Karuna-Shechen Report 3rd trimester 2013

1 | P a g e

THIRD QUARTERLY REPORT

JULY-SPETEMBER, 2013

2 | P a g e

CONTENTS CONTENTS

PAGE NUMBERAPAPGEER

Main Activities and Achievements 3

Introduction 4

Health

An Overview of Medical Activities 5 Access to Primary Healthcare in Urban Area: Shechen

Medical Centre in Bodhgaya, Bihar 12

Mobile Clinics 17

Malnutrition 20

Health Education Program (HEP) 21

Education

Strengthening Basic Education 25

Non-Formal Education (NFE) 26

Vocational Training for Women 28

Environment

Bodhgaya Clean Environment, Hygiene and Sanitation Program

30

Solar Electricity 31

Social Small Money Big Change 33

Kitchen Garden 35

Computer Course-Vocational Training for the Youth 38

Networking with other NGOs 39

Other Important Informations

Finances 40

Upcoming Activities 41

Our Partners 41

Annex

Case Study I 42

Case Study II 43

3 | P a g e

MAIN ACTIVITIES & ACHIEVEMENTS

HEALTH

Total number of consultants in OPD (Outreach Patients Department) and Mobile

Clinics was 13,868, where number of new consultants was 5607.

The second phase of the Malnutrition Baseline Surevy was conducted in our 6 new

villages.

The number of Sanitary napkin packets sold was 3459.

The Shechen clinic is now open on all seven days of the week.

2 medical officers including a lady doctor have been recruited

EDUCATION

Bright and enthusiastic woman was recruited as support faculty for the school in

Gopalkhera.

Yoga and fitness training was conducted in schools of 9 villages.

Several PTA meetings were held in Dema, Gopalkhera and Chando.

Vocational training commenced with 3 workshops where our NFE students

participated.

Computer training courses were started within the premises of the Shechen clinic,

Bodhgaya.

ENVIRONMENT

Four freshly graduated students of Magadh University were hired an interns to

conduct surveys and organize awareness campaigns in relation to the Bodhgaya Clean

Environment, Hygiene and Sanitation Program

SOCIAL

The small money Big Change program was extended to Gopalkhera and Banahi

A new program, Kitchen Gardening, was launched in the outreach areas.

4 | P a g e

The third quarter of 2013 can be deemed to be more successful than the last two

quarters as the total number of consultants at the Shechen clinic in Bodhgaya and at the

Mobile clinics in our 18 adopted villages registered the highest number in comparison

to the first six months of the year. Also, the currently running programs are progressing

steadily, despite the monsoons which make roads to the remote villages almost

inaccessible and the construction work in the outreach areas extremely difficult and

tardy. The third quarter saw the commencement of our Vocational training program

including the Computer course for the poor and marginalised youth and Kitchen

Gardening. Other new activities include the DOTs training and refresher, apart from the

Green Schools Program training at the Centre for Science and Environment, New Delhi.

In a nutshell, this quarter was full of currently running and new activities and was

therefore, quite eventful.

In the following sections of the report we will see the progress of programs under each

of our four areas of intervention:

AREAS OF INTERVENTION

HEALTH

ENVIRONMENT

SOCIAL

EDUCATION

INTRODUCTION INTRODUCTION

5 | P a g e

AN OVERVIEW OF MEDICAL ACTIVITIES

OPD and Mobile Clinics

In the third quarter of 2013, the total number of Consultants who availed the healthcare services of our OPD (Outreach Patients Department) in Bodhgaya and Mobile Clinic in 18 villages was 13,868, wherein new consultants constituted 5607 people (40.43% of total number of consultants).

Table 1: Total Number of Consultants at OPD and Mobile Clinics

Months OPD Mobile Clinics

July 1851 2572

August 1904 2311

September 2218 3012

Total 5973 7895

The third quarter of 2013 has registered the highest number of consultants (13,868) in comparison with the first and second quarters where total number of consultants at OPD (Outreach Patients Department) and Mobile clinics were 7358 and 8152 respectively. This was partly due to the fact that during the monsoons people are susceptible to water-borne and other diseases. The increase in the number of consultants at mobile clinics (7895 consultants compared to 3524 and 4390 in first and second quarters respectively) shows the increasing awareness among the people in and around the new villages and their growing confidence in our services.

The number of patients refered to PHC & Government Hospitals was 82 ( 0.59% of total consultants at OPD and Mobile Clinics ).

The total patients who were treated “Free of Cost” (Pregnant women, children and aged people above 60 years) in the OPD Clinic and by our Doctors were 8724 ( 62.91% of total consultants).

