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FIRST QUARTERLY REPORT

JANUARY-MARCH, 2014

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CONTENTS

PAGE NUMBER

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

8

Mobile Clinics 12

Medical Camps 15

Health Education Program (HEP) 17

Education

Early Childcare and Development 20

Non-Formal Education (NFE) 22

Social

Vocational Training for Youth and Women 24

Kitchen Garden 25

Networking with other NGOs 26

Environment

Bodhgaya Clean Environment, Hygiene and Sanitation Programme

27

Rainwater Harvesting 28

Solar Electricity 29

Other Important Informations

Finances 30

Recruitment of New Staff 30

Jharkhand Visit and Future Plans 31

Annex-Success Stories 32

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MAIN ACTIVITIES & ACHIEVEMENTS

Health

In the first quarter of 2014, the total number of Patients who availed the healthcare services

of our OPD (Outreach Patients Department) Mobile Clinic and Medical Camps was 18,066.

1566 medical tests were conducted in our pathology laboratory.

Total number of Sanitary Napkins distributed was 2337.

Education

We started our new programme- The role of play in the life of a child: A way to contribute to

children well-being and healthy development’ in Gopalkhera, Chando, Dema and Banahi.

Environment

31 households in the village of Bhupnagar received solar lights.

3660 Jute bags were distributed among local people in order to reduce the rampant use of

plastics

Social

The first session of Computer Training for the youth came to a close with all 35 students

who ahd taken the test, passing out with good marks.

A new session was started in March with 55 students.

227 Households and 2 Schools (Kadal and Barsuddi) were given vegetable seeds for kitchen

gardens.

Other Events and Activities

3 new staff members were recruited for positions of medical officers (2) and village

coordinator (1).

We had the honour of welcoming our external visitors Tarek Toubale, Chief Operating

Officer of Karuna-Shechen and his wife, Laura.

A visit to Jharkhand was made in March where meetings with several CBOs and NGOs were

conducted and field visits to villages made.

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We stepped into our 14th year of relentless humanitarian service to the underserved populations of

Gaya district (Bihar) with the continual commitment to improving and expanding our existing

activities as also to introducing new programmes in order to ameliorate the lives of our beneficiaries.

The first quarter of 2014 witnessed two big achievements in terms of the commencement of our new

Educational programme- ‘The role of play in the life of a child: A way to contribute to children well-

being and healthy development’ in 4 villages (Gopalkhera, Chando, Dema and Banahi) and Solar

electrification of a new village, Bhupnagar. Our first session of free Computer courses with 35 students

came to a close and in March a new session began with 55 enthusiastic youths hailing from poor

communities. Besides, as part of our Bodhgaya Clean Environment, Hygiene and Sanitation

programme we distributed 3660 Jute bags in order to discourage the use of bio-non degradable plastic

bags. In an effort to reach out to a greater number of beneficiaries and serve them better we have

hired a second female medical officer and a female village coordinator. We have taken the first and

important step towards the geographical extension of our activities to Bihar’s neighbouring State,

Jharkhand. In March we made a visit to the State, engaging in discussions with various NGOs and CBOs

and deciding upon our potential partners. We also made field visits in the process of village selection

for our future humanitarian activities there. In this quarter, we also had the honour of welcoming our

Chief Operating Officer, Tarek Toubale and his wife, Laura to our India office.

This report will give the details of all our existing programmes, activities and events that happened in

the months of January through March, 2014.

INTRODUCTION

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AN OVERVIEW OF MEDICAL ACTIVITIES

OPD, Mobile Clinics and Medical Camps

In the first quarter of 2014, the total number of Patients who availed the healthcare services of our OPD (Outreach Patients Department) Mobile Clinic and Medical Camps was 18,066 which is 4.7 % more than Quarter 4 of 2013 (17,247). New patients (for OPD and Mobile Clinics) constituted 5824 people (34.16 % of total number of patients at OPD and Mobile Clinics). Table 1: Total Number of Patients at OPD, Mobile Clinics and Medical Camps

Months OPD Mobile Clinics Medical Camps Total

January 2613 3240 0 5853 February 2384 3075 513 5972 March 2668 3071 502 5739 Total 7665 9386 1015 18,066

The number of patients refered to PHC & Government Hospitals was 71 (0.39 % of total patients).

