFY were

providing comprehensive health cares to resettlement colonies.

Visited immunization program, general OPD, Tuberculosis OPD with sputum examination, Dental

OPD, gynecology OPD, Pharmacy, rehabilitation center and Laboratory section. Over all the

technical experience and skills together shared and discussed on importance of record and

reporting system.

2- Introducing CMAM package for treatment under five malnourished children through

community based approach:

Children with SAM are nine times more likely to die than

well-nourished children. Because of that Community

Based Management of Acute Malnutrition (CMAM)

introduced to health staff and training on outpatient

therapeutic program (OTP) conducted.

To improve knowledge and skills of DFY Mumbai staff on

identifying malnourished cases among under five years old

children and treat server acute malnourished children for

contributing the reduction of mortality and morbidity rate

in Mumbai state

Participated doctors, Nurses and management staff of DFY

Mumbai.

The training mainly focused on update and practical ways

on identifying, screening, growth monitoring and

treatment of under-five server acute malnourished

children without medical complications at community and

health facility level by providing RUTF (ready to use

therapeutic food) plumpy nut as home base ration. During

training the participatory method, both in theory and clinic

sites used. The standard CTC/CMAM curriculum defined by

valid international completely used and for learning

continuation the soft and hard copies of training materials,

handouts, reporting formats and soft copy of CMAM data base provided to participants.

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1. Jamu Kashmir state:

1- Meeting DFY Srinagar team :

On 19 September, 2015 visited DFY office at Srinagar city after

introduction we had a meeting regarding the program running

by DFY in Jamu Kashmir.

Mr. Shandeepan Ganapathy as emergency response manager for

DFY describe the projects implemented by DFY in Srinagar

particularly he shared the experience on providing primary

health care and capacity building of community in public health

emergencies. Discussed, exchanged the experience on DRR programs running by CHA and

DFY.

2- Bandi Pura district visit:

A primary health center (PHC) visited at Bandi Pura

district, set a meeting with clinic in charge, observed

the health services provided to that community.

Exchanged the information regarding health services

provision, health system as well as community

participation.

Discussed mostly on reproductive health and

immunization programs which DFY organization had

plan to support and increase the access and coverage.

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Lesson learn:

- This kind of ADRRN fellow ship programs bring the network members together toward addressing valuable development programs for further support of local communities.

- Experience exchanged on health and nutrition programs in emergencies. - Build the capacity of technical staff on CMAM. - Discussed provision of health services and report analysis for decision making and planning. -

Recommendation:

- Preparation the advance payment to fellow by sending organization recommended to be added

in LOU under sending organization responsibilities.( CHA done)

- The fellow destination plan changing by host organization recommended to fulfill in close

coordination of ADRAAN and sending organization considering the available fund.

- Multi fellows in one group from different countries would be most effective to exchange the

different skills and share the experience than one fellow from a country.

- Sharing in advance the tentative time table for fellow ship activities by host organization.

- The visited clinic centers and communities requires further support and attention as a priority

on immunization, nutrition, behavior change communication and reproductive health cares.

Conclusion:

This was a good opportunity to exchange the knowledge and experiences, enhance capacity on health and nutrition programs in emergency. I would like to thank DFY organization especially Dr.Ravikant Singh that he mad this fellow ship program very fruitful give the opportunity to conduct rapid nutrition assessment (RNA) and community based management of acute malnutrition (CMAM) trainings to DFY technical staff at Patna and Mumbai. As well this fellow ship program mad opportunity to CHA and DFY organizations to share the best practices for local communities’ development. Thanks from ADRRAN.