The third quarter has registered 70.12% higher consultants than the second quarter.

HEALTH

6 | P a g e

Table 2: Total Number of Patients Referred to PHC and Government

Hospitals

Month OPD Mobile Clinics

July 4 14

August 19 17

September 16 12

Total 39 43

July August September

1851 1904 2218

2572 2311

3012

Total Number of Consultants at OPD and Mobile Clinics

OPD MOBILE


4

19 16

14 17

12

Total Number of Refer Patients at OPD and Mobile Clinics

OPD MOBILE

7 | P a g e

Table 3: Total Money Collected from Registration Charges


July 22980 16480 August 24020 14645

September 27305 18115 Total 74305 49,240

Direct Observed Therapy (DOT)

TB patient at DOT centre in Shechen Clinic DOT services in villages

8 | P a g e

Out of 1677 medical tests conducted in our pathology laboratory 128 were Sputum tests

(for Tuberculosis). Out of these the number of people who were diagnosed with TB was

9. Currently, the total number of TB patients undergoing treatment is 35.

Table 4: Details of DOT Program

July August September Total

Number of TB patient’s started medicine 7 5 10 22 Number of sputum tests conducted 34 38 56 128 Sputum Positive 2 3 4 9 Refer TB Patients 0 0 2 2 Completed TB Medicine 5 3 3 11 Total Number of TB Patients currently undergoing treatment (OPD and Mobile) 27 28 35 35

DOTs Training

After receiving proper DOTs training our efficient pathology laboratory technicians and village

motivators have been successfully running the DOTS program at the clinic in Bodhgaya and in

the villages respectively. With the inclusion of 6 new villages under the ambit of our

organisation early this year there was a need to provide DOTS training to the freshly recruited

motivators of these villages. With the twin objective of extending the success of our DOTS

program to the new villages and reducing the burden of our lab technicians at the OPD we

organised a one-day DOTS training in Bodhgaya on 26th July for village motivators, village

coordinators, doctors, nurses, laboratory technicians, a senior pathologist, research and

documentation officer and receptionist. This training not only served to teach those who had no

prior training in DOTS but also acted as a refresher for those actively involved with our DOTS

9 | P a g e

program. The training was given by the District TB Officer (DTO) and an eminent team of

members from RNTCP and Primary Health Centre (PHC).

Meeting with TB patients

TB Patients who attended the meeting

We conducted a meeting with the people who have been cured of TB through their treatment at

our DOT centre and those on their way to recovery as we are planning to invest the money

received as registration charges in the amelioration of livelihood opportunities of the TB

patients. As this disease leaves a person weakened and fragile, leading to loss of several days of

work hampering their socio-economic lives we realise that curing them is only a part of bringing

them to normalcy. Therefore, in order to help them restore their socio-economic loss we

envisage providing them with some start-up capital and other possible assistance to ensure

them better lives. At the meeting we discussed our plans with the TB patients, seeking their

opinion and feedback.

Types of Diseases observed among Patients in OPD and Mobile Clinics

The following table gives us information about the various types of diseases observed

among the patients in our OPD and Mobile clinics.

10 | P a g e

Table 5 : Types of Diseases

The table and graph show that the most common health problems observed among our OPD and Mobile clinic patients were Bone and Joint problems, cough and cold, skin diseases and ENT.

Identity Cards for Medical Consultants

In order to keep track of the medical history of each patient identity cards are issued to every individual seeking medical help from us. These cards cost a mere INR 5 and have to be brought along in every visit to the OPD or Mobile clinics. The total number of identity cards issued in this quarter is 5037 which is 52.64% higher than the total number (3300) issued in second quarter.

Types of Diseases

Total

Diarrohea/children 15

Diarrhoea / dysentery adults 517

Amoebiasis 324 Typhoid 176

TB 329

Gynecological patient 849

Bone & joints patients 3411

Burn patient 204 Worm manifestation 10

Skin diseases of all kinds 1660

Ophthalmologic infections 100

Number of identify malnourished children 0

Cardiac Infection 45

HTN 699

Diabetes 131 Asthma & COPD 754

Cough & Cold 3560

Epilepsy 168

ENT patient 1590

Lymphadenopathy 25 I&D Dressing 244

Other Patients 3146

Total 17,957

11 | P a g e

Table 6: Number of Identity Cards Issued to Consultants at OPD and Mobile Clinics


July 848 857

August 865 773

September 893 801

Total 2606 2431

The number of identity cards issued in this quarter (5037) is much higher than the previous quarter (3300)

Appointment of Two New Medical Officers including a Lady Doctor

In the third quarter we hired two new medical officers including a young and dedicated lady doctor.