The total patients who were treated “Free of Cost” (Pregnant women, children and aged people above 60 years) was 9225 ( 51.06 % of total patients treated).

From the above graph and table we observe that for every month the Mobile Clinics have registered slightly greater number of patients than OPD, which may be due to an increasing number of patients from satellite villages.

HEALTH

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

Months OPD Mobile Clinics Medical Camps

Total

January 0 5 0 5 February 5 1 29 35 March 6 1 24 31 Total 11 7 53 71

Direct Observed Therapy (DOT)

Out of 1566 medical tests conducted in our pathology laboratory 125 were Sputum tests (for

Tuberculosis) which is 42% more than the last quarter (88 tests). Out of these the number of people

who were diagnosed with TB was 3. Currently, the total number of TB patients undergoing treatment

is 103.

Table 3: Details of DOT Program

January February March Total

Number of TB patient’s started medicine 3 4 4 11

Number of sputum tests conducted 34 33 58 125

Sputum Positive 1 0 2 3

Refer TB Patients 3 2 2 7

Completed TB Medicine 7 3 11 21

Total Number of TB Patients currently undergoing treatment (OPD and Mobile) 36 37 30 103

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.

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Table 4: Types of Diseases

The table and graph show that the most common health problems observed among our patients were

Cough and Cold, Bone and Joint pain, Skin diseases and HTN.

Types of Diseases Total

Diarrohea/children 29 Diarrhoea / dysentery adults 195 Amoebiasis 431 Typhoid 1 TB 194 Gynecological patient 644 Bone & joints patients 4544 Burn patient 45 Worm manifestation 13 Skin diseases of all kinds 1308 Ophthalmologic infections 6 Number of identify malnourished children 10 Cardiac Infection 0 HTN 1031 Diabetes 125 Asthma & COPD 650 Cough & Cold 3773 Epilepsy 52 ENT patient 493 Lymphadenopathy 7 I&D Dressing 149 Other Patients 3269

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ACCESS TO PRIMARY HEALTHCARE IN URBAN AREA: SHECHEN MEDICAL

CENTRE IN BODHGAYA, BIHAR

The total number of people who came to the Medical centre in Bodhgaya for Patients in the first

quarter of 2014 was 7665, which is 10.34% higher than previous quarter (6966 patients). Out of this

total 3068 were new patients, representing 40.02 % of total patients in OPD.

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Table 5: Details of Patients in OPD

January February March Total

Total Patients 2613 2384 2668 7665

New Patients 1068 911 1089 3068

Men 712 608 697 2017

Women 1283 1187 1342 3812

Children 618 589 629 1836

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The above graphs show that majority of the patients at our OPD are women and children (73%).

Pathology Laboratory

Total number of patients who came in the first quarter of 2014 for different medical tests was 543.

Total analysis done was 1566 which is 19.54% greater than the previous quarter (1310analysis). The

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

Table 6: Types of Medical Tests conducted in our Laboratory

Types of Medical Tests Conducted Total Number of Tests

TC/DC 238

ESR 217

HB% 163

Malaria 37

Uric Acid 29

Blood Sugar 232

Serum Blirubin 29

AFB (Sputum test) 125

ECG 19

Urine routine examination 83

Urine culture sensitivity test 55

Other Tests 339

Total 1566

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From the above table and graph we see that the highest number of medical tests conducted are TC/DC,

ESR, Blood Sugar, HB% and AFB (Sputum Test).

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MOBILE CLINIC

MOBILE CLINICS

Number of patients who came for the consultations in mobile clinic from 18 villages was

9386 out of which 2756 (29.36 % of total patients at Mobile Clinics) were new patients. The total

number of patients in this quarter was 7.38% greater than that in the previous quarter (8741). The

number of patients who were treated Free of Registration Charge (Pregnant women, children and

aged people above 60 years) in the Mobile Clinic was 4042 (43.06 % of the total patients at mobile

clinics).