12 | P a g e

ACCESS TO PRIMARY HEALTHCARE IN URBAN AREA: SHECHEN MEDICAL

CENTRE IN BODHGAYA, BIHAR

13 | P a g e

Outreach Patients Department (OPD)

The total number of people who came to the Medical centre in Bodhgaya for Consultations in the third quarter of 2013 was 5973. Out of this total 2646 were new consultants, representing 44.30% of total consultations in OPD. The number of patients at OPD in the third quarter is 58.77% higher than in the second quarter.

Table 7 : Details of Consultants at OPD

OPD July August September Total

Total Number of Consultants 1851 1904 2218 5973

Total Number of New Consultants 858 881 907 2646

Men 482 501 591 1574

Women 821 878 1028 2727

Children 548 525 599 1672

The above table and graph show that the total number of consultants have increased steadily from July to September. The growing number of patients can be attributed to the monsoon season when people are, in general, susceptible to water-borne and other


1851 1904 2218

858 881 907

Consultants at OPD

Total Number of Consultants Total Number of New Consultants

14 | P a g e

diseases. Again, September being the festive season records the highest number of patients in this quarter.

From the above graphs we can see that women and children form majority of the consultants at OPD (72%).

OPD is now open on Sundays

In lieu of the growing demand for our healthcare services our OPD is now open on all

seven days of the week. All the concerned staff members render service on Sundays on a

rotational basis. The Saturday prior to one’s working Sunday is his/her day off.


482 501

591 821 878

1028

548 525 599

Number of Men, Women and Children at OPD

Men Women Children

Men 26%

Women 46%

Children 28%

Percentage of Men, Women and Children at OPD

15 | P a g e

Pathological Laboratory

ECG conducted at Shechen Clinic

Blood test at the Pathology Laboratory

16 | P a g e

Total number of patients who came in the third quarter of 2013 (July-September) for

different medical tests were 547 and total anaysis done was 1677. The number of

patients and tests are different because one patient may go for several tests. Total

amount spent from Poor Patient’s Fund for patient’s medical tests was INR 32349. Total

money collected from these tests was INR 18675.

Table 8: Types of Medical Tests Conducted

The table and graph show that the highest number of medical tests conducted are

TC/DC, ESR, HB% and Blood Sugar.

260 259

186

30

128

18

93 37

347

Medical Tests

Medical Tests Number of Tests

TC/DC 319

ESR 260

HB% 259

Blood Sugar 186

Serum Blirubin 30

AFB (Sputum test) 128

ECG 18

Urine routine examination 93

Urine culture sensitivity test 37

Other Tests 347

Total 1677

17 | P a g e

MOBILE CLINICS

18 | P a g e

With the expansion of our outreach activities to 6 new villages in the first quarter

services of our Mobile Clinic was also extended.

In the third quarter of 2013 (July-September), the number of patients who came for the consultations in mobile clinic from 18 village was 7895, out of which 2961 were new patients representing 37.50 % .

4162 consultants from 189 satellites villages around our 18 adopted villages who sought medical help from our mobile clinic services.

The total patients who were treated for Free of Registration Charge (Pregnant women, children and aged people above 60 years) in the Mobile Clinic was 5829 (73.83% of the total consultants at mobile clinics).

The total number of consultants at the mobiel clinic has increased by 79.84% from the last quarter.

Table 9 : Details of Consultants going to Mobile Clinics

Mobile Clinic July August September Total

Total Number of Consultants

2572 2311 3012 7895

Total Number of New Consultants

1040 853 1068 2961

Men 566 564 721 1851

Women 1256 1149 1436 3841

Children 750 598 855 2203


2572 2311

3012

1040 853

1068

Consultants at Mobile Clinics

Total Number of Consultants Total Number of New Consultants

19 | P a g e

We can see that, as in the OPD, at the mobile clinics too the maximum number of

patients registered was in the month of September, the primary reason being it the

month of festivals. Again, as mentioned earlier, the number of patients are much higher

than in the previous quarter due to the high prevalence of seasonal diseases during the

monsoons.

Women and children constitute 72% of the total consultants at Mobile clinics, which is similar to

the trend in last quarter where they formed more than 70% of consultants at both OPD and

mobile clinics.