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Table 7: Details of Mobile Clinic Patients

January February March Total

Total Patients 3240 3075 3071 9386

New Patients 1098 879 779 2756

Number of Satellite Villages from where Patients come

803 686 724 2213

Number of Patients from Satellite Villages

2347 2232 2253 6832

Men 909 849 1758 3516

Women 1647 1571 3218 6436

Children 684 655 1339 2642

From the above table we see that majority of the patients 6832 (72.79% of total patients at Mobile

Clinics) in the rural areas come from the satellite villages around the one where our outreach medical

team pays regular visits. This is a big achievement for us as it shows the level of satisfaction among the

beneficiaries which results in spread of information about our healthcare services by word of mouth

and the eventual increase in the number of patients from nearby villages.

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The months of February and March register slightly lower number of patients at Mobile clinics than

January. This can be attributed to the celebration of the Spring festival and the onset of the Harvest

season.

The graphs clearly show that, like that in the OPD, here too women and children form majority of the

patients (73%).

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MEDICAL CAMPS

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Free Medical Camps for the underserved and needy people were organised in Bodhgaya in the months

of February and March where 1015 patients availed our medical services.

Table 8 : Details of Medical Camp Patients

January February March Total

Total Patients 0 513 502 1015

Men 0 214 157 371

Women 0 187 196 383

Children 0 112 149 261

No medical camps were organised in January. Both in the months of February and March more than

500 patients were registered.

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From the above table and graphs we see that, just like in OPD and Mobile Clinics, at medical camps too women

and children for majority of the patients (64%).

HEALTH EDUCATION PROGRAMME (HEP)

Our Health Education Programme continues to run successfully as can be seen from the following

tables:

Table 9: Some Details of HEP

Indicators

Total Population reached 9449

Total Households reached 1285

Total Families reached 1936

Total Number of Health Groups 87

Total Number of Members in Health Groups 516

Total Number of Home Visits by Village Coordinators (vc) and Motivators

(m)

406 (vc) and

1324 (m)

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Table 10 : Reproductive and Child Health

Indicators

Total Number of Sanitary Napkins distributed 2337

Percentage of Pregnant Women Followed-up by Village Coordinators and Motivators 93

Percentage of Pregnant Women sent for Immunisation by Village Coordinators 33

Percentage of Pregnant women immunized with TT1& TT2 95

Percentage of Pregnant Women having Institutional Delivery 61

Percentage of new-born children immunized with BCG and 1st DPT 73.2

Percentage of Neo-natal deaths 0

Table 11 : Total Number of Sanitary Napkins reaching the Poor Women and Girls

OPD Mobile Clinics Medical Camps

January 177 695 0

February 158 586 102

March 108 613 135

Total 443 1894 237

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We observe from the graph that sanitary napkins reaching the target population have been much higher for

the villages than those distributed at our OPD in Bodhgaya. The primary reason that the motivators, who are

members of the village communities themselves, sell the napkins.

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EARLY CHILDCARE AND DEVELOPMENT

Recognising the vital role of play in the social, emotional, physical and cognitive skills development of a child

we have introduced our new programme, ‘Role of play in the life of a child: A way to contribute to children

well-being and healthy development’ in collaboration with Inter’Lude, France. The programme, which focuses

on children (0-6 years age) at the Anganwadi centres, was initiated in January after getting the approval and

encouragement of the District Magistrate (DM) and the District Programme Officer (DPO) of Gaya district.

This programme is being led and supervised by a volunteer from Inter’Lude who has been working with us

since the programme’s inception. He made several visits along with our village coordinators to the Anganwadi

centres in our operational villages, interacting with the Anganwadi workers, children and the local

communities. Having acquired a clear idea about the Early Childcare scenario there and about the socio-

economic-cultural aspects vital to the efficacious planning and implementation of the programme our next

step was to search for locally available games and play materials for the children. This was followed by a day-

long training session organised for select staff members of our organisation, Child Development Project

Officers (CDPOs) of the blocks where the four villages belong and Anganwadi Workers of those villages. In this

interactive training, which was given by our volunteer from Inter’Lude and our Director, the participants

learnt about the importance of play in a child’s growth; the objectives, methods and expected outcomes of our

programme.