566 564

721

1256 1149

1436

750

598

855

Number of men, Women and Children at Mobile Clinics

Men Women Children

Men 23%

Women 49%

Children 28%

Percentage of Men, Women and Children at Mobile Clinics

20 | P a g e

MALNUTRITION

The second round of MUAC measurements

With intensive training forming the foundation of our Malnutrition program the nutrition team soon started the first phase of the baseline survey in the 6 new villages, using Middle Upper Arm Circumference (MUAC), universally recognised as a standard tool for measuring malnutrition, to

measure children up to 5 years of age. As acute malnutrition is seasonal in nature the baseline survey was conducted in two phases to get a clear picture of the prevalence and intensity of the problem; the first phase was conducted in February, the time of the year when food shortage does not usually take place and so chances of finding severe acute malnutrition is much less. Besides, this was the only time that the Consultant, Dr. Nadine Donnet, could give for such survey. The second phase was conducted through this quarter (July-September) during the monsoons when people, especially children are susceptible to water-borne and other diseases. It is also the season of food scarcity. Thus the second phase of the baseline study gives us an accurate figure of the rate of Severe and Moderate Acute Malnourished children in the chosen villages. During the second phase children found with MUAC> 12.5 cm and those absent during the first phase of the survey were measured.

21 | P a g e

HEALTH EDUCATION PROGRAM

Health Education Program (HEP), which was introduced in our 12 villages in 2010,

continues to run smoothly. Currently there are 87 health groups with 534 members

under HEP.

Table 10: Some Important Data on HEP

Total

Total Number of Home Visits by Village Coordinators 539

Total Number of Home Visits by Motivators 1558 No. of People who Received the Message regarding Health & Hygiene

1397

Number of trainings/group follow-ups on HEP given by Village Coordinators 73

Total Number if Health Group Meetings by Village Motivators 172 Total Number of Hand Pump Committees 63

Total Number of Functional Hand Pump Committees 48

Number of Hand Pump Meetings held by Village Coordinators 39

Number of Hand pumps Repaired 15

Table 11: Some Important Data on Reproductive and Child Health (RCH)

Indicators Total

RCH Meeting By Village Coordinators 42

RCH Meeting By Motivators 181

Total Pregnant Woman 142

Number of New Pregnant Women Identified 88

Total Number of Pregnant Women who have taken T.T.1 48



Total Number of New Born Children 64

Number of Child Deliveries at PHC 35

Number of Child Deliveries at Home 29

New Born Children Immunized 47

Other Children Immunized 672

Total Number of Sanitary Napkins Sold (at OPD and in the Villages) 3459

22 | P a g e

A great achievement in this quarter is that 73.44% of the total new-born children have

been immunised compared to 63.79% in the Second quarter. Again, more than half of

the total Child Deliveries (54.69%) in this quarter have taken place at the PHCs which

shows that RCH program has been successful in creating awareness amongst the target

population about the health hazards and risks involved in the traditional practice of

child deliveries at home by midwives. A huge achievement in the RCH program is that

related to Menstrual Hygiene and Sanitation where 3459 napkins have been sold in this

quarter compared to 607 in the last quarter (a 470% increase in this quarter compared

to the last one). These achievements illustrate the success of our incessant efforts to

sensitise the target population on health and hygiene, including reproductive and child

health.

Menstrual Health and Hygiene

A woman with packets of sanitary napkins Our Community Health Worker with rural women

Menstrual Hygiene is one of the most important yet neglected health issues in our

society. It has remained a taboo subject, surrounded by silence and shame that restrict

mobility and access to normal activities and services. As women and girls make up more

than 70% of our healthcare consultants it becomes imperative for us, as an organisation

pledged to provide all possible quality healthcare services to the underserved

populations, to pay special attention to their menstrual health issues.

Our Menstrual Health and Hygiene program, which took off in June this year, intends to

tackle the problem at two levels; providing the rural women with appropriate materials

23 | P a g e

to enable proper management of the menses by distributing good quality sanitary

napkins at minimum possible prices to the rural women and girls who are otherwise

denied access to the same. Secondly, the program attempts to address the issue through

awareness creation of the target population by imparting education about hygienic

practices related to periods and the safe disposal of sanitary pads, and encouraging

women and girls to voice their problem and queries regarding the same.

Table 12 : Number of Sanitary Napkin Packets sold

Month OPD Mobile Clinics & Motivators

Total

July 167 1910 2077

Aug 204 784 988

Sep 72 322 394

Total 443 3016 3459

The above table and graph show that the total number of sanitary napkins sold in the

villages is much higher than in the OPD for all 3 months (July-September). This is

primarily on account of the fact that in the villages both the mobile clinic team and

village motivators act as distributors of sanitary napkins, while at the OPD the medical

nurses are the sole distributors. The motivators being part of the communities where

they work it is easier for the women to buy sanitary napkins as and when required,

instead of having to wait for the mobile clinics to come. A reason for the huge number of

napkins (1910) sold in the villages in July and then the gradual decline in the next two

months clearly highlights the need for awareness and education on target issues. In the

July Aug Sep

167 204 72

1910

784

322

Total Number of Sanitary Napkin Packets Sold

OPD Mobile Clinics & Motivators

24 | P a g e

months of June and July one of our staff members, a nurse cum community health

worker conducted regular meetings with the women and girls of all the 18 villages,

discussing menstrual health and other related issues. However, August onwards it was

not possible to hold such meetings very frequently as she became involved with the

second round of Baseline Survey for our upcoming Malnutrition program. This vividly

brings out the vital need for constant discussions and information sharing on problems

which are otherwise considered as social taboos and hence neglected.

25 | P a g e

STRENGTHENING BASIC EDUCATION

The education scenario in Bihar is very grim. The State needs nearly twice the number

of teachers currently in service to achieve the national pupil teacher ratio (PTR) and the

RTE (right to education) norm of 30:1. Around 60,000 schools in the state do not have a

permanent campus and less than 3% of the school management committees (SMCs) are

actively involved in planning and development work. Through our new program,

‘Strengthening Basic Education’ we attempt to ameliorate the basic educational

standards in Bihar and provide a joyful learning environment.

Last quarter a Parent-Teacher Association (PTA) was formed in Dema village. By the

end of this quarter PTAs have been formed and Parent-Teacher Meetings conducted in

three villages; Chando (1 meeting), Gopalkhera (2 meetings) and Dema (3 meetings).

A Yoga trainer, hired to teach physical and breathing exercises to school children, had

started fitness classes in 3 villages namely, Chando, Dema and Bandha in the last

quarter. By the third quarter 9 villages were covered.

Table 13 : Number of Students taught Yoga in the Villages

Serial Number Village Number of Students attending Yoga classes

1 Dema 150

2 Gopalkhera 200

3 Sirpur 80

4 Mansidih 110

5 Bandha 105

6 Nawatari 65

7 J.P. Nagar 60

8 Chando 100

9 Kharati 80

EDUCATION

26 | P a g e

While in the last quarter a support faculty had been provided to the government school in Dema village, this quarter we have been successful in providing a well-educated and enthusiastic support faculty to the school at Gopalkhera village. Besides, our motivator at Banahi has started conducting informal education for children in the 6-10 years age-group who are not enrolled in schools. Apart from the above initiatives, we continue to supply Teaching-Learning Materials (TLM) to schools in an effort to fulfil the basic requirements of teachers and students and help improve the education standards in rural schools.

NON-FORMAL EDUCATION (NFE)

27 | P a g e

Our NFE program, which was scaled up from 6 villages in 2011 to 16 villages in April, this year continues to run successfully with satisfactory 62.84% regular attendance as can be seen from the table below.

Table 14 : NFE Students Enrollment and Average Attendance

Although when the program was scaled-up in April 488 women had enrolled

themselves for NFE classes, in this quarter the number has slipped to 444. Factors, such

as disapproval of husband/family members and lack of time during Harvest season,

account for this decline. The high 63% average attendance shows the sincerity and

interest of the students towards NFE classes.

VILLAGE NUMBER OF STUDENTS

ENROLLED FOR NFE

AVERAGE ATTENDANCE IN

NFE CLASSES

Banahi 30 20 Dema 30 22

Gopalkhera 30 18 Lohjara 30 16 Bandha 32 20

Nawatari 32 22 Mansidih 31 12

Sripur 30 14 Mastibar 25 20 J.P.Nagar 28 15 Kharati 18 15 Karhara 60 44

Trilokapur 21 10 Bhupnagar 25 16

Kadal 22 15

Total 444 279

28 | P a g e

VOCATIONAL TRAINING FOR WOMEN

29 | P a g e

Recognising the vital role acquisition of new skills can play towards income generation and poverty alleviation, we have introduced Vocational Training as a component of our Non-Formal Education (NFE) program. As the first major step towards our Vocational Training program we conducted, in the month of July, 3 workshops spanning 7 days. A proficient vocational trainer from Jamshedpur, Jharkhand was appointed for the purpose. The workshops were attended by students from our 18 NFE centres. All our village motivators and some staff from Shechen clinic (Bodhgaya) also participated in the same. In each workshop the participants got the opportunity to learn 2 types of vocations; incense sticks and candles, 2 popular snacks, and phenyl and chalk. The vocations were selected on the basis of their market demand, income-earning capabilities and interests of the NFE students. While 2 workshops were held in Bodhgaya the third was organised in one of our new

villages, Chando. The travelling, food and lodging expenses of the participants was

borne by our organisation.