We have been conducting drawing sessions with the Anganwadi children, providing each of the 4 Anganwadi

centres with various indoor and outdoor games like hoops, stilts, construction games, sensorial mats, etc. Our

regular, often surprise, visits to the Anganwadi centres to monitor and supervise the programme have already

started showing very satisfactory results in such a short while, in terms of the role of the Anganwadi workers

as animators and the active and enthusiastic participation of the children.

Presentation on the programme activities in front of the DPO and CDPOs of Gaya district

EDUCATION

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Participants at the Training Display and Explanation about different types of Games

Drawing session at Anganwadi centres

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Outdoor Games In-door Games

NON-FORMAL EDUCATION (NFE)

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Our NFE programme continues to run in our villages.

Table 12 : NFE Attendance details

The average attendance at the NFE centres is lower than the usual, in this quarter, at 43% as this is the time of

the Spring festival as well as the Harvest season.

Name of Villages Number of Students enrolled in NFE

Average Attendance in NFE classes

Banahi 30 15 Dema 30 16 Gopalkhera 30 16 Lohjara 30 12 Bandha 32 10 Nawatari 32 12 Mansidih 31 8 Sripur 30 12 Mastibar 25 12 J.P.Nagar 28 8 Kharati 18 10 Karhara 60 30 Trilokapur 21 6 Bhupnagar 25 15 Kadal 25 10 Total 447 192

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VOCATIONAL TRAINING FOR UNDERPRIVILEGED YOUTH & WOMEN

Computer Courses for the Underprivileged Youth

The first quarter of 2014 marked the completion of the first Computer training session and the beginning of

the second. Out of (no enrolled in classes) 35 students appeared for and passed the written and practical

examinations with 46% of the students achieving between 60% and 80% marks and a ‘Good’ grade. 3% of the

students attained a ‘Very Good’ with more than 80% marks.

Table 13: Marks obtained by students of the first computer session

Marks Obtained out of 100 No of Students Achieving the Marks

Percentage (%) of Students Achieving the Marks

0 – 40 06 17

40- 60 12 34

60-80 16 46

80-100 01 3

An overwhelming 75 youths applied for our second session of Computer courses out of which 55 were

selected on the basis of their performance in the written examination and interview. Classes started in

March with the 55 students divided into 6 batches.

SOCIAL

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Vocational Training for Rural Women

The women who had attained advanced training in candle-making in Jamshedpur continue to impart

refresher and advanced guidance on candle-production and marketing to the students at the various NFE

centres. In this quarter the NFE students at Banahi, Gopalkhera, Bandha, Nawatari and Dema received

tutelage from the vocational trainers.

KITCHEN GARDEN

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Our Kitchen Garden programme that focuses on improving the nutrition status of the rural poor continues to

run successfully. In this quarter seeds of seasonal vegetables were distributed among 277 households across

18 villages and 2 schools (Kadal and Barsuddi).

Table 14: Vegetable Seeds distributed among households

NETWORKING WITH OTHER LOCAL NON-GOVERNMENTAL ORGANISATIONS (NGOS)

The scale and scope of developmental challenges requires that all organisations sharing similar mission and

goal work collectively towards the realisation of their common aspirations. With the aim of forming a

network of like-minded humanitarian organisations we have completed, in this quarter, collecting detailed

information about NGOs working in Gaya district. The total number of functional NGOs in the district was

found to be 98. Our next step will be to bring them together on a common platform to organise an NGO fair.