All 3 workshops were very successful in terms of the participant turnout and their

satisfaction in being able to learn some useful livelihood skills. The enthusiasm of the

participants can be gauged from the fact that the one-day workshop on candle and

incense sticks making had to be extended to an extra day as 90 participants, against the

anticipated 40, turned up for it.

As the second step seven participants from the candle and incense stick making

workshop were chosen on the basis of their ability to produce what they had leant, and

sent to Jamshedpur, in August, for a week-long intensive advanced training.

30 | P a g e

BODHGAYA CLEAN ENVIRONMENT HYGIENE AND SANITATION PROGRAM

These are two of the few food covers that we have chosen for distributing to the street vendors

In order to conduct survey among the locals, tourists and street vendors and to spread

awareness regarding the importance of cleanliness and hygiene among the people we

have hired four bright and enthusiastic youths as interns from the Department of Rural

Development and Management of the esteemed Magadh University.

Besides, we have conducted an extensive search and market survey on the types of

covers that can be used by the street vendors for covering the food from the dust and

germs by the roadside while it is on display. We have selected a few types of covers and

will finalise which ones to order only after we have received the feedback and

responses of all street vendors in Bodhgaya regarding the same.

As the first step towards creating awareness regarding clean environment, sanitation

and hygiene among school students so as to make them responsible citizens of the

nation, three of the staff members (the Director, a Village Coordinator and the Research

and Documentation Officer) attended a 2-day intensive training program (Green

Schools Program) at the Centre for Science and Environment (CSE), New Delhi. We

envisage conducting the Green Schools Program in collaboration with CSE at the schools

in our 18 villages and those in Bodhgaya town.

ENVIRONMENT

31 | P a g e

Green Schools Program training at the Centre for Science and Environment, New Delhi

SOLAR ELECTRICITY

In the last quarter we had sent four women from our villages to the Barefoot College,

Tilonia, Rajasthan to attain 6 months training in Solar Engineering. However, one

woman had to return to her village in the middle of the trainingdue to family reasons.

While these women prepare to be Solar Engineers we studied, analysed and evaluated

the data collected from the survey that was conducted in the villages of J.P. Nagar,

Banahi, Kharati (where our Solar Electricity program is running), Chando, Barsuddi and

Kadal (where the program will start soon) to evaluate the impact of the existing solar

program and to understand the feasibility of the program in the new villages.

The ‘Socio-economic Impact Assessment and Feasibility of Solar Home Lighting Systems

in Gaya District of Bihar’ Report was prepared by an economist Dr. Amit K. Bhandari of

the esteemed Kalyani Institute of Applied Research, Training and Development. The

following key findings were observed:

Around 97.6 per cent respondents have expressed their willingness to use

solar lighting and are willing to pay around Rs. 1,700 during the time of

installation that is 70% higher than the current price paid by the households.

32 | P a g e

Majority of the households are not paying installments at regular intervals,

while some households haven’t paid any monthly installments at all. This

raised question mark regarding preferred mechanism for solar energy.

Per capital income of the respondents is higher for those who haven’t

installed solar lighting system, which in turn indicate money is not a

constraint for installing solar power.

Household with solar lighting installed enjoys better quality of life compared

to those without it.

Variables that have found to have significant impact on willingness to pay for

solar lighting are per capital household income, per capital energy

consumption, type of house and holding saving bank account.

Parents are willing to spend more on home lighting system whose children

performed satisfactory in their study. However, there is no reflection in

education performance between household with or without solar lighting.

No significant difference is found in amount willing to pay between

household with school going children and without. However, students

performing better in study, parents willing to spend more on solar lighting

system for their study.

The empirical study found that people from rural villages from are ready to pay more

than the current installation price of solar lighting system. Regarding preferred mode of

payment for solar photovoltaic systems, contrary to popular belief monthly payment

system should be abolished for better penetration of solar energy. Villagers from

financially well off households, better educated, higher energy consumption per month

and have access to financial services are the important determining factors for

willingness to invest for solar home lighting system. The study also reveals that there is

an improvement in quality of life for the people living in remote villages through the

spread of solar energy. Further expansion of solar energy can be adopted in order to

achieve universal access to energy to rural non electrified areas.

33 | P a g e

SMALL MONEY BIG CHANGE

Land levelling in the agricultural fields at Chando

Work in progress at Kadal

SOCIAL

34 | P a g e

Bathroom for women being constructed at Kadal Bathroom and well completed

Land levelling in front of Chando school

Under the ‘small money Big Change’ program we had started working in three villages,

namely Chando, Barsuddi and Kadal from June this year. In this quarter the program

was extended to two more villages, Gopalkhera and Banahi.

In Gopalkhera an existing check dam, which had been broken and had remained

dysfunctional for long, was successfully repaired. This has enabled rainwater to flow

straight into the village pond which will not only allow the villagers to perform their

daily activities but also provide water for the agricultural fields, increasing crop

productivity and consequently improving the villagers’ livelihoods.

A small pond is being dug in Banahi village. Due to the monsoons work had to be stalled

as it was not possible to continue due to bad and erratic weather conditions. Of the total

35 | P a g e

8 ft depth to be dug, 3 has been done and 5ft will be completed soon after the monsoon

is over.

The work of land levelling continues in Chando where the agricultural field of 15

villagers has already been levelled which will make crop sowing and crop management

much easier and also considerably increase the yield and quality.

Again, in Chando government school, the school filed which was uneven and hence

could not be used for playing outdoor sports has been levelled and can now be used as a

playground.

At Kadal, the well whose repair work had started in June was completed at the

beginning of this quarter. Next the construction of a bathroom for the women of the

village and the digging of the nearby pond began. The bathroom is now complete and

the digging of the pond has also progressed well with not much left to be done.

The construction of the check dam in Barsuddi, which had begun in the previous

quarter had to be stalled due to the bad weather. The work will resume as soon as

monsoon is over.

This quarter saw the ‘small money Big Change’ program cover two more villages in

addition to the initial three. While the work in most villages progressed smoothly it was

a bit tardy as we had no option but to slow down or stall our work in certain places due

to the erratic monsoon pattern unlike other years.

KITCHEN GARDEN

36 | P a g e

Looking at the abysmally high incidence of malnourishment in Bihar (around 80% of

children below five years of age and 68.2% of women in reproductive age group (15-49

years) in the state are malnourished) and the extreme poverty of small and marginal

farmers where 91% of the land holdings in the state belong to small and marginal

farmers who practice cash cropping in an effort to escape the grinds of acute poverty,

we have started a program on Kitchen Gardening from the third quarter.

Commercial agriculture, in which crops are cultivated according to the market demand,

limits the production of certain food crops and does not allow for self-consumption by

the farmer’s family. Kitchen Gardening, on the other hand, fills the gap by providing

proper nourishment through inexpensive, regular and handy supply of fresh vegetables

devoid of chemicals used in farming. Besides, it is a well-known fact that growing a

kitchen garden positively improves the overall health conditions of the family.

We have planned the program so that 50% of the produce grown in the kitchen garden

are kept aside for self-consumption by the families and the rest sold in the market to

earn some additional income. 30% of the profit from sales will add to the farmer’s

household savings/consumption and the remaining 20% will have to be contributed

towards community welfare. Thus, while the target population will be able to utilise

80% of the produce for direct personal benefit (through own-consumption and earning

from sale of vegetables) they will be indirectly benefitted through the community’s

development, towards which they will be making a minimal contribution.

We have started the program by distributing vegetable and fruit plants and seedlings to

our villages like brinjal, tomato, chilly, pumpkin, sponge gourd, bitter gourd, raddish,

ladies finger, mango, lemon and guava.

37 | P a g e

Table 15: Number of Households that have received vegetable plants for Kitchen

Gardening

Serial Number

Villages Number of Households

1 Bhupnagar 24

2 Karhara 23

3 Simariya 21 4 Trilokapur 8

5 Kadal 31

6 Barsuddi 24

7 Banahi 17

8 Dema 114 9 Bandha 20

10 Nawatari 20

11 Mansidih 24

12 Sripur 25 13 Mastibar 10

14 JP Nagar 18

15 Kharati 15

16 Chando 28

Total 422

38 | P a g e

Table 16 : Number of Households that have received fruit plants and seeds for

Kitchen Gardening

Serial Number

Villages Number of Households

1 Banahi 40

2 Dema 101

3 Gopalkhera 35 4 Lohjhara 43

5 Bhupnagar 45

6 Karhara 52

7 Simariya 51

8 Trilokapur 37 9 Kadal 22

10 Barsuddi 26

11 Mastibar 70

12 JP Nagar 22

13 Kharati 20 14 Chando 20

15 Mansidih 110

16 Sripur 40

17 Bandha 61 18 Nawatari 45

Total 840

We envisage manifold advantages from this particular project. This entire model of

kitchen gardening will generating productive, income-earning opportunities for poor

and marginalised communities, which is pivotal to reducing chronic poverty. At the

same time, through the consumption of fresh, chemical-free vegetables, it will help

ameliorate health conditions of the target populations. Lastly, it will make way for the

community’s development.