Name of Villages Number of Households receiving Vegetable Seeds

Schools receiving Vegetable Seeds

Banahi 12 - Dema 31 - Gopalkhera 14 - Lohjara 20 - Bandha 11 - Nawatari 12 - Mansidih 20 - Sripur 10 - Mastibar 14 - J.P.Nagar 9 - Kharati 9 - Karhara 44 - Trilokapur 11 - Bhupnagar 17 - Kadal 14 1 Chando 14 - Barsuddi 5 1 Simariya 10 - Total 277 2

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c

BODHGAYA CLEAN ENVIRONMENT HYGIENE AND SANITATION PROGRAMME

Distributing Food Covers to Vendors at Gaya Station

Distribution of Jute bags among NFE students

ENVIRONMENT

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With the pledge to reduce the indiscriminate use of bio-non degradable plastics we have been distributing

Jute bags to each of our patients, our NFE students and to all the students and faculty of the schools where

we had conducted drawing, and speech competitions last year. We have been able to give away 3660 bags in

the past three months.

Another major step taken towards cleanliness and hygiene was the distribution of 21 covers for the food

sold by the vendors at Gaya station. This has been followed-up by our staff who have paid several visits to

the station to monitor whether the vendors are actually using the covers and to get their feedback regarding

the same.

RAINWATER HARVESTING

Our programme on Rainwater Harvesting which was started at the end of last year continues with water

tanks being installed in 18 households across 3 villages (Dema-5households, Chando-11 and Karhara-2) this

quarter. Besides, 3 tanks have been provided to the school at Lohjhara.

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SOLAR

SOLAR ELECTRICITY

People of Bhupnagar enjoying their evening in the light of a Solar set

Our Solar Engineers installing solar lights in Bhupnagar

Our Solar Electrification programme which was running in the villages of J.P. Nagar, Kharati and Banahi for

more than 2 years, has been scaled-up to cover Bhupnagar which is one of the remotest and most backward

of all our operational villages with hardly any possibility of electrification in the near future. Therefore,

acting on the demand of the community we have installed solar lights in 31 households of the village with

the help of our new Solar Engineers. These LED sets are cheaper than the sets that we had previously

installed in the 3 above-mentioned villages. We have collected a one-time amount of INR 2000 from each

beneficiary as their contribution.

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FINANCES

The expenses incurred in the first quarter of 2014 are presented below:

RECRUITMENT OF NEW STAFF

We appointed 3 new staff members to better serve our beneficiaries- 2 female medical officers, one of

them being hired on a daily basis and a female village coordinator. For the position of the village

coordinator our 4 village coordinators had to compete with the other shortlisted applicants. Two of

our existing village coordinators qualified while for the third position a new, experienced and well-

qualified woman was selected.

OTHER INFORMATION

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JHARKHAND VISIT AND FUTURE PLANS

With the objective of reaching out to more people in dire need of humanitarian services we have

decided to expand our area of operation to the neighbouring state of Jharkhand this year onwards. The

State is bound by Bihar in the North, West Bengal in the East, Odisha in the South and Chhattisgarh

and U.P. in the West.

Jharkhand, like Bihar, not only ranks as one of the poorest states in the country but also fares very

badly in most of the human development indicators and is Maoist-affected with several districts being

declared as Red Corridors.

We are targeting the East Singhbhum as it is one of the most backward districts of Jharkhand and the

Maoist-Naxalite groups here are less active compared to the other districts. Jamshedpur (the largest

industrial city of the State and headquarters of East Singhbhum) will be our potential base in

Jharkhand. Besides, the city’s connectivity with the rest of the State and other parts of India are much

better than other big cities of Jharkhand like Ranchi and Dhanbad. Also, various amenities required

for establishing and running our office and programme activities will be easily available. Again, in

Jamshedpur more human resources and better logistical facilities are likely to be available compared

to the other two cities as it is the third largest city in eastern India after Kolkata (in West Bengal) and

Patna (in Bihar).

In March Shamsul Akhtar along with our COO, Tarek Toubale visited Jharkhand for this purpose. There

they engaged in discussions and meetings with Community Based Organisations (CBOs) and Non-

Governmental Organisations (NGOs) and went on field trips to various villages in the district of East

Singhbhum. Thereafter it was decided that from late May or early June, after the General Elections in

the country are over, we will start working in Jharkhand in collaboration with a CBO called Dhad

Disham Vikas Sangh (DDVS) and two NGOs- Grace India and Cause for Change. Our areas of

intervention will be Jamshedpur, Potka, Jadugora, Musabani and Ghatshila towns of East Singhbhum

district.