COMPUTER COURSE-VOCATIONAL TRAINING FOR THE YOUTH

With the objective of empowering the poor and marginalised communities with e-

literacy skills we have started free computer training courses for youngsters hailing

from remote villages in Gaya district, Bihar. We aim to equip the rural youth with

adequate digital skills to provide them with better employment opportunities, economic

self-sufficiency and socio-economic empowerment. Two types of computer courses are

being taught at our Bodhgaya office namely, Office Management (which will teach MS

Office) and DTP (Page maker, Coral Draw and Photoshop). The duration of each course

is 6 months.

39 | P a g e

Prior to the commencement of the courses on 16th August a day-long interview was

conducted for the 101 enthusiastic applicants. 58 shortlisted youths were divided into 3

batches; two batches for Office Management course and one batch for DTP. These

batches also accommodate our office staff who wanted to join these e-literacy courses.

While the trainings are imparted free of charge it is mandatory for the students to devote 5 hours per week towards voluntary services in their respective villages. This provision will fulfil the twin objective of promoting computer literacy amongst the marginalised communities and serving the rural poor.

NETWORKING WITH OTHER LOCAL NGOS

We have started collecting details of all Non-governmental organisations working in

Gaya District as the first step towards networking with organisations with similar goals

and views.

40 | P a g e

FINANCES

The budget and expenses for the third quarter of 2013 are presented below:

Table 16: Budget and Expenses

Budget in USD($1=50 INR)

Expenses in USD($1=50 INR)

Administration, transportation and functioning cost

82,993.45

13,797.38

OPD direct benefit to population in Bodhgaya town and close surroundings

14,590.58

18,234.42

Mobile clinic benefit to population in 18 villages

20,128.80

21,818.82

Education direct benefit to population in 18 villages

13,441.07

9,132.42

Environmental Program 32,033.33

1,315.58

Social Program 20,853.33

20,177.24

Program Support 7,000.00 109.66

Investment: Equipment 400.00 3,304.56

Contingencies 6,007.87 25.80

Total 1,97,448.43

87,915.88

OTHER IMPORTANT

INFORMATIONS

41 | P a g e

UPCOMING ACTIVITIES

Meeting with key stakeholders for the ‘Bodhgaya Clean Environment, Hygiene and

Sanitation’ project will be conducted.

A training for Anganwadi workers on child development through play where, apart from

other things they will be taught to make various Teaching-Learning Materials.

Rainwater Harvesting in the villages

Green Schools Program in villages

School Competition to raise awareness among students about cleanl environment and

hygiene.

OUR PARTNERS

Current Partner: Barefoot College in Tilonia, Rajasthan

Prospective Partner: Centre for Science and Environment, New Delhi.

0.00 10,000.00 20,000.00 30,000.00 40,000.00 50,000.00 60,000.00 70,000.00 80,000.00 90,000.00

Budget and Expenses in USD

Budget in USD($1=50 INR) Expenses in USD($1=50 INR)

42 | P a g e

CASE STUDY 1

During the treatment After the treatment

Nageshwar Manjhi, a smallholder farmer of Rampur village, approached Shechen clinic

for treatment. He was extremely weak and emaciated. The doctor suspecting

tuberculosis asked him to go for x-ray, sputum and blood tests at our laboratory. He was

tested positive for Pulmonary TB and underwent DOT treatment at our DOT centre in

the Shechen clinic. He has completed his treatment and his post-treatment sputum test

was negative. His X-ray and blood tests are yet to be conducted but now, unlike

previously when he did not have the strength to walk a few steps, feels healthy and

strong.

ANNEX -SUCCESS STORIES

43 | P a g e

CASE STUDY II

Chandni Kumari at our Computer Classes

Chandni Kumari, an undergraduate student, has joined the 6 month long DTP course at

our newly launched computer training program. She says that previously she was

totally computer illiterate and whenever she saw her friends and classmates working on

or discussing computers she would feel a severe lack of self-confidence. But now after a

few weeks of attending classes she has already started gaining confidence. She can now

work on MS Word and has just started learning Photoshop. She enjoys her classes and

expects to find a good job after completing this course.

44 | P a g e

Karuna-Shechen Report 3rd trimester 2013

Health & Medicine

Transcript of Karuna-Shechen Report 3rd trimester 2013