DDVS works with and for tribal communities, focussing primarily on improving their livelihoods, land

rights and women empowerment. We intend to collaborate with them on outreach activities like

Kitchen Gardening, Vocational Training, Rainwater Harvesting, small money Big Change and Medical

Camps. Grace India is an NGO which organises regular Medical Camps for the underserved people.

Cause for Change collects unused medicines from households and redistributes them among the

needy populations through medical camps. Therefore, with both these organisations we envisage

working on the common ground, i.e., healthcare activities. Both the above-mentioned NGOs will send

us formal proposals for our future endeavours.

We also held meetings and field visits with two other NGOs, Yuva Jagriti Swavalamban Kendra and

Catholic Charity/SJVK. From the end of the third quarter of this year we intend to start looking for

possibilities to work in collaboration with both the above-mentioned NGOs.

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Jagiya Devi, a resident of Bhupnagar Village narrates how life has become better after

the installation of Solar Lights at her Household

Jagiya Devi can now cook in the evening with the help of the solar light

The latest village to receive solar lighting facilities through Karuna-Shechen, India is the remote and

backward village of Bhupnagar. Acting on the demands of the community in the village we installed

solar lights in 31 households early this year, collecting a one-time payment of INR 2000 per

household. Jagiya Devi, a recipient of solar set is very satisfied with our initiative. She narrates how life

for her family in particular and the village communit, at large has become easier and more

comfortable than before.

She says that previously, after sunset, the villagers could not perform any activities as there was

complete darkness. They would have no choice but to go to bed early. ‘Pehle raat ko saanp aur bichhoo

ka dar bana rehta tha’ (previously, at night, we would have to face the threat of being bitten by

poisonous scorpions and snakes). Another big threat was kerosene lamps, which are a serious fire

hazard especially for the children. With the installation of solar lights at their household Jagiya Devi no

longer has to worry about such mishaps.

She points out that the primary benefit to the village community as a whole has been the extension of

their workday into the evening hours. Previously, for example, she had no choice but to complete

most of her household chores before the onset of evening. Cooking dinner in the insufficient light of

the kerosene lamp was very difficult for her but now, since the installation of solar lights in her

household this problem has been solved. Besides, children can now study by the solar light after dark

which, she believes, would enable them to improve their education levels in the long run. She offers

her heartfelt thanks to Karuna-Shechen for taking the initiative to light up the lives of her community.

ANNEX-SUCCESS STORIES

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Satyendra Manjhi- A patient of Tuberculosis with enlarged gland

Swollen Gland at start of Treatment (May,2013) Swelling reduced during DOT treatment (Oct, 2013) Swelling cured after DOT treatment(Jan, 2014)

Satyendra Manjhi, a 30 year old resident of Arjunbigha, Bodhgaya, had come to our clinic to treat a

lump in his neck, which had been developed for quite sometime and was causing him a lot of pain.

After several futile efforts of local doctors around his village to cure him he went to Varanasi, in the

neighbouring state of Uttar Pradesh, in search of proper treatment. Unfortunately, there too nobody

could diagnose his problem correctly and he returned to his village utterly dejected. His physical

condition was so weak that he had to leave his job as an out-migrant labourer and return to his village.

This caused a huge set-back for his family consisting of his parents, wife and four brothers, as he was

the main source of earning.

At last, following a friend’s suggestion he visited the Shechen clinic in Bodhgaya where, after several

medical tests he was diagnosed with tuberculosis. He started his CAT II treatment at our DOT centre

from early May, 2013. Within a few months there was a remarkable improvement in his physical

condition. Eventually he revived his lost energy and physical and mental strength. The glandular

swelling on his neck started to reduce and by the end of 8 months of his treatment it had completely

disappeared.

Satyendra Manjhi now feels healthy and is strong enough to have started working as an agricultural

labourer in his village. He is immensely thankful to Karuna-Shechen for diagnosing and treating him

properly, with utmost care and for granting him a new lease of